Archive for July 31, 2009

Computerised CBT

All the really exciting developments in therapy these days make claim to the title ‘Cognitive Behavioural Therapy’ or CBT.  It’s a great therapy that helps you to understand the relationship between how you think and how you feel.  I know from my own practice, that for those clients that are open to the approach, they can make rapid improvements.  What about those clients that are unable, or unwilling, to visit a therapist?  Well there is an alternative in the form of online self help courses known as computerised CBT.

Do the courses work?  What is interesting is that these online courses appear to get good results, particularly for mild to moderate anxiety and/or depression.  In fact the government agency, the National Institute for Clinical Excellence, approve a number of courses that are available free through the NHS with a GP referral – well that’s in theory, as uptake by Primary Care Trusts is sporadic.

If you want a good free course that doesn’t involve getting your G.P. involved, I can recommend “Living Life to the Full” a Scottish Government funded site for depression, anxiety and life skills.  It has supported nearly 100 000 people.

Is the course for you?  Well for many men, working away ‘in our caves’ or the modern equivalent ‘the potting shed’ on our problems is our instinctive first line of defence when faced with any difficulty.  This course holds the benefit that only you need know that you have a problem, and you can get practical help and support without anybody else getting involved.  This is great if your problems are relatively mild and of recent onset.  If your problems are more severe and/or chronic, I would still recommend the course, but I would also seek the help of a skilled professional.  It might be more difficult to start with, but you will ultimately benefit from the one on one support and encouragement.

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Childhood Sexual Behaviour

There has been a lot of recent press attention given to young children who have been excluded from school for inappropriate sexual behaviour.  I watched one mother talk of her outrage and concern at the ‘predatory’ behaviour of a boy in her sons class.

The problem with having a sensible discussion about pre-teen sexuality is that the ‘official’ line is that pre-teens aren’t supposed to have one.  One recent study by Iqbal et al. (in press and cited by Iqbal and Pipon-Young, 2009) showed that across a panel of experts, very little consensus could be found on what is sexually inappropriate behaviour amongst children under 10.  In fact the only point of agreement was that children shouldn’t be labelled sex offenders.  Thank goodness for that at least.

What I find remarkable about this, is that it is over 100 years since Freud first theorised about childhood sexuality, and we find it just as profoundly shocking now as people did then.  Furthermore, there has been precious little advance in our understanding of the subject.  The reality of my consulting room though, is that men often talk to me about early sexual experiences, usually layered with years of guilt and shame.

I, like everybody else, am simply in the dark concerning ‘normal’ sexual development in children.  I tend to take a lead from ethology, however, which has no difficulty in describing the ‘proto-sexual’ development of, for example, the higher primates.  We, strangely, find it kind of cute to see animals start to lay down the foundations of their adult sexual behaviour in childhood.  Yet we find it so difficult to have the same disinterested acceptance of our own children’s development.

If Iqbal et al (in press) is a representative finding, and childhood professionals simply don’t agree or, it seems, understand childhood sexual development, then no wonder we, as adults, find it so difficult accepting this aspect of our own early life.

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Fathers Mental Health Impacts On Their Children

Children of fathers who have psychiatric disorders are twice as likely to develop psychiatric or behavioural problems themselves.  This research has been published in The Lancet by a team of University of Oxford experts.  What is interesting about this, is men are most prone to psychiatric problems at about the same time they are likely to become fathers, between the ages of18 and 35.

According to the researchers, too much emphasis has been given in the past to women’s mental health and its impact on their children and the effect of men’s mental health on their children has been neglected.  As men become more involved in the care of their children, the influence of men’s mental health is set to rise.

What I find concerning about this information, is not that it’s particularly new, it just emphasises the need for men to look after their mental health.  Some men still find it extremely difficult to seek help for a mental health issue like depression, anxiety or drinking too much.  Perhaps knowing it is for the good of their children, they might just be encouraged to do so.

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New Mental Health Campaign For Men

MIND, the UK’s leading mental health charity, has launched a a new campaign focussed on men and mental health.  It has a two pronged attack.  First, it wants to encourage more men to talk about their mental health.  Second, it wants to urge health services to take better account of men’s needs.

To launch the campaign, MIND commissioned a YouGov survey of over 2000 men and women.  They found that one in three men would be too embarrassed to seek help for a mental health issue, and only 23% of men would see their GP if they felt low.  Men, the same survey found, were also half as likely as women to share their problems with friends.

The consequences of this are real enough.  “… men account for 75 per cent of all suicides, and three times more likely than women to become alcohol dependant …” (Kemple, 2009, p. 6).

What I find interesting about this is why men behave like this.  As I’ve argued elsewhere in this blog, I think there is good reason to believe that men are biologically less emotional than women.  I think the real issue here, though, is how safe men feel in sharing their problems.  If sharing a problem will be taken as a sign of weakness, then a man isn’t going to open up.  Men need relationships and services that meet their needs to open up and not be judged.  Interestingly, the YouGov poll suggested that men don’t go to their GP because they feel GP surgeries are more geared towards women.

To this end, MIND is campaigning for more male-specific services that recognise the different needs men have.  MIND also wants the government to develop a men’s mental health strategy “as a matter of urgency”.

This men’s therapist is fully supportive of the MIND campaign.

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