Reclaiming Our Heritage Project

Episode Four: Mental Health Over Generations

In this episode, Halina Rifai speaks to guest Sean McCann, cognitive behavioural psychotherapist and lecturer, about mental health over the generations with the help of testimonies from Hugh, Dougie and Chris from the Reclaiming Our Heritage archive.

Content Note: Features discussion of suicidal ideation.

Reclaiming Our Heritage is a Mental Health Foundation podcast inspired by its two-year oral history project supported by the National Lottery Heritage Fund. The project’s aim is to record and preserve the spoken testimonies of the mental health community between the 1950s and early 2000s.

Each episode will explore themes that have come out of these spoken testimonies, and these will be further discussed by a professional guest. The full interviews by these contributors and others are available in the Reclaiming Our Heritage archive.

In this episode, Halina Rifai speaks to guest Sean McCann, cognitive behavioural psychotherapist and lecturer, about mental health over the generations with the help of testimonies from Hugh, Dougie and Chris from the Reclaiming Our Heritage archive.

The Reclaiming our Heritage project is funded by a number of donors including an “Our Heritage” grant from the National Lottery Heritage Fund.

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Episode Transcript

Hugh: When it was called an asylum, when it was created in the Victorian era there were an awful lot of well-meaning people about why it was done. And there would have always been good nursing and good care, but there were far too many people in there. And the classic thing of young lasses being put in there because they’d had a child.

Dougie: There are some bipolar groups for people with manic depression, which I believe they don’t use that expression anymore. There are songs that musicians have written, like Jimi Hendrix wrote one.

Chris: We are talking about the kind of late 1990s, early 2000s, there were a lot of hospital closures. And within communities that we would generally kind of say had lots of inequalities anyway, people were being rehoused.

Sean McCann: Rather than seeing the person. We hear the label and we respond to that often enough in a way that’s not helpful.

Welcome to Reclaiming Our Heritage, a Mental Health Foundation podcast inspired by its two-year oral history project supported by the National Lottery Heritage Fund. The project’s aim is to record and preserve the spoken testimonies of the mental health community between the 1950s and early 2000s. The full interviews by these contributors and others are available in the Reclaiming Our Heritage archive on the Scottish Mental Health Arts Festival website.

My name is Halina Rifai and in each episode I will explore themes that have come out of these spoken testimonials and these will be further discussed by a professional guest.

On this podcast, we’ll be exploring the theme of mental health over generations and hearing from different voices on this theme from the Reclaiming Our Heritage archive.

We’ll also be exploring themes of creativity and the arts because the thing that “ties all these voices together is their involvement in mental health and the arts” Our expert on this episode is Sean McCann. Could you please introduce yourself to us and tell us what you do? Yeah, sure.

SM: Yeah sure. So my name is Sean McCann. I’m a Cognitive Behavioral Psychotherapist I work in the main at Strathclyde University and their counselling team. I work in a specific team that focuses on working with suicidality and students who we’ve identified to the most risk of harm and the past of what a residential treatment centre treating veterans with PTSD and complex PTSD and substance misuse services treating long term addictive behaviour. I also teach as well so I lecture at the OU in counselling and mental health.

HR: Just on the basis of this subject of mental health over generations, you and I had a conversation before starting this podcast whereby you mentioned that the theme of the episode was very close to your heart. Can you tell me why that is?

SM: When I was younger I was even before I met you, which seems many, many, many moons ago, when I was younger, I was a musician. I used to play in bands. My first degree was in music. And I moved to London when I was 19. Chasing the dream, I developed an addiction for drugs and alcohol. Not that I noticed at the time, you know, because in the industry that we were working, it was fairly prevalent, you know, a lot of the behaviour that I was able to engage with seemed abnormal, probably to most people, but certainly not out with the realms of what was going on for everybody else. And for well over a decade, I really struggled with my mental health. And with addiction, I finally managed to get some treatment from the late my late 20s and early 30s through going to therapy. And that was run by the same team that we met. We met actually at a period of my life when I stopped drinking and drugging and started looking after myself better. And I realized that that time that not only was my behaviour, like unacceptable to a lot of people, but it was mostly unacceptable to me. And also notice that there was a number of people who are new as friends, musicians, artists, writers who on the face of it seemed to be struggling the way I had, but at that point, I just wanted to look after myself. And I started to get the help that I needed at the right time from really good professionals, which ultimately led me into my current career. I went back to school and retrained and I ended up becoming a therapist.

