Staying stuck in mental distress (and low self-worth)

[Could be considered Part 1(b)ii
of the previous series Part 1 and Part 1(b)]

[If you'd just like the recommendations, skip ahead to the bullet pointed section about a third of the way through the post]

My lived experience
    I write as someone who's pretty much had mental health difficulties all of my life.  Once upon a time I would've been embarrassed to admit that, but not anymore.  I've realised there's no shame in mental ill-health and I now talk more openly about it, as I believe this helps to de-stigmatise it.

Diagnoses, and lack thereof
    I've come to believe I've undiagnosed ADHD from childhood.  And that has always tended to bring with it criticisms of being disorganised, scatter-brained and even lazy.  You get told that enough throughout your childhood (and adolescence, and early adulthood) and at a certain point you internalise it.  Not to mention all the time spent comparing yourself to others.
    ADHD also brings with it anxiety and overwhelm from constant efforts to mask and fit in.
    Then there's the rejection sensitivity, sometimes known among sufferers as rejection sensitive 'dysphoria'.  If you don't know what RSD is, it reflects an inability to regulate emotional responses to stimuli.  And having what would be perceived as exaggerated reactions, disproportionate to that stimuli.  For example, an argument with a friend in the mind of the RSD sufferer means that the friendship is over, you'll never speak again and you're a terrible person.  With all the emotional anguish this perceived reality brings with it (albeit -generally- temporarily).

    I was a highly anxious and neurotic child, teen & young adult, eventually getting diagnosed with generalised anxiety disorder.  (How much of that's related to the ADHD and how much is a whole separate thing will -I guess- never be known.)

    Chronic physical ill-health, an unpaid caring role alongside full-time work and chronic work-related stress later added depression into my collection.

Attempted treatment
    I was first offered treatment by the department of psychiatry in my early 20s for social anxiety.  But I felt -at the time- that the CBT which was offered to me was not a good fit, and I was unable to engage with it.

People I see stuck in mental distress
    Now, with the benefit of age and experience, I sometimes see others who I feel are in a similar position.  People who are having chronic mental health difficulties, and seem to be stuck there.
    I imagine there are a number of reasons for being stuck (not having found a source of support or a therapy type which is a good fit, for example).  But I wanted to address one of those reasons in this blog post.

    I see people who either won't seek help, or have had some help but been unable to take it on board and allow it to improve their situation.  Like when I was in my 20s and couldn't engage with the CBT which was all that was on offer.
    In part being-unable-to-engage was due to it being uncomfortable.  And my lacking awareness that the discomfort was something which needed to be tolerated to come through the other side and begin to have a better experience.  (And, as I've come to learn latterly, that distress-tolerance is actually even a useful technique to practice.)
    But I think part of it was also an extremely low sense of self-worth.  A subconscious part of me didn't think I deserved to feel better.  I somehow deserved to be punished, so I stayed stuck in feeling bad.

A possible root cause?
    The people I see around me who seem unable to move on into that better experience?  I feel like a lot of them are likely stuck, the same way I used to be.
    Someone in their life taught them -through their words, actions or lack of action- that they didn't deserve any better.  Abuse, bullying, neglect, coercive control.  These are things which are inflicted upon people.  And the perpetrators want their victims feeling low, so that they won't stand up for themselves or leave.  This doesn't mean that it's in any way deserved.  But -sadly- the insidiousness drives the message deep into a person's subconscious.
    In my case -looking back- it started with the RSD in childhood and some bullying in school, then was really compounded by an abusive intimate partner in my mid-late teens.
    I've seen people for whom it was caused by bullying.  I've seen people for whom it was either a neglectful, a hurtful or abusive parent.  I'm sure it could be caused by teachers, coaches and other such figures, even.  Or a combination.
    And as we know, a lot of folk who've experienced harmful people in their lives tend to find themselves attracting more damaging people in their relationships going forward.  It's that insidiousness, again.

Recommendations
    So, what do I -a layperson, but with lived experience- recommend?

