Adventures in Psychotherapy Number 6: The Dangers of Google

Freud famously said that a therapist should be a blank page, a canvas onto which the patient can project their feelings through the process of transference. This theory – and arguably, it is above all a theory, given that even Freud had personal interactions with some of his patents outside of the consulting room – is an increasingly challenging one to put into practice, given how much of our life (and therefore the life of the therapist) exists on the internet these days.

The principles behind Freud’s guidance are sound and designed to benefit the relationship between therapist and patient. Psychotherapy provides the latter with the opportunity to confront and explore the issues that have perhaps made life more challenging. Over my years of therapy, I have greatly appreciated the time and space that my sessions have afford me to do just that. Not only that: my therapist’s consulting room has always been a safe space in which I have felt increasingly able to discuss emotions, thoughts, impulses and relationships in a way that I would have generally felt too vulnerable to discuss elsewhere. Often, we shy away from raising our most difficult emotions with those closest to us, for fear of burdening them with the responsibility of feeling the need to ‘solve’ them in some way. I have always felt that my therapist Alexis  – whom I saw over a period of seventeen years until last December – has had the emotional resilience to bear even my darkest thoughts. Furthermore, I have rarely felt the sense of judgement that I might have experienced, had I discussed some of those issues with friends – and where I did feel it, I can acknowledge that it was most likely my own projection, rather than a genuine response emanating from her.

Had I known more about Alexis’ life, politics, opinions, interests and so on, it is inevitable that these would have had a bearing on my view of how she might respond to or feel about anything I shared with her. Not least given my extreme anxiety about how others perceive me, this could have led to a tendency to censor my interactions with her, passing my expression of my feelings and thoughts through the filter of my own perception of how she might receive them, given what I knew about her. For this reason, relationships between therapists and patients need to be (peculiarly) one-sided. It is possible that a patient might share something that chimes with an experience that the therapist has had. Yet while a therapist seeks to create a supportive and empathetic environment in which the patient can freely discuss her concerns, this must not involve the sharing of personal experiences as a means of creating this sense of empathy. Conversely, should a therapist feel antipathy in response to an opinion, emotion or behaviour shared by the patient, she must also seek to conceal this reaction. I imagine that at times this is incredibly difficult, and is one of the reasons that therapists often have their own psychotherapeutic supervisor, with whom they can discuss the details of their work with clients in confidence.

Of course, the idea of a blank canvas is largely an idealistic one, even if one ignores the possibility of uncovering something of the therapist’s ‘outside life’ on the internet. We communicate so much of ourselves in so many ways, and the patient feels able to draw inferences and conclusions. Were they ever to be discussed, many of these assumptions might turn out to be entirely inaccurate, based as they are on the patient’s own subjectivity, value system and wider experiences. Inaccurate or not, the patient will nonetheless bring this putative knowledge of the therapist’s circumstances to bear in how she communicates in sessions, and in how she interprets or anticipates her therapist’s responses. Even without wider knowledge of Alexis’ personal life, I am aware that I drew many conclusions about her from our interactions in our sessions. I think this curiosity is a natural human instinct, and particularly when it concerns an individual who can come to play such an important role in your life. I also became aware over time that I was on the look out for hints in my sessions that might give me further insights into what her life was beyond our sessions.

In a way, it is interesting to consider why this was so important to me – because I think it was. As I have said, I think my curiosity was primarily motivated by my affection for Alexis. My relationship with her has been the most significant and important in my life so far. In a way, it was unnecessary and counterintuitive to want to know more about her than I did. Unnecessary since my relationship with her showed how relationships can develop and thrive without any of the experiences, paraphernalia and indeed encumbrances of daily life outside of the consulting room. Our relationship existed solely in that room  – with the exception of the occasional telephone session. Nonetheless, it developed, changed, thrived and existed in as vibrant a way as any other relationship in my life – at least from my point of view. The counterintuitive aspect relates, for me, to my ability dismantle the positive in my life if I am feeling particularly masochistic or self-pitying. There was always the risk, knowing more about Alexis, that I might assume that she would see me in a certain light, or be unable to understand a particular difficulty I brought to her in a session. Equally I might discover something about her that I could find it hard to get beyond. To be more concrete about it, had I discovered that she was a Tory voter or had voted Leave, would my assumptions about people in either of these categories have coloured our relationship, notwithstanding almost two decades’ worth of personal interactions? Who knows. I would hope not!

Despite these potential risks, I am aware that I was on the look out for clues about her life beyond our sessions. I drew conclusions about her origins from the hint of an accent. I made assumptions about her disposable income from her clothes and from the shopping bags I occasionally saw in her flat. In one session, in response to a –  for reasons I forget – very detailed account of my latest visit to the Jewish Museum in Camden, Alexis asked me if I thought she was Jewish. I hadn’t until that point, but of course then spent significant amounts of time trying to work out whether I thought that she was. Not that it mattered either way, other than for the fact that it was then a new insight into her wider personal life. I did always assume that Alexis was married – largely because I tend to assume that people are – but I noticed that she didn’t wear a wedding ring. I assume that some therapists choose not to, either so as not to reveal this aspect of their private life to patients, or to avoid placing any form of obstacle in the path of their patients’ ability to share their feelings and worries  – might a patient whose anxiety has been brought on by the end of the relationship find it harder to open up to a therapist who they may assume is happily married? I think it speaks to the strength of my relationship with Alexis and the level of emotional support that she offered me that I did not feel inhibited by anything I thought I might know about her personal life. As mentioned elsewhere in this blog, it was often clear in our sessions that our lives were very different – speed dating, chicklit and Pinterest are among the things that I explained to her over the years! Nonetheless, I never felt that our differences precluded her understanding of and empathy for my situation and concerns. For me, those differences were not really relevant in terms of our respective roles in our therapy sessions, whereas they might have been in any other kind of relationship in the ‘outside world.’

I mention the outside world, and have also said that my relationship with Alexis existed solely in her consulting room. This is true to the extent that this was the only place we would meet. The impact of our relationship has had and continues to have a far wider reach. Nonetheless,  I have never bumped into Alexis (or my new therapist) outside of our sessions and am not sure how I would feel were I to do so. I imagine that I would feel unprepared, unsure of how to act, and I worry that the awkwardness of any such encounter would have a negative effect on our relationship. Doubtless it would be something to be discussed at length in subsequent sessions! I did catch sight of Alexis walking to her consulting room on two occasions, and both times it provoked an extremely peculiar sensation, a sense of secretly spying on her – albeit unintentionally – of seeing her in her daily life rather than in her role as psychotherapist.

I have to admit that I have ‘spied’ on Alexis more intentionally, through the internet. As is the case with the occasions on which I saw her outside of her consulting room, this is not something I have discussed with her. Perhaps because I was worried about how it would make her feel, and whether she might feel that this quest for knowledge might hinder our relationship, or even suggest that there was something almost unhealthy in my sense of attachment to her – as if I wanted to get closer than it was helpful for us to be in an effective psychotherapeutic relationship. Above all, beyond these anxieties, I think I chose not to discuss my googling with Alexis because I felt I was unable to articulate the precise motivations that lay behind it, and was also aware of what it revealed about my vulnerabilities.

As far as I am aware, it is common practice for therapists to take regular time off during the year. Alexis would usually take two or three weeks at Easter and Christmas, and then just over a month in the summer. I am currently on my summer break from sessions with my new therapist, Sarah. Therapists need time and space away from the psychological and emotional pressures of their work, and the regularity of the breaks is helpful for patients. I think that patients can often benefit from a break from regular sessions too, as an opportunity to process conversations that have taken place, to consider the impact of those discussions on ways of thinking and being, and more generally to allow feelings and thoughts to percolate and shift, and new ideas and emotions to emerge. Nonetheless, these breaks can also be very difficult, and at times the patient can feel the absence of the support that her sessions provide, particularly during more challenging times.

I often missed Alexis during her breaks, particularly over the summer. I think a sense of loneliness was the primary reason I googled her for the first time. I was curious anyway to know what her online presence was, but I didn’t go looking for an answer to this question for a very long time. When I did decide to google her, I suppose I felt that seeing something of Alexis online would make me feel closer to her, and that knowing more about her might serve the same purpose. Perhaps not surprisingly, and in common with many therapists, Alexis has a very limited online presence. Some therapists host websites for their practices, other write blogs or even contribute to magazines and other online publications. This online activity tends to be related to their professional life. In terms of personal accounts, therapists are very aware of the need to ensure either that their privacy settings are suitably high, or that they are aware of the potential wider audience for any comments or posts they make online.  As a teacher, I have to be equally careful, in case students or parents stumble across anything I would not want them to see – including the perfectly anodyne, but personal.

Alexis is listed on various therapy directories on the internet. Through one of these, I inadvertently discovered that she has a PGCE, i.e. a teaching qualification. I am a teacher and over the years told her a huge amount about my role, my colleagues, and my experience of the pressures of the profession. When I first made this discovery, it did make me wonder what her own experience had been, why she had left the teaching profession, and also to what extent she could relate on a personal level to kind of issues I might mention in our sessions. I think I also found it rather amusing to think that I had probably explained things to her in terms of life in schools that she fully understood. I was briefly surprised that she hadn’t given me any indication that she had had experience of teaching – though of course, I then reflected that sharing this kind of personal information is precisely what a therapist does not do. Overall, this information was above all a curiosity, a titbit that had no real effect on my feelings about Alexis or my openness with her.

Beyond her listings on online directories, a google search also revealed Alexis’ home address. As is often the way with the internet, I then disappeared down a rabbit hole, a search of a search result leading to a subsequent search, and so on. As is frequently acknowledged in any discussion about the dangers of the internet in the media, most of us would be hard pressed precisely to identify the impulses that drive us to pursue these labyrinthine paths online, moving further or further away from our original point of departure, or examining it in increasingly minute detail and from a multitude of angles. One of the many ways in which the internet consumes our time so effectively, and encourages this almost compulsive behaviour, is the way in which it feeds, and feeds on,  our desire to know, and indeed our sense that the availability of knowledge and answers is somehow our birthright, with everything we need available somewhere on the internet. In the days before the world wide web, we contented ourselves either with not knowing, or with having to make a concerted effort to find an answer to our question at a later date. I often think about this shift in expectations when watching a TV programme. I will half recognise an actor, but fail to recall where I have previously seen him or her. A quick search on my phone gives me the actor’s entire biography, filmography and confirmation of which of his/her other work I have already seen. A question posed and an answer found. But why does it matter? It doesn’t I don’t think, but we have all got into the habit of believing it does.

The Alexis-related virtual rabbit hole I fell down revealed her home address, her husband’s name, some of his professional responsibilities, and the psychotherapy body of which Alexis had previously been a director. None of this information materially changed my relationship with Alexis, not least since by the time I uncovered it, our relationship was already well-established. Had I googled her at an earlier stage, perhaps its impact would have been different, or more significant.  Nor did it make me feel any closer to her. I came to understand that my sense of emotional proximity to Alexis came not from information that either of us might know about the other, but from our shared experience of our sessions, and from the sense of support that these gave me. I think this is a valuable lesson to apply to all relationships, to realise where the heart of each of them is, to understand what genuinely matters, and what is largely extraneous noise, or superfluous information. Nonetheless, Google brought me if not into Alexis’ presence then into the company of information about her, and these searches became a habit at times when I was feeling particularly low or lonely. In the months prior to her retirement – and particularly when she let me know that she had had to bring it forward for personal reasons – a Google search could feel like a source of comfort.  In fact, it often led to a greater sense of upset and despair, as it provoked me to contemplate the looming prospect of life without her support.

The circumstances around Alexis’ retirement also gave me an insight into precisely why it is so important for the therapist to withhold personal information from her patient. Alexis had given me over a year’s notice of her intended retirement date, aware that a lack of certainty was causing me a degree of anxiety. However, in the end, she was forced to bring her retirement forward due to circumstances in her personal life, and there were only six weeks between her giving me this news and our final session. Unusually, Alexis did give me a certain amount of detail about the reasons for her imposed early retirement, telling me that she was finding it increasingly difficult to juggle her work with other appointments, and referring to illness in the family. My knowledge of her personal circumstances led me to wonder whether it was her husband who was ill. However, this didn’t particularly alter the sense of concern I was in any case feeling about the difficulties she was facing. I think what was more difficult was an initial sense that it was or would be wrong for me to express my upset at the relatively abrupt way in which our relationship was coming to an end. I felt that any such admission of my sense of grief and loss might indicate a lack of concern for Alexis’ personal circumstances, might communicate a selfishness on my part or might just be inappropriate. These feelings and concerns were exacerbated by my own tendency to assume responsibility for other people’s emotions as well as my own. I understood that Alexis wanted to emphasise that her decision to bring forward her retirement was not one that she had taken lightly and was one that had almost been imposed on her. I was ultimately grateful that she told me what she did. However, this did not preclude an acknowledgement on both our parts that this revelation had the potential to complicate what was already a very difficult moment in our relationship. Of course, Alexis was able to recognise this and reassure me that there was absolutely still a place for my feelings of sadness in our sessions, irrespective of her own personal circumstances. While six weeks felt like an absurdly short period of time in which to bring such a long relationship to a close, those remaining sessions, while incredibly emotional, were very valuable and remain very precious to me.

Seven months on from the end of our relationship, and I still feel that I am coming to terms with the fact that I no longer see Alexis twice a week. I have been very lucky to find a new therapist with whom I have felt such a positive connection from the start. Nonetheless, I am still grieving the end of my sessions with Alexis. Writing this blog post has reduced me to tears on a number of occasions as I have reflected on what our relationship meant to me. Although I already know what is there, and although it won’t alter the fact of her retirement, I have continued occasionally to google Alexis when I have been at my lowest ebb or when I have particularly felt her absence from my life. This admittedly pointless habit has recently taught me one further lesson about the dangers of Google as far as one’s relationship with a psychotherapist is concerned. One search suddenly threw up a new result, a listing on a directory of therapists of which I had previously been unaware. Rationally,  I can understand that this will be due to something related to Google’s algorithms that has changed the order in which results are presented. However, at the time, it was a real shock. My emotional vulnerability and tendency to catastrophise led me to conclude that Alexis had not in fact retired, that this was a new listing for new clients, and that everything she had told me had been part of an elaborate ruse to encourage me to seek out a new therapist. Of course I quickly acknowledged that none of this was the case. Firstly because Alexis would never take such a course of action and secondly because I recognised a paranoid and masochistic way of thinking that I have a tendency to indulge whenever I feel vulnerable or insecure, particularly as far as my relationships with people I care about are concerned. Nonetheless, my discovery caused me a huge amount of upset, if only for a short period of time. A particular danger of the internet is that we often spend time online when we are on our own, or at unsociable times of day when we are less able to reach out to friends for the emotional support that our browsing might lead us to need. We can be left alone with some very complex feelings, whether they are as obvious as those I experienced when I came across the new website, or whether they are the almost imperceptible but nonetheless damaging shifts in our self-esteem or emotional make-up that research repeatedly shows can be caused by internet browsing and social media in particular.

I hope that I have almost learnt my lesson as far as googling my therapist is concerned. I did of course research my new therapist online when she was recommended to me by Alexis. I found her professional biography on an online directory, and it was perhaps helpful to put a face to a name prior to our first session. Some time after we began seeing each other, I did go back to the internet to see what other information I could find. As was the case with Alexis, this was at a time when I was finding my emotions and indeed life in general particularly difficult to navigate, and  in a way it was a quest for some source of additional comfort. Even at the time, I could recognise that nothing I might find would bring me the solace I was looking for, and that I my time and energy would be better served looking after myself and my emotions, getting more sleep and just generally allowing myself time to be, rather than seeking distractions outside of myself. My relationship with Sarah is relatively new, and we are much closer in age than I was with Alexis. Both of these facts increase the risk that greater knowledge of her personal life could undermine our therapeutic relationship.

I am now determined not to get drawn back into this unhelpful habit, and in fact will even take the step of joining the Scroll Free September event next month, with the aim of reducing the amount of time I spend specifically on social media, but on the internet more generally. I do not want to do anything to jeopardise my relationship with Sarah. I am also determined to challenge bad habits that undermine my emotional wellbeing and to give more time to those that boost it. Hopefully this will free up mental space, firstly to reflect on the outcomes of my therapy sessions, but also to think about my own path into a potential career as a psychotherapist, on which I have now begun to take my first, tentative steps.

