Dorothy Rowe

Foreword to Dorothy and Walter Swartz The Glass Wall Chipmunch Publishing 2005 

Most of us don't discover what helplessness really means until we become a parent. We think we know how to solve problems, how to get things done and be in control. Then we become responsible for a small scrap of humanity and we discover that there are problems we don't know how to solve, things we don't know how to do, and events for which we are responsible but over which we have no control. As the small scrap of humanity becomes a child, a teenager, a young adult, our sense of responsibility becomes greater as our ability to solve problems and be in control of events becomes less. Even if our child is strong and healthy and deals with education, work and relationships competently and happily we have some inkling that all of this could fall apart and we wouldn't know how to put it right. Being a parent is an impossibly difficult task because what determines a child's behaviour isn't what parents do but how the child interprets what parents do. This is something over which parents have no control whatsoever. Nevertheless, as the years go by, we feel the helplessness that accompanies the thoughts of 'If only' and 'I should have'. When things do go wrong we vacillate between the guilt of 'It was my fault' and the helplessness of 'There was nothing I could do.' In guilt we feel the archetypal terror of punishment that we deserve, while our helplessness awakens the ancestral terror of being prey to an unknown but an immense, ravening beast. And then there is sorrow, the sorrow of a loss for which there can be no recompense or reward, and the sorrow of no forgetting. This is the experience of loving parents whose child has lost his grip on his life. It falls apart, and the child, despairing, kills himself.  

Many parents who experience this keep their suffering private, and in so doing can feel that there is something peculiar about them because they suffer so. They don't want to risk being condemned by others or leave themselves open to the thoughtlessness of others, and so they don't discover how universal their suffering is. Dorothy Swartz experienced all this when her beloved daughter Zoë killed herself, but celebrating Zoë's life, showing how little the extremes of mental distress are understood, and how badly such sufferers are cared for by those who say they are experts in the field were far more important to her. All this she has achieved in this courageous and vastly important book. 

These experts, the psychiatrists, say that there are mental illnesses, or, as they are now called, mental disorders, which are the equivalent of physical illnesses. When parents are told that their child has a mental disorder they may assume that this means that their child is suffering from an illness for which there is effective treatment. However, they soon discover that, though the psychiatric language used may be that of physical illness, what actually happens is not like a physical illness at all. When we are physically ill most of us do whatever we can to get better. Most of us see our doctor, follow his instructions, ask family and friends for advice, and we rest and take care of ourselves, but those who are said to have a mental illness resist all help. They refuse to see a doctor and, if forced to do so, they neglect to follow his advice. They reject psychotherapy, or else see a therapist but resist the wisdom and understanding of that therapist. They may go into a psychiatric hospital, but then the parents discover that little happens there and that patients may be abandoned at the moment they need help the most. Physical illnesses have a natural progression which a doctor can describe but with mental illness none of the professionals can give any kind of prognosis. Psychiatrists may talk to chemical imbalances and manic-depression genes, despite the complete lack of scientific evidence for any of this, but then they urge the patient to try harder, even though no amount of trying ever cured cancer or even the common cold. Watching all this, the parents oscillate between hope and despair, and always with a sense of utter helplessness. 

The cure for helplessness is to take control, if not the situation itself but of something relevant to the situation. In the last fifty years the greatest improvements in the care of those in extreme mental distress have come, not from the professionals, but from the sufferers themselves and from their family and friends. These people have seen that their greatest asset is their experience, and that what they need to do is to work collectively and change not just the psychiatric system but society itself. Extreme mental distress is not an illness but part of what it is to be a human being who lives in an uncertain and dangerous world, as we all do. The Glass Wall is not merely an account of the tragedy of a young life cut short but a challenge to us all to understand ourselves and thus  learn how best to care for one another. 

Dramatic fall from grace for champion of the people
by Alison Campsie
Published in the Scottish Herald: 24 Dec 2010

He advanced through a dark battlefield of sex, lies, power and truth, waging a war against the tabloid press and the stories it printed about his private life.

But Tommy Sheridan ultimately became his own enemy, isolated by his attempt to rewrite history and erase a predilection for kinky trysts and lust for women other than his wife, Gail.

Yesterday, Sheridan was found guilty of perjury after 12 grinding weeks at the High Court in Glasgow. It was here that his downfall was staged in the most devastating fashion: in the full glare of his wife, his mother, and a packed public gallery, with spectators queuing every day for one of the 100 or so available seats.

Four years earlier, Sheridan had stood triumphant on the steps of the Court of Session in Edinburgh, punching the air alongside his wife, after convincing a jury that stories published in the News of the World about his private life were not proven to be true.

Then, he praised the "ordinary people" of the jury for their ability to differentiate truth from muck. It is now clear that Sheridan is not equipped with the same virtue.

Yesterday, he left court as he entered every day for 48 days, with his wife Gail, smiles clenched and hands gripped together. This time, however, he was mobbed by cheering supporters, surrounded by friends turned minders who scuffled with photographers in a bid to shield the Sheridans. He will be home for Christmas, to return to court on January 26 to receive a custodial sentence.

The seeds of his downfall were planted when Sheridan was at the height of his powers. Elected in 1999 as the first MSP of the newly formed Scottish Socialist Party, he went on to lead the most successful left-wing party in Europe, with the SSP earning six seats at the 2003 Holyrood election. 

People connected with the man from Pollok who refused to take his full parliamentary salary. For some, his appeal endures today, with Sheridan even signing autographs for supporters as he waited in the lobby of the High Court for his trial to get under way.

But what is known now is that Sheridan was leading a double life. While trading on a public profile fuelled by honesty and decency, Sheridan was cheating on Gail in the most damning of ways.

Katrine Trolle, a former lover, took part in group sex with Sheridan and his brother-in-law Andrew McFarlane, the court heard. Journalist Anvar Khan told the jury she, too, had slept with Sheridan on a number of occasions.

All went to the now infamous Cupid's swingers' club in Manchester in 2002, along with former professional footballer Gary Clark.

Stories about Sheridan's sex club visits started to circulate soon afterwards. He had already confided in two of his closest friends and comrades, Alan McCombes and Keith Baldassara, but now journalists were talking.