• First and foremost, allow yourself to believe that you deserve to feel better.  It may be easier said than done.  But for almost everyone on earth, there are people who care about you.  So if you can't yet accept that you deserve this for you, then do it for those people in the beginning.  You'll be in a position to be a better friend/spouse/co-worker/team-mate/neighbour once you start working on yourself.  And if you're currently socially isolated, know that starting to feel better in yourself will undoubtedly put you in a better position to start making new connections.
• Reach out for help from services when you feel you need it, but do be aware that the first thing which comes along may not necessarily be most appropriate for you in the long term. You might need to have a little bit of patience & perseverance before you're able to get into your stride.  Don't give up.
• With the above in mind, if you can afford to shop around, it's fine to shop around and find a good fit.
• If you can't afford to shop around and instead have to rely on free help (like here in the UK under the NHS) it's still okay to ask the question as to whether you can speak to someone else if you don't mesh well with the therapist.  It's not a personal failure of yours if that happens -- it's going to be vital that you feel you can open up to the therapist; so if that doesn't seem like the case, then you're entitled to at least ask about the alternatives.
• Try to be open minded about the type of therapy offered.  And actually give it a fair go.  It isn't meant to be comfortable, certainly in the beginning.  But it also isn't powerful enough to work after only 1 session, so you're going to need to persevere for a while.  (This is another reason why finding a good fit is important if at all possible.)
• It doesn't necessarily have to involve talking about past trauma, at least not extensively.  A therapist will likely want to have a rough idea of your background, but a good one should understand if you'd rather focus attention elsewhere.  For example, you may chose to look at specific goals, or practical exercises to help with your chosen areas of concern.  In fact, they'll likely be encouraged that you've done some thinking about what you want to get out of therapy.
• Reflect.  Whether you're having face-to-face sessions or online, try not to be intimidated by periods of silence -- reflecting on your thoughts is important, and helpful, so see silences as a chance to do so.
       Try to reflect between sessions as well, and even make notes to bring to your next session.  (If you're following some sort of online course involving reading material &/or written exercises, or reading a book, you can still reflect and re-read sections.)  You can even discuss the material with a trusted confidant in between sessions if you feel comfortable and have someone in your circle who'll be supportive with it.

In the meantime...
    What if you're not able to access therapy right away?  Or you're in the process of finding that good fit and haven't found it yet?

