M I C A Carers and confidentiality robbing the poorbox about schizophrenia about depression

Consider the porcupine: the closer it gets to another , the more prickly; the further away from an other, the colder it is. G C Homans the more often you are with someone, the more you like to be like them, or you move to hating them - the sentiment increases with the contacts The people you are most often with is your family of origin. No other people are more frequently met with, Frequency of meeting may well include reminiscing - mental meeting. From that frequency of contact comes feelings of loyalty and obligation Losing those positive meetings leaves a big hole. About anxiety. About anxiety ... What is felt in uncertain circumstances, alone or with uncertain relationships of help. The paradigm is somebody leaving a familar territory, unaccompanied and moving across a border - the uncertainty time and place - into another unknown territory, where the rules are not personally secure, and someone else is better prepared there and the hierarchy is uncertain: called transitional states - all deriving from crossing properties; boundaries For the receiving territory - are you a friend or an enemy, a threat or an ally. The same uncertainties occur in growing out of one stage onto another - puberty, adolescence, changing jobs, changing and abandoning partnerships, marriage,pregannacy, starting school, accepting promotion, facing retirement. Previous securities are not here. For some this is a temporary state - reflecting anticipation about failure on some particular matter, which is time limited to that paricular occurrence, and returns to base level after that. For others, they are always somewhat anxious personalities - sensitive - ready to anticipate and fear the worst, and this will peak as some deadline approaches, often replacing a previous over confidence in facing a particular problem. Some public exposure seems necessary for the anxiety. On their own, failure brings self criticism, shame,guilt, and depression, which dissipates over time. There are general points to be held in mind when thinking about anxiety. It is a universal feeling, if more with some than others. Therefore there have always been cultural ways of 'handling it'. 1. Reliable companionship. Someone present at your side , guarding behind your back. 2. A safe place where your own kind live. Familiarity. Your own crowd and your own position in it, with friends. A tribe, a state, a religion. Best to anticipate change and have another network in hand. If the companionship becomes uncertain unstable then ... 3.... 'distancing' is available from exposure until regrouping about the anxiety object or situation. Money helps. Going out to settled work brings distancing from home and different companionship and security. Going home from work provides another safe resource. But what about the 'stay at homes' solitary and/or minding smaller people - they depend upon the companionship and security from those who leave the home and go out to work; or what is left in the neighbourhood - not so reliable ? Doubt the confidence in those and .. ? Men can grab distancing - they can shout and aggress. Women, on the whole, look to companionship, and try to replace a bad one? Failure in 1. and 2. 3. Sedatives - alcoholic drink of various cultural kinds - institutionalised - so that everybody knows the rules. Generally used where uncertain people come together in mixed companies of people - at feasts - at football matches, in 'protests', at parties, to ease rhe anxiety of what might come, and is unknown. Troublesome when cultures and generations clash. John Bowlby - of maternal separation fame - declared what happened to infants when both their base and their chief companion was lost for a while - drew attention to the value added effect of different sources of anxiety coming together. alone 1. in a strange place 2. in the dark 3. hearing a noise 4. without companionship 5. add 6. with a reckless companion who won't go away. Bear these points in mind when assessing anxiety and how to relieve it. Any anxieties in the background should be settled before taking on new ones. Marry well. Helping phobias - phobic anxieties - follows the same lines. Start off with the background in a safe place, obtain a companion in whom you have built trust. Then try out the fear object under the most favourable conditions, increasing a bit at a time, with your trusted companion somewhere on hand at appropriate distances. All psychotherapy depends upon building and testing out the trusted relationship - the length of the interviews the time inbetween interviews the work set or expected in-between Take house-bound anxieties. Begin with explanation. Create the companionable trust. Best to start from somewhere outside, with the trusted companion, and the testing exposure outside is in the safe homeward direction. Whilst out with companion, find and try out sanctuary sites -fail safe places that can be eventual stopping points, breaking up journeys. Overdo the cure

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