The News of the World was already probing his private life, triggered by a tip he was having an affair with a high profile media figure.

The touchpaper was lit by a story by Ms Khan, then a freelance writer with the paper, during the promotion of her book Pretty Wild, described as a Scottish Sex And The City- style diary. In it, she included a fictionalised account of the trip to Cupid's, using fake names to hide identities. 

On October 31, 2004, the Sunday tabloid carried a spread on an unnamed MSP and his love for spanking and swingers' clubs. Sheridan was not directly named but its publication set him on the road to ruination. 

The story appeared just days after Gail, then 40, had the first scan of her unborn baby. On the day of publication, Mr McCombes, official spokesman for the SSP, stared at the front page of the tabloid in fear. He knew the story was about his friend and comrade.

Mr Baldassara, then a Glasgow councillor and a parliamentary assistant to Sheridan, also knew that his boss was at the heart of the story. 

An emergency meeting of the SSP was called. The date sticks in the memory for all concerned: November 11, 2004. It was described in court as the party's 9/11, "the night our totem came crashing down," according to MSP Colin Fox.

That night, tension rippled through party headquarters at Stanley Street, Glasgow, as members packed into the small office. People froze as Sheridan began to speak. He mostly kept his head down, staring at a pad of A4 paper on his knee. Yes, he was the unnamed MSP in the News of the World article. Yes, he had been to a swingers' club called Cupid's on two occasions, once in 1996 and again in 2002 with Anvar Khan.

The socialists were stunned, but Sheridan had more to say. Yes, he was going to fight the paper because there was not one piece of proof that he had been to the club. The first stone in the fight between Sheridan and the loathed, union-bashing, Murdoch-owned newspaper had been cast.

Grown men cried at that meeting, with the SSP suddenly shattered. Sheridan left early, announcing he had to be at dinner with his wife's sisters to show them the scan of his unborn child, now their five-year-old daughter, Gabrielle.

Carolyn Leckie recalled: "He manipulated the situation to make us feel guilty. He used his family as a human shield."

That meeting was a major chapter in the prosecution's case. Sixteen people said Sheridan admitted that night to visiting Cupid's. Four said no admission was made.

By this time, journalists were in overdrive. Briefings were given that Sheridan had been pushed out in a coup led by one of his oldest friends, Mr Fox.

Sheridan's action against the News of the World grew closer and his panic seemed to deepen. He attempted to persuade Mr Fox, who took over from him as SSP leader following his resignation, to commit perjury too. Mr Fox refused. The request came little more than a fortnight before the defamation case began in July 2006.

Sheridan sacked his legal team during the case - as he would later do in the perjury trial - and went on to represent himself in typically barnstorming fashion, eventually convincing the jury that he was "hardly likely to have time for any secret life of sexual Olympics".

Lord Turnbull awarded him £200,000 damages.

But Sheridan's victory was shortlived. The conflicting evidence from SSP members attending the same meeting led Lord Turnbull to suggest a perjury probe may be necessary. 

Just over a month later a new piece of evidence emerged - a secret video filmed by George McNeilage, Sheridan's former best man.

Mr McNeilage sold it to the tabloid for £200,000 and a police investigation was launched, with the video capturing a confession from Sheridan that he had visited Cupid's.

Yesterday, the power of the truth prevailed - not seen through a left-wing or right-wing prism, just the truth.

The latest draft of history has been written and Tommy Sheridan is guilty.

Ego led him to sack his lawyer ... and he lied to protect self-image

THE LIES: It was Sheridan's ego that led him to sack his QC and lead his own defence, arguably his biggest mistake.

Psychologist Dr Dorothy Rowe told The Herald Sheridan's move to lead his own defence was an extreme position to take as he tried to keep his lies alive.

The associate fellow of the British Psychological Society and author of Why We Lie said: "It is a way of saying that nobody else will believe you - 'I know that I am telling the truth'. It is a most extreme position to take. It also has the difficulty that, doesn't his lawyer believe him?

"Sometimes people do convince themselves of the righteousness of their own case and delude themselves or overlook the bits where they really haven't been totally truthful. We lie in order to protect ourselves. When somebody lies they tend think of it as being quite non-important or trivial. But behind all the reasons for why the person lies there is that necessity of just protecting the image you have of yourself."

She added: "He seems to have been a man who wants to be noticed and for other people to admire him - not because he is a hard-working politician but because he has this flamboyant quality that people are supposed to love."

Dr Rowe concluded: "When you lie to yourself, you end up lying to other people. It is part of the consequences of your lies. If you lie to yourself regularly, it becomes such a habit that you lose track of what is true and false. You can very easily convince yourself that what you said was true. You get into a terrible tangle … he would have found himself in a situation where his idea about himself and other people's idea about him were in danger of being rubbished.

"He started to perhaps just tell little lies, just omit certain things. It is that basic need to protect other people's image of us and our image of ourselves and to protect ourselves from being shamed.

"That is the idea of public exposure. You can sometimes live with guilt, but living with that feeling of shame is very difficult."

January 11, 2009

An Aussie expert's guide to the eternal quest for a more benign God

She's rated among the UK's smartest 100 people, but this Aussie-born woman has ideas to reshape the world, writes Paul Pottinger

Consider this: without life's one great certainty - death - there would be no need for religion. Without religion, Dorothy Rowe might not be in business. And if she wasn't, she wouldn't have spent the morning after her 78^th birthday last month discussing her 22^nd book with us.

As a clinical psychologist of world standing, whose books are among the bestsellers in that increasing portion of major book store space give over to religion/self-help, Rowe has listened to reasoning a lot less coherent than that above.

Likely this pixieish, but relentlessly logical, woman would merely see this as further evidence that "this is the way we're constructed, the way our brains work. Every person sees in their individual way".

Which is why the unyielding nature of monotheism just doesn't work: except, of course, in terms of supplying a stream of clients. It's why her new book - What Should I Believe? - examines beliefs about the nature of death and the purpose of life dominate our lives. 

"Fundamentalists see people in binary terms" she writes. Yet a decade into century 21 "their actions have conspired to make religion a political power that affects us all."

Unless you tune into Radio National, it's possible in this country to have little notion of Dorothy Rowe. In the UK, she's an altogether more mainstream figure. In one pool she was rated among the 100 living geniuses. Another considers her one of the six wisest people in Britain. 