• The 1st bullet point above still applies; you deserve to feel better.  This is probably the most important of the bullet points.  Take steps to address how you're feeling -- seek out books &/or online resources.  I highly recommend Why Has Nobody Told Me This Before by Dr Julie Smith.  It's available on Audible, as well as in hard copy.  I will also put a list of other resources at the end.
• If you haven't already, try to confide in a friend, family member or other trusted confidant as to how you're feeling.  You don't necessarily have to go into details if you don't feel comfortable.  But having someone who knows a little about what you're going through at least means you can express it when you're feeling low.  They might be able to give a gentle pep talk, or just a hug (depending on the relationship you have).  Or at the very least they can probably help take your mind off things temporarily by doing something together.
• Self-compassion.  Once you've taken on board that you deserve to feel better, try to cultivate some self-compassion.  All of us have automatic negative thoughts, and they keeps us stuck feeling badly about ourselves.  The first step is to try to spot these thoughts.  It doesn't necessarily work so well just think the opposite of them right away.  So -for now- try to alter them into something neutral instead.
       When you catch your brain thinking: "I can never seem to make small talk", don't try to pressurise yourself into thinking you're amazing at small talk.  But instead, tell yourself you just need more practice, like a lot of people.  Try to gradually change the negative self-talk into neutral, and in time you'll find you're ready to start giving yourself pep talks, like those you'd give to a good friend going through a tough time.
• Self-care.  I know it sounds corny, but allow yourself to have regular self-care on a daily basis, as a minimum (preferably two to three times every day).  It doesn't have to be a long soak in a bubble bath (though it can be if that's your thing).  It can be taking a little extra time to make yourself something healthy to eat, or taking a walk outdoors.  It can be taking a few minutes to sit down and savour a beverage during an otherwise busy day, or even just sitting with your eyes closed for a few minutes.
       Whatever it is, pick something which -to you- represents self care -- maybe make a list of self-care activities in a little note book and keep it with you.  Self-care is a way of demonstrating to your subconscious that you deserve to feel better.
• Consider journaling.  I've not been very successful at this one myself (my mind always goes blank when I sit down to write)  But lots of people have recommended it to me.  It turns out, as well, that there are lots of different types of journaling you can try, too.  So I recommend an internet search for journaling techniques, to find one which appeals to you.
       [I will add one note: when I have tried journaling to get the distressing thoughts and feelings out, I've preferred to write it on a loose leaf of paper, and then dispose of it rather than putting it in a notebook or journal which I'm intending to keep.  But I do also know that some folk like to look back at past entries to look for patterns, or to see the progress they've made.  So, it's one of those personal preference things.]
• Affirmations, but this one has a couple of caveats.  The first caveat is that I believe manifestation has it's limitations and isn't a panacea or cure all.  So make sure you don't make it your only approach.
       The second caveat is -from personal experience- the affirmations you choose need to resonate well with you as an individual.  Because -from personal experience- if you try to tell yourself something which your mind sees as outlandish, it will contradict you (at least mine does, anyway!)  For example, if you try to tell yourself "I'm perfectly happy", the next thought to surface is likely to poke holes in that, such as "that's bull, I'm actually really stressed out..."  And that just seems counter-productive.
       So, be choosy, especially if listening to audio recorded by someone else.
       You might also like to try this grounding technique instead from the Therapy in a Nutshell YouTube channel, at least to begin with: Relaxed Vigilance.
• Relaxation &/or grounding exercises.  Lots of us get stuck in fight-or-flight mode, making relaxation really difficult (search the term 'nervous system dysregulation').  But know that relaxation doesn't necessarily just arrive after you finish work, or get home from doing grocery shopping, or whatever.  Very often you need to go after it, proactively.  And it doesn't just mean watching the television or playing video games (indulging in some of that's fine, just not too much).
       Now, along with journaling, I struggle with this one (despite it feeling good when I do occasionally take that long, slow breath).  So, rather than recommending specific relaxation techniques, I'm -again- going to suggest doing an internet search.
       And if you spend the last chunk of your day -say an hour or so- before bedtime doing your relaxation, it's likely to help with sleep.  But do set aside time for this after your TV or video gaming session, ideally every day.
• Mindfulness is really big these days.  I've listed it separately to relaxation, because mindfulness doesn't have to represent an hour out of your evening (nor even 20 minutes).  Instead, mindfulness can feature at intervals throughout your day.  Plus, I wanted to talk about different types of mindfulness.  I'm heading this one: think outside the box.  In other words, find what works for you as an individual.
       For example, I've heard some stuff about mindful eating.  But, you don't necessarily have to savour only the flavour of the cup of tea or bowl of soup.  You can sense the warmth and texture of the cup in your hands, if that works better for you.  You can watch the swirling of the steam in the air.
       If -like me- you struggle to do mindfulness purely within the mind (if that makes sense), try something else that's tactile.  Cup your face in your hands; notice the relative temperatures of the skin of your hands and your face.  Focus on keeping your spine in the optimum position for a bit, but without tensing -- turns out it may take more concentration than you might think.
       Or, you could try something visual -- try to memorise your toes, or trace the tangle of branches in some trees with your eyes and just allow yourself to get lost.
       Just pick something mindful to do at regular intervals that works for you.  Get out of your own head, as they say.  Reconnect with your body a little.  And know that it's giving your mind a little break each time.  Plus you're cultivating a healthy habit which will only become stronger over time.

    These last two, relaxation and mindfulness, can really help with the mind-body connection.  So, whilst -on the face of it- they might not seem to be helping directly with feelings of low self-worth, they'll help to regulate your nervous system.  This, in turn, will help send signals from your body to your brain that all's well.  Plus these activities also come under the category of self-care.

    Finally, exercise is also meant to be really helpful with depression.  So it can be extremely helpful to find a physical activity you enjoy doing and take up doing it regularly.  If -like me- you struggle with regular exercise, at least know that movement can be helpful in moments of anxiety and stress.  Even if all you do is stand up and shake out your hands & feet for a few minutes.

    When you've come to the end of the bullet points... go right back to the top and begin again.  (Or, just pick a random one anywhere in the list.  Or, for that matter, if the above list doesn't speak to you, come up with your own ideas and practices.)
    You see, this isn't a one-off exercise, it's a process you want to make into a well-established habit, like training a muscle via gym equipment.
    And hang in there.  You do -I'll say it again- deserve to feel better.