 

 

 

 

 

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Adventures in Psychotherapy Number 5: Envy

Yesterday I was doing some reading around a range of issues associated with psychotherapy –  pre-reading for my Foundation course in counselling and psychotherapy next year, and also part of my wider attempt to understand the factors at play in my own emotional difficulties.

One chapter in the book I am reading focused on envy. I found it particularly interesting, in terms of the negative impact envy can have on our (and my) psyche, but also in terms of the pressure it can bring to bear on a psychotherapeutic relationship. My envy was a topic that Alexis and I discussed on a regular, if infrequent basis. Since childhood, much of my self-loathing has had its roots in the comparisons I draw between myself and others, in which envy plays a key role. More recently, there has also been a clear link between feelings of envy and my feelings of dissatisfaction with the life I find myself living.

I think a certain degree of self-reflection and taking stock is inevitable for anyone entering their forties, and I see many people around me of a similar age who are engaged in a process of self-evaluation and change. The outcomes of that process may vary in scope and scale, from a wardrobe and style upgrade, to the decision to undertake further study, to a five-year plan to get out of the city and into a more rewarding career, to a decision to up sticks and move abroad, whether that might mean leaving home or returning there. I have found that the scale of these changes is often in inverse proportion to the stability of the individual’s family life: those who are married with children have been less likely to make wholesale changes, whereas those who are single or co-habiting tend to make larger and more significant decisions. This may seem like a sweeping generalisation and perhaps it is, but it is certainly the pattern I have observed among my own friends and acquaintances. Of course, this will in part be due to the fact that a family, and especially children, necessarily limit your freedom of choice. On the other hand, those with no ties to a particular childminder, school and so on arguably are more at liberty to take bigger steps to effect change. At the same time, the reality of a single income can also sometimes limit one’s options in the way that the security of a partner and a shared mortgage might increase them. Either way, it seems clear that people around my age are often reviewing their progress so far and setting the agenda for the next five or ten years. The reasons for this will be hugely varied. In my case, they are born out of my intense dissatisfaction with the situation in which I find myself as I edge inexorably towards my mid-forties.

I said that envy has played a role in feeding that sense of dissatisfaction. I think it is important to begin with a clear understanding of the difference between jealousy and envy, two terms that are close cousins, along with resentment. To summarise, if envy is about wanting what you don’t have, jealousy is about wanting to protect what is already in your possession. We feel envious when we see a desired attribute that we lack in another person. We feel jealous when something we already possess (often a special relationship) is threatened by someone else. Envy involves two people whereas jealousy often involves three. People often find it difficult to distinguish between the two emotions. Ask someone to describe a situation in which they felt jealous and they are as likely to describe an experience of envy (I wish that I was as attractive as my friend) as one of jealousy (my attractive friend danced with the man I like.) This can create a sense that jealousy and envy are really similar, when in fact they are quite different. An added difficulty in making a clear distinction between the two emotions arises above all since the two often go hand in hand. You are jealous that your friend is dancing with the man with whom you were hoping to have a relationship. The reasons for this may well lie in the characteristics that you most envy – her physical appearance. In this scenario, you are experiencing both jealousy and envy.

So far so interesting, but also so abstract. Having read a chapter on envy during the day, I then went out for dinner with a group of friends, all of whom are married with children, and who lead a very different life to mine. I wouldn’t say that jealousy and envy play a particular role in our relationship, at least from my point of view. While they seem very happy in their lives, they seem quite far removed from the life I imagine that I would have had, had I got married and/or started a family (an extremely hypothetical sentence there, since my feeling at this stage is that any opportunities for either of those eventualities – such as they were – have now definitively passed.) However, if I am completely honest, I do envy them the choices that I perceive that they have, due to the security of being in a partnership, with all of the emotional and financial support that that brings. I can recognise that there are also limits to their freedom, due to the whole host of commitments that inevitably arise from investing in family life, in a property, and in a particular geographical area. I suppose it is sometimes hard for me to feel that those are real limitations, since they are imposed by something that they have – a family, a family home and so on – rather than by things that are missing from their lives. The main obstacle to me making the changes that I would like to make in terms of work-life balance, career and future study for example is a financial one. I don’t earn a huge amount and I have no one to back me up financially. It is hard not to look at others – those friends, but also a range of other people –  and to feel that they enjoy a freedom of choice that I do not have.

While I mention envy in an attempt to be entirely transparent, I don’t feel it is a determining emotion in my relationship with that particular group of friends. What I would say I find more difficult is the stark contrast between our lives, which is implicit and at times explicit in our conversations. By virtue of the very fact of them being young, their children are constantly changing, having new experiences and growing up. This means firstly that I feel that there is more going on in my friends’ lives than in mine – since their lives incorporate a whole family, rather than one person – and secondly that there is more of a sense of progress. This contrasts with my own feeling of being stuck. Given the fact that they live outside of London on the whole, and that we are only able to find a time to get together perhaps every two months or so, it is inevitable that they are unaware of the ins and outs of my daily life, much as I don’t really know the details of theirs. On a rational level, it makes sense that the questions they might ask me would revolve around work, or my flat or my cats. But at the same time, it can make me feel that those are the only things of note in my life. My life feels very empty compared to the busy-ness, colour and affection of their family lives.

When I came home from dinner, I found it hard to get to sleep. Despite my history of periods of insomnia, I have foolishly developed a really unhealthy habit of looking at trends on Twitter before I go to bed. Last night, when I still couldn’t sleep, I then switched to Instagram. I don’t really get Instagram. When it comes to social media, I am a words rather than a pictures person. Also, much in the same way as I can’t allow myself to be bothered about rugby as I really don’t have the time or emotional capacity to engage with more than one team sport (it’s football all the way…) I just don’t feel I have the time to keep up with events on more than one social media platform. Twitter seems like my natural home, especially given my interests in politics, satire and sport. In any case, I ended up on Instagram, scrolling through the pictures and updates of various friends, and disappearing down various rabbit holes as I followed links to other friends and acquaintances via comments and likes.  It is strange how, when it comes to social media, an awareness of just how much time you are wasting on an almost entirely pointless activity does not preclude a sense of compulsion, driving you to trawl through  more and more posts, going deeper and deeper and further away from your initial starting point.  I knew last night that if asked, I would have been unable to articulate the reasons for which I was scrolling through so many pictures, aside from a need to distract myself from my thoughts in the hope of falling asleep (despite the obvious counter-effects of so much blue light…) I also knew that the benefits of any momentary distraction were outweighed by the negative, psychological impact of looking at the colourful, edited highlights of other people’s lives, not least in the light of what I had been reading about envy the very same day.

Envy as an emotion is so closely associated with the experience of using social media that it has made FOMO (Fear of Missing Out) the acronym perhaps most closely associated with it. As we all know, social media images and posts often represent the edited highlights of an individual’s life, and create an impression that may only bear a passing resemblance to the reality of their everyday existence. Instagram users in particular pay close attention to the aesthetics of the posted image – whether that be a selfie, a snapshot of friends, or a shot of a particular location. On one hand, as a keen photographer, I am really interested in and impressed by the quality of images posted by people with a whole range of photographic experience – from professional to none – and also the process of democratisation that it has led to in the field of photography more generally. It is traditionally a very expensive hobby or profession, and requires a great deal of equipment and technical know-how. Yet here are all sorts of people, young and old, capturing often beautiful images with nothing more than a smart phone. On one hand, image-based social media has been hugely positive in that people are much more aware of the physical and natural environment around them. On the other hand, taken to an extreme, people are excessively focused on the potential for an effective social-media image. This need for the perfect image is evident all sorts of ways, from the current trend for contouring, to the fact that animal charities now organise annual events to promote the benefits of adopting one of the black cats often overlooked in cat rescue centres, since their potential owners worry that they are not sufficiently photogenic.

Social media – from Facebook to Twitter, from Instagram to Snapchat – have given envy a new lease of life. It can be provoked by a post celebrating someone’s personal or professional success – a beautiful holiday or a new and exciting job. Envy can be provoked by something shallow – a new pair of shoes captured in a selfie – or by something more meaningful – your child’s latest academic achievements at school. It can be provoked by an achievement in an area of common interest – you publish a chapter in a book on teaching and learning – or in an area that is yours alone but which somehow connects with something in me: you are developing a career as an interior designer. It is not an area that interests me, but somehow connects with my wish to do something more creative with my professional life. The envy can focus on something tangible – the beautiful new house you have just bought with your partner – or on something more abstract, such as how happy you and your family are, despite your limited financial resources.

Social media can increase feelings of envy since it also increases our sense of being close to the people who are the object of those feelings. The philosopher Aaron Ben-Ze’ev explains that our envy tends to be directed at people who are socially close to us “because those who are close to us, but still above us, emphasise our own inferiority more than those who are distant from us.” The accessibility of other people through social media makes a wider range of goods, experiences and lifestyles feel like they are within our reach. We have at least an illusion of intimacy with, and proximity to, a much wider range of people. On a practical level, this means that we have a greater number of people with whom to make comparisons, and who may provoke feelings of envy. My circle of Facebook friends not only includes my actual friends for example, but also childhood friends, former and current work colleagues, and an assortment of other people whose paths I’ve crossed over the years. It includes the childhood friend who has married a very wealthy man and who posts pictures of her attractive children, her beautiful home, and her holidays in a variety of exotic locations. It includes the pretty school friend who still looks as slim, youthful and attractive as she did more than twenty years ago. It includes the former colleague  who has found another new, wealthy boyfriend and is constantly posting beautiful pictures from her latest holiday. It also includes another former colleague who, despite the challenges and vicissitudes of the last few years, is happily settled with her husband and pets in a cosy home in a northern village, surrounded by family and friends.

At least, these are the stories that the pictures are telling me.

If social media celebrated a quiet night in with a Chinese and rubbish TV, we might feel less envious of other people’s wild nights out. If it celebrated the comfort and calm of a one-bedroom flat, free from the chaos and noise of family life, we might feel less envious about other people’s children – especially if it also captured their hysterical breakdown in the aisle of a supermarket ten minutes before closing time. Of course, that’s not the role social media has come to play in our lives, and if it were it is unlikely that it would enjoy the audience it currently does.  We all have a role to play in terms of what we choose to post, but at the same time we have realised, almost too late, that we are inextricably trapped in a virtual game of Keeping Up with the Joneses. As with so many aspects of technology, virtual reality and social media, the impact of our aspirational posts has only become clear long after we took our first, naive steps on Facebook – remember when we were all still posting in the third person?! – and long after we really still had any degree of agency in terms of mitigating that impact and/or reining our posts in. In the same way that reality TV has encouraged conformism in terms of how young people dress and in terms of what is considered attractive, social media has ironed out a great deal of diversity, and much sense of an alternate view of what happiness and success could look like. It is like a huge algorithm that rewards, promotes and celebrates certain life events over others. This in turn leads its users towards a singular view of what should be considered enviable. That envy is in turn enhanced by the fact that social media also brings lives that were previously unknown and out of reach to somewhere within our grasp, or at least appears to. We may envy our friends or work colleagues, but by narrowing the distance between us and them, social media also enables us to envy the confidence and happy family life of Mary Portas (me), the wealth of the Kardashians (not me), the influence and clear-sightedness of David Lammy, or the talent of Taylor Swift.

This artificial sense of proximity is linked to the way in which social media is gradually dismantling the social strategy of encapsulation. Encapsulation creates sub-societies within society. Each of the members of those sub-societies has more or less the same access to what are considered the good things in life. These sub-societies are separated from each other by social, psychological, cultural and often physical boundaries. Think about your circle of friends. You probably share similar values, and it is likely you share a similar quality of life to those to whom you feel closest, not least because you value and enjoy similar experiences. As someone who has spent most of her life in London, I can recognise that I share a number of values with many residents of the capital, and even more with fellow members of what some might call  (dismissively or otherwise) the liberal metropolitan elite. Not that, as a teacher, I would class myself as particularly elite, but events such as the EU referendum or the most recent European elections – in which London was one of the few areas in England not to cast more votes for UKIP than for any other political party – have made me realise that the views I personally consider  typically ‘British’ are very much not shared by many people living in the UK, but rather may be representative of the very small sector of society of which I am a part.

Beyond shared values, these sub-societies often share a sense of who should or should not have access to them, and actively work to exclude the latter group, either through circumstance or by design. Private clubs with restricted membership, expensive new housing estates in fashionable parts of the city, suburbs whose house prices reflect easy access to good schools and good transport links, universities whose entrance requirements often exclude those from more disadvantaged backgrounds; these all bring together people of comparable means and statuses (whether financial or otherwise) and exclude those who are deemed not to meet the entrance requirements.

Social media is not the only mechanism that is challenging this process of encapsulation, but it is playing an extremely significant role. Social media, along with the proliferation of online news, celebrity gossip and reality TV, has meant that boundaries between sub-societies are being broken down. The advantages of the haves are now very much visible to the have-nots. This can have a huge impact on the extent of our envy, since as I have said its object can now be not just our immediate circle of friends and colleagues, but a whole range of celebrities and other prominent and successful figures.  It can also have – and indeed, has already had – a significant impact on social stability. As we become increasingly aware of the success and advantages of others, we also become less tolerant of any sense of inequality. Faced with a daily stream of posts and images from the lives of the rich and famous, we may feel increasingly dissatisfied with our own, more mundane daily existence. Other societal changes, particularly in relation to the media, are fuelling our envy, not least because they create a sense that we can genuinely aspire to the lifestyle we see depicted on our feed. Reality TV shows such as Love Island and Big Brother seem to provide an easy way to access the lifestyles of the rich and famous. Talent shows offer a short cut to success, a short cut that seems all that more realistic since the distance between us and those who have already achieved it has been narrowed by social media. Our feelings of envy at the seemingly gilded existence of the rich and famous is reflected in the fact that so many young people now state that their ambition in life is to achieve a similar celebrity status.

Social media and celebrity culture have allowed people to feel it is okay to flaunt what they have. Many prominent figures on social media  – those immersed in the subculture around rap music, for example – are very much associated with a sense of ‘excess’ or ‘bling’. By contrast, in the past, a strategy of concealment was regularly employed to ward off others’ envy, since the latter was seen more negatively than it is today. People preferred to conceal the possessions and achievements they feared might be envied. Now, the opposite appears to be true: what is the point of receiving a new designer handbag for Christmas if you don’t post a picture of it on social media? How can you really enjoy your exotic holiday unless you post pictures for friends back home to admire? Would your pregnancy be less exciting if you hadn’t chosen to share the scan on Facebook? Of course there is a certain element of cynicism in these questions, and it is undoubtedly true that social media plays an important role in enabling us to keep in touch with friends and families, and to share aspects of our lives with them much more easily than in the past. However, we continue to post these celebrations of acquisitions, experiences and achievements without considering the psychological impact they might have on those who see them, even when our own wellbeing can be negatively affected by the posts and status updates of other people.

Studies have shown that increased use of social media is in direct proportion to increased feelings of dissatisfaction and unhappiness. While it allows people to make instant connections, it is ‘offline’, face to face social networks that have been shown to enhance wellbeing. Social media, on  the other hand, is linked to greater feelings of social isolation. Whether the individuals browsing Facebook, Twitter, Instagram and so on really are socially isolated or not – though they certainly are in their moments  of solitary browsing – it is the perception of social isolation that has been shown to be more damaging, both mentally and physically. Research has also shown that all kinds of comparisons via social media – whether we feel we are better or worse off that the friends whose posts we are reading – can have a negative impact and can lead to depressive symptoms. Perhaps because continually drawing these comparisons and then evaluating our own position in some kind of virtual pecking order is incredibly emotionally draining.

These comparisons can lead to a vicious circle that is psychologically damaging. Our feelings of envy or jealousy can make us want to make our own life look better. We therefore post envy-inducing status updates of our own, and so the cycle continues.  The longevity of this unhealthy cycle also lies in the fact that we appear to feel compelled to come back to social media, even though we know it will not make us feel any better. This is called a forecasting error, and can also be seen in drug addiction. We think that a fix of Facebook will help, but it actually makes us feel worse. We are unable accurately to predict our own response to social media.

So how can we break this cycle? We need to steel ourselves to be strong, and to remember the negative impact that social media can have on us before we casually open our apps. If we find this too difficult, we can consider removing social media apps from our smart phones or tablets. Moment is a great smart phone app that enables you to monitor your screen time, to limit it, and to see which apps are taking up most of your time. On my laptop, I use Freedom to block internet access while I am working, to ensure that I don’t get distracted by social media or other websites. Beyond these practical adjustments, I think we should take a moment to reflect on our own personal use of social media, the envy and negative comparisons we may be generating, and the extent to which we are contributing to a monolithic and conformist understanding of what achievement and success look like. If we continue to use social media, we should think about how we can celebrate a whole range of definitions of success and contentment. We can aim to be as honest and vulnerable online as we might be in person, and expect the same from our friends.