The Poms either assume she's one of their own, or she's so smart that they're prepared to overlook the fact that she isn't. Rowe was born in Newcastle - NSW, not on Tyne - in 1930. Most northern winters, since 1968, when she joined that decade's exodus of Australian intelligentsia, she's come back.

Best-known for her bestseller, Depression: The Way Out of Your Prison, she infuriates psychiatrists by asserting that listening and talking to depressed patients can be more useful than prescribing pills. 

The new book stems from her second work, The Construction of Life and Death. "While I've used some of the original material, when I wrote the 1982 book, religion was something that was never talked about," Rowe says. "Some people were religious. Others weren't. But now, no-one can escape the politics of it."

Hence, those best-selling ripostes to the fervid: Richard Dawkins' The Good Delusion and Christopher Hitchens' polemic, God is Not Great.

"They're both written in an interesting way," says Rowe, whose mother was devoutly Presbyterian and whose father was a World War I veteran, who defied the maxim about there being no atheists in the trenches by becoming one.

"But there wasn't anything in there that was new. My father was full of all the things that are wrong with religion," she says. "But what I thought was wrong with Dawkins and Hitchens is (that) they're almost saying: "How can people be so stupid?' I decided to take that question, not rhetorically, but seriously. So, my book is explaining why people believe impossible things." 

Yet the book isn't necessarily for secular, humanist crusaders.

"I'm against (religious practice) that causes pain," Rowe says. "How dare anyone think, just because they hold a certain ideal, that they're entitled to kill people.

"I wouldn't ever try to persuade anyone to stop believing in God. All I would suggest is that the person think about a more benign God…Jesus, as he is in the New Testament, is a very pleasant person, and, if you felt the need of God, why not someone like him?"

Rowe writes: "If there were no death, there would be no need for religion; all religions promise to overcome death."

"What none of us can bear is the idea that you stop being and just disappear," she says.

"You can't imagine not existing. We find it very, very difficult to think of us not existing. We rather like to do things that mean a part of us continues.

"That's one of the reasons we have children," she chuckles. "They're very expensive and hard work, but you continue on."

Equally, Rowe recognises that life would be unendurable, or at least unpalatable, without some sustaining fantasy.

"The problem is that whatever belief we have, has consequences," she says. "All religions think that we live in a just world and it's alright to believe that, so long as nothing bad happens to you.

"When someone suffers disaster, it's always, 'Why did this happen to me?' There are only three possible answers: it's my fault; it's someone else's fault; or it happened by chance.

"Now if you believe in the just world, nothing happens by chance. I have people saying, 'If I'd been really good, I wouldn't have lost my job'. That's how you turn ordinary sadness into depression.

"I think it would be a good idea if we all became less stupid. This terrible financial crisis is the result of stupidity and greed. It's entirely man-made.

"We need to develop for ourselves a set of beliefs in which we accept uncertainty. (Religion) expects you to believe without questions. It's seriously strange because if Gld did make us, he made us infinitely curious and we've got the capacity to create altenative hypotheses.

What Should I Believe? By Dorothy Rowe (Routledge) is out now; $34.95

www.sundaytelegraph.com.au

Misconceptions about Depression

If you've been depressed and you consulted a GP or a psychiatrist very likely you were told that your depression was caused by a chemical imbalance in your brain. If the doctor prescribed an antidepressant like Prozac or Zoloft he'd have told you that the drug would replace the missing serotonin in your brain, and this would cure your depression. Many doctors would still say the same thing, not because they're right, but because they don't read the research, they don't consult the depression website beyondblue (www.beyondblue.org.au ), and they hate having to change their mind. However, if you become depressed and you consult a doctor who does keep up with the research, you'll find that the doctor doesn't mention "chemical imbalance". Instead, they'll ask you about the stressful events in your life and how you've interpreted these events. Do you see these events as challenges which you'll master, or another defeat in a long line of defeats, or the punishment you deserve for being such a bad person.

Psychiatrists have always known that there has never been any scientific evidence for the theory that depression is caused by a chemical imbalance in the brain. The imbalance is supposed to be in the neurotransmitters noradrenalin and serotonin, usually referred to as monoamines. In her book The Myth of the Chemical Cure, Joanna Moncreiff, senior lecturer in psychiatry at University College London, wrote, 'Despite decades of research, there is no evidence to support the monoamine theory of depression. Eminent mainstream pharmacologists admin that there is no evidence of serotonin dysfunction in depression. It is as if the psychiatric community cannot bear to acknowledge its own findings.'[i]

In recent years the medical profession has set as their standard what they call "evidence-based medicine". Diagnosis and treatment have to be based on the research. Hence the words "chemical imbalance" have vanished from the beyondblue website. Under the heading 'What puts a person at risk?' is a long list, beginning 'stressful events' like divorce or bereavement followed by 'long term risk factors'. The first is that depression can run in families, just as voting Labor or gambling on the pokies can run in families. There's no depression gene, just as there's no 'voting Labor gene' or a 'gambling gene'. Younger generations learn from older generations. More factors are chronic illness, substance abuse, the age you are, what gender, living in a rural area, and being an indigenous Australian. It's not these things in themselves that leads to depression but the way the individual interprets these things. If you say, 'My mother and grandmother got depressed therefore I'll get depressed,' you are making sure that not only you'll get depressed but that you'll never stop being depressed. If you say to yourself, 'I was born a horrible person and I can't change,' you're stopping yourself from changing.

Some people argue that, because the antidepressant drugs have helped them when they were depressed, this proves that depression is caused by a lack of serotonin in the brain. Aspirin undoubtedly cures a headache. Can we conclude from this that headaches are caused by a lack of aspirin? Being depressed always comes to an end, with or without antidepressants. Follow-up studies show that people who don't take antidepressants have a better outcome than people who do.[ii] This is probably because the people who didn't take drugs had to work out what in their outlook on life led to them being depressed.