Other resources to consider exploring

• Apps for self-care posts: post 1 (from June 2020) and post 2 (from January 2022)
• CIMHS/Bliss Free Online Therapy for Depression free short course
• Crappy Childhood Fairy free online resource (e.g. daily practice)
• Empowered Self - The Somatic Strength Collective (free 7 day trial)
• Every Mind Matters - NHS
• Getselfhelp.co.uk
• Meditainment | Guided meditation and visualization
• Meditation - HelpGuide.org
• Mental wellbeing audio guides - NHS
• 'Overcoming' Apps
• Psychkit.org
• Rhythm of Regulation Meditations
• Self-Administered EMDR (Is it A Good Idea For You?) - YouTube
• 750words.com -- daily writing habit site
• Side by Side | A community platform by Mind
• Therapy in a Nutshell | How to Process Your Emotions - YouTube (see Somatic exercise - The Robin, in particular, and also 6 Keys to get WAY more out of therapy may be helpful too)
• Wellbeing Support | Activities & ideas | British Red Cross
• Wysa - Everyday Mental Health app

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Seek first to understand...

    Just a somewhat brief post about an incident which occurred on the street today.

    An older man had -it appeared- fallen and was laid on the path beside the road.  My friend and I were on out way to get coffee and passed by him.
    We asked the man if he was okay and when he said yes, & that he was sure, we were about to proceed on our way.  But it didn't sit right with us, so we hesitated.  No-one lays on the path beside a busy road in the traffic fumes if all is well.
    Another group of people also stopped to ask the man if he was alright, and if he wanted a tea or a water.  He declined their help.  We all hung on for a few minutes, encouraging him to accept help to sit up, at least, because he looked really uncomfortable.  He said he wanted to sit up by himself, though.

    The other group noted the man had a gash on one of his cheekbones.  He wasn't very coherent when asked what had happened, and his speech was indistinct so it was difficult to communicate effectively, but he seemed to say he didn't want an ambulance summoned.
    The other group went on their way, but my friend and I hesitated, because it occurred to us how vulnerable the man was.  He had retrieved his mobile phone (an old model, not worth anything, but still...) from his pocket and had it in his hand.  The area is not an awesome one in terms of rates of violent crime.  And you hear stories about people perpetrating violence on the vulnerable, such as houseless people.

    What struck me was that -while my friend and the other group of folk stood pondering what to do for the man- numerous other people commented to us as they passed by.  They said: "he's often around" (presumably implying that he's unemployed) and they also said: "he drinks" or "he uses".  Their tone of voice was disparaging.

    Why did these points of 'information' (whether true or not) mean that this man wasn't worthy of having emergency aid summoned for him?  Even if he was under the influence of something and had fallen because of it, did that mean he shouldn't get checked over by a paramedic for a concussion?
    Would it have been okay if he did have a concussion perceived as 'self-inflicted' and we all left him there to deteriorate, or for someone else to steal whatever cash he might've had?
    Alternatively, isn't it possible that someone had hit him in the face sometime prior to our arrival?

    So, my friend and I called an ambulance anyway, and then went to get our coffee at the nearest place so we could see when the crew arrived.
    Meantime, the man had actually got himself into a sitting position, put his cap back on his head and then managed to get to his feet.  He lit a cigarette, and slowly made his way up the road.
    As he passed we asked if he was feeling better and he said (still somewhat indistinctly) that he's diabetic, and he was on his way home now.  We asked if he thought he'd be okay and when he confirmed, we called to get the ambulance stood down.
    Maybe he was only claiming to be diabetic to cover for a substance abuse issue.  Or maybe it's both things.  But it really doesn't matter, you still just don't leave someone who's clearly injured themselves on the street without assistance.  Whether they're unemployed or not.  Whether they're houseless or not.

    I'm not perfect, and I do admit to a bit of trepidation when approaching someone in that sort of position.  Because you're never quite sure if someone has mental health issues, and -if they do- whether they could be volatile.  It would've been different if it was dark and unpopulated -- it would've been necessary to prioritise our own safety more heavily if that were the case, but this was broad daylight with plenty of folk around & businesses open.