HR: Which is an incredible story and it seems to be one that’s becoming more and more prevalent. I want to get on to the three voices that we have on this episode. And for listeners’ benefit, you and I have had the list that we’ve had the chance to listen to these clips that we have on this episode. I’ve given you a bit of background on each of our speakers. And I just want to begin with you if that’s okay, Cuba’s interviewed by volunteer Isabel for Reclaiming our Heritage project. And for our listeners just to give a bit of background on who he was born in 1954. He grew up in London and move to Scotland at the age of 17. In his early professional career, he was a nursing assistant at Argyll and Bute psychiatric hospital in Lochgilphead located in Argyll and then actually moved into forestry and self-employed gardening. He’s also a published writer, and he voluntarily established the Easy Club, which offers music sessions for people with disabilities, learning difficulties, mental health issues, isolation, and more. So let’s listen to the clip of Hugh and Isabel.

[CLIP] HUGH FIFE [Isabel Interviewing]

IM: And when you first started working, how was mental health viewed?

HF: Oh, very differently. I mean, really differently. The psychiatric hospital had 500 when I started working there, and it had even been above that before that, apparently. And during my later time there, I did quite a study of the history of the whole hospital and I know that when it was called an asylum, when it was created in the Victorian era, there were an awful lot of well-meaning people about why it was done. And there would have always been good nursing and good care, but there were far too many people in there. And the classic thing of young lasses being put in there because they’d had a child out of wedlock and things. And people in there because of learning difficulties or injury and that were not what we’d really call psychiatric problems, and I saw a lot of it. And quite honestly, I’ll be frank about it, when I worked in the 70s, I saw cruelty as well from the nursing staff to the patients. I saw the opposite but I did see cruelty and great ignorance.

And I’m very still sceptical about the very high use of medication, trying to learn that when it’s good, it’s good but… It has all improved a lot, obviously things are much more out in the public eye and there are psychiatrists who talk of a whole range of therapies now, and staff are better trained in the right person-centred approach. And a lot of the hospitals have shut or shrunk, and that’s overall good and there’s an awful lot of good care in the community, in spite of difficulties. Yes, it’s got better. There’s a different kind of… I talk about people who have been…particular examples of schizophrenia, and then become totally institutionalised.

Well, I mean, there’s going to be less of that, in a sense, but there are wider, obviously, threats to mental health with the wider community in modern society. But then there are lots of good arts out there, so that’s got to help [laughs].

IM: Do you feel there was an arts and mental health community existing at the time that you started working?

HF: Oh, no, I didn’t. I wasn’t aware of it. I mean, of course there would be things, and things I’ve learnt since, that the concept is not brand new by any means. It’s the same as the thing I’ve been working in, people with mental health out in nature, and I wasn’t the first to see this kind of thing, it’s been there. But I wasn’t, in my early employment, really aware of any kind of movement in that way. And as I say, I go back to the beginning, this psychiatrist, a very fine gentleman he was, a local man, trying to encourage creative painting and was turned down. I mean, the psychiatrist did not have the right say in the way in the way the place was managed, it isn’t the same kind of management as has often been since, but there was management that was not doctors and psychiatrists and this one stuck his neck out, saying that there should be more people painting and was not able to achieve or make that happen in the 70s, incredibly.

I mean, obviously a lot of my thing is coloured by institution, even though it’s all shut now, but I still want and get frustrated. It’s a bit of a strong word, but I know there are still people in the communities of Argyll & Bute who are not accessing the potential, the local arts of the… It could be some of them just don’t want to, but some of them just are not aware of it or are too shy as to come forward and get involved. And that’s what I would like to see more of, that there are more of these people, some of them have been in mental health services for a long time, but would benefit if they got into more community arts and so on.