Some people reject the idea that their depression comes from the way they see themselves and their world because they don't want to think about these matters. They fear reawakening painful memories, or they don't want to acknowledge, for example, that theirs is a very unhappy marriage. They prefer to see their depression as being a chronic illness for which they're not responsible. If they believe they'll never get better, and, if they work out the conditions under which their depression returns or deepens, they'll strive to avoid these conditions and they might think they can make a reasonable life for themselves. However, a danger remains. There's a great deal of research which shows that the emotional stress of being depressed causes physical changes which can lead to major physical illnesses such as heart disease and cancer.

Accepting that your depression is a result of the way you see yourself and your world means that you've taken responsibility for yourself. You can talk to a friend or a therapist, and you can consult a doctor about a taking an antidepressant which will ease your mental pain, but you're responsible for choosing what medication you take, just as you're responsible for thinking carefully and truthfully about your life and deciding to change.

Taking responsibility for yourself means becoming your own best friend. Instead of constantly criticising yourself, you give yourself praise and encouragement, and do nice things for yourself. You work out what really matters to you. You become a much wiser and stronger person. You might find that the people around you don't want you to be depressed but they don't want you to change. Now you're strong enough to resist them.

You'll need to confront the events that occurred just before you became depressed which showed you that life was not what you thought it was This discovery was absolutely terrifying. You might have grown up believing that, 'If I'm good nothing bad will happen to me or to my loved ones', and then something bad happened. In an attempt to hold yourself together you blamed yourself for the disaster, and in doing this you inadvertently created the prison of depression.

But there is a key to the prison of depression: valuing and accepting yourself, and accepting the natural uncertainty of life. Once you have this key, you know how to prevent yourself from becoming depressed ever again. 

Dorothy Rowe Depression: The Way Out of the Your Prison third edition, Routledge (distributed in Australia by Palgrave Macmillan).

Perspectives

Emma is one of the brightest of her generation of lawyers. She can anticipate the different interpretations of the evidence likely to be made by an opposing lawyer in a case, and she is very shrewd in her assessment of what motivates her client to tell his story in a particular way. In short, as a lawyer she knows that different people interpret events or circumstances in their own individual way. She knows too that individuals can choose to change how they interpret an event or a circumstance. Yet she doesn't apply this knowledge to her own life. She lives in fear of her mother's criticism, just as she has ever done since she was a child. Her friends tell her to stand up to her mother, and not to feel guilty when her mother complains, but Emma insists that she's been like this since she was a small child and that she can't change.

Emma learned about alternative interpretations as part of her legal training. She never studied human physiology, and so she has no idea where these alternative interpretations come from. She's not alone in this. When I lecture to people who consider themselves to be very well educated and I start to explain why it is that no two people ever see anything in exactly the same way, many faces show puzzlement, even total disbelief. But I persist, because, if we don't understand how human beings operate, how can we ever understand ourselves?

When we are born we don't open our eyes and see the world. We open our eyes and begin to learn how to see the world. What we learn depends first on our environment, such as the kind of room we're in when we're learning how to see depth and distance. A baby in a rectangular room learns to structure space in terms of angles and parallel lines. A baby in a round room - a kraal or a yurt - learns to structure space in terms of curves. As the baby grows, the adults around her explain the world to her. Some babies learn to see the world as filled with spirits and gods. Some babies learn to see the world as a dangerous place, full of germs and other nasties. Lucky babies learn to see the world as a wonderful place, full of an infinite number of delightful possibilities. Our brain doesn't allow us to see reality as it really is, whatever that may be. Instead, our brain constructs a picture of the world. This picture is drawn from our past experience. Since no two people ever have the same experience, no two people ever see anything in exactly the same way.

We're always engaged in interpreting what is going on around us and to us. Interpretations are something we create, and so we can change them. We can't always change what has happened to us, but we can always change how we interpret what happens to us. Always remember, what determines your behaviour isn't what happens to you but how you interpret what happens to you.

Emma had learned to see her world as being dominated by her giant mother who demanded that Emma please her. She saw this picture of her world as an absolute reality, even though she was now a woman and her mother was getting smaller and gentler with age. To please her mother Emma had always striven to be good, and always felt guilty for not being good enough.

The world is full of Emmas, women who are experts in feeling guilty. They blame themselves for whatever disaster occurs, and so many are familiar with the prison of depression. The key to this prison, as it is to persistent unhappiness, is to inspect the ideas that dominate our life, and see them, not as fixities, but as ideas we can choose to change. Emma can decide to give up being frightened of her mother, and instead be fondly amused by her peculiarities. She can be good simply because it pleases her to be good. She needn't live in fear of not being good enough. All Emma has to do is to recognise that she is free to change her ideas.

Dorothy Rowe Depression: The Way Out of Your Prison third edition, Routledge.

Another sibling argument! From the Independent.co.uk on Tuesday, 4 March 2008

'Keep me out of your novels': Hanif Kureishi's sister has had enough

Hanif Kureishi has made a habit of attacking relatives in print - and his latest book is no exception. It's time to stop, says the novelist's outraged sister, Yasmin Kureishi

So there is a new novel out by my brother called Something to Tell You. I was, of course, relieved to learn from a recent review that the central character's sister wasn't based on me, but appears to be another family member. There is quite a bevy of us now - my mother and father in The Buddha of Suburbia; Uncle Omar, portrayed as an alcoholic in a bedsit in My Beautiful Laundrette, then lauded in Hanif's memoir, My Ear at his Heart; an ex-girlfriend, Sally, who renamed his filmFor my birthday he used to give me novels by Jean Rhys, Balzac, Camus. He introduced me to RK Narayan, Thackeray, Rabindranath Tagore and Dickens... These are truly great gifts. And he never stopped encouraging me to write, though my resistance was often formidable.

Sammy and Rosie Get Laid as "Hanif Gets Paid, Sally gets Exploited". A semi-autobiographical novel, Intimacy (1998) centred around a man leaving his wife and kids for a younger woman. Tracey Scoffield, his ex-partner ("the wife") was not impressed. She stated that the book wasn't a novel: "You may as well call it a fish." There are probably many more...

And then there is me... Ouch! The sister, Paula, in the film The Mother (2003) - a particularly spiteful portrayal, via an amazingly insipid, two-dimensional character. Perhaps the viciousness is not on a par with that dished out in Hanif's novel Intimacy; however, in a singularly nasty twist, Scoffield was the producer of the BBC film, and must presumably must known darn well what she was doing - must have known that my life was out there being assassinated in the cause of "art". Her apparent collusion with Hanif was not a dignified move.