    I myself am not the tidiest looking person, I've hair like a bird nest and my old worn-out hippy clothes have been around the block a long time in some cases.  If I fall down and hit my head, I'd like to think someone wouldn't be too scared of my appearance to offer help, or at least make a phone call to summon it.

    Someone said to me in a virtual conversation (paraphrased): I like to protect the weak, because sometimes that's me.

    Just something to think about.

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SilverCloud coping with stress course -- review

Part 2 -- the actual review

SilverCloud

    I've been doing an online course on coping with stress from SilverCloud.  [This review will be of very limited use to folk outside of the UK, because this course was made available to me through the NHS.] ☁
    If you're in the UK, I recommend doing a websearch for SilverCloud and the county you live in.  Or approach your GP (did you know -because I didn't until recently- a lot of GP practices have a Social Prescribing Team?). 💬

Pros

    I think the main thing that I want to say about the course is that it's fairly nice and interactive.  It isn't just: read this block of text, followed by this other block of text.  It really hit the spot for me. 💻
    There are videos, quotes, quizzes, exercises, MP3s and mini case studies (aka lived experiences from other past patients).  Also, attractive photos.  You additionally get the opportunity to write your own reflections, goals & etc as you work through it.  This includes the chance to add your 'take-away' at the end of each section.  Then there's a toolkit, including a journal, where -once again- you can reflect and record your own information (a bit more on that later). 🔧
    You can bookmark sections which are particularly helpful to you, and it groups them all together in their own section (named Bookmarks, as you'd imagine).  You can even also download a summary sheet as a PDF for each module, if you want. 🔖
    It looks as though access to the course isn't immediately removed the moment you finish the last chapter.  This gives an opportunity to re-read bits (or even the whole thing). ⏳

Cons
    My criticism of the course is that there are lots of great tools available to go alongside it, but -the way it's laid out- it didn't necessarily make all of them really obvious.  And that's something of a shame, because some are really useful. 🠊

    For many of these tools there was an area within the relevant chapter for you to explore the associated tool, which was ideal.  For others, the link to take you to the tool was tucked away beneath a single clickable arrow to expand the page, and when the arrows were single ones I found them easy to miss.  (Though where there were 2 or 3 of these arrows together, I didn't have this same issue, because it was more obvious.)❕
    If you're following the course -or planning to- I definitely recommend clicking into Tools to check out (and/or revisit) each of the tools available,.  (Note: I think some of them only become available once you've completed the relevant section they go alongside, which makes sense.)🔧

    Finally, in terms of cons, the standard set of wellbeing questionnaires popped up at odd timings, making me complete them before I could continue the course.  But this was fairly minor. 🗎

Other tips

    With this course, there's also the option to be matched with a Psychological Wellbeing Practitioner to 'coach' you through the course, keeping you on track with a weekly call.  This weekly conversation is also an opportunity to reflect on what you've covered in your latest chapter/s. 🖁

    My specific PWP turned out not to be the best fit (although very nice).  This was because they talked a lot, which left me without much time during our calls to reflect on the material in my own words.  This might not have been solely down to the PWP, because -I do admit- I was following the course at a hugely distracting time in my life (to say the least).  As such, I mostly read the chapters whilst out and about -- on the bus even.  (It was nice to have that option in many ways; but it meant that I wasn't taking any notes, meaning I wasn't getting the most out of the course.) 🚌
    So, I recommend taking notes in a hand-written form as you work through the chapters.  (Or, you can stick to the journal provided within the course if preferred; but either way remember to have it in front of you during the weekly calls.)  Then, make a point of bringing up points you'd like to reflect on during the conversations.  (I believe I'm right in saying that PWPs are not trained counsellors or therapists; but they can certainly discuss the course material with you.) ✍

    You can also communicate with your PWP -up to a point- in written format via the website.  (I believe it's standard practice for them to review your comments etc just prior to the weekly call, though.) 🗟