HR: Sean, just immediate reactions to that clip. Was there anything that stood out immediately for you?

SM: Depressingly, like Hugh’s experience is a fairly common one, fairly typical one of people who walked in the asylum and our rules about the asylum system in the UK, the asylum system idea was actually an improvement on the treatment that went beforehand and went onto the mid 1700s. If you are poor, then you would get locked up if your behaviour seemed in any way unusual, you could get locked up, poor houses, proper lunatics in the middle, obviously be what cases people will just be put to work. So it was a kinda indentured system, the asylum system was brought under because there was this theory that rather than looking at people having a moral deficit as the reason why they are poor, maybe people could have illnesses and the main and the might be treatable, the best way to treat it would be to basically create an environment and atmosphere that was different and helpful for these people in that, and that was built in big houses and the country where there’s space where people would be given the time to go for walks in nature to breathe to paint. So it was a vast improvement on the kind of treatments that had went before. But unfortunately, once the Asylums Act came into being, fairly quickly, the asylums filled up with people, and all at a time, it would still be the same kind of people that have been poorly treated in the past. And then through the sort of 1800s. And throughout the first half of the last century, you ended up with no money, poorly trained staff overworked you know, like, the ratio of staff to, to patients would be like astronomical, you know, it’s completely unsafe. So nobody was getting treatment. The original idea just became so bastardised and sort of turned into something awful. And Hugh recognises that that’s where he ended up.

HR: What do you feel has actually improved now compared to what you’ve just been talking about then?

SM: One of the things that Hugh mentioned, there’s really interesting progress, maybe moved slowly, in some unusual ways. Because like, in that respect, we are still a country, that probably doesn’t invest enough, in my opinion, in looking after people, both physically and mentally, you know, like, just health is health, and we probably don’t invest as much in that as we could or should but in attitude towards mental ill health. Like, there’s a really good TED Talk, a really famous TED Talk by a schizophrenic lady, who’s a psychologist called Eleanor Longdon. Like, she probably wouldn’t identify that we I just named her but like, it is absolutely fantastic. She taught, I think it’s called The Voices in my Head. She talks about how she was treated the way Hugh described through people like Eleanor Longdon, talking about the voices in her head, and normalising that it’s ok for some people to experience thoughts in a different way, age, a neuroatypical way. A lot of times if people access services now they would be treated differently. So I think that that is progress. It’s always qualified. You know like, some people will not experience it, unfortunately, because it isn’t uniform.

HR: Most definitely. Hugh mentioned, obviously, we’ve spoken about the Easy Club that he formed, and it was at the Argyll and Bute hospital, and it contains actually, what I hadn’t mentioned, a number of former patients and volunteers. And the main aim is to get the audience involved with their voices and various instruments. Have you seen more of these activities being introduced to try and support mental health over your time in this field?