Failing that, we can always post more pictures of cats!

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Adventures in Psychotherapy Number 4: Second session

I saw my new psychotherapist, Sarah, for the second time last week. (In fact, this post has taken me a while to write, so I have now seen her four times in total.) Anyway, it was not as positive an experience as the first session had been. It was not as positive an experience as the first session had been. I think that was probably always going to be the case. When we met the first time, I felt an immediate, positive connection with Sarah. That made me feel incredibly relieved, since it meant that I appeared to have found a new therapist. As I have said, it also made me feel very emotional, since it threw the reality of the end of my relationship with Alexis, my previous therapist, into even sharper relief than it had been previously. Nonetheless, our first session was an overwhelmingly positive experience, and I left it with a figurative and almost literal spring in my step.

I suppose after the relief of that connection in the first session, the second was about beginning the process of getting to know one another in greater depth. We spent a long time talking about my family, and also about the origins and extent of my low feelings and depression. I am so used to the way that Alexis responds to what I tell her, and to the dynamic of our relationship. It is inevitably extremely difficult to adjust to a new dynamic and to a new therapist. There are clear similarities between Alexis and Sarah in terms of their style, their presence, the way in which they engage with what I tell them, and the way in which they encourage me to express myself. Some of this is undoubtedly due to the fact that they have both undertaken training at the same institute, and so approach their work from the same psychodynamic – psychoanalytic angle. Some of it I imagine lies in their personalities and personal preferences, and I feel I can understand why Alexis thought that Sarah would be a good match for me. However, despite their similarities, I have to ensure that I try to avoid making direct comparisons between Sarah and Alexis. I need to build a new relationship, and I need to remember that my relationship with Alexis was a unique one, at a unique stage in my life.

I don’t think that I felt critical of Sarah during our session. When I feel vulnerable, unsettled or unsure I can often retreat in a personal relationship, creating an emotional distance which I then fill with overly critical analysis of both participants in it. It wasn’t that. Rather, it was me feeling slightly self-conscious and self-aware, uncertain I suppose about the impression I was giving her, overly aware that I was creating a first (or second) impression of myself and not quite sure as to which were the most important things to share. Not that I had much opportunity to make that kind of conscious decision about the direction in which the conversation should go, since for the most part it flowed very freely, aside from the moments in which I caught sight of myself, or caught up with myself,  and suddenly felt slightly awkward.

When I left, I realised that those moments made me feel slightly unsettled. That in turn made me panic slightly, and by the time I had walked to my car I had explored one possible emotional path that led me to a realisation that perhaps the relationship wasn’t going to work, and that I would have to start my search for a new therapist all over again. I didn’t really take that path however. Rather, I tested it out, to see how it would feel and where it would take me. Just as quickly, I retreated from my catastrophising and rationalised that it is quite natural that there should be a period of adjustment, on both sides. Sarah knows very little about me, and goodness knows what she does know or what sense she can make of what I have said, since our conversations have jumped around all over the place, from my birth and early years in Manchester to my holiday in Italy the week before last. She said in our first session that she would need to get a sense of my personal history. I am not sure whether I have really begun to give her that, which in turn makes me feel as if I might have done or be doing something wrong, albeit our second session was very much guided by her questions.

I suppose the thing that is most difficult is that I feel that at the present time there is a wider aim, i.e. allowing Sarah to gain an insight into who I am and who I have been. We are not at a stage where I can simply talk to her about how I am feeling today, or about events that have happened since our last session. That was often the focus of my sessions with Alexis, and those conversations would often then lead to much broader discussions about underlying issues that I find it particularly difficult to address, or about patterns of emotional behaviour. While it is incredibly reassuring to know that I have now begun to build a new therapeutic relationship with Sarah, it is nonetheless difficult to feel that I still don’t necessarily have the opportunity to discuss events and emotions whose immediacy can pose a significant challenge or cause me a significant amount of distress. Still, we will get there, and just as I underestimated the reality of the effect that my ending with Alexis would have on me, it is not particularly surprising that I have underestimated the emotional effort required to establish and develop a relationship with a new therapist. It is at least a positive that I understand very clearly that there is a new relationship there, waiting to be built. When I think back to when I first saw Alexis, I don’t think I understood the nature of the relationship that could and would be established between therapist and client. I was in a very different place, a very distressed and helpless place. I saw Alexis as someone who might be able to help me, but it took me a very long time to understand that we were also building a relationship, a unique one which nonetheless shone a helpful (therapeutic?) mirror on many of my other relationships and the challenges that they might pose me.

Despite the element of anxiety provoked by our session, two particularly helpful things emerged from it, which have stayed with me over the last week. The first relates to happiness. Discussing my current job, my personal circumstances and the fact that neither of them are enough for me, I told Sarah that I want to be happy. I also told her that I am aware that this sounds rather trite, and in any case may not be attainable given my predisposition for low mood or depression. Sarah wondered whether content might be an appropriate alternative to happy, and it really struck me that this is precisely what I am aiming for: contentment. It encapsulates my desire to feel fulfilled, to feel that I have created something, achieved something. At the same time, it feels as if it would allow for flexibility, for the possibility that I may have periods of unhappiness or depression alongside a more overarching sense of some degree of personal fulfilment. Content seems to capture my current sense of striving and also of dissatisfaction. It makes it okay to feel dissatisfied despite everything I have achieved, since there is something else that I want to accomplish, which is more important to me than what I have achieved so far. I feel that it may also enable me to attribute some sense of value to my personal and professional achievements – they are achievements, just not enough to enable me to feel content. That could be helpful for me, since I am prone to almost entirely dismiss anything I have in my life –  my job in particular – since those accomplishments are not the thing I most want to achieve, and don’t help me feel the way I would most dearly like to feel – not happier, I have discovered, but more content. Even reflecting on this as I write makes me feel calmer, and makes me feel that I can perhaps incorporate my positive achievements  – whether professional or personal – into my sense of self in a way that will be beneficial, since doing so no longer means that I am in some way settling for something that does not make me happy, with the implication that I am therefore abandoning my ambitions and dreams. (While this all makes sense in my head, who knows if it does to anyone who is reading. I suppose what I mean is I can accept that my job, my friendships and my personal circumstances represent a positive success of which I can and should be proud. I can recognise that success, but at the same time acknowledge that it does not bring me contentment. I can recognise that success, since doing so does not mean I am abandoning all hope of achieving the things that I believe would make me happier, or more content.)

The second thing that particularly struck me in our session was a discussion around Alexis, which tied into a broader discussion about my family life. Sarah said at one point that in many ways Alexis had become a mother figure for me. I suppose I had never thought about it in quite those terms. I know that I loved Alexis, and also that I was aware, in the process of finding a new therapist, that it would feel quite odd if the person I began to see was significantly younger than me – I think Sarah and I may be around the same age.

Sarah’s comment made sense in a lot of ways. When I think about what might be described as the typical attributes of a caring mother, I do feel that they apply to my relationship with Alexis: I felt I could rely on her, I felt that she had my best interests at heart, she was interested in what I had to say, and I felt that it was a very nurturing relationship. The fact of it being a therapeutic relationship meant that I was able to discuss difficulties and challenges that I might find it harder to talk about with family or friends, however close. There was less judgement in our relationship, and fewer taboos in terms of what could be discussed.

While I know people who have extremely positive and very close relationships with their parents, I have very little sense of the extent to which feel able to discuss their most personal emotions, needs and fears with them. Can those relationships,  or other close relationships with friends and family, obviate the need for a psychotherapist, even in moments of crisis? I suppose what I am saying is that Alexis gave me a great deal, some of which I might have got from a parent, and some of which was dependent on the fact that our relationship was a therapeutic rather than a familial one.

It is difficult for me to identify the extent to which Alexis fulfilled a maternal role since I do not have a close relationship with my own mother.  During my childhood, my mother was a source of anxiety for me. She was very highly strung, emotional and unpredictable. A great deal of family life revolved around ensuring that she was placated, that she did not erupt into emotions that were distressing and destructive for both her and those around her. I was very frightened of her moods and her anger. On the occasions when her anger did erupt, I and my sister were on the receiving end of emotional and at times even physical wounds. Particularly on weekend days when my dad was at work, we would tiptoe around her, both literally and figuratively, hoping to avoid an eruption until the return of my dad’s relatively calming presence was signalled by the sound of his key in the door. While physical blows were more frightening – since they signalled that the situation had almost completely spiralled out of control – the emotional wounds have proved to be more durable and more damaging. Over recent years, I have learnt that my mum suffered from post-natal depression when I was born. At the time, my parents were living in Manchester, in exile from my mum’s native London and far from the support of friends and family. They didn’t last long in the north, and by the time my sister was born 22 months later they were back in the capital. It must have been an extremely challenging period for them, compounded by the fact that my aunt was also living with them at the time, and also suffered some kind of breakdown that led to her leaving university and going home to my Grandma in Buckinghamshire.

As I grew up, my mum was very much the career-orientated parent in the family. From a disadvantaged background, she nonetheless succeeded in funding her way through university and carving out a career in IT. When I look back now, I can see that although determined to make a success of her career, my mum simultaneously found it incredibly stressful. While we have never talked about it – and I doubt we ever will – I now think it likely that my mum was suffering from undiagnosed depression for most of my childhood. I also think that she found being a mother incredibly difficult. My mum – as a woman who was determined to have a career alongside her family – was an incredible role model to me in many ways. I can also recognise the many, many choices and sacrifices my parents made to ensure that my sister and I had all of the opportunities that they did not. My parents paid for my music lessons, gave up their Saturdays to take me to music college, ferried me around to orchestras, choirs and even my part time job. They paid for me to study A Level Latin privately when my school was unable to offer it, and paid for me to access an incredibly wide range of educational and other opportunities, from school trips to Christian summer camps to annual French exchanges and exciting camping holidays in Europe.

My parents gave me so much practical and financial support in my childhood, and have continued to do so. What was more difficult was the emotional support that I also needed. I didn’t and do not feel that I get this from my parents. It seems a little unfair to say that, since they can be great in a crisis, and are always willing to offer the more practical assistance that can often be required alongside support of a more emotional kind. I will phone my dad if I have a problem with my house or my car – or even to ask him ridiculously mundane questions about parking restrictions when I am out and about, based on the fact that he pretty much seems to know everything! My parents generously helped me with a deposit for my first, shared-ownership flat. When I worked out that the salary for my new job was significantly lower than  I had realised and felt that I had no choice but to reverse my decision to accept it, my parents very kindly offered to give me some money to bridge the gap between the two incomes, anxious that I needed to leave a school that was having a significantly negative effect on my mental and physical health. In the end I resolved this situation myself, but this kind of support and generosity is incredibly helpful and also very kind in its spontaneity.

I have no doubt that my parents have my best interests at heart. I think what they find more difficult is the messy reality of me and my emotions. My family have never been good at communicating, and I would say that we are now at a stage where our interactions are all about practical updates, rather than anything particularly personal, at least on my part (and when my mum in particular tells me about her own personal issues, I sometimes feel incredibly angry and resentful that she expects me to listen, when she is not prepared to listen to me, or even to ask if there is anything I would like her to listen to. I guess we have now completely got out of the habit.) I think the fact that we have found ourselves in this situation is due to several factors, some of which relate to me and some of which relate more to my parents.

Firstly, for various reasons, I felt very let down by my parents in my early teens and made a conscious decision not to talk to them about personal issues. I suppose I got a glimpse of who my parents were as individuals, not just as parents, and I found that very hard to process. I spent a lot of time on my own, working, studying or doing music practice, and it was easy to avoid meaningful interactions. Secondly, as I have mentioned, I don’t feel that anyone in my family is particularly, naturally inclined to emotional communication, which makes it easier to avoid. Thirdly, at times when I did talk to my parents about difficult feelings and experiences, I often felt let down by them. These days I can rationalise this. I didn’t talk to them about much, and so gave them very little insight into my thoughts and emotions. When I did talk to them, this was usually at a crisis point when I was trying to manage something particularly difficult on an emotional level. I imagine that, for them, these emotional outbursts came completely out of the blue, and because I didn’t talk to them, they had no context in which to place them, and no broader understanding of why I found certain experiences and feelings as difficult as I did.

The final reason for which I feel there has been a gradual breakdown in communication is also linked to the third. As I have said, with the benefits of hindsight and distance, I can understand that my parents were themselves under a great deal of emotional pressure while I was growing up. I also think they were at times under considerable financial strain. My mum was constantly stressed and emotional. In a way, I felt closer to my dad. He was a policeman and due to his shift patterns he often spent more time with us than my mum was able to. My dad is very intelligent and very interested in culture and history. During our holidays, he would take us on trips to museums, exhibitions, or on tours of London. He has an almost photographic memory and was a source of stories, facts and anecdotes. I would say that I am closer in personality to my dad than my mum, which inevitably has meant that we are more prone to clash. Aside from that, however, the thing I found most upsetting during my childhood was the role my dad would assume in an argument or when the atmosphere at home was extremely tense. This relates to the final reason for a failure of communication.

do understand how difficult it must have been for my parents to cope with my extreme emotions, and clearly they found them very hard to understand. To all intents and purposes, I was a successful, busy and focused child. Yet beneath the surface and beyond my practical achievements and accomplishments, I was incredibly unhappy and incredibly insecure. At times, I would feel overwhelmed by these feelings, and at those times I would often discuss them with my parents. As an example:

When I was 18 and just after I left secondary school, my parents moved from Surrey to Essex. My mum’s company was moving out of central London, and they offered her an excellent relocation package. Even at the time, I completely understood why she would take them up on this offer. However, for the 6 months or so from when I knew it was happening to when it finally did, it caused me huge amounts of distress. My school friends have always been incredibly important to me, and I was terrified that I was going to lose them. I was going off to university of course, as we all were, but the move meant it would be that much more challenging for me to see them in the holidays. In the event, it was all fine, but at the time, uncertain that I would be able to make such good friends again or that I was worth them making an effort for, I was terrified of rejection and being left out. I felt that I would be left with nothing, and didn’t know how I would cope. I cried myself to sleep on a regular basis. Sometimes I would discuss my fears with my parents. I remember one particular occasion, not long before my A Levels, when I was really upset and telling my parents how much I would miss my friends, and how much I was dreading the move. My parents were sympathetic to a point, but then lost their patience. My mum got angry and told me that she had only kept in touch with one friend from school and she had died of cancer (my mum’s best friend, Pat, had passed away the previous year.) The implication being that I had no right to complain. This was a common pattern. My parents would get frustrated with me, lose their temper, and my mum would often compare my fairly privileged life with the challenges she had faced during her own childhood. What right did I have to be upset or unhappy? She had had it so much harder. Not only that, she was now making all kinds of sacrifices to ensure that I could have a different experience. I understand all of that, of course I do, but it didn’t make my feelings at the time any easier to bear. I kind of see it as the equivalent now of someone looking at my job, my flat and my friends and asking me what I have to be depressed about. It is not really the point.

I mentioned my dad’s role in the family dynamic in these moments of conflict. Again, on a rational level, I can understand the choices my dad made. He wanted to support my mum, and he was clearly affected by her emotional difficulties and mood swings. What I find hard to accept is the way in which he would therefore side with my mum in any conflict, and turn on me and my sister. I experienced this as a betrayal, and precisely because at many other items I did feel closer to my dad, I found and still find it very difficult to forgive him. He would call us selfish, or stupid, and blame us for the tension in the family home and for my mum’s upset or anger. A particular favourite was ‘Are you really that stupid or have you been practising?’ I mean, in a way it’s laughable, and/or a good catchphrase, but I internalised it all, and it served further to dismantle my already fragile self esteem. Even now, I have a very critical and masochistic internal voice, and I think it’s origins lie in large part in the things my dad said to me during my teenage years. Of course my dad was under his own stress, and probably has no idea that I took what he said so much to heart. I don’t think that my sister did for example, even though she was almost as frequently on the receiving end of his anger and frustration as I was. I think (hope?) he would be devastated if he knew. Not that we are even going to discuss it, obviously! I will just share it all with a wider audience via this blog….

