Vine leaves, dandelions and serendipity ~ my thoughts on the TAP conference

Vine leaves, dandelions and serendipity ~ my thoughts on the TAP conference

There is a woman on the train with two small children. She’s beautiful, dressed in stylish clothes, her hair immaculate. The children are boys, one aged about four, the other a baby of about fifteen months, seated in a pushchair. They’re well clothed, clean, well-fed. The older boy talks constantly, the air punctuated by “mummy mummy mummy”, and the baby grizzles in that tired way of babies who need a nap, a feed, a cuddle, the grizzling becoming an occasional screaming fit. The mother ignores the children more or less totally, only answering the older child when his demands become loud or he makes the baby yell. Her entire focus is on her smart-phone, held in manicured hands like a pearl beyond price, her long fingernails whipping across the screen and her eyes dead as they scan the phone for something . Her face is without expression; it looks more like a mask. The older boy glances at me from time to time, his eyes bright but I can see shadows behind them. I want to say, “You have two beautiful children” and take the phone from her and throw it out the window, but I do not know her story, only the one I am making up for her.

This weekend I traveled down to Somerset to be a small part of the annual TAP conference. . Asked to present two small vignettes (that’s the vine leaves of the title) as a kind of grounding exercise, I was inevitably very nervous. I felt entirely out of my league. But my friend Suzie / was wonderfully supportive. She’s their administrator, and also the reason I was there at all. You may remember the launch of Dandelions and Bad Hair Days, / the book collated and edited by Suzie to raise awareness and funds for mental health charities (SANE and OCD Action). The book is a collection of essays, poems, and pictures written by people affected by depression and anxiety (and other things too) and is something I’ve been very proud to be a part of. My essay also gave the title for the book, and it was one of two vignettes I read. The other, which I read at the start of the conference, was The Uninvited Guest.

But I’m only a tiny part of this conference. There were other vignettes, and three main speakers. Dr Christopher Irons, Alison Evans and Martin Seager were the headliners. Alison spoke about Mindfulness, a buzzword right now, and billed to be the next magic bullet for the NHS once CBT starts to lose its lustre. Chris spoke about Compassion Focused Therapy, and his words on the genetic side of depression made a big impression on me. “It’s not your fault. You didn’t choose this.” At the heart of this is compassion, the theme that ran through everything, and cropped up seredipitously in every conversation. Compassion for the self. “It’s NOT your fault. You didn’t choose this.” It was good to hear. I see and read and hear so much from people who espouse the philosophy of The Law of Attraction whereby (put simply) everything in your life from relationships to illness is something you have at some level chosen and drawn to you. The guilt and the self blame and the sheer misery this is creating in many people is a damning indictment of such a concept. Those of us with illness that threatens our very existence do not need such blaming.

It was the final main speaker whose words really made me sit up and take notice. I’d had dinner with the other speakers and the committee members the night before and that had been a great chance to get to know them a little. Martin mentioned that he’d suffered a serious bereavement that week which gave certain poignancy to his talk, because the nub of his hour and a half is that depression is not an illness that can be medicalised but rather something endemic to the human condition.

This is what he said:

Depression is not a “mental illness” but a common part of the human condition when key emotional needs are not met  Where does self-worth come from? Not difficult to answer. It comes from relationship from the first attachment onwards.

Mentalization and personality/self development  The vital relationship between identity and identification – if a caregiver doesn’t accurately identify with you, you can’t become a healthy self

We don’t fail to value ourselves because we have a condition called “depression”, rather we feel depressed when our lives are not mirrored, valued or supported – this is the human condition

2007 (Seager et al) paper refers to 5 key (overlapping) needs that can be summarised thus (beyond Maslow’s hierarchy which is upside down!):

(a) to be loved (attachment and emotional investment)

(b) To be heard/recognised/attended to (empathy)

(c) Identity and belonging (identification with a family and/or other social group)

(d) To make a difference (achievement and influence)

(e) Belief, meaning and purpose (spiritual)

It brings me back to that little family on the train. I don’t know that woman’s story, or why she failed to engage with her children at all. I was on a train with her for more than forty minutes and another forty minutes in a waiting room. She never once met my eye or the eye of anyone else. She never spoke to her children, or cuddled them. She attended to their physical needs, giving a drink to the baby without letting him out of his pushchair, and gave a baby wipe to the older child so he could wipe his own hands and face. There was an awareness of the basic needs of the physical, of keeping them safe, and warm and fed, but from an observer’s point of view, that seemed to be all.

Imagine this: if all human beings have these needs {to be loved (attachment and emotional investment) To be heard/recognised/attended to (empathy) Identity and belonging (identification with a family and/or other social group) To make a difference (achievement and influence)Belief, meaning and purpose (spiritual)} and if these needs are not met, is it any wonder that depression is the fastest rising condition and there was a rise of 40% in medication to treat it in 2011? You cannot put love in a pill. You cannot give meaning to another life by medicating the person. You cannot hear a person by prescribing them with Prozac. Martin (and I for that matter) are not against medication for acute phases of depression; it can save lives. But the evidence is that medication is not working and the search for newer, better, medications and therapies goes on. My thoughts are we are missing something very important here.