SM: 100%. I think there’s been a growing acknowledgement as a psychotherapist, I’m well aware of the limitations of what I can do for people. And the thing is my perspective on how I can help someone is often wildly different than the person that’s coming in to meet me, because they often have this idea that they’re going to get therapy and it’s going to fix them in some way. But actually like the idea is that we have it within ourselves, but sometimes we will need help to unlock that potential to gain a better perspective or to make the changes in our life that will be useful for us. A wide evidence base and a wide acknowledgement that a holistic approach to mental health is probably way more effective than basically the this can Westernised model of just diagnosis. Recovery is a journey. And how can you support recovery? Well, you can be supported through medication, you can support it through treatment in treatment centres. But you can also support through the community, you can support it through peers. And then if you look at the wider thing, and the service that I used to work in treating PTSD, we had an art therapist on staff, who would work with clay would teach people how to paint would use photography would use walking in nature and mindfulness in nature, in order to treat some of the symptoms of PTSD. Those type of things recovery community approaches peer approaches using are using music therapy, using dog therapy, sometimes using horse therapy with some of the veterans that we’re working with. All these things have been shown to be as effective and in some cases, more effective than classical give you drugs and let’s talk about what’s happened in the past, which is a gross oversimplification of what I do like, but it just highlights the point that when someone comes to me and my current role in the university, and they’re saying that they’re really affected by anxiety and they describe panic, then a very small part of what we will do with them next, will be talking about what’s brought them here you know, what the presenting issues are, what kind of things they’ve got going on, like a lot of what we’re going to do is going to focus on the body focus on the context, you know, what have you got going on your life? Is it any wonder that you’re panicking, just know, when the stress that you’re under and the pressure that you’re feeling? What other things can we do that can help? How are you looking after yourself? Are you eating right? Sleeping, right, exercising? Are you doing anything for fun, you use the game, you don’t game anymore? You used to go out don’t do that, and we’re used to dance you don’t do that anymore? How can we start basically making your life look more like the kind of life you want to have. And rather than just doing bits and pieces, by chance, actually building it into an actual proactive therapeutic intervention, you know, an actual treatment plan, all the evidence would indicate that that kinda approach is not only like, going to be effective, it’s going to be more fun for the person, you know, that they’re going to live their life or for someone who’s going to try more things enable doing more things is going to be more enjoyable, you know, more beneficial, and that seems to be desirable for me as a therapist.

HR: So I’m now going to introduce everyone to Dougie, he was born in 1954 and grew up in Laura Largo. He studied in abundance for a BA in accounting and finance, but it didn’t work out and mental illness set in. However, he did go on to complete his degree in later years and went on to become successful. Later, he took voluntary redundancy because he was experiencing mental illness again. Despite being out of work for 20 years, he went on to become an artist, writer and musician. He was in hospital and found this very challenging as drug therapy is not something he was happy about. And he would be locked in at night because of security, which meant he couldn’t do things like meditate. Three times he was distressed. He was pinned down by around four nurses and injected with a sedative, which is also known as Acuphase. Very sadly Dougie has passed away since the recording of this interview.

[CLIP] DOUGIE [Isabel Interviewing]

IM: So, in 1976 was there a particular perspective of mental health or did you not feel that at the time?

DS: None of us knew what was happening. My parents didn’t know, I didn’t know what was happening. I’ve got a severe mental illness which they diagnosed two years later, first of all they said I was a schizophrenic, and then two years later they said I was a psychotic schizophrenic. Then eventually they said my diagnoses was Bipolar Schizoaffective Disorder, and they don’t talk about that, nobody talks about that. They are beginning to open up about mindfulness and the meditation and helping people with anxiety and depression, but they don’t talk about schizophrenia or weird disturbances. There are some bipolar groups for people with manic depression, which I believe they don’t use that expression anymore. There are songs that musicians have written, like Jimi Hendrix wrote one, and yes.

IM: Is there anything else that you would like to say or anything you feel we haven’t discussed that you would like to add?

DS: Spirituality, [pause], a lot of the things come from within, and it depends on what kind of spiritual outlook we have as to what kind of materials you produce and what kind of songs you sing. Some of my artwork is related to the Balloch Line World Spiritual University where I am a student, I’ve been a student for 40 years, almost as long as I’ve been mentally ill I’ve been doing meditation and studying spiritual knowledge, and it is sort of half and half, it influences everything I do, from what kind of food you eat, when I sleep, kind of what I do, so I think it’s important to have a spiritual aspect to do art, and also a spiritual aspect to mental health, because they are now exploring mindfulness as a way of assisting people with their mental difficulties and there are things above that, like transcendental meditation was a sort of start point, and mindfulness is a step up from that, and Raja yoga is a step up from that and it’s the highest form of yoga or meditation that you can do. Raja means King, and yoga means union. So, Raja yoga means, the highest yoga, it will transform you into being a royal person, and that’s the aim to be a royal person, like [inaudible 51:48], the Worst Empress of the golden age which may happen or will happen quite shortly. Om shanti.