I talked a lot about my family with Alexis when I first started seeing her. While we would often return to talk about them, particularly if we had a difficult interaction or if something they had said or not said had upset me, they were not really a focus of my sessions with Alexis in recent years – or at least, it didn’t feel as if they were. I suppose with Sarah, as she seeks to gain an insight into my emotional history, they have moved back into the therapeutic foreground. All sorts of feelings are being stirred up and that, along with my keen awareness of Alexis’ absence, it proving very difficult to cope with. However, I subscribe to the principle that in therapy things often have to get worse before they get better, and I am sure that my feelings will soon cease to be as difficult to navigate as they currently are.

Adventures in Psychotherapy Number 3: First Steps

I have recently been exploring courses on offer in London that would enable me to train to work as a psychotherapist myself. As with writing, this is a decision and a step that it has taken me a long time to take. I first broached the subject of working as a psychotherapist with Alexis (my former therapist) a few years ago. I think it was some time after my last period of serious depression in 2014.  As I began to feel more myself, I spent time thinking about what I valued in life, and what I valued in myself. From a practical point of view, I focused on two areas: my home and my job. As much as I like spending time with friends, visiting galleries, or travelling, my home environment is incredibly important to me. It is vital to have a space in which I can be myself, in which I feel no sense of judgement, and in which I can achieve and maintain a sense of equilibrium. My home reflects my interests and my personality. It is colourful (and colour-coordinated ), full of a variety of patterns and textures, of books, dvds and pictures. It is cosy and welcoming, generally tidy, and ruled by my two cats. On a more negative note, at times I feel a more minimalist approach would enable me to feel a greater sense of calm. Unfortunately, the concept of less is more on an aesthetic level is almost entirely alien to me. It also occasionally feels overcrowded or messy, when I need to have a clear out or to find a place for the various new books, clothes and shoes that have found their way into my home. (How did that happen?!) At those times too, my home can often appear to reflect my state of mind. There sometimes seems to be too much going on, too many distractions, too much noise.

In any case, the latter, more negative relationship I can sometimes have with my home was exacerbated at that time by the fact that I was living in a one-bedroom flat that I appeared to be  outgrowing rapidly. The fact of it being a onebedroom flat also came to be something I saw as deeply symbolic of a perceived lack of progress and success in my life. Therefore, once I had overcome the worst of that period of depression and could look to the future and to a focus on the things that would make me happier, I determined to move house, and to do so so prior to my 40th birthday that autumn. In the event, I didn’t quite manage it within the timeframe I had set myself. In fact, on my 40th birthday I was lodging in the annex bedroom of the house of two very dear friends, my cat was lodging with my parents, and my belongings were mainly in storage, as I waited for the labyrinthine requirements of the government’s Help to Buy scheme to catch up with the fact that I had already exchanged and completed on my new flat. In terms of things I valued, however, I did eventually succeed in effecting a significant change.

The second area I considered at that time was work. The way in which my depression was managed by my school during that period was a significant contributing factor to my eventual decision to leave. In fact, it took me a further two years to actually make the move. The reasons for this were partly practical and partly emotional. After a year in which I had been very unwell, a dear friend and colleague had been off work receiving treatment for breast cancer, and in which two further, much-loved friends and colleagues left the school, I was in great need of stability. Albeit alongside increasing sickness and stress due to my unhappiness at a number of aspects of my job, the following school year did provide that on some level.

When I look back now, I can see very clearly that the negative effects of my decision to remain at the school far outweighed the benefits. I was physically sick more mornings than not when I arrived at work, and often felt so nauseous with anxiety and stress that I had to move around the school with extreme caution, almost as if I were balancing a pile of books on my head, fearful that any sudden movement would induce further nausea, dizziness and vomiting. It seems scarcely credible now that I tolerated and accepted these physical manifestations of anxiety for so long. Yet at the time I suppose they became normalised, just part of my everyday routine. I have often suffered physical symptoms of psychological stress, but it is only now that I am no longer working in that environment, which put me under such acute, emotional pressure, that I can understand how many of my physical symptoms it caused.

Aside from the way in which my job affected me negatively, it also brought clear benefits. In professional terms they related to the many opportunities for career advancement, innovation and carving out a personalised path in education that it offered me over the years. In personal terms, I was extremely, extremely lucky to work with a wonderful group of colleagues, many of whom became and remain dear friends.  Today, the vast majority of us have moved onto different schools or different careers, but most of us remain close friends, who often reflect on the serendipity that brought us together over the same period of time in the same school. We recognise that life has moved on, people have moved away, had children, chosen different paths, and that we are highly unlikely ever again to find a group of friends and colleagues with whom we will share so much on a personal and professional level. For me, as mentioned elsewhere in this blog, the development of my friendships with that group of colleagues was a real turning point in my understanding of how I am able to connect with other people. I had long thought – despite evidence to the contrary – that most of my friendships had come about through circumstance, that I had no agency in terms of how they developed, and that I had very little to offer my friends. The way in which I was able to build new friendships with colleagues at school forced me to reconsider this long-held belief, and led me to a different, more positive view of myself, as an individual with something to bring to both personal and professional relationships. While I have, not many, but a significant number of friends outside of work, this new group of friends was really important to me. We were all, initially, relatively close geographically, which is unusual and to be treasured in London. While there were variations in age and family circumstances, we coincided to a significant degree in terms of our interests, outlook, and values.  It is a precious thing to go to work every day and to talk to and work alongside dear friends. We shared so many positive experiences, and they were also of unbelievable support to me at my most difficult times. I was terrified at the prospect of losing them if I moved to another school. Of course, that has not happened. We are still in touch, still see each other regularly, and still support each other both professionally and personally. It took me a long time though to have the confidence that those friendships would continue. As a woman lives on her own and who does not have children, it is very easy to feel lonely and isolated, and my lack of confidence in my ability to sustain valuable relationships held me back from making decisions in my professional life.

Despite those hesitations, I was considering the direction I wanted my career to take. For a long time, I considered the possibility of undertaking a PhD in Italian. This is still not something I have completely ruled out. I intended to study for a PhD on completion of my M.Phil, and while my decision to leave academia at the time was the right one, I have long since felt that I have left something unfinished in terms of my academic studies. In a way, however, I almost feel that a PhD would be a step back, an attempt to return to the person that I was when I left university. That is not to say that I no longer enjoy the rigour of academic study. I do, and I have really enjoyed the times at which I have been able to bring my passion for literature, Italian cinema, politics and so on into my classroom teaching, particularly at A Level. But I have changed since my time at university. I feel I have a more rounded view of who I am. While I would enjoy the challenge of further postgraduate study, I am anxious not to set too much store by an area of interest in which for a long time I sought emotional refuge, and which was the one area of my life in which I could feel a sense of control and self-worth.

While reflecting on home and career, I was also reflecting on my personal strengths and capabilities. I wanted to understand myself better and to identify the traits, abilities and capacities that I could and should value, partly to counterbalance the negativity that had almost entirely taken hold during the period of depression from which I had just emerged, and partly further to develop my awareness of what I had to offer on a more holistic level. At times over the years, my work has taken over, both in terms of time and of emotional and mental capacity. At those times, I have felt that I am a teacher and nothing more. I have no time to do anything other than teach, and in any case have no energy to pursue any of my other interests. I think if I were coming home each night to a family, or a partner – a something – this might not matter so much, since the ‘something other than work’ would already be there. But when I come home to my cats, an otherwise empty flat, and exhaustion, I feel I am not living, merely existing. I am an empty shell, an automaton who gives her all to her career and drains away the resources she might like to put to other uses.

Forcing myself to consider what I might be able to offer outside of teaching has led to positive change in a number of ways. It was during that most recent period of depression that I began to write this blog. I have found the experience of writing incredibly therapeutic and rewarding, and I have gained and continue to gain in confidence in my writing. I write for whatever audience my blog might have, but I think primarily I write for myself. I have also engaged with my creativity through my developing interest in photography. Both activities have given me a focus, a new form of expression, and the opportunity to be in the moment, to just be. 

I also began to recognise the support I was able to provide others on a personal level. I became aware that people would often turn to me for support or advice at work, and that people saw me as empathetic, someone who could offer emotional or practical guidance. I gradually allowed myself to accept that my ability to connect with others in this way is one of my strengths, despite the anxieties I often have around social interaction. I think a lot of this ability to empathise derives from my own experiences around mental health, the ongoing reflection in which I have engaged through my therapy, and my awareness of unhelpful patterns of thoughts and behaviour and potential strategies to counter them. It was due to this increasing awareness of another area in which I may have something to offer that I began to think about the possibility of training to be a psychotherapist. At the time, I didn’t really look very far into the practicalities of the training. I did however broach the subject very tentatively with Alexis, my therapist. I was very anxious about this, worried that she might think it was a ridiculous idea, due to my own, ongoing issues. In fact, she was very supportive, and also pointed out that one’s own personal experience of therapy and mental health issues can really enrich a career in psychotherapy. She also made the point that basically, you don’t need to be ‘cured’ to be a psychotherapist – not in so many words, but I suppose that was what I was worried about.

In the event, I didn’t get any further in my thinking at the time, as moving house and then changing job took priority. Since Alexis told me last spring that she was retiring, I have been actively thinking about and investigating psychotherapy as a possible future career. As I have already said, I am determined that positives will continue to emerge from my relationship with Alexis, even though it has come to an end. I continue to strive to engage in more positive thought processes, I am dedicating more time to the things that make me happy, and I am considering the direction I would like my life to take in the future, from a professional point of view. While I love teaching, I know that it is not enough. I want to find a means of engaging with and expressing my creativity, in a way that goes beyond the opportunities offered within a school environment. I also know that my current work-life balance is not sustainable in the long run. I am not prepared to dedicate any more of my time or mental capacity to my job, partly for the sake of my quality of life, and partly because I need spare capacity to explore the other avenues that are important to me. I am not interested in becoming a Headteacher – for many reasons, the most significant of which revolve around work-life balance – and cannot see myself being a Deputy Head for the next twenty or twenty-five years.

So far I have attended two open days, one at WPF and one at the Minster Centre, and will attend an open evening at Metanoia in a couple of weeks’ time. The two training centres I have visited so far have been really welcoming, and I could potentially see myself undertaking training at either of them. The training structure at each is fairly similar, consisting of a compulsory foundation certificate in counselling skills and psychotherapy, and then four or possibly five years’ formal, part-time training, leading to an accredited, professional qualification as a psychotherapist. The foundation course is held either in the evening or at the weekend, and seems to be compatible with a full-time job. While expensive, the costs involved are nowhere near as high as the fees for the professional training.

A number of things have struck me while attending these open days. Firstly, without a certain amount of prior knowledge, it is difficult to know which course might be the best fit. The Minster Centre takes an integrative approach to psychotherapy, whereas the WPF’s training is along psychodynamic lines. Metanoia, on the other hand, offers a range of routes through its training programme. While I have begun to do some reading around psychotherapy itself – beyond further familiarising myself with the works of Freud, Jung and other theorists whose texts are studied as part of the courses – it is quite hard to establish clear differences between the different approaches. For mainly practical reasons, I think I am most likely to undertake the foundation course at the Minster Centre. I have gathered that that decision would not preclude a possible subsequent enrollment with either of the other organisations for the four-year training course (whereas the Minster Centre made it very clearly that nearly all of the places on their course go to students who have completed the foundation year with them.)

The second thing that struck me at the open days was the number of people who are interested in training to be a psychotherapist without apparently having had any personal experience of therapy. Admittedly, the foundation courses for which the events were organised focus primarily on counselling skills, and appear to be less intensely theoretical than the professional training. Nonetheless, much of the discussion at both open days was about the foundation course as the first step towards acceptance onto the   post-graduate diploma. Of course, many people have had experience of counselling, whether on a formal or an informal basis, and whether as counsellor or client. However, I would say that there are clear differences between counselling and psychotherapy, and in the relationship established between client and therapist. I understand that people choose to pursue a whole variety of career paths with limited prior experience of them, but psychotherapy to me seems like such a particular choice, such a vocation, that I find it hard to understand what people understand by the term psychotherapy if they have had no experience of it themselves. Perhaps I am being unfair, and I am sure that there are all sorts of reasons and journeys that lead people to consider psychotherapy as a career. While I do have many, many years experience of psychotherapy, until now this has all been with one therapist, with one particular approach, and it is likely that I therefore have a very specific and possibly very narrow view of the relationships one develops as a psychotherapist. Whatever people’s motivations, the training represents a significant commitment from a financial point of view and also in terms of time, and I do not think it is something that anyone would enter into at all lightly.

That commitment presents something of an obstacle to me in my current circumstances. As mentioned, the foundation course seems more or less compatible with my current job. The Minster Centre offers a fast-track foundation course that runs across one or two weekends a month, from February to July. I need to undertake the foundation course, firstly because it is a pre-requisite for any further study, and secondly since it will enable me to decide whether I definitely want to undertake the professional training. That in itself is a positive decision, but it is hard not to feel anxiety about what would happen were I then to decide that I wanted to continue my studies. There are a number of practical considerations. Firstly, the courses at WPF and The Minster Centre both run on a week day. This would therefore require me to reduce my working hours to four days a week. I have no idea whether this is something that my headteacher would countenance, and I would be reluctant to ask him until I were certain that I wanted to commit to the diploma. Were he not to offer me the option to reduce my hours, I would then have to think about changing job, and would possibly need to wait a further year to begin the further professional study. Metanoia runs the diploma at the weekends, which would give me greater flexibility, and more time to make decisions about my teaching job. With any of the courses, however, there are additional requirements that make further demands on the trainee’s time. A trainee is required to be in therapy him or herself of course, but also from the second year of training to take on a number of his or her own clients. The time required for these sessions, alongside personal therapy and supervision by a more experienced therapist – to say nothing of the study and wider reading involved in the training –  mean that it is unrealistic to expect to be able to complete the diploma while working full-time. Both the Minster Centre and WPF suggested that working four days a week would be the very most that would be compatible with psychotherapy training, and that three days would be a better fit. Given my personal and financial circumstances, these requirements could potentially pose insurmountable obstacles. From a financial point of view, the cost of training is considerable, ranging from £3500 to £6000 a year depending on where you training and the precise route you take through the diploma. There are now government loans available, but these would nowhere near cover the full cost of the diploma.

Despite the potential obstacles, however, I have decided that I will apply to start the foundaton course in the next academic year. It may well be that at the end of it, I decide not to take my training any further. If I do want to continue, I guess I will have to find a way to make it work, though I am not quite sure what that would look like yet.  Psychotherapy has given me a great deal over the last seventeen years. It has changed my life, my self-image and my outlook in ways that are very hard to put into words – though I continue to try – and the idea that I could put my experience, knowledge and skills to good use to help other people is a very appealing one.

 

Adventures in Psychotherapy Number 2: A New Chapter

Last Monday, I met Sarah, a potential new therapist, for the first time. She had been recommended to me by Alexis, my long-term therapist who retired in December. In fact, Alexis had initially recommended two other colleagues, neither of whom turned out to have any availability, so I went back to her and she contacted Sarah to see if she might have space to see me.

When Alexis retired in December, I had decided that I would give myself some time to come to terms with the end of our relationship before I found a new therapist. However much I need the support of regular psychotherapy, I also needed to allow myself time to grieve the ending of what has been the most important relationship in my life, and to reflect on the many lessons I have learned over my years with Alexis. One of the many things we have discussed is my propensity to avoid difficult thoughts and feelings. I am so adept at this that I can suppress a strong, emotional reaction at the very moment that I feel it. Say, for example, a friend lets me down in a significant way and I know that in theory I feel incredibly upset and rejected – and rejection is one of the things I fear most in life, so when I actually experience it I find it incredibly difficult. I can have a rational knowledge of how the rejection has made me feel – I am aware that I  must feel upset – but I actually feel nothing at all. I find this very frightening. I am aware that this is something that we all do to a certain extent. However, I am acutely aware of the difficulties and pain I have caused myself in the past by failing to engage with my feelings, and am determined that I should not allow myself to take this way out of difficult situations again.

And so, I wanted to give myself time to come to terms with the ending of my sessions with Alexis – I tend to say the end of our relationship, but Alexis has repeatedly reminded me that a relationship continues even when its two participants no longer meet, which is an idea I find really reassuring. I often wonder ‘What Would Alexis Say?’ when I catch myself on a downwards spiral, or indulging my most masochistic thoughts, and this can help me catch myself before I fall too far. At the same time, when challenging situations, interactions, thoughts and feelings have presented themselves over the last few months, it has been incredibly, incredibly difficult and upsetting to realise that I no longer have a session with Alexis in which to try to make sense of them. Our sessions were like a safety net or a release valve, and without them I feel that I am floundering, desperately trying to grasp hold of some sense of stability or meaning.  (In fact, Alexis seemed distinctly underwhelmed when I described our relationship in that way, and pointed out that one of the key aims of a psychotherapeutic relationship is to ensure that the patient can develop the capacity to find strategies and answers within herself. I understand that, but at the same time the relationship with your therapist is, in and of itself, incredibly important.)