CBT

    I'll also add that the course is -as it says on the 'tin'- cognitive behaviour therapy, but it's a sort of 'abridged' version.  It's definitely a useful introduction, but it might not go deep enough for everyone.  💭
    There are other sources of CBT information available, obviously.  For example, I highly recommend Dr Julie Smith's book: Why Has Nobody Told Me This Before.  (This title is available on Audible as well as in hard copy -- I have -and use- both formats.) 🕮
    However, if you're not in the right frame of mind for reading or just not a big reader to begin with, this course is an excellent way of accessing CBT information.  Or, as a supplement, to further reinforce the ideas you may have learned elsewhere.  The videos guide you into each chapter (though there are also transcripts available it you prefer).  And it can be really helpful to read the comments from other real life users at the chapter ends. 🖊
    Additionally, don't be afraid to re-read and re-visit sections of the course -- on a different day, you might have a different take-away, plus it'll help the information 'stick'. 📆

Thoughts on the course content (mild spoilers!)

    The modules are: an overview of stress; coping with stress, including our resources; taking action; de-stressing thoughts; lifestyle choices; communication and relationships; and finally, a moving forward section. 📑
    The course is written in accessible (but not patronising) language.  It's not too in depth (so it doesn't pile on the pressure), but it covers the basics well.

    One thing the course cannot provide, is real-world opportunities to practice communication techniques for being assertive.  And as this has always been something I've struggled with, I really do need practice.  I guess my poor spouse will be the guinea pig! 🗪

Thoughts on the Toolkit

    There are tools for reflecting on: your goals and support network; stressors and responses to them; strengths and values; current coping strategies, and new ones; time management priorities and problem solving; and for recording/tracking moods (among others). There are lots of downloadable MP3s, too. 🔧
    These are all available via tiles you can click/tap from the toolkit when you want, so it doesn't feel overwhelming. ⊞
    There's also a stress plan you can complete for moving forward, pulling some of the elements together.  (If you've ever come across a Wellness [Recovery] Action Plan before, this is like slightly a scaled down version of that.) 🗋

    One addition I'd like to recommend to SilverCloud, is a place specifically for recording thought-processes whilst trying to challenge unhelpful thinking; I think it could be potentially valuable (maybe a downloadable PDF worksheet, not unlike this).  This might help to put the recommendations from that section into practice somewhat more tangibly (in written format), since it's another a skill which needs practice. 🗟

    In fact, on reflection, perhaps a spot could also be provided for the user to reflect on assertive communication options, too.  It won't ever replace a role-playing exercise together with another person, obviously; but perhaps it could stimulate some thought on the matter, at least. 🗪

Some final thoughts from me on grounding/relaxation

    The section on relaxation in the course has this to say:

"What happens when you try combine oil and water? They just don’t mix.
    The same thing happens to stress and relaxation: you cannot be stressed and relaxed at the same time. This is because of the fight, flight, or freeze response: your body either gets ready for this or else it relaxes, it cannot do both at the same time.
    Your body cannot be tense and relaxed at the same time.
    It is because of this that learning to relax can be very helpful in managing stress. If you can learn to tell your body to relax when it’s tense, you will be able to bring down your stress levels."  [sic]

    For me, this point didn't quite land right, to begin with at least.  It felt a bit like saying: just calm down and you won't be stressed any more.  (Well, if I could do that then I wouldn't be needing a course on coping with stress in the first place, would I...?) 😵

    I much prefer some of the other explanations I've come across, in which it's clarified that not only does the brain send signals to the body that there's a stressor present, but it also works in reverse.  The body also sends signals to the brain that it ought to be hypervigilant & consequently stressed, or -conversely- that it's safe to be relaxed.  See, for example, the section in this video talking about the vagus nerve (it's at timestamp 3:43 or so). 🔃
    Additionally, I've often found myself just far too 'keyed up' from the stress to sit still and even attempt breathing exercises, or whatever other relaxation technique. 💥
    From other sources, I've learned that a helpful option before trying a relaxation exercise is to do a grounding one first.  This helps bring you back out of your own head, as they say, and back into your body a bit.  For example, the '5 things', or 5-4-3-2-1 technique.  If that 'keyed-up' feeling is very significant, you might even want to try a bit of physical activity first, to 'burn off' some of those stress hormones, too. 👏
    Hopefully after grounding, you'll be more receptive to relaxation techniques and those muscles can be coaxed into letting go of tension, to the benefit of your whole nervous system. 😤