HR: I just want to talk about Acuphase to start off with Sean, if that’s okay. Have you spoken to other people that have experienced that?

SM: Different formats or different forms, but similar experiences like the it must have had ailments and psychosis in order to get that diagnosis. So often people who experience psychosis are the people that practitioners are often the most afraid of, you know, because psychosis is this big scary thing. You know, we all have thoughts, and we all have in our dialogue, and some people’s inner dialogue can become external and seem like another person. But psychosis can often be something, I mean, you only have to look at how the police have treated people with psychosis in the past, and some really famous cases. It is something that causes fear so often, that the first response to an episode of extreme psychosis would be that someone would be restrained in some way. And often, drugs would be administered without their permission. Often, unfortunately, depending on what type of episode the person is experiencing, there’s a good rationale for doing it, you know, sometimes, that the rationale is that this is designed to keep the person safe. But the context is key. And sometimes there may be other ways to deal with the person in that situation.

HR: Dougie touches on it there and certainly from my perspective, anxiety, depression and panic are things that are becoming far more normalised in conversation, but people are still approaching with trepidation, conversation surrounding schizophrenia, bipolar disorder, schizoaffective disorder and more. Firstly, I want to ask you, do you feel that that’s more to do with a stigma attached to it?

SM: 100%, stigma and fear, you know, each individual would need to basically answer for themselves as to what their reaction would be. But certainly, I’ve worked with other professionals who, and services who when you mentioned that someone like has psychosis they visibly withdraw, you know, like, they would say things, that’s too complex for our service, you know, we shouldn’t be, you shouldn’t be working with him, or we shouldn’t be seeing that type of presentation here. Because our service isn’t set up to work with that. The reason why the person would be coming to our service was because maybe they had a drink problem, or maybe they would experiencing sort of traumatic re-experiencing that was causing them stay indoors or you’re affecting their life quite profoundly. There is a fear element. Historically, people who experienced psychosis, I think had been linked with violence maybe, you know, I don’t think the media has been helpful in that, you know, there’s loads of portrayals in the media of people experiencing psychosis that have been really unhelpful. So I think we have a culture of where we accept things like we’ve come to a place where because it’s more commonly talked about and people accept anxiety, they accept depression, they accept substance misuse, they accept agoraphobia and panic, you know we’re ok talking about these things, but when it comes to the big things like schizophrenia, bipolar, like stuff but that maybe is linked to an analysis and maybe something that’s also linked to people who are neurotypical, you know, people who have are on the autistic spectrum. The portrayals that historically that people in the autistic spectrum have had in the media tend to be the most extreme versions. And that’s often not what people present with. So rather than seeing the person, we hear the label, and we respond to that often enough, in a way that’s not helpful.

HR: Yeah. One of the things that I really wanted to include in this was Dougie talking about spirituality and meditation, because I do feel that it’s something that’s become more prevalent. I remember when people would even describe to me negatively about it. And again, in the media, they can be very negative, and so on. But there’s millions of apps now there’s gurus, there’s classes. How have you seen that evolve over time?