Anyhow, in celluloid, there was my life at the time up on screen: single parent, teacher, a son, reckless boyfriend (well, one or two, though none of them went for my mother, nor were they Daniel Craig, who played the part in the film). And there was the writing group, though I wouldn't give my brother the satisfaction of burning my writing, as Paula did in the film. It made excruciating viewing. It was like he'd swallowed some of my life, then spat it back out. I got the video from my mother when I heard what the storyline was - mother screws the daughter's boyfriend. I knew the daughter was me.

I watched The Mother on a portable television (the smaller the screen the better). I watched it in two parts, over two evenings. After part one, I thought it couldn't get worse, but it did. It was kind of freaky to me, that someone so successful should seemingly feel that threatened by me, that obsessed.

And now it is happening again, in the form of cheap jibes. Hanif said in an interview in The Telegraph recently, where I was referred to as "an aspiring writer": "But you can always rely on her for a letter to a newspaper. That's the extent of her writing ability." So here I am again being slagged off.

It seems rather ironic that Hanif's latest book should centre on psychoanalysis, because I'm afraid I've always been his emotional dustbin. And now (perhaps because he doesn't speak to me) he's using the media to play out his game of bullying and intimidation. He only does "hate" with me, always has, always will; even when we were speaking, it was always there festering, like some psychotic cocktail. I'm surprised he hasn't resolved those issues around sibling rivalry with his analyst. Think Dorothy Rowe's sister and sadly you have my brother. The psychologist says in her book about sibling rivalry, My Dearest Enemy, My Dangerous Friend: "All siblings in a position similar to mine, and there are a great number of us, find ourselves in a power struggle where we are in double jeopardy: first, the ordinary power struggle between two siblings; second, the undeserved revenge for something which we had been powerless to prevent." Put this together with my brother's access to the media, his ruthlessness and my powerlessness, and I'm in an awful position.

As for the "aspiring writer" tag, it's the first I've heard of it. It is hard to resist the allure of the Biro if you've been brought up by someone like my father. Hanif should know. His lure was potent. He was the father who sat me on his knee when I was four or five and read Oscar Wilde stories to me.

I have written "stuff" from time to time. But I'm not aspiring - I write, sometimes, between looking after my three-year-old twins, nagging my 19-year-old, working as a teacher, doing the washing and so on. Perhaps I'm doing a bit more lately. And big brother doesn't like it. How pathetic. He isn't entitled to sole ownership of the Biro. Nor should he expect to be able to just trample over others like a greedy shopper at the first day of the sales, rifling though the gear for the best bargains to enhance his own image. I'm sorry, but that isn't art.

Oddly enough, my brother seems always to have loathed the idea of me writing. I remember a few years ago, after my father died, I'd won a competition for a play I wrote, and Hanif told me I should give up writing. I've always felt that he can't stand the thought that I might be any good, might be better than him.

Germaine Greer said recently: "It's getting harder and harder to be a real person. You used to have to die before assorted hacks started munching your remains and modelling a new version of you out of their own excreta." You don't even have to be famous these days.

I would have liked not to have written this, to be able to get on in my own way with my own life, but I know the insults, the remarks, will keep coming. I don't want to be seen as "good" in the preachy sense. I do believe that writers should be able to take from their experiences. But I don't think they should use their "art" to be malicious, or to settle scores, or to rewrite history without any regard for others. That is simply an abuse of privilege.

Hanif Kureishi's 'Something to Tell You', out on Thursday, is published by Faber and Faber, priced £16.99

It's not the innocents who suffer, it's their poor Parents

Nov 26 2007 by Peter Elson, Liverpool Daily Post

IT IS a question as old as time. Are we born with original sin as imperfect beings? This nagging anxiety has latterly translated itself into the nature versus nurture argument. Do we possess a sense of innate goodness, an in-built ability to distinguish between right and wrong?

Yale University has concluded that babies as young as six months are able to tell the difference between good and bad behaviour. The kiddies, aged six to 10 months, were set a task to watch two colourful toy climbers struggling up a hill. In one scenario, the "goodie" toy helped the other, in the opposing set-up the "baddie" tried to stop him.

The researchers claim that the children were able to make a reasoned response to this situation.

In contrast, one can ask, will goodness prevail if a group of children were told to hold precious china for a long period?  Probably even if suffering regular exposure to the Antiques Roadshow, they would display a preference for breaking it and jumping up and down on the broken pieces.

The whole of children's comic book japery is predicated on the belief that children would far rather indulge in mischief-making and darker deeds than please their parents and other adults. Those that do, such as the poetry-loving Fotherington-Thomas, in the Molesworth books, are at best dismissed as hopeless wets and other terms denoting unnatural creatures.

The most serious aspect of such behaviour was explored by William Golding, in Lord of the Flies.

Then there's the whole nightmare of sibling rivalry, as any parent of more than one child will know. The surreptitious jabs and pokes and desperation to get the last word in, even if you laughably believe that the inter-offspring row has been quelled.

Ask any colleagues or friends of their earliest misdemeanours, and memories will centre around such incidents. Particular favourites include the desperate desire to communicate with the parent, no matter what time of the night or day. One friend of mine wanted to tell her father she'd found his hammer while rooting around the house at some ungodly hour. Finding him asleep in bed, her preferred method was to start hitting him on the forehead with it to wake him up. Anyway, luckily their doctor was a family friend and was able to attend quickly and ascertain that, once her father came round, he wouldn't suffer any permanent damage.

This lack of insight into pain and cranial damage can be firmly put down to nature in my opinion, not nurture. Those baby blue eyes might show an innocence, but they also display a self-interest as the whole being is focused on being helped as it cannot help itself. Manipulation of the adult world is the name of the game, which is survival. However, if you the parent do prevail, there may be modification over time into some sense of acting for a greater, or less destructive, good. We're talking about damage limitation here, in trying to make a less-bad child.

Plenty of adults are driven by two main forces, those of self-preservation and self-advancement to minimise the impact of a hostile world. You could take this to mean that it's no more than an adaptation of what they've learned as coping strategies as children.