SilverCloud

    Here is the NHS website (or one of them)   https://www.italk.org.uk/how-we-help/silvercloud/ and here's the company one: SilverCloud® by Amwell®: Evidence-Based, Digital Mental Health. ☁

Other

    There are also some wellbeing videos available  here, audio files here and other podcasts here.  In fact, it's fascinating what you can find if you click around the NHS website, and especially some of the NHS sites for different areas around the country...  Something to do of a rainy afternoon, maybe. 🌦
    Here are 25 Grounding Exercises, including that 5 things one again. 🜃
    Finally, see also some of my past blog posts for a number of other mental health tips and resources (most recently, this one). ☔

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Tearjerkers in media, and their effect

SPOILERS ALERT (but for old stuff, from the 1990s and 2000s)

    I've been known to blubber whilst watching many a movie (and many a YouTube video, often where the death of a pet is announced).  Frankly, I've been known to bawl my head virtually right the way off.  (I will never, ever watch 'Bridge to Terabithia' ever again. Ever.)

    But sometimes my spouse turns to look at me when, say, a character dies in a movie, to check how I'm doing.  And he can't seem to fathom why I'm -sometimes- not crying after the loss of a main character.

    This YouTuber has an interesting take on why the loss of 'Wilson' in 'Castaway' is such a tearjerker moment.

    I'm inclined to disagree a little bit with his conclusion.  But I do agree it is a tearjerking moment.

    For me, it's the reaction(s) of the survivor(s).  I cry every time I watch 'Lord of the Rings', despite knowing that Gandalf actually returns.  And it's because of the reactions of the hobbits to his initial loss (they, of course, think he's dead in that moment).

    And every time I re-watch 'Buffy the Vampire Slayer' (the series, which is my comfort re-watch) I blubber during that one episode, 'The Body', despite knowing it's coming.  (Actually, this last re-watch I made the decision to skip it because of the emotions it provokes in me.)

    It needs to be a good performance, of course.  If a movie or series has sub-par acting it doesn't have the same impact.  (But there again, if it's a sub-par movie/series it's generally difficult to persevere watching it anyways.)

    The loss of Wilson is emotional for me because Tom Hanks' portrayal of the anguish of that moment is so convincing.  Yes, it's an inanimate object.  But it's also been Chuck's only companion all this time.  And now Chuck's forced to part with Wilson, or else give up his bid for rescue and salvation.  It's all or nothing for Chuck.  And now he's got to brave it alone.  (Of course, he's been alone with a volleyball all this time, but you get what I mean.)

    I disagree with Peaked Interest over on YouTube that the loss of Wilson represents the loss of hope.  I think it represents, as mentioned, the scale of what's at stake for Chuck on his raft ride to freedom.  This is a one time deal, either Chuck makes it or he dies trying.  You might say that Chuck has to let go of the 'safety blanket' that Wilson has been, in order to free himself to reach out for the hope of civilisation.  He can't have both.  He can't have the-devil-you-know of castaway island, and this chance to return home.  He has to throw in his entire lot on this voyage.

    Or maybe it's simply that I empathise so much with Chuck's sense of loss.  I'm a highly neurotic person (to use a bit of an outdated term), with a history of attaching too much sentiment to objects.  That's something I'm trying to work on, actually, as I've got a lengthy de-cluttering journey ahead of me in my home.  (Things are just things; often they can be replaced, and even if they can't that doesn't erase the memory of the thing and what it represents.)

    For me, it's not the fact of the death of Joyce in that episode which triggers the sadness.  It's that her loved ones are bereft, and I can feel it through the actors' performances.
    If the script doesn't incorporate a focus on the effects of that grief on the survivors, it doesn't give rise to the same emotional reaction in me.

    As is often said about pain, though: it's a signal that you're alive.  And I've been learning about 'sitting with' uncomfortable emotions, and about distress tolerance lately.  So there's something to be said for watching media which makes you sad, beyond just appreciating a good performance by an actor.

    By the way, if you or someone you know is too young to have seen Castaway I highly recommend it.  It's aged well and is definitely worth a watch.  (Sorry for the mild spoilers above.)

🕯 Rest in peace precious Greebie and Toffee. 🕯

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Anhedonia as a feature of grief, burnout, or both?