SM: It’s absolutely incredible. It’s hard for me not to be enthusiastic about it, as someone who was brought up with a specific sort of religion and didn’t feel any affinity to it, and don’t really have any supernatural beliefs, so I was always taught that spirituality was linked to religion. But actually, once you have stood in a tiny room, in a cafe in Falkirk doing Tai Chi were with 10, or 12, like heroin addicts, you don’t understand what spirituality is, you know, spirituality as Dougie you described, I mean, it’s linked to that sort of Zen Buddhist idea that if your cup is filled, then you have no more room to learn. And if we see therapy as a journey in and see life as a journey, then that spiritual aspect is a journey as well, they voyage of self discovery, but also discovering who we are in this place that we are, whether it be in a room with a couple of people, or whether it be in the wider communities and the different groups of people that do exist. By the time I finished working in substance misuse services, I would see people coming out of an AA meeting and going straight into a meditation session. Now that would have been unheard of 30-40 years ago, a bunch of guys like sort of in Govan, leaving an AA meeting and going on and meditating for half an hour, 40 minutes, you know, doing a Guided Discovery, there’s, there’s your health, there’s your physical health, there’s your relational health, but then there’s your spiritual health. And it’s this idea that if we have spiritual deficits, then that means that we are not well. It just seems to be a really effective way of getting people in touch with who they are and being more compassionate towards theirself. Kristin Neff does loads of stuff about this on her website, an excellent resource. There’s loads of really good guided discoveries and new stuff that our stuff is really focused on developing a more compassionate way of seeing yourself and seeing yourself in the world. And if that’s not spirituality, I don’t know what is and the chat amongst the therapists will always be that everybody’s, knows this other stuff that’s really important to focus on and, and it’s really effective for treating people you know, and you don’t need a therapist to do this. You know, it’s basically just, it’s what people have been doing for centuries.

HR: Yeah, in Dougie’s full interview, he talks about volunteering in occupational therapy with Royal Edinburgh Hospital thanks to his talent and love within music and art. I know certainly, again, from my experience, and I’m sure you do for yoursl, I know you do for a fact. And you just want to help people with what you’ve lived in your life so that they don’t have to go through the same hardship. Do you see this time and time again with some of the people that you’ve been working with and who you’ve spoken to?

SM: The 12 step program, one of the steps is that you give back, you know, basically, it’s all about like, your wellbeing and your journey will only be like, sort of on the right road when you’re able to help others. And one of the questions we ask in assessment in every service that I’ve worked in has been are you being looked after by anyone? Are you being supported? But also are you able to support anybody else? Because if you’re able to support other people, then that tells you something about how well someone’s doing, because not only does it mean that they feel well enough to basically engage in this, but also means that there’s something in their life that actually is empowering and gives them agency. And as useful. There’s a whole positive psychology thing about sort of gratitude. That’s one of the things that you can actively practise. And part of gratitude involves being able to give of yourself, you know, without feeling or thought about other people, because you’re grateful for things that people have given you. The danger is basically not looking after yourself while doing that creates a deficit, you know, that you’re only giving to others and not looking after yourself. If it can become a healthy thing, then it’s a really powerful tool. It’s one of the reasons why peer communities, the idea of peer support is so effective, because people respond better to other people who have got lived experience they just do, but also our reciprocal community where people who see other people giving it changes them because all of a sudden that says, Well, if this person’s given me then I must be worth something. I’m worthwhile over here. person’s given me and not doing it for nothing other than because that’s what they do.

HR: No, I think you’ve just positioned that so well. I’m starting to learn more about gratitude and trying to practice it more. And I just think it’s such a beautiful kind of idea in general.

Our final voice is Chris, who was interviewed by Ros. Chris was born in 1966, in Glasgow and grew up in Yorkshire then returned back to Scotland. And professionally, he is now the citizenship and participation officer for Mental Health Foundation. He struggled with mental health and was in and out of hospital in the 90s, he joined community based writing groups, including Survivors Poetry Scotland, which helped his mental health and continues to work in these fields to help break the hospital cycle. And so let’s hear from Chris…

[CLIP] CHRIST WHITE [Rosalind Interviewing]

RS: Okay. Can we talk a little bit about public attitudes. So when you first began your work, how was mental health viewed?

CW: I think, you know, we are talking about the kind of late 1990s, early 2000s, there were a lot of hospital closures. And within communities that we would generally kind of say had 3lots of inequalities anyway, people were being rehoused. So I was…I’ve lost my tendencies during the times that I was in hospital, so kind of on discharge, got allocated a council house, local authority housing, in not the best areas of the city. That was quite common, lots of people found themselves in those areas.