"Babies can make their distress known to others, but those people won't necessarily respond in the way that babies need," says psychologist Dorothy Rowe.

"To survive, babies have to assess whether an adult will be helpful or not. So do toddlers for whom being able to read feelings is essential."

In the Yale experiment, when asked to decide on choosing a toy, the babies showed a strong preference for picking the toy that helped its climbing partner, rather than hindered it.

"Identifying good guys and bad guys is necessary for a baby's survival - and for our own as adults - but that ability does not make us innately moral," says  Rowe.

That comes about through the baby forming a bond with someone who mothers him or her. Only when that bond is formed, does the child want the mother's approval.

The End of Chemical Imbalance

In his letter in the summer edition of A Single Step Tim Shanks referred to an article in Saga Magazine where I'd written about how the Royal College of Psychiatrists, the professional body which sets the standards for psychiatrists practising in the UK, had removed all mention of chemical imbalance as the cause of depression from its website. Tim seemed to have the impression that my article was no more than the statement of my opinion. I have been an Associate of the Royal College of Psychiatry since 1970. I read all its journals to inform myself of new research findings. I also read books written by leading psychiatrists like David Healey and Julian Leff. I try to pass what I have learnt on to those people who might find this information interesting and important. In the hope that facts will not be taken as merely my opinion, in this article I shall carefully label what is fact and what is my opinion.

FACT There has never been any evidence that depression was caused by a chemical imbalance in the brain. The psychiatrist David Healy gives the history of the idea of chemical imbalance in his book Let Them Eat Prozac. Psychiatrists have always known that there was no evidence for a chemical imbalance as the cause of depression but for many years they have called this idea an hypothesis and hoped that one day is would be proved. Many psychiatrists have told me that they tell patients that they have a chemical imbalance because they think this is a comfort to them. MY OPINION Whether patients want to be told a tooth fairy kind of lie is debatable.

FACT Last year the Royal College of Psychiatrists dropped any reference to chemical imbalance from their website. If you look up the fact sheet on depression which is on their website you will see that factors such as circumstances and life events are listed as causes of depression. The fact sheet is very cautious about mentioning genetics other than to say that depression runs in families. The fact that a behaviour is found in succeeding generations in a family does not prove that this behaviour is caused by a gene. For example, my father voted Labour, I vote Labour, my son votes Labour. Does this mean that we have a voting Labour gene?

MY OPINION Psychiatrists are caught in a bind. They know that all the scientific research shows that depression is not caused by a chemical imbalance and that complex behaviour like being depressed cannot be explained by a gene. They want to practise evidence-based medicine. So, they abandoned chemical imbalance but they don't want anyone to know. Psychiatrists and GPs who don't keep up with what their professional body is telling them are continuing to present patients with what David Healy calls 'a myth'.

FACT Drug companies used the chemical imbalance idea to create what have proved to be a very profitable set of drugs, the SSRIs. These drugs undoubtedly put serotonin in the person's brain but, as the brain wasn't imbalanced originally, these drugs don't right the balance. Psychiatrists who value truth over profits or personal prestige like Dr Joanne Moncrieff, senior lecturer in psychiatry at University College London, now are showing that what these drugs do is to treat symptoms which accompany being depressed. They do not cure an illness in the way that antibiotics cure an infection.

FACT This is the current situation. MY OPINION It is a tragedy that those people who are depressed are not being properly informed so that they can choose how they wish to see their depression. They can see it as an illness or as a result of the way they live their life. Like everything in life, each alternative has advantages and disadvantages. If you see it as an illness you are not responsible for it, but, for your psychiatrist, it is a chronic illness like diabetes which cannot be cured but only managed. If you see it as a result of the way you live your life, you are responsible for your depression, but you can choose to change how you see yourself and your life and thus cease to be depressed.

Taking responsibility for yourself isn't easy but it does lead to a satisfactory life.

David Healy Let Them Eat Prozac New York University Press

Dorothy Rowe Depression: The Way Out of Your Prison third edition Routledge.

Observer July 15, 2007

I knew that The Blair Years was an account of events enlivened by Campbell's unflattering comments about the people who had angered him, but I had not expected the occasional precise, perceptive assessment of certain people. His introduction confirmed my long-held suspicion that he was an introvert, one of those who need to keep chaos at bay and fulfil their need for achievement. Elsewhere I had read his description of what he calls his 'serious psychotic breakdown', which to me was a clear description of what happens to introverts when they discover a serious discrepancy between what they thought their life was and what it actually is. Here he explains that he kept a diary to give 'some kind of order to often chaotic and confusing events around me'. Introverts are often better observers of other people than extraverts, even though extraverts rely on their relationships with others in order to feel that they exist. Campbell's description of his meeting with Dick Cheney and George Bush made me wish, very fleetingly, that Campbell and not Blair had been the PM. He wrote, '[Cheney] managed to seem relaxed while at the same time emanating tension . . . and as straight man for Bush, who would later seem warm and personable by comparison. . . [Bush] was clearly pumping out the personal charm but beneath it you got a real sense that if he didn't get his way he would be, to quote himself, a tough son of a bitch.' But Blair, the extravert, saw the 'special relationship' in simple, sentimental terms, and went with Bush into Iraq.

Extraverts' greatest fear is being disliked. When people turned against Blair he began to age. Campbell understood this. He wrote, 'TB was coming to terms with the fact that there were people on the right and on the left who actually hated him. . . I said you are not confident at the moment, are you? He said, you read me too well, but no, I'm not.' Partnerships between an extravert and an introvert can work well because each sees in the other what he lacks in himself. Campbell knows he lacks charm, and Blair sees in Campbell a strong inner core which he lacks. So there may indeed be daily phone calls.

Perhaps in 20 years' time Campbell will write a book about the people he knew in the Blair years. That will be a book worth reading.

Dorothy Rowe 12/7/07

Mental Health and Learning Disabilities
Research and Practice: Vol 4 No 2

Plus ça change

Shortly after my book Depression: The Way Out of Your Prison was published in 1984, Angela Tilby, now the Reverend Angela Tilby but then a BBC TV producer working on the Everyman series, made a programme about my book called The Mind Box (Rowe ). This programme attracted nearly 2 million viewers, and afterwards it seemed that every one of these viewers wrote to me. This may be an exaggeration, but it is not an exaggeration to say that the majority of those who wrote said, "I've asked my GP if he'd refer me to someone I could talk to but he said not to be silly, just keep taking the tablets".