I have been keeping a close eye on my emotions and thought processes since December, trying to work out if I am coping, whether I am still creating space and time to think, or whether I am avoiding any serious engagement with quite how difficult I have found this ending. I have adopted various strategies to achieve this: writing my diaries even more assiduously than usual, as a valuable way of engaging with my feelings; taking myself off to cafés in an attempt to create physical and mental space to reflect on how I am; talking openly about how the ending has been with friends when they have asked.  Alongside this, I have been incredibly busy at work, coping with the effects of the cold, dark British winter, busying myself with friends, writing and other plans, worrying about whether any or all of these are an avoidance tactic, and/or a sign that my mental health is deteriorating, while all the time becoming ever more aware that things have become increasingly challenging as time has gone on, without the support of a therapeutic relationship.

So in summary, the time was right to meet a potential new therapist. I had spoken to Sarah on the phone. We had agreed a time to meet for an initial, exploratory session, and had had a brief discussion about what sessions would look like going forward, should we both decide that we would like to work together. Apart from a significant sense of relief that I had taken a step towards finding a new therapist and that we had pencilled in a date, I didn’t really allow myself to reflect a great deal on what the first session would be like. When I did think about it, I couldn’t really imagine how it would be. I have only had a first session with a therapist three times (though several more with counsellors over the years.) My very first session was with a psychotherapist called Ian McShane. After that session, he quite rightly decided that I was better suited to a female therapist, and recommended that I meet with Alexis. I don’t remember a huge amount about that first session, other than a slight sense of irritation that I was having to ‘tell my story’ for a second time – and at the time, I was unused to talking about the factors that had led me to therapy, finding it both extremely difficult and extremely upsetting. My first impressions of the space in which we met for the first years of our relationship are lost in the mists of time and in the encyclopedic knowledge I had of its dimensions, furnishings and art works by the time that Alexis moved her consulting room from Acton to Chiswick a few years ago. Nonetheless, while I can’t remember precisely what we discussed, I do remember that even that first session had a significant impact on me.  I have a very clear sense of how I felt after I left. I went and sat on a bench in the park near Turnham Green tube and cut up all of my store cards and all but one of my credit cards. I felt invigorated, and for the first time in a long while had a sense of hope. I was determined to find ways of coping with my (at the time) depression and difficult emotions that were more positive and effective than compulsive spending and the accumulation of a security blanket of things. 

My final ‘first session’ was at a training centre for psychotherapists, an assessment session to place me with a trainee when I finally decided to seek help following the break down of my relationship with J. I was not seeing Alexis at the time. As discussed elsewhere on this blog, I had ended our sessions a year into my relationship with my boyfriend, which officially goes down as the worst decision I have ever made in my life. When the relationship ended and I needed help, I was scared to go back to Alexis – I suppose in part because I saw it as an admission of failure, and in part because of how I had behaved once I had decided I didn’t want to see her any more (in summary: not well.) So I looked for support elsewhere and ended up with a trainee psychotherapist at the Metanoia Institute in Ealing. I am now exploring the possibility of undertaking some psychotherapy training myself – of which more in a later post – and can feel a degree of empathy with the relatively young man who sought to engage with me over those two or three sessions. I was inwardly incredibly critical of him, even as I sat in the sessions. He muddled a few of his words, true, but basically, I criticised him because he wasn’t Alexis. Luckily, despite my stubbornness and shame, I subsequently allowed myself a moment of truthful, psychological insight and admitted to myself that I should call Alexis and ask her if she would take me back. Equally luckily, she said yes.

Perhaps not surprisingly, the potential for comparisons with Alexis came up several times during my first session with Sarah. Alexis had told her that I had briefly seen a different therapist after the break in our sessions, and perhaps also that I had found that very difficult. I wanted to reassure Sarah that that was due to the fact that I had not ended my relationship with Alexis for the right reasons, and was searching for a way back to her. I think Sarah also wanted our sessions to start from the basis of a common understanding that any potential therapeutic relationship between us will not replicate the relationship and experiences I have had with Alexis. I think it was really important for that to be stated explicitly in our first session. It was something that I already knew, but it needed to be acknowledged on both sides.

I found the session with Sarah really positive, and left feeling uplifted and hopeful. Our next session is in a few weeks’ time, after the Easter holidays, and the plan is then to meet on a weekly basis. It is always strange to think back to the first time you ever did something which then became a habit or a regular activity. The route to Sarah’s house was new and unfamiliar, but I imagine will soon become a reassuring part of the routine of our sessions. I had a very positive first impression of her – from her manner, to her clothes, to the wallpaper in her consulting room, to the way in which we were able to interact. I do feel that I was always likely to be positively disposed to her, given that Alexis had recommended her to me and felt that we would work well together. Nonetheless, I don’t feel that I would have felt beholden to Alexis’ endorsement of Sarah had I found the first session awkward or uncomfortable. I also feel that I generally establish connections with people fairly quickly when I spend time with them on a one-to-one basis, whether or not those connections are positive ones. In this case, they certainly were. Even as I write this, I feel an emotional sense of relief, optimism and reassurance as I reflect on that first session. I had been worried about what we would discuss. Would I have to give Sarah a potted history of my mental health over the last twenty years? Would she want a chronology of key life events? Would she expect me simply to start talking about my feelings around recent events and personal interactions, as I would have done with Alexis? This last seemed the most unlikely, but I was really not sure what to expect. In the event, the session began and then progressed in an entirely natural way.

I feel comfortable as the patient in a therapeutic relationship since it is a position I have occupied for a very long time. Beyond that, I experienced Sarah as a calm and reassuring presence. While that echoed the way I have experienced Alexis over the years, it was definitely a different feeling. I was very clear throughout that it was very much about my interaction with the therapist sitting in front of me (no couch yet!) and in no sense an attempt on my part to recreate or recapture my relationship with Alexis. That in itself was incredibly comforting, since it reassured and continues to reassure me that there is the potential to move forward in a positive way with a new therapist, while at the same time conserving the many, many positive memories and outcomes of my years with Alexis. That is not to say that it has not also been difficult. Of course I knew that I would not be going back to see Alexis. I knew that she would be retiring almost a year ago. I knew in November that her retirement would happen sooner that she had hoped. I knew in January that going back to school would not be accompanied by a return to our twice-weekly sessions. However much I have wept and desperately wished that I could see Alexis at my lowest points over the last few months, I have known that it cannot happen. Nonetheless, my appointment last Monday, the beginning of a new chapter in my psychotherapy, also represented the definitive closure of the previous one. There can be only one reason for beginning a new therapeutic relationship: the previous one has come to an end. I knew this, of course I knew this. But in a way this week has been like learning it all over again.

That has been really hard.

Overall though, I am hopeful and optimistic. I have been through a period of significant change over the last couple of years, and even more so in recent months. I anticipate further change as I try to make decisions about my future direction on both a personal and professional level. I feel that I can see myself moving forward with the support of Sarah, which is a hugely reassuring thought. Of course, there are still anxieties. We covered a great deal of ground in our first session, and discussed the future in terms of an expectation that we will continue to work together. Nonetheless, the spectre of rejection has inevitably reared its head. What if, as she learns more about me, she decides I am not the kind of patient she wants to work with? What if – less dramatically – she simply decides that she is not the right person to help me? Rationally I know that neither of these outcomes are particularly likely. I feel that what I told her in our first session gave her a good insight into how I think about myself and interact with those around me. Having said that, as I reflected on our conversation in my diary later that evening, I did write a list of the more significant neuroses that I have yet to discuss with her and which I feel that I must remember to raise next time! I don’t think that this is to test her. Rather, I suppose I want her to understand that while I have made huge progress over my time with Alexis, there are still significant areas of my life that I find incredibly difficult. She may well have a sense of this already. During our first session, I told her that I do a good line in self-loathing, though this is nowhere near as extreme as it was in my teenage years and early twenties. When she asked me what was worse than self-loathing and how I would have described it at the time, I said that I would not have had the words with which to articulate it, since I was not in the habit of self-reflection or talking about my feelings. I am very glad that I am now very much in that habit, and very glad that I seem to have found a new psychotherapist.

 

Adventures in Psychotherapy Number 1: I miss my therapist

It has been eleven weeks since my last appointment with Alexis. It has been incredibly hard.

I always find the dark weeks after the Christmas holidays challenging. SAD definitely has a negative effect on my mental wellbeing at this time of year. I attempt to counter its impact with light therapy, cosy nights in, comfort food, fun trips to the theatre or the cinema, retail therapy, sensible early nights and generally trying to be as kind to myself as possible until I make it to half term and feel that there is some end to the murkiness in sight. A trip away always helps, and this half term break I went to Paris for a few days, where I finally felt that the weight of the preceding six, dark weeks had been lifted from my shoulders, at least temporarily.

As the date of my last appointment with Alexis crept ever closer at the end of last year, I was increasingly prone to moments of panic in which I tried, and failed, to process what life without her support would look like. I just couldn’t fathom what it would feel like to know that I would no longer be seeing her twice a week, and to know that the sense of security I felt thanks to those sessions would no longer be there. I had been seeing Alexis for a very long time. She knew (and knows) more about me than anyone else in my life, and her knowledge and understanding of how I have been and how I have changed validates the progress I have made, and gives me hope that things can continue to be better.

When it came to it, I feel that I coped with the ending better than I might have expected to, at least initially. I didn’t spend the whole of Christmas crying, and in a way the anticipation of our last session was more difficult to handle than the event itself. I left my last session with Alexis happy that I had had the chance to communicate everything that I wanted to, about how much the relationship had meant to me, and about how grateful I was for everything she had done for me. I do not cope well with the unexpected – the day that Alexis told me she was retiring sooner than expected was one of the most difficult days of my life – and I feel much calmer when I can retain a sense of control in a challenging situation. I knew when my last session with Alexis would be and so I could prepare myself for it psychologically, and with the kind of military precision that I put into planning for any potentially difficult experiences. I wanted to buy Alexis presents, and also to write her a letter to say goodbye. These acts were important to me in and of themselves, but also served the broader purpose of helping me to establish some sense of control in a situation in which, ultimately, I had no control at all. It is almost as if I seek to stage manage difficult situations, in the hope of somehow reducing their ability to have a negative emotional impact on me.

The fact of Alexis’ retirement is an irreversible one. She has described my experience of the end of our relationship as a bereavement. While the last thing I would want to do would be to belittle others’ very real experiences of very real loss, the end of my relationship with Alexis does have that sense of finality to it that I might associate with a death. When I am feeling low and unable to cope with the fact that I am no longer seeing her, I feel overwhelmed by a sense of panic whose origins lie in my awareness that there is nothing I can do to change the situation, nothing I can do to  halt the passage of time, and no way that I can go back to our twice weekly sessions.

When I was at school I had a parallel existence playing on a screen in my mind most of the time, an escapist drama in which I was a better, more attractive and more successful version of myself. The events of my day to day life would be reinterpreted and rose-tinted, and I would then experience them again in my thoughts and daydreams, a much more satisfying version of the life I was actually living. To an outsider, this re-processing of my daily life might seem unbalanced or even slightly mad. It became such a regular feature of my thought processes that to me it was completely normal. Almost everything would be experienced twice – once in the harsh light of reality, and then again in the softer focus of my mind.

This daydreaming became not just a habit but a ritual for me. In some ways it was a great source of comfort: however difficult daily life was, however negatively I felt about myself, I had the comfort of knowing that I could experience it again with far more positive outcomes. I would often revisit the day’s events as I lay in bed, trying to get to sleep. In this sense, my daydreams were a kind of emotional comfort blanket, which helped me to overcome the insomnia and anxiety that regularly assailed me when the activity of the day was done. On reflection I also feel that my daydreams helped me to find some kind of limited outlet for my creativity. They certainly enabled me to express my wishes and desires. On one hand, my daydreaming enabled me to do this in a safe way, since I was always in control. On the other hand, I gradually came to an understanding that it had become a very unsafe and self destructive  way of thinking and being. If my wishes were safe within my head, I didn’t have to engage with them, or take any steps towards their realisation. In this way, my daydreams became a form of inactivity. Furthermore, the rose-tinted retelling of my daily life inevitably set up a comparison with reality. This in turn reinforced all the negative thoughts I had about my day to day life and about myself, albeit largely on a subconscious level. The daydreams were a way of coping with my difficulties, but also precluded any engagement with them. This daydreaming habit continued well into my twenties, and it took a real effort of will to force myself to break the habit, once I really began to focus on how self-destructive it was. Even then, I would occasionally go back to it in moments of crisis. Sometimes I would allow myself an indulgence, but more often I would catch myself at it and shut my thought processes down before I allowed myself to go too far.

So what has this got to do with Alexis?  (It’s not what I intended to write about when I started this post…)

Sometimes, as a teenager, I was so so desperate for the rose-tinted version of my life to become reality that I almost convinced myself that I could will it into existence. I thought that if only I had the confidence to start acting like the version of me that existed in my head, I would then, magically, become that person. I might be myself (of course), but (incidentally) incredibly pretty, French, and from a wealthy family. I only had casually to start speaking in French and in character to my French teacher at school and lo and behold! I would become the person that in the most hidden corner of my heart I desperately wanted to be. Of course, on a very real level I knew that this was nonsense. Nonetheless, sometimes I was so, so unhappy that I became incredibly anxious that I might actually follow through and attempt to assume the role that I played in my daydreams. That in turn made me even more anxious, since I felt that any such behaviour would represent a turning point and the beginning of a descent into some kind of madness.

My daydreams reflected an ongoing need to control my identity and my surroundings. In my daydreams, nothing untoward or unexpected could happen. No one got old or died (unless for dramatic effect), and nothing happened that could not easily be reversed. My anxiety about acting out my daydreams in real life nontheless reflected a profound wish to be able to control my fate and the passage of time. (I would often have a very clear sense of where my parallel life should start were it to become a reality, and this often involved re-living recent months or even years.) In a way, I have felt similarly about my inability to control the end of my relationship with Alexis. I often drive past the flat where we had our sessions, since I park nearby to get the train home from work. I challenge myself not to look too intently at the flat, and don’t allow myself to reminisce about the many, many times I have stood on the doorstep waiting to ring the bell precisely on the hour. I have worried about what would happen if I allowed myself to wander too far down that path. One possible outcome is that I might find it so difficult to cope with the fact that our relationship is over that I decide to will it back into existence. I have flashes of an image of myself standing on the doorstep, ringing her doorbell, and hoping that by doing so I can will her out of retirement, back into the flat and back into our relationship. Again, as with the daydreams, I ultimately know that I am unlikely actually to do this. Nonetheless, were the end of our relationship to become intolerable, I could imagine myself outside her old flat, ringing her doorbell, crying and desperately hoping that she answers.

 

Managing my Mental Health Part 5: New School

I started a new job in September 2016. I was appointed in April of that year. Prior to beginning the process of applying for jobs, I had considered how to manage communication around my two weekly appointments with my therapist. It didn’t seem right – or in fact, advisable – to put this information on any application form. I also decided not to share this information at interview. I think this decision was based more on my concern that it might appeared presumptuous to be discussing my appointments and the impact this might have on my working hours before it was even clear that anyone had any intention of offering me a job, rather than on any anxiety about how a potential employer might feel about my relationship with my therapist.  In any case I had to discuss it soon enough, when the Head of the school at which I had spent two days interviewing for Deputy Head called me on my way home to offer me the position.

had decided that I would tell the Head immediately, in the event of being offered the job. I let him know about the appointments, and about their impact on my working hours. In fact, my new school is much closer to my therapist’s flat, so my afternoon appointment now required me to leave twenty minutes after the end of the school day, and the morning appointment meant that I missed a Friday morning Leadership Team briefing and morning registration, but no teaching time. The Head’s response was to thank me for letting him know, but also to say that it wasn’t ideal. I felt a range of emotions after our conversation. Of course, I was extremely happy to have been offered the job; I felt worried about how his opinion of me would be affected now I had shared this information; I felt bad that I had sprung something on him out of the blue and I hoped that he did not feel that I had in some way tried to ‘hoodwink’ him by not telling him during the interview process – though I really don’t see how I could have done.