So that did create some tensions within communities because folks would know who the houses were that the mad folk got put in. And particularly if there were times where in that, I was still having some hospital admissions, so there’s the mad folk getting taken to hospital in the ambulance. And so coming back from hospital, getting discharged from hospital back into a community that wasn’t your community anyway, you don’t have a choice about where you got allocated housing, and feeling kind of different and stigmatised, and then having these kind of experiences where people saw you taken away, was always very, very difficult. But there was a societal kind of expectation that, well, actually that’s what happens, that’s where you get rehoused. And of course you’re going to be stigmatised, you just have to get on with it.

RS: How often did people talk about mental health, their own and more generally?

CW: Again, you know, you kind of had to separate bits of my life. So where I was with folks that hadn’t experienced illness or hadn’t experienced hospital admissions, then don’t say anything about your mental health. And that was quite difficult where you do have hospital admissions and [pause] I would go to the pub two or three times a week, because you don’t have a so-called social circle. So you go to the pub and then, you know, you don’t go to the pub for four months and then get discharged. And folks go, where have you been? There’s very few places that you can go for four months if you’re unemployed and living in a poorer area of the city, you know, it’s kind of did you go to prison or did you go to a psychiatric hospital? They were kind of…so that was kind of difficult, so you tried not having conversations in those…about mental health in that sense.

And then touching base with folks who had been in hospitals, in community-based groups and such, there was a whole different language. We would use a very kind of clear mad language and would talk about kind of experiences together that you just couldn’t have elsewhere. And working in mental health these days, actually I couldn’t have very many of those conversations today because there’s kind of an insider language.

HR: First of all, I want to talk about language and how it’s changed. Chris obviously gives examples there about some of the language that was used when he was having hospital admissions. You’ve obviously explored a plethora of learning through conversations in education, how stark has a difference been over the years?

SM: Yeah, very different. And you know, it’s an ever moving field. And I think it’s one of the things I mean, I’m always willing to hold my hand up and say the bits of my job are the bits that I would like to be improved, you know. And I’m the sum of my parts I grew up in East End of Glasgow, the language that I used to describe things, in the main comes from those places that people are mixed with my family. It’s one of those things where it’s crucially important that people are able to be identified by how they would like. That involves me changing how I perceive language and use language. And it can be tricky. There’s more and more events… When you’re a therapist, you have to do like correctly a certain amount of training every year, you know, like just basically in order to keep your accreditation, with your accreditation bodies, and more and more, there’s training and being offered about how to discuss things correctly. Now the only reason that there’s all those trainings available is because it’s clearly an ongoing problem. You know, the language that people use, to talk about things historically, has been poor. I remember, one of the services that were very very specific about how they would call people who used the service, and it was service users they were not clients, even though they were encouraged to call people clients, these people aren’t clients, they aren’t basically coming to us, and paying for a service and using the service. They are service users, we had a service in the end user service, we do call them patients because we’re not patients, they’re not ill, you know, the human beings who are using this service because they have a need to use the service. Very few people address themselves as an alcoholic these days, people who have problems with drinking rarely see an alcoholic, they see a problem with drinking, or they say I don’t have a problem with drinking, which is the problem. But nobody wants to be called an alcoholic but in the past, if you came in a service and you were identified as someone who had a problem with drinking, then you would be called an alcoholic you wouldn’t have a choice in it. And it’s the same with things like Dougie’s explanation of manic depression, you know, like manic depression is a really poor name anyway because it sounds like mania as one of the major problems. Mania is the smallest part of bipolar disorder. The problem with manic depression is people are really, really depressed most of their life. The mania is a relief from depression, the depression is the thing that’s hard to contend with. So historically, things have been called really unhelpful names and people have been called really unhelpful names. And that continues because human beings are human beings.

HR: No 100%. Coming back to the arts, and Chris talked about poetry within his full interview and the importance of the groups that he was part of. It’s come up in quite a lot of the conversations, poetry, not just this conversation, but a number of them. Do you think that from an older generation’s point of view, and you’ve probably might have come across this? They think that things like that are totally nonsense, and that people just, they go with the attitude of you need to toughen up? Or have you been quite surprised by the level of acceptance for it?