These GPs were not being obtuse and difficult. They were simply following the advice given by the Royal College of Psychiatrists who saw depression as a physical illness caused by a chemical imbalance in the brain, underlying which was the gene for depression. Consequently the appropriate treatment was antidepressants and electroconvulsive therapy.

In 2006 the Royal College of Psychiatrists abandoned the idea of chemical imbalance. The College now advises doctors that antidepressants (and, rarely, ECT) should be used only with severe depression, while in all levels of depressions, mild, moderate and severe, psychotherapy is the appropriate treatment.

What has brought about this change? Psychiatrists have known all along that there was no scientific evidence for a chemical imbalance in depression, and that nothing remotely like a depression gene had ever been found. They regarded the idea of a chemical imbalance as a hypothesis which validated their way of working as doctors dealing with people with a mental illness. In 2006 they changed their ideas about depression. This change appears to be significant, but appearances can deceive.

When Kraepelin identified the mental illnesses of depression and schizophrenia he described them as being lifelong conditions. When in 1968 I arrived to work in the clinic attached to the Department of Psychiatry at Sheffield University my psychiatrist colleagues were revising their definition of depression. The advent of the first antidepressants meant that many patients seemed to get better. Perhaps depression was not a lifelong illness. Many of these patients became depressed again, but this was seen, not as a failure of the drugs to cure, but as evidence of a permanent underlying condition from which the drugs gave periods of remission. This was but a slight modification of ideas, not a change.

However, the old order of the psychiatric system was beginning to crumble. Some enlightened administrators and psychiatrists were concerned about the run-down state of the asylums, not just the buildings but the stagnant system itself. In 1971, when I had finished my PhD and was looking for a job, I was appointed to a post by an administrator who hoped that a few psychologists might be the wedge he was trying to drive into a local psychiatric system which was highly resistant to change. I had done my PhD in a university department of psychiatry where I had found that the psychiatrists I worked with had no idea what psychologists did other than to give intelligence tests. Naively believing that my role as psychologist was to offer alternative hypotheses for the phenomena we were examining, i.e. the behaviour of our patients, I committed the greatest heresy of challenging the ideas held by the consultant psychiatrists. Moreover, I took a completely unnecessary interest in the life histories and the relationships within the families of our patients. These life histories and relationships were invariably sad, even tragic, and revealed so much loss, cruelty, betrayal, enmity and neglect that it seemed to me that to explain the patient's behaviour in terms of some unknown physical cause was a reprehensible neglect of the principle of Occam's razor, which requires that nothing unnecessary or tangential should be included in an hypothesis.

An influx of new ideas always leads people to question the old ideas, even those ideas which were regarded as absolute truths. The 1970s was a decade of new ideas about what it was to be a person. These new ideas penetrated even the closed worlds of the two asylums where I worked. In our psychology department we ran many workshops on the new kinds of talking therapy. Social workers, occupational therapists, nurses came, but not one psychiatrist. Meanwhile, across the country, people were discovering that, if there was no expert who could solve their particular problem, they could get together with others with the same problem and help themselves. Many depressed people found that their self-help group effected a cure, the like of which psychiatrists and drugs had never done.

One group called itself "Survivors of the Psychiatric System", and went on to create more changes in the thinking about mental illness than any of the professionals achieved in the following years. "Survivors" demanded that the account they could give of themselves and their lives should be taken seriously by the professionals and not dismissed as being no more than evidence of a mental illness. In 1976 MIND stood at the crossroads. Was it going to become an establishment charity as SANE did some years later, or would it not just represent but work with the very people it was set up to help? There was a battle, but the "Survivors" won. Their role in MIND led to "Survivors" working as advocates for patients who could not represent themselves, and to being given places on advisory teams, even within the Royal College of Psychiatrists. In the advice, which is now given to psychiatric staff, much is made of treating patients with respect. Psychiatric patients might no longer be despised and neglected as they were in the old asylums but now they have to endure being patronised, usually in terms of, "I feel so privileged that you've shared that with me". Would we say this to a friend who had confided in us?

In the early 1980s the Thatcher government decided to turn a health service into a business. Consultants saw their power being taken over by managers. Some consultant psychiatrists resisted losing their supreme power but others saw an advantage in appearing to share responsibility with a multi-disciplinary team. Many of the younger psychiatrists were enthused by what they learned from psychologists and social workers. However, the turmoil caused by the various governments' continual reform has often negated whatever beneficial changes there were.

The 1990s marked thirty years since the invention of the first antidepressants. The creation of antibiotics had meant that common infectious diseases like typhoid and diphtheria disappeared, but depression did not disappear. Statistics eemed to suggest that it was increasing. Moreover, long term studies were howing that people treated only with antidepressants were unlikely to recover. Each episode of depression was a predictor of yet another episode. Some eople might conclude from this that the antidepressants were not working, but, in a swift act of hypothesis saving, psychiatrists decided that there is a form of depression which they called chronic depression. Patients who appeared to be well should continue to take antidepressants in order to ward of the chronic form of the disease. Unfortunately, the prophylactic use of antidepressants was found not to work. Psychiatrists returned to Kraepelin's view that depression was a lifelong mental illness. Depression needed to be managed in the way that diseases like diabetes and epilepsy are managed. Psychiatrists could no longer take refuge in the belief that there was a depression gene. Geneticists kept telling them that a single gene could not account for any complex behaviour. Even worse, research results seemed to suggest that the talking therapies could effect some kind of cure. Perhaps the greatest blow followed from the day that Patsy Hage ceased to be a grateful patient and told her psychiatrist Marius Romme that he should ask her what her voices actually said to her. It was patients, not professionals, who showed that auditory hallucinations are not symptoms of an illness but meaningful experiences. It was survivors, not professionals, who developed the techniques for living with such experiences.