Having now got to know my Headteacher, I understand that his response was probably a surprised one, but was also a factual one. His comments were not loaded in any way. It isn’t ideal for your sole Deputy Head to leave early one day a week – though I would often return to school after the appointment (those appointments have of course now finished.) However, I feel that now he has got to know me, and now we have established a very positive working relationship, he would probably agree that the inconvenience of that Tuesday afternoon appointment was outweighed by the frequency of our communication at other times, and by the way in which I manage my workload. The Head has shown that he is very understanding of and sympathetic to issues surrounding mental ill-health, and I have seen this in particular in the way in which he has handled meetings with staff who have returned to work following periods of absence. He is genuinely concerned about his staff, and is not at all judgemental. On the day that I found out that my therapist was taking early retirement, he happened to ask me how I was. I was extremely upset, but he was incredibly supportive, even returning at the end of the day to check that I was okay and that I would be seeing friends over the weekend. He also showed a similar degree of concern and care when it came to my last appointments with Alexis, even allowing me to come into school slightly late after our final session, aware that I would be in no fit state to teach my first lesson.

Being in such a supportive environment can have (and for me, has had) a hugely positive impact. As far as I am aware from what he has told me, the Head of my school has had no direct personal experience of mental ill-health, although he knows people who have. However, he is scrupulously professional and aware in his interactions with his staff. He is also a very decent human being.

My time at my new school has made me aware of the importance of having managers who follow procedures, who do not impose any personal judgement on their employees’ mental health, any more than they would on their physical health, and who genuinely make an effort to understand difficulties, illnesses, experiences and conditions of which they may themselves have no personal experience. All of these can be extremely beneficial in terms of the wellbeing of their staff.

It has also made me aware of the challenges inherent in communicating issues relating to mental health to a new employer. I was very lucky when I moved to my current school. Everyone should feel that they can be open about the support they need to maintain their mental (and physical) wellbeing, It shouldn’t just be the luck of the draw. This is why I go back to the wish I expressed in the very first blog in this series: that the government shows that it is serious about supporting the nation’s mental health, and takes clear and decisive action to ensure that employers adopt the recommendations of the Thriving at Work report. These recommendations could represent a sea change in terms of the management of mental health in the workplace, and have an enormous effect on the wellbeing and also the productivity of the nation’s workforce.

Managing my Mental Health Part 4: 2014

The academic year 2013 – 2014 began fairly well for me, and I feel I was relatively resolved to put the difficulties of the very end of the previous school year behind me. I was still struggling with depression, still on medication and seeing my therapist twice a week. Sometimes there can be clear triggers for particularly challenging periods of depression, and sometimes it just happens. Aside from the passage of time, my general dissatisfaction with the direction my life was taking, and the pressures of work, there was nothing in particular that had changed, nothing I could identify as the trigger for the downward spiral I had been on for most of that year. Nor was my life entirely dominated by depression. Even during my darkest periods, I have still seen friends, been to the theatre, travelled, and tried to make the most I possibly can of life in London, time and money permitting.

am able to identify two clear events that had a significant impact on me that autumn, and which probably accelerated the downwards trajectory I was already on. Perhaps had I been on more of an even keel, I would have had the resilience to cope much better, but as it was, both contributed to my increasing sense of despair. In September, I unexpectedly learnt that the fiance of one of my dearest school friends had cancer. It was the first time that any of my contemporaries had come face to face with the disease, and my sense of the injustice of the situation was exacerbated by what my friend and her partner had already experienced in their family life.  I was overwhelmed by sadness at what he was going through, and by concern for both him, and for my friend and the rest of her family. I know that my other school friends felt very similarly, and I would not want in any way to suggest that the situation affected me any more than it did any of them. However, in my frame of mind at the time, I found it very hard news to process.

A few weeks later, one of my dear friends whom I also line managed since she was Head of Languages at my school, told me that she had breast cancer, and would shortly be off work to begin treatment. Of course, I found this news really shocking and upsetting, particularly since for a period of time I was the only one of her work colleagues that she had told. I felt really touched that she had wanted to tell me, really worried about how she would cope with the treatment, and also felt so much emotion about the air of calm and resolve with which she was handling her situation.  When she was signed off a few weeks later, I stepped in to line manage the Languages Faculty (she was Head of Faculty, and line managed a team of Heads of Department. I had held the role before my promotion to Deputy Head.) This effectively meant that I was attempting to do the essential parts of her job, while at the same time continuing to do my own. I made this decision for a number of reasons, some of which have only become clear with the passage of time and through discussion with Alexis. I felt a huge sense of loyalty to the school and to the students, and wanted to ensure that the Languages Faculty continued to function as efficiently as possible. I also felt that I could support her in some way by ensuring that things didn’t fall apart in her absence. Finally, this was a situation in which I felt a lack of control. I find that very difficult, and have a tendency to want to assume responsibility for solving problems and easing difficult situations and relationships, even when they are not of my own making. I have realised that by taking over the running of the faculty, and supporting staff and students, I was seeking to impose a sense of control on a situation that I found incredibly challenging on an emotional and also practical level.  And speaking of practicalities, however much I was perhaps more willing that I should have been to assume additional responsibilities, there was no discussion within my school or between me and the Headteacher to decide what should be put in place to cover my colleague’s absence. He tacitly acknowledged that there was no one in the Faculty who could or would step up to take the role on, but offered no further opportunities for discussion, or any other solutions.

Within about a month of my colleague being signed off, I was finding the dual responsibility very challenging. I was off ill on my birthday at the start of December, and then was signed off a week later for the remainder of the term. When I went back to work in January, mindful of how difficult it had been for the school to managed a return to work with reduced responsibilities, my doctor instead asked for a two-week phased return of half days. This meant that I went home at lunchtime each day. Physically not being in the school definitely helped reduce the pressure I felt on returning to work, and gave me more time and space to continue to focus on feeling more positive and more able to cope. To be entirely fair to the Headteacher, he did try to discuss ways in which the school could support me in our weekly meeting on my return to work. I raised my concerns about the amount of work I had had to take on, and the fact that I felt that no one else had been asked to step up to assume greater responsibility in my colleague’s absence. He asked me about upcoming school trips I was scheduled to accompany. He said he was concerned that I might feel more stressed being out of school for the duration of the trips – though only one was in term time – and also raised the question of whether I would be a risk to myself or to other people. He didn’t really offer any solutions in terms of how the school might support me, but at least he was trying to engage in a productive discussion.

Despite the support of a phased return, I was still struggling with depression and suicidal ideation and my GP referred me to my nearest mental health team.  I initially undertook a telephone assessment with a nurse, who then organised an appointment with a psychiatrist a week or so later, and called me regularly in the meantime, as far as I could tell to check that I hadn’t killed myself before I could attend the clinic. Going to the clinic for the first time – around a week after I returned to full-time hours at work – was certainly very challenging. Over time I have become less and less concerned about the stigma associated with mental health problems and have increasingly sought to be open about my mental health. I have long since stopped worrying about whether I sit on a chair or lie on a couch at my therapist’s, about how frequently I need to see her, and about the variations in my prescription dose of antidepressants. Even at the time of my visit to the clinic, I had cast off most of these concerns. However, a first visit to a mental health clinic is a big step. It is the unknown, and there are various visual clues that reinforce the fact that this is something out of the ordinary. All of the doors had key pads, meaning that you were unable to leave the waiting room or indeed go anywhere in the building without being accompanied by a medical professional. There was a notice outside advising visitors what to do in case of a mental health emergency if the clinic was closed, and the waiting room was full of posters and literature advertising services for people whose social and mental health needs were clearly more pressing and life-threatening than mine. Actually, when I finally saw the psychiatrist, that was the least disorienting aspect of the whole experience. I am not sure whether I expected him to interrogate me at length about my mental health, to offer me advice on how best to manage it, or express concern at my frequent suicidal thoughts. In the event, he was a practical but seemingly  – from the state of his office – very disorganised man who had a brief chat with me and then prescribed some new antidepressants and a follow-up appointment in a few weeks.

The appointment was a very unsettling one, and seemed to represent a step change in the way in which my depression needed to be managed, suggesting that my mental health was deteriorating. I was unable to shake the effect that it had on me, and I was absent from work the following day, unable to process and move on from the feelings it had aroused. On my return to work, I had a meeting with the Headteacher. I don’t remember exactly what we discussed, but the sad face emoji I have drawn in my diary suggests it was not a particularly positive conversation… What I do remember is that the next day I received a letter from him, inviting me to an informal review meeting in line with the school’s sickness management policy and procedure. I reproduce the contents of the letter below:

Dear //

Re: Sickness Management Policy and Procedure: Invitation to informal review meeting.

I would like to invite you to a meeting to discuss my concerns in respect of your health and recent absence from work since 11 December 2013 as a result of depression, your subsequent return to work on 6 January 2014 and then my agreement, on the advice of your GP, to a two-week period of phased working of half days only, up to 17 January 2014.

As we discussed at my meeting with you on 29 January 2014, whilst I appreciate your attempts to be in work, I am concerned about your welfare and that following one week of full-time working you then reported feeling unfit for work again and were absent on Tuesday 28 January 2014. I have encouraged you to seek further advice from your GP.

As you are already aware you are scheduled to attend an Occupational Heath review on Thursday 6 February 2014 and I anticipate receipt of their report early the following week so I would like to invite you to a further meeting when we may review the circumstances in respect of your levels of absence to date, including any medical advice received, and to positively and constructively discuss options to improve your future attendance.

The meting with take place on Thursday 13 February at 10.20am in my office and will be held in accordance with the school’s Sickness Management Policy and Procedure, a copy of which I enclose for your reference.

I will be conducting the meeting and will be accompanied by /// from /// [the school’s personnel company]. // [the Head’s PA] will be present to take notes.

You may, if you wish, be accompanied at the meeting by a trade union representative or a work colleague.

I would like to stress that this is neither a disciplinary matter nor an attempt to determine whether your absence or health concerns are legitimate.

The meeting will allow us to discuss the standards of attendance expected from you in your role, including the impact that your absence has had on service delivery and colleagues, and to explore whether there are any further adjustments that can be made to your role which may assist in facilitating your sustained attendance at work.

The intended outcome of the meeting is that we will agree an action plan that will clearly identify:

The improvements necessary to achieve the expected standards of attendance.

The timescale for improvement

Additional support to be provided

Any temporary or permanent work adjustments

The review period and

How attendance will be monitored.

I would be grateful if you could please confirm that you will be able to attend the meeting and the name of any person accompanying you to the meeting at least two days prior.

If you have any questions or concerns please do not hesitate to contact me.

Yours sincerely,

//

Headteacher

It is quite hard for me entirely objectively to evaluate the exact extent to which this letter and the procedure it put in place was at variance with the school’s sickness management procedure. What I do know is that the receipt of this letter caused me a great deal of distress. Even setting aside the fact that the procedure followed was not, in a number of ways, the one set out in the policy, there was no verbal communication in advance of it landing in my pigeonhole. I had met with the headteacher the previous day; he could easily have advised me that we would have a meeting to discuss ways in which the school could support me, and ways in which I could work to improve my attendance He chose not to do this and the letter arrived out of the blue.

It was entirely appropriate for the Headteacher to request a meeting with me to discuss my absences. The school’s policy stated that an informal attendance review meeting could be triggered in the case of a total of 11 days absence in a rolling 12 month period. After my two weeks’ absence prior to Christmas, I was well over this. The Head also stated in the letter – though I subsequently discovered that it was not written by him – that while he appreciated my attempts to be in work, he was concerned about my welfare. That may well have been true – or at least, was the official position the Head needed to take – but it didn’t feel it at the time. In fact, there were a number of reasons for which I considered that the policy was not being followed correctly, and that I was being treated differently, whether because I was a Deputy Head in the school or because I had a mental illness rather than a physical one (or a combination of both.) Firstly, the way in which the letter was delivered, seemingly with little regard as to the effect it might have. I have delivered a number of similar letters myself, and have always sought to do so in person. Secondly, the people who would be present at the meeting. According to the school’s policy, the first stage in addressing staff absence should be an informal Attendance Review Meeting. The policy stated ‘normally [personnel company] or trade union representatives need not be involved at this stage, but this can be varied by mutual agreement. Not only was the presence of the representative of the personnel company presented as a fait accompli, but the letter also advised me that the Head’s PA would take notes. There was no prior discussion regarding the attendance of either person. A small point perhaps, but this and other issues combined to cause me a great deal of distress and to make me feel personally and professionally vulnerable at an already very difficult time. In the event, the representative of the personnel company was a reassuring and proactive presence in the final meeting, and played a key role in highlighting the school’s responsibilities towards me. As far as the Head’s PA was concerned, we got on well, and I had (and have) absolutely no doubts as to her professionalism and awareness of the need for confidentiality. However, the meeting was about very personal issues, and I felt strongly that I should have been asked whether I was happy for her to be there. I raised this as a concern and asked for the school’s personnel manager to be there instead.

Aside from these issues, the policy advised that the meeting was “an opportunity for the employee to advise the manager if there is an underlying medical problem.” The school already knew what my medical problem was. The policy also made reference to the Disability Discrimination Act 1995: “Headteachers should be alert to the possibility that sickness absence may amount to a disability under the Disability Discrimination Act 1995.” It went on to state that in this instance special care should be taken and adjustments might need to be made. This is an area on which I remain unclear, and is another aspect of the management of my illness at the time that caused me a great deal of upset. There were other staff in my school who suffered from long-term, debilitating physical illnesses, such as colitis or chronic arthritis. I was aware that they had not been asked to attend similar meetings. When I subsequently met with staff suffering from these sorts of conditions as their manager, it was an informal meeting, in line with the policy’s guidance: we would meet face to face following advance notice of the meeting, discuss the condition and ways in which the school could support, make any appropriate adjustments and a referral to Occupational Health if necessary, follow-up with a letter and then review after three months. Following that three-month review, if the person’s attendance had not improved, he or she might then be invited to a formal review meeting. A further and serious deterioration in a member of staff’s attendance could then lead three months later to a Contractual Review meeting, at which the feasibility of the person’s continued employment might be considered, possibly leading to eventual dismissal.  However, progression to a formal review meeting rarely happened with staff who suffered from a long-term condition which, while increasing their absences from work, did not prevent them from fulfilling their role.

While a condition relating to my mental rather than my physical health, my depression was a long-term and at times debilitating condition. I understand that had I sought to do so, I could have asked my GP to write me a letter confirming that she considered it a disability, which would have helped me gain protection under the Equality Act.  I did not think to do this at the time. Instead, I continued to dwell on my perception that my mental health problems were being treated differently, and continued to experience a great deal of additional anxiety and distress as a result. The school’s policy stated that “following the attendance review meeting the employee should be allowed reasonable time to demonstrate an improvement in their attendance. As a general guidance this monitoring periods would normally be for a period of three months, although there may be occasions when a shorter/longer term monitoring period would be reasonable. ” As with a long-term condition such as chronic arthritis or colitis, there is no guarantee as far as time frames are concerned with depression. This statement left me with a clear and extremely worrying sense that I had three months to get better or my position in the school was at risk. Again, the lack of communication about the meeting and its intended outcomes before I received the letter, my perception that an informal review meeting was being escalated to a formal review, and my awareness of the way in which other long-term conditions were treated in the school all combined to make me feel incredibly anxious and vulnerable. I felt at the time and I think still feel now that actually my life would have been easier had I been signed off for six months. My GP was entirely willing to sign me off for an extended period of time, I would have been on full pay, and I would have gone back to work when my symptoms had become more manageable, which by the summer they had. I didn’t want not to be at work. I don’t know whether this was the right or the wrong decision – when you are in the grip of depression it is hard to think rationally, to weigh up the pros and cons. Being at work gave me periods of relief, a sense of purpose, and social interaction. I would be at home, thinking about when my suicide would cause the least inconvenience to the people who would have to deal with the fall out, or worrying about who would look after my cat, and then could go to work, teach a lesson and have a coffee with a colleague, and genuinely experience a moment of light and happiness. I do know that throughout this period work was probably not only the thing that kept me sane but also the thing that pushed me closest to the final edge.

The meeting took place two weeks later, two weeks which were among the hardest I have ever had to endure. Looking back at my diaries, I noted that at the end of one of our sessions Alexis told me not to do anything that would make her angry between then and our next meeting, by which she clearly meant – as I understood it at the time – that she would prefer me not to kill myself before she saw me again. I saw the Occupational Health doctor during that period too. In his report to the Headteacher, he made a number of points, the most salient of which I include below:

  • She has suffered from depression over the last four years, with little effect on attendance in that time. She has benefited from regular sessions with her therapist, increased in 2013 to twice weekly.
  • Her condition is stable but chronic. She continues much the same week by week. She manages all normal day-to-day activities, but continues with some symptoms of her condition especially irregular sleep.
  • She continues fit for her own work….