SM: The two things probably coexist at the same time, people have like, a real ambivalence within them, you know, like, they’ll come for, especially if we’re talking about older people. So older me, I feel pretty old these days, Halina, you know, like, so especially, like, in the team that I work in the university, I think I’m the third oldest person and the entire team, you know, so like, if we’re talking about people that I’ve treated in some way that are like a generation older, you know, so like, maybe 60 and above. I think in general the the hold both of those ideas at the same time, because they’ve been brought up with that that was that experience, you know, it wasn’t talked about or it’s basically you just got on and they’ll come to you and say I should just go on I should just basically be happier. I should just be more positive and say am I actually know if that’s possible? I don’t know if you can just go I’ll be more positive and flick a switch and it comes on and If we accept that, it’s okay for people to have this idea, change comes through experience. So often it’s about saying, Well, tell me about us, let’s basically just try something that you’ve no done before, because what you’ve been doing up to this point hasn’t really worked so let’s experiment and try some different things, this was really interesting. In the clip there, you get a glimpse of sort of writing in and narrative work and those are really, really powerful tools in therapy, narrative therapy is a really useful approach. And it can be a really effective approach because it’s completely non judgemental on it’s the person basically telling their story objectively and not basically being affected by the emotion of it in terms of blame, blame of self blame on others, it’s just like, these are the facts rated don’t it can often mean people could step back in have a more compassionate view of what’s happened. Now, writing poetry or writing songs, or even writing stories that are length to your life, you know, what we have processing and the memories and, and, and are more useful or helpful way. It can be a really, really powerful thing. There’s a specific type of therapy that I’m trained and called narrative exposure therapy that we useful for helping people with trauma, and it was designed, in a really simple way. So it doesn’t need to be a therapist that staff, it could be a because it was designed to be used in refugee camps. So you would go and you would go in a refugee camp, and you would train some of the elders to basically do this narrative exposure therapy. And it’s just a way of teaching people to tell their stories, that safe that keeps them safe, even though they’re really traumatic things and in talking about it in a safe way, in a visual way, because they see things they see, they use stones and twigs to represent different types of events. And in doing that, it allows people engage with memories and work through them without being affected by the emotions of what they experienced. It allows their emotions to change to something more reflective than feeling present in the moment. And I think poetry and writing and art, photography, creating things that represent our experiences of the past, they can all do that if they’re nurtured in the right way.


Hugh, Dougie and Chris all spark a number of different talking points in this episode. Attitude is one of the main points that is raised when discussing mental health over generations. Whether that be attitude to mental health, attitude to to treatment and attitude to incorporating the arts. Whilst empathy and understanding has liberated approaches more, it’s still clear to this day that more investment is needed when it comes to health, wellbeing and support. Progress in this will hopefully see this evolution mirrored as it has done with attitude. This progress and fair access is especially needed when it comes to the class system, geographical placement and gender.

It’s important to move outside our own bubbles when it comes to understanding the experiences of others when it comes to mental illness. This also brings the education around what will help different people over generations. Whilst evolution in technology has brought the internet and a new digital landscape, we have to understand that this may not be what benefits generations and differing experiences and Sean articulates this perfectly when talking about a 55-year-old man with a heroin addition or a 60 year-old-woman with trauma that has resurfaced. But his point about making things work for as wide a range of people as possible is where, it can be argued, the concentration should lie.

With all 3 testimonials, the arts have been key in their journeys and having the means to explore creativity in different forms including with Scottish Mental Health Arts Festival has helped to further this. The way that creativity can be incorporated with recovery has clearly given a freedom, an independence and also a notable means of therapy. Community is a vital part of this and the positives it brings. Ultimately, Arts can be used in a reflective way, they can be as Sean says “if nurtured in the right way” engage, educate, communicate and ultimately help recovery.


This podcast has been presented, produced and edited by me Halina Rifai for the Mental Health Foundation with music by Lucy Parnell, the reclaiming our heritage project is funded by a number of donors including an “Our Heritage” grant from the National Lottery Heritage Fund.