At the same time many survivors were demonstrating that it was possible to recover from schizophrenia and go on to live an ordinary life. Out of this came a survivor-led movement called Recovery. In an effort to reclaim the ground they had lost, many psychiatrists and psychologists made the word "recovery" their own and now use it when what they actually mean is "manage your illness". Similarly, many psychiatrists and psychologists now claim to be the experts on the diagnosis and treatment of auditory hallucinations.

By the beginning of this century it was clear that, whatever depression was, it had a markedly deleterious effect on the economy. Something had to be done. Some people might feel that, as psychiatrists had not solved the problem of mental illness, they should bow out and let another group see what they could do. Such people overlook the fact that the profession of psychiatry enjoys power, status and privilege, and throughout history no group has ever voluntarily given up power, status and privilege. It takes the ballot box, if not the AK-47, to achieve that. When different groups battle for power, status and privilege, it can be difficult to see the ideas which underlie such a battle. Yet it is a battle over whose ideas shall prevail. In the field of mental health these ideas are many and various, but there are two ideas on which all the other ideas depend. These are the ideas of what constitutes a person.

All the theories which psychiatrists and psychologists have devised can be grouped according to the particular idea of a person on which the theory is based. Is the person a puppet or an agent? A puppet behaves according to which of his strings is pulled. These strings might be mental illnesses, or traits, or instincts, or society, class, nationality, religion, or planets. An agent is an autonomous person who assesses, decides and acts. Puppet theories might seem to demean the person but they have two delicious advantages. A puppet theory allows for an expert, someone who knows more about the puppet than the puppet can ever know. Moreover, a puppet can never be responsible for what he does. A puppet can claim that whatever he did was the fault of his illness, his traits, his instincts or his star sign. Agent theories have two great disadvantages. An agent is always responsible for his actions, and no one other than the agent can be the expert. An agent always knows more about himself than anyone else can know. Professionals who use the agent model of the person know that they cannot cure their client nor advise him about the best way to live his life. Their task is to help their client explore and clarify his ideas and to examine alternative constructions and their possible outcomes. There is little power, status and privilege attached to their role.

It might be some comfort to those who espouse the agent model to know that neuroscientists have shown that the agent model best represents the way human beings behave. The research which shows this is vast and detailed, but a number of the scientists involved in this research have written excellent books for the general public. Two of these are Antonio Damasio, Professor of Neurology at the University of Iowa, and Dennis Noble, Emeritus Professor of Cardiovascular Physiology at the University of Oxford.

Antonio Damasio writes about images which he defines as, "mental patterns with a structure built with the tokens of each of the sensory modalities - visual, auditory, olfactory, gustatory, and somatosensory [which] includes varied forms of sense: touch, muscular, temperature, pain, visceral, and vestibular. . . The word also refers to sound images. . . . Not all the images the brain constructs are made conscious. . . When you and I look at an object outside ourselves, we form comparable images in our respective brains. . . But this does not mean that the image we see is a copy of whatever the outside object is like. Whatever it is like, in absolute terms, we do not know. . . The brain is a creative system. Rather than mirroring the environment around it, as an engineered information-processing device would, each brain constructs maps of the environment using its own parameters and internal design, and thus creates a world unique to the class of brains comparably designed" (Damasio 2000 p 318 - 321, 337). In other words, each of us sees the world in our own individual way.

Antonio Damasio sees the mind as a process, not as a thing. Dennis Noble sees the self "as an integrative construct, occasionally a fragile one. It is also a necessary construct. It is one of the greatest symphonies of the music of life" (Noble 2006). In his book The Music of Lifei he shows how Richard Dawkins' description of the selfish gene can be read as an example of the puppet model or as an example of the agent model. Noble writes, "Genes, like the digital information on a CD, are "only" bits of a database, they do not deterministically "program" anything on their own, and it is organisms that live or die and so provide the basis for evolutionary selection. . . A gene can do nothing without this interpretation by the system" (Noble 2006). For both Noble and Damasio, the agent model is the one which best fits what is known of how human beings operate.

A naïve observer might think that what neuroscientists have found would be of immense importance to all psychiatrists and psychologists. It provides an explanation of why people behave as they do. This could be stated as, "What determines our behaviour isn't what happens to us, but how we interpret what happens to us." These interpretations are constructions created by the brain out of the person's past experiences, and, as they are constructions, the person is free to change them. A naïve observer encountering CBT might think that this form of therapy is based on this explanation of behaviour. Yet, when Raj Persaud interviewed Dr Ben Wright, head of the Newham Psychological Treatment Centre, Dr Wright said, "What we think affects the way we feel and how we function in the world" (All in the Mind BBC Radio 4, May 1, 2007).

Such a use of "affects" implies that other things are of importance in how we feel and function. It ignores the fact that we interpret all these other things, and that these interpretations are part of what we think. For instance, we might live in poverty, but we can interpret our situation as being one to which we must be resigned, or one that shows that our suffering will be rewarded in heaven, or one which justifies our criminal behaviour, or one that provokes us to rebel. However, Dr Wright was following the example of his professional college. The website of the Royal College of Psychiatrists carries a fact sheet about depression which lists the factors involved in the causation of depression (http://www.rcpsych.ac.uk/). These are: things that happen in our lives; circumstances; physical illness; personality ("This may be because of our genes, because of experiences in our early life, or both"); alcohol; gender ("Women seem to get depressed more than men do. It may be that men are less likely to admit their feelings and bottle them up, or express them in aggression or through drinking heavily. Women are likely to have the double stress of having to work and look after children"); and genes (depression can run in families). No mention is made of how different individuals interpret each of these factors in different ways.

Psychiatrists may have abandoned the model of the puppet manipulated by chemical imbalances but they have replaced it with the model of a puppet manipulated by seven factors about which they, the psychiatrists, are the experts. As Talleyrand, that great master of political survival, said, "Plus ça change, plus c'est la même chose".

References

Damasio, A. 2000. The Feeling of What Happens. Vintage, London.

Noble, D. 2006. Music of Life. Biology Beyond the Genome. Oxford University Press.

Rowe, D. 1984. Depression: The Way Out of Your Prison. Routledge.

Rowe, D. 2007. Beyond Fear, 3rd Edition, HarperCollins, London.

Royal College of Psychiatrists. Leaflets at: http://www.rcpsych.ac.uk/