I have the following general comments and suggestions:

  • I have reviewed work related factors in her case. There is a temporary increase in workload due to covering colleague absence.
  • She has taken appropriate medication, recently increased, and has enhanced her talking treatments, and will be engaged with the specialist in March.
  • Her brief absence before Christmas and phased return in the New Year have helped her, and her condition has improved, and there is a good prospect of attending work regularly.
  • She would appreciate general stress adjustments of adequate support and supervision, appropriate workload and clear duties and responsibilities.

The head had asked specific questions about the impact of my depression on my ability to fulfil my role, and the doctor made various observations including the following:

  • Her range of duties is not a work-related factor for her, however she will appreciate support and development as required.
  • Her underlying medical disorder is treated appropriately, seems to be under control, and she should be able to attend work regularly, with suggestions outlined above.
  • The two sessions of counselling are part of her treatment and in her case are vital to her management strategy, at least for the next 6 months. She will try to arrange the timing to minimise impact on working hours.

I took my dear, dear friend Kate to the meeting with me for support. She was incredibly kind, understanding and supportive both in the run-up to and also during the meeting, and I will always be grateful for this. In fact, Kate, the personnel manager who was writing the minutes and the representative from the personnel management company were all extremely kind and helpful in the meeting, and in many ways it turned out to be a positive experience, albeit an incredibly difficult one. Whether or not the Head was kind, I really couldn’t say. Most of the acknowledgement of the issues I raised, and most of the suggestions as to how to move forward came from the personnel representative.  Obviously the Head was calm and polite, in a way in which he often was not in meetings before and after this one, not least I suppose because other people were there. In any case, so much had gone before the letter and the meeting that I found it hard to accept anything positive from him, either then or later. Addressing some of the issues raised by Occupational Health, I mentioned that I had found it really helpful that S., the previous Head, had always recognised the challenges of the job for the leadership team and had always taken the time to ask how we were. However, I went on to make the point that in the situation in which I now found myself I did not want to be asked about or to discuss my emotional and mental state with the Head, since any enquiry on his part simply felt like an additional pressure.

My anxiety prior to the meeting – and also my general, ongoing reliance on the written word – meant that I had prepared copious notes prior to the meeting. By the time it came around, I had pretty much memorised the contents of the letter I had been sent, and constantly re-visited those parts of it that I found most upsetting or unjustified. The notes covered the things that I felt it was important that I should have the opportunity to express, and I was given the opportunity at the start of the meeting to raise my concerns and to respond to the fact that the meeting had been called. When I look back now at those notes, I feel very emotional. I no longer work at the school, and am no longer affected by my anger at how I was treated, not least because the meeting did lead to short-term positive change, albeit not instigated by the Headteacher. I do feel very sad at how vulnerable, scared and unvalued the experience made me feel and I do feel angry, given my ongoing conviction that procedures were not applied in the way they would have been had I been suffering from a physical rather than a mental illness. As I said in the first of the posts about the management of my mental health, my experience was just my experience. But I know other people who have been through equally if not more challenging experiences when they have been experiencing periods of mental ill-health, both in the teaching profession and elsewhere. Policies and procedures are of little use if they are not followed, or if they are supplanted by a manager’s personal view of mental illness, or if there is no recourse for those who feel that their mental wellbeing has not been managed or supported correctly. Clear structures but also clear systems of accountability need to be put in place to support individuals and groups within the workplace. I continue to hold out hope that the recommendations made in the Thriving at Work report may still be implemented.

Returning to my own experience, as I have said, the meeting did lead to some positive outcomes for me, which helped me in terms of managing my mental health. I wanted to emphasise that while my depression was not caused by my job, it could at times be an exacerbating factor. It could be a source of stress – not just for me, but for members of the Leadership Team and a whole range of staff. The meeting gave me the opportunity to highlight recent circumstances that had made my working life especially difficult. In particular, I highlighted the lack of support around my colleague’s absence. There had been no proactive discussion around how to manage her workload. I was finding the situation personally difficult due to the illness of a close friend, and it was also incredibly challenging on a professional level, given the ongoing stress and anxiety in the Languages Faculty. The representative from the personnel company was very clear with the Head; in the case of staff absence, adjustments needed to be made, to ensure that the member of staff’s work could be covered in a manageable way. As a result of the meeting, certain responsibilities were removed from me in other areas, and other members of staff were given enhanced roles and salaries, to support me and the Faculty. These adjustments made my workload more reasonable, and certainly contributed to my recovery. While according to the school’s policies the personnel representative should only have been in attendance with my prior agreement – which given my anxiety about the meeting I would probably not have given – her presence in the meeting, her direct guidance to the Headteacher, and her kindness all helped me a great deal. Arguably – and this was the point she made – the Headteacher should have recognised the need for and then made these adjustments at a far earlier stage. His failure to do so pointed not only to lack of concern for my professional and personal wellbeing and for that of the staff I was managing, but to broader issues relating to the management of staff illness and absence.

I addressed various other issues arising from the letter that I had been sent and how it related to the management of my condition. In particular, the apparent divergence from the procedures set out in the policy, which had made me feel incredibly anxious and also that there was a wider motivation underlying the way the meeting had been organised – namely, to put an agreement and timeframes in place that would ultimately lead to my dismissal, or to put me under such significant pressure that I would choose to walk away from my job. Even now, looking back to that time, it hard for me to work out the extent to which this anxiety was due to my paranoia and depression. As I have mentioned, I was doing well in my job and received extremely positive feedback from the governors, external organisations, the Headteacher and those that I line managed. No significant concerns had ever been raised about my professional capabilities. It seems illogical and unlikely that the school would have wanted to get rid of me, under normal circumstances.

What was clear to me however was that the Head showed very little awareness of issues relating to mental illness – both in relation to me and also to a number of other members of staff during my time at the school – showed little willingness to learn, and also that he found managing me, and my condition, very difficult. I am sympathetic about the challenges of working with someone who is struggling with their mental health. My condition was unpredictable in ways that perhaps a broken leg or recovery from an operation might not have been. While the long-term illnesses of other members of staff that I have mentioned – colitis, or chronic arthritis for example – might provide a more appropriate analogy, those were illnesses whose effects were visible in ways that the effects of my depression often were not.  In any case, my sympathy is limited by the Head’s lack of personal or professional engagement with my workload or condition. His mismanagement of my workload that year, plus the way in which the meeting was arranged, directly contributed to my anxiety and therefore to my fears about a possible agenda behind it.

I have been very lucky to work with people who are instinctively supportive and understanding. I have also worked with people who have undertaken further to develop the leadership, managerial and interpersonal skills that they require in their role. Particularly when one takes on a leadership role, I feel a degree of honest, critical self-reflection is essential. Managing people is never straightforward, even without the added complications of the impact of people’s health or events in their personal lives.

Despite my anxieties and the distress I had been feeling in the run-up to the meeting, I was angry enough at the way in which I felt the school’s policy had been misapplied to be determined to address this issue. I said that ‘according to the school’s policy the informal review meeting is not usually attended by someone from [personnel management company.] The policy states that this can be varied by mutual agreement. The letter advised me that [representative] would be attending, and I did not feel that I would say that I did not want her to be there. Her attendance, alongside the fact that the meeting was originally going to be minuted by [Head’s PA], has caused me significant anxiety. As has the fact that I was sent a formal letter, since this is not standard procedure for an informal attendance meeting. All of this combines me to give me the impression that we have moved to the formal stage of the policy without first having had an informal meeting. I also feel anxious as when I was last off for an extended period of time due to depression, for three weeks in 2011, this kind of meeting was not held on my return. [This had been under the previous Headteacher, S.] Therefore I feel that my absence in itself is not the sole reason for this meeting, since the procedure that is being followed is different.’

I don’t remember precisely what was said in response to this, in terms of the application of the school’s sickness management policy and procedure. I then went on to raise other points around my attendance, and the wording of the letter. Once I had finished, the personnel representative apologised for the way in which the standard wording of the letter – for which she was responsible – had aggravated my anxiety, addressed the issue of my workload and sought to reassure me that the school was seeking an outcome that was positive for all parties. Following this meeting, there was only a very cursory review meeting after three months [again, not in line with the school’s policy], and I generally knuckled down and got on with my job as best I could. By the following September, I was feeling significantly better, and my colleague had returned to work following her treatment for cancer.

I think it is useful to reproduce here some of the other points I prepared for the meeting, if only to illustrate the impact that it had on me. Again, to reiterate, I do not feel – nor did  I feel at the time – that a meeting should not have taken place. I do feel that the meeting took place at the wrong stage in the school’s sickness management policy, and that the communication around it was mismanaged.

‘The letter refers your agreement, on the advice of [my] GP, to a two-week period of phased working of half days only. This phased return was in fact a stipulation of my certification for a return to work.  When I returned to work after my last period of absence, the doctor indicated that I should be given reduced responsibilities. This was not organised effectively and provided me with very little material benefit when I first returned to work. It was for this reason  that the GP indicated that I should work half days in the first instance. I now feel that this has counted against me.

My attendance overall is very good. Even allowing for the recent absence of 10 days, since September 2010 I have been absent for a total of 40.33 days. This includes 14 days signed off in May 2011 and 8 days in December 2013, a total of 22 days. This leaves only 18 days of absence in three school years and one term, a period during which I have been suffering from depression.  The letter states that ‘this meeting will allow us to discuss the standards of attendance expected from [me] in my role.’ I am fully aware of the standards of attendance expected in my role and want to achieve them. I could have stayed at home after Christmas. My doctor let me decide where the best place for me would be. There are advantages and disadvantages to being at home and being at work. I assumed that it would be preferable for me to be in school as much as possible, but to stay at home if I have a particularly bad day. I assumed that the school would prefer me to be here. I now feel that I am being penalised for this assumption, and that this meeting would not have happened at this stage had I been signed off for longer.

I have a long-term condition and I am living with it and seeking treatment for it. I cannot stay at home until I am better for two main reasons: firstly since that would probably not help me feel any better, and secondly because I don’t know when that will be.

The letter and the policy state – if this is in fact a formal review meeting, which is what it appears to me to be  – that a period of time will be set within which I need to improve my attendance. I am concerned that if I had a physical condition such as colitis such a timeframe would not be put in place. The framework within which this meeting is taking place states that I need to be less depressed in the next three months. The fact that this meeting is taking place within that framework has caused me a huge amount of anxiety and has been counterproductive for my health. I feel incredibly anxious about having a bad day, not because I don’t want to have a bad day but because I now feel extremely worried about having to take a day off work. I feel I have to get better because otherwise, ultimately, my job is at risk. I want to get better because I would prefer not to be depressed and not to have the thoughts and feelings that I regularly have, not because I feel there is pressure from my workplace to do so.

The letter states that ‘the meeting will allow us to discuss… the impact that your absence has had on service delivery and colleagues.’ I am not sure what is meant by service delivery. In terms of my colleagues, of course I have been off work. I am keenly aware that this has had an impact on other people. However, other people have also had extended periods of absence from work, albeit for very different and in some cases very positive reasons [the latter related to frequent maternity leave absences in the Languages Faculty, which in the Italian department in particular had often led to others of us picking up additional classes or taking on additional roles.] Equally, [the Head of Faculty] has of course been off work for an extended period of time. One thing that I have found particularly stressful is the fact that the impact of this on me and my staff does not seem to have been taken into consideration.

If service delivery relates to my capacity to fulfil my role, I also feel that I am very effective in my role. Even allowing for my absences, the school is getting a huge amount out of me. If there are any issues with underperformance, I would like those to be raised explicitly so that I know what they are and so that I can ask for support to make improvements.

I am aware that in my current state of mind I am prone to paranoia and negative thinking. I do understand on one level that you are trying to support me and I also fully appreciate that mental health issues are hard to understand and also more complex to manage – I feel that myself as someone who is suffering from them. On the other hand, the way in which the sickness management policy is being applied has made me feel very vulnerable. I feel that trying to identify the extent to which work is a factor in my illness is on one hand almost an attempt to cover the school, and on the other a possible way of proving that I can no longer do my job.’

Typing up these notes, I have wondered how the feelings they express will be received. Some of you may feel that it is understandable that I felt the way I did, given the way my condition and my absences were managed. Others may feel that the school was doing its best in a very difficult situation and attempting to apply the school’s policy as best it could to an unusual situation – unusual in the sense that it involved mental rather than physical health, and a member of the school’s Leadership Team.  I personally continue to find it hard to evaluate what happened, or to separate it from issues that arose both before and after that time. Writing this blog has nonetheless provided me with a valuable opportunity for reflection and to organise my thoughts.

I have also wondered about my motivation in providing so much detail about that period of time and the meeting itself. I genuinely feel that my overriding motivation in writing all five of these posts [last one to come, it’s very short I promise you!] has been my determination to both address and illustrate the need for managers to follow clear procedures when managing staff who are suffering from poor mental health, and the need for protection and support for those employees when procedures are not followed. I have of course also had to consider whether an additional motivation was the opportunity to settle old scores. I don’t believe this to be the case, though of course you may disagree with me. The people who read this blog and who can identify the players in this story are limited in number, and are probably aware of much of the detail already. For others who read these posts, I hope that I have managed to communicate something around my broader aims. Since 2014, I have had occasion to line manage a number of people who have been experiencing mental health problems, and I have always sought to be as understanding as possible, and to anticipate and allay their fears. I have tried to identify opportunities to make adjustments that might enable them to continue in their role, but have also, at times, encouraged them to consider whether a period of absence from work might be the best thing for their long-term health – thought of course the final decision must always be their own. I hope that I can continue to support the people I work with in the way in which they have supported me, and in which I hope they would continue to support me in more challenging circumstances, should the need arise.

 

 

  

Managing my Mental Health Part 3: 2013

The next time that issues with my mental health really impacted on my ability to fulfil my professional role as a Deputy Head was in 2013. S had left the school and there was a new Headteacher in place, who had previously been one of the school’s Deputy Heads. I had a good professional relationship with him, and had been very supportive of his application for the Headship, as had other members of the school’s Leadership Team.

In the spring of 2013, I was finding life very difficult. My therapist Alexis suggested that I would benefit from additional weekly sessions with her. This was something that it took me a long time to accept. There were significant practical considerations, including the financial commitment and also the commitment of time that an additional session would entail. Beyond that though, I was worried that a move to more frequent appointments would somehow signify a turning point in my mental health; I might subsequently think ‘that was the point at which I stopped coping’, or ‘that was the period when my mental health really deteriorated.’ In the event, moving from one to two appointments didn’t mean either of those things, and much like returning to Alexis after time away during my relationship with J., it was one of the most positive decisions I have made to support my mental wellbeing. Seeing Alexis twice a week of course gave us more time to discuss the aspects of my life that I was finding most challenging, but it also meant that my sessions with her felt more integrated into my daily life, more an essential part of it, rather than a calm interlude for reflection after which I would then return to the stress of the rest of my week. There was more continuity between the issues that we would discuss in sessions and the way in which I would then approach events and difficulties on a day-to-day basis. I found it easier to hold onto some of the messages and understanding that emerged from our sessions.

The change was initially a temporary one, to see how I felt about the increased frequency of our sessions. Due to Alexis’ limited availability, the only time that she was able to offer me was early on a Friday morning. This would mean that I would be late to work, arriving at around 9.15am. While I tended to arrive at school around 7.45am, lessons didn’t start until 8.40am, and I was not teaching the first period on a Friday morning. (As a Deputy Head, my teaching load, while important, was one of the smaller parts of my role. I taught six or seven lessons over the week, compared to the twenty-two taught by a Head of Faculty, for example.) I approached the Headteacher to discuss the possibility of this temporary arrangement being put in place. The appointment I already had with Alexis was on a Tuesday after school. This meant I had to leave as soon as school finished, which in turn meant I couldn’t run detention or training sessions on that particular evening. The previous Head had always been really understanding about this arrangement, and it had continued after his departure.

In my meeting with the Head, I reiterated my commitment to my job, and my desire to be at work. I explained that this additional support would help me better to cope with the difficulties I was facing around my mental health, and would have a positive impact on my ability to fulfil my role. I should say that my attendance at work throughout the whole period of my depression and anxiety was, while not excellent, very good. I probably averaged two days’ absence a term, aside from the periods when I was signed off by my doctor. Again, throughout this whole period, no concerns were ever raised about my capacity to do my job; I continued to complete successful performance management cycles and was awarded annual pay rises. I ran whole school training, acted as a consultant for another school, trained as a Lead Practitioner for the Specialist Schools’ Trust, delivered London-wide training in Modern Languages, and added whole-school Assessment and Reporting to my other responsibilities, which included Teaching and Learning and the Language College. I say all of this simply to contextualise my request and to emphasise that any reluctance on the part of the Headteacher was not to my mind linked to his concerns about my ability to do my job. (If it were, these were certainly not concerns that he ever voiced, either formally or informally.)

In any case, the Head kindly accommodated my request for the summer term of that year. The difficulties came when Alexis and I agreed that it would be beneficial for me to continue seeing her twice a week for the foreseeable future. In discussion with her before I raised it at school, she agreed that she could begin the session even earlier, ensuring that I would arrive at work by 9am, or twenty minutes after the start of the school day. When I got my new timetable and saw that I would be teaching first thing on a Friday, I identified a potential direct swap with another teacher who taught our shared group at another time in the week, who was free on a Friday morning, and was happy to make this swap.

I was not sure how the Head would respond to my request, and also felt anxious about the discussion, since I found it relatively hard to discuss my mental health with him – he is not as emotionally open a person as the previous Head had been. I therefore arranged to meet in the first instance with the Deputy Head with responsibility for staff welfare and HR. She and I had never really got on; I found her manner patronising and insincere, felt that she blocked innovation and change on our leadership team, and was driven to distraction by the amount of work she managed to delegate or even not do, while I felt permanently snowed under. In part this was due to our differing strengths and capabilities, but the fact that her working day tended to finish around 4pm, and that she didn’t appear to do much at the weekend was almost unbearable at times. Nonetheless, she had vast experience in personnel related issues and a good understanding of the school’s responsibilities to its staff and vice versa. I therefore felt that a preliminary discussion with her would help me raise the issue of my second session with the Head in the correct way. I explained the situation, and also asked her whether I should ask for a referral to Occupational Health in support of my request.

During that discussion, the Deputy Head told me that she completely understood why I wanted to continue with the second appointment. I explained to her that I had been thinking about the different ways in which the school might be able to accommodate my request: I could make a request for a reasonable adjustment, in line with the school’s Equality and Diversity policy, which was in turn compliant with the Equality Act. I could ask for a reduction in my hours from full-time to …. whatever 20 minutes less would be in the average 60-hour week. She was quite clear: none of that would be necessary, she would present the case to the Headteacher, she was sure that he would be in agreement and we would not need to make any adjustments on a formal basis.

When I think back to this situation and to that conversation in particular, I still feel incredibly frustrated that I took her at her word, and allowed her to speak to the Head on my behalf. I think this is an example of how a failure to follow the proper procedures and policies can leave those suffering with poor mental health in a very vulnerable position. I didn’t really need her to talk to the Head on my behalf, nor to make any unofficial arrangements. I had the school’s policies and the law on my side, and was prepared to take a cut in salary to accommodate the second session if it came to it. However, I was in a very fragile state at the time, the request was related to the support from my therapist that I felt was one of the few things helping me to function on a day-to-day basis, and I felt uncomfortable and unsure discussing intimate details of my mental health with the Headteacher of my school. Therefore I chose to trust the Deputy Head, and to let her speak on my behalf.

As you may have surmised, things did not proceed as she had told me they would. She came back to tell me that the Head could not accommodate my request, since it would set a precedent for other staff to ask for similar adjustments. While writing this blog, I have found the email that I sent to my union following our meeting, and it contains details of that conversation that I had forgotten, and which make me feel even angrier and an even greater sense of injustice over how I was treated.  Amongst other things, although my session after school on a Tuesday was not the issue at hand, she raised it. She said that as a member of SLT [the Senior Leadership Team] I could be called on to stand in for the Head at any time, and asked me what I would do if this happened on the day I had to leave promptly to see my therapist. I pointed out that this had yet to happen in my five years in the role (as one of four Deputy Heads, and the most recent appointment at the time) but that if I had to stay in school to deal with an emergency then of course I would do so. I felt that her line of enquiry was intended to question my professionalism, and felt it was inappropriate, based more on her own views that any genuine concern about the efficient running of the school. She also mentioned the directed time calculations she was then undertaking for all staff, pointed out that teachers in the school were all under their maximum allocation [directed time is the maximum number of timetabled hours staff can be asked to be in school to teach, attend meetings, parents’ evenings and so on] and also felt the need to remind me that there is no limit for members of a school’s Senior Leadership Team. Again, as someone who rarely left school before 6.30pm other than on a Tuesday, and who was working as a minimum a 60 hour week, I failed to see the relevance of her line of argument. Furthermore, her working hours were significantly shorter than my own – she arrived around 8am and was rarely in school beyond 4 or 4.30pm at the latest, and to question my own commitment to the school, or to suggest that i was working insufficient hours, seemed irrelevant and also incredibly insulting. All of this gave me the strong impression that her response and questions were motivated more by her own personal agenda than by her professional role as Deputy Head in charge of HR and Personnel.

In that moment, as I sat in the meeting, along with my upset at the Head’s response, I felt so unbelievably angry with her for initially promising something she should never have promised me the first time we spoke, and with myself for allowing myself ever to believe her. I had never really trusted her, and was so, so angry that I had chosen a moment at which I felt so incredibly vulnerable to allow myself to do so. I really felt that she had failed to fulfil her HR role correctly, and that she should have advised me as to which procedures I should follow to make my request. The conversation really affected me, and while I had been and was still willing to take a cut in pay to allow my working day to start twenty minutes later on a Friday, I became obsessed with the fact that we were potentially in disagreement over such a short period of time in my incredibly long working week – and I worked longer hours than either the Deputy Head or the Headteacher. Rightly or wrongly, this came to symbolise the lack of support I felt that I had at the time from the leadership of the school. It caused me a huge amount of distress. I had been at the school for eleven years by that time, and was completely, professionally and emotionally invested in it. Even before the deterioration in my mental health, I had made innumerable sacrifices and compromises – as so many teachers do – to be able to fulfil my role effectively. Of course, many of the decisions I had made along the way – working extra hours, taking on additional responsibilities, staying home to work rather than going out with friends, giving up my Saturday to plan lessons because I refused to compromise on my students’ learning experiences despite the increased responsibilities that took up more of my working week – were decisions that I chose to make; they were not imposed on me by other people; I had a choice. Nonetheless, I had made and was making a significant contribution to the school, and felt I was getting very little in return. For a number of reasons – partly linked to my commitment to the school, to the people with whom I worked, and also due to the challenges posed by my depression and anxiety – it took me three more years finally to move on from the school. When I look back now, I realise what a physical and psychological toll those three years took on me. A significant part of that dates back to those conversations in 2013. It is astonishing how quickly signs of ill-health can become normalised: I would regularly retch or throw up in the toilets at the start of my working day; I would often feel so dizzy and nauseous that I would have to move around the school with extreme care, since any sudden vertical movements of my head would make me feel almost unbearably ill – I walked as if I were balancing valuable books on my head. It is only now that I no longer feel that way that I realise how ridiculous it was that I accepted those physical manifestations of stress as my day-to-day normality.

Following my conversation with the Deputy Head, I sought the advice of my union. I include excerpts from the letter that I subsequently wrote to the Headteacher below:

Dear ///

I am writing to you in relation to the time which I have been given on a Friday to attend a second psychotherapy appointment, to help me cope with my depression, for which I am also on medication. I am very grateful for the support that the school has given me so far. This has helped me manage my symptoms, and as a consequence to be able to continue in my role at /// with only very few days of absence related to them.

I would like to ask you to consider whether it would be possible for me to continue to receive this support from the school in September…….

I met with /// last week to ask her what my position was in terms of a referral to Occupational Health to see if the school could accommodate this additional support that I need. I am not sure how long I will need this support for at the moment. In our first meeting, she did say that OH could be an option. However, she felt that it would not be necessary and she would discuss my request with you directly. When we met a second time she discussed morning duties, [leadership team were on the gate most mornings and the session would mean I would have to miss a Friday] my timetable, prior cases that she had discussed with [personnel management company] and did not seem to think that the request could be accommodated.

I have since spoken to an advisor at my union to ask for guidance on the best way to proceed with this request. They have advised me to make this request in writing to you. They have also confirmed that I can ask for a self-referral to Occupational Health, and please take this letter as my request for that process to be put in place. They have advised me that depression, as an ongoing mental impairment, would be considered a disability in terms of our Equality and Diversity policy. I am therefore writing to you as advised by that policy to ask whether the school can make a reasonable adjustment which will help me overcome and minimise  the difficulties I face at work in light of my depression.

On receipt of this letter, the school agreed to let me continue with my Friday morning appointment. They did not make an adjustment to my salary, which meant no one had to work out what percentage of my full-time hours 20 minutes might be. To give the school its due, this was very generous, and in fact my Friday morning arrangement continued for the next three years until I left the school. However, any positives were completely outweighed for me by my perception that I had been treated both unfairly and unprofessionally. While the school had a clear Equality and Diversity policy, its guidelines had not been followed, and my anxiety and depression had been exacerbated by an inconsistent and personal response to my request. This experience definitely impacted negatively on my relationship with both the Headteacher and the Deputy Head, though it did not lessen my commitment to the school as an institution, the pupils or my colleagues. I had a clear sense that I had been treated differently due to my role within the school – not least since on numerous occasions I had seen the kinds of reasonable adjustments that were made for other members of staff – and it gave me the sense that my professional output and impact was all that counted, with no regard for my personal wellbeing. Ultimately, the way in which I was treated did not benefit the school, since I decided that I could no longer work there. During the time that I was there, I found it hard to see myself as a part of the a Leadership team, since I felt that Headteacher had shown a lack of care and professionalism towards me. I do not doubt that I was at times a challenging colleague to work with both before and after 2013 – partly due to the challenges of my mental health, and also because I am someone who will always challenge underperformance, inconsistencies, misguided thinking or complacency where I find it – I consider this to be part of the role of a leader with moral purpose. Of course another aspect of the role is to offer new ideas, innovation, leadership and support to fellow leaders and other colleagues. My time at the school gave me a great deal and I believe I gave the school a great deal in return. It is incredibly sad and upsetting to feel that it was not able to give me support at the time when I most needed it and when it had a moral and legal duty to do so.

Managing my Mental Health Part 2: 2011

The first time that I was signed off work was in 2011. It was not really something that I had considered as an option previously. I had been seeing a GP at my local practice who had been recommended to me by a friend. Great at dealing with asthma, depression not so much, it turned out. I had been on antidepressants for some time, maybe a year. Things were becoming increasingly challenging, for reasons I was finding it hard to fathom. On one previous visit to my regular GP, he had suggested increasing the dose of my antidepressants, but I had been reluctant to do this. The decision to start taking them in the first place had been a difficult one. I have since talked to many people who have been prescribed medication for anxiety or depression. I think many of us have shared preconceptions about antidepressants: that they will suppress not only our negative feelings, but all of our feelings, reducing us to a zombie-like state, unable to feel anything at all, albeit released from some of the despair of our darkest thoughts and emotions. I am not sure where the origins of these ideas lie. Perhaps in films, fiction, or perhaps in the reality of the more primitive medication of the past, or stronger medication for those whose mental health problems are more serious and more debilitating. In the event, I discovered that despite some pretty difficult initial side effects – terrible headaches and chronic fatigue, in the main – the pills didn’t suppress anything, didn’t change me on any fundamental level, just made my thoughts and feelings a little easier to cope with.

Despite this, I was reluctant to increase my dose, worried that I would become over-dependent and also preferring to put more of my faith in my therapist and in other positive changes I could make to my lifestyle, in the hope of making my day-to-day life more manageable. I discussed my therapist with my GP, citing our relationship as one of the reasons I was wary of increasing my medication. He asked me how long I had been seeing her – it was ten years at the time. He was immediately sceptical, and asked why I had been attending sessions for such a long time. I said that I had various difficulties with which I needed help, and that my conversations with Alexis were really important to me. He didn’t quite snort – though he might as well have done – as he replied that everyone has problems and anyone who claims that they don’t is definitely crazy and a liar. In his opinion,  you just needed to pick a couple of them, sort them out, and then move on. I found this response very upsetting and also very inappropriate. In the moment, I think I was shocked, but the more I thought about it later on, I was also angry.

I didn’t increase my dose of antidepressants, and stayed away from the GP for as long as I could. A few months later, life was becoming increasingly difficult to cope with, and my emotions were becoming increasingly overwhelming. I returned to the GP, and finally agreed to increase my medication. His comment? “If you had put your dose up when I told you to, you wouldn’t be in this position, would you?” It’s hard to tell whether or not his opinion had a grain of truth in it – not least because my mental state then continued to deteriorate – but what I do know is that his attitude aggravated my feelings of despair, and I vowed never to see him again.

I was now asked to return to the GP on a more regular basis, to monitor my state of mind and also my response to the antidepressants. My next appointment was just after the May bank holiday weekend. I was worried that I was feeling increasingly low, but felt powerless to do anything about it. I and my friends had spent the long weekend in Devon, and on the face of it I had had a lovely time. Before we went however, I had told one of the girls that I would not be joining the group on any of our regular cliff walks, since I didn’t feel I could trust myself not to walk off the edge. While I often felt completely overwhelmed by my feelings, the moments in which I was able to engage in a  clear-sighted rational evaluation of my difficulties were almost more frightening, for the way in which I identified the dangers posed to me by my poor mental health in such a matter of fact way.

The result of my visit to my GP, this time to see a female and very understanding doctor who continued to support me for the following four years, was that I was signed off work, initially for two weeks and eventually for three.  This was not an option that I had ever considered, but it turned out to be exactly what I needed: some time and space to look after myself, to try to slow down the rush of negative and anxious thoughts, and to allow myself to focus on my wellbeing, rather than the work and daily routine that themselves were a source of anxiety and which left me with very little capacity to address the difficult thoughts and emotions that were making it almost impossible to feel that I could keep going.

I had left work to go to the GP, intending then to return and to carry on with my working day. I did go back to work, since I had left various personal effects there. Even now I have a very clear memory of going into the Head’s office to give him my sick note, telling him that I had been signed off, and then leaving to collect my belongings before driving home. At that point, there was nothing else to say really, though S – the Head – was very kind, despite the fact that I am sure that my announcement must have come completely out of the blue, given how highly developed both my coping strategies and my skills in dissimulation were when I was at work.

Over the whole period of my absence and on my return to work, S. tried his very hardest to be supportive and understanding. In this way, he also demonstrated an awareness of his responsibilities firstly as a manager in the public sector more generally, but also as my direct line manager. He offered to meet with me during my absence, to talk about how he could facilitate my return to work. This offer came after had contacted him for some reason. A period off work inevitably leads to anxiety around your impending return, and on one level this offer was a helpful one. However, the more I thought about it, the more the prospect of any interaction with any person or any practicalities at all related to work made me feel increasingly anxious. Following a discussion with my therapist and following her advice – since I often felt that she gave me ‘permission’ to make the decisions that I would otherwise have been too anxious to make – I contacted S to say I didn’t feel that I could meet, and again he was very understanding and very kind. When I finally did return to work, it was on the basis of reduced responsibilities for a number of weeks. While this was harder to achieve in practice than in theory, S tried his best to support me. Most importantly, at no point did I feel that I was being judged for my depression, nor did I feel that S considered that I was any less capable of fulfilling my role than I had been before my period of absence from work. This was crucial in enabling me to readjust to being back at work, and also meant that I felt increasingly able to discuss the aspects of my role that were having a negative effect on my mental wellbeing with my manager. I will never forget the support and kindness that S. showed me. He was (and is) a fundamentally very decent human being, as well as an effective manager. Given the difficulties I encountered later on, I have questioned whether my positive opinion of S is perhaps partly due to the fact that we didn’t clash over issues relating to the absence or the nature of my return. Had I asked for something that proved to be more problematic for the school or for S as a manager, would he have reacted in a less sympathetic way? Given the evidence I have of his kindness towards me and also towards other colleagues who suffered with poor mental or physical health, or with others of the challenges that life can periodically throw at us, I don’t believe so. Even if he had been less aware and understanding of mental health issues, I feel that his basic sense of decency and awareness of his responsibilities as a manager would have led him to seek guidance as to the appropriate course of action to take. His actions facilitated my return to work and supported my gradual return to better mental health.