    I had a bereavement very recently.  The months preceding the death were exhausting, involving lots of travel and days spent at the hospital bedside (as well as administrative work around a power of attorney, and significant disagreements with the other attorney over same).
    Rather than the grief I expected, I'm now experiencing anhedonia.  This post is -at least in part- to try to work out why.  Am I just burnt-out from the significant amounts of energy expended in recent months?  Or is this an unexpected presentation of grief?

    I cried a lot over the past 6 weeks or so while my relative was ill.  I felt guilty for not visiting more frequently (as I also have a caring responsibility for my spouse, so rather than staying locally I generally had to return home.  And the journey was a lengthy one, meaning I had only limited time to spend at the bedside.)
    I also had a significant amount of guilt over not being able to fulfil my relative's last wish, which was to return home.  I'd describe it as heartbreak, actually.  I did just about everything I could to try to facilitate it, but for a variety of reasons -all of them largely out of my control- they ultimately became too poorly to make the final journey.
    I could technically have done more, but I refrained because I knew it would mean hammering the final nail in the coffin lid which was the relationship with that other attorney.  (Something which has been hammered away, now, in any case.)

    The day we were notified of the death I cried upon hearing the news.  And the following morning a bit, after I woke up.  But I haven't really cried since (seven days have passed since the death at the time of writing [though not necessarily at the time of publishing]).
    So, does this mean I'd already done my grieving over the preceding 6 weeks, when I was mentally adjusting to the impending death?  Because, now, I'm -oddly- feeling a sense of relief, both that my relative is no longer suffering and -selfishly- that I'm now able to have some rest.

    Or could this mean that a part of me is in the denial phase of grief, where it doesn't seem real yet?
    For a couple of days my mind felt like there were 2 completely separate individuals: the one still persevering at home, before the disease progressed, and then the one who wasted away in the hospital bed.  I felt that sense of relief for the latter, but had a hard time comprehending that the former was also gone.  It felt as though I could still just pick up the phone or get on the bus and talk to them.  For a while, that is.  That seems to have passed, now.

    Is the anhedonia just a feature of burnout, because I'd been doing so much these past few months my mind and body just desperately want to take a break?  I don't know the answer to this, because the one thing I can usually reliably settle down to do -whenever- is to watch TV, but I can't even find a show I feel like watching lately.
    (The only thing I've been wanting to do is write blog posts, but I can't spend all day every day doing it, as I don't have enough to write about.  And also, I sometimes don't have the energy to be sat up with my laptop on my lap, and instead I need to lay on the sofa to rest.)
    I could almost understand it if there were some guilt attached to experiencing enjoyment following the death.  And there is some of that, particularly when I've found myself laughing out loud at something cute one of the cats has gotten up to or something.  But it's not overwhelming, so why would it be stopping me from pursuing activities I enjoy?  I've got to do something with my time, I can't just sleep all day (as a chronic insomniac that'd be a recipe for yet more night-time misery, anyway).

    Does this lead me to believe that this is more a product of burnout than it is of grief, at least right now?  I think that would probably figure, actually, because I'm genuinely exhausted.
    I will admit I am isolating myself from people a bit right now, because these past months have been so overwhelmingly busy and I just feel like I want to consolidate my energy.  My phone still won't stop ringing.  So seeing people feels like too much.

    Does this, then, mean I've got the majority of the other stages of grief still to come?  I know I'll cry at the funeral, because -if nothing else- my empathy will get triggered when any of the other close relatives becomes upset.  After that, I guess I'll just have to wait and see what happens.
    I've got the support of my spouse, and I'm therefore not feeling as though I need a whole lot of other people around me right now.  Perhaps I'll need them later at a later stage, though.

    This was rambly, and I don't really intend to proof read or re-draft this one, because it's more of an emotion processing post.  So it is what it is.

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Inclusivity, diversity, equality etc - some thoughts

    I'm certain this has all been said before and by much more articulate folk than me.  But it'd been on my mind somewhat lately, so I thought it might make for a blog post.  [I actually began writing this some time ago, but never posted it at the time for some reason.  Given recent events in the US it now seems insanely inadequate.  But I'm going to post it anyway.]

Privilege
    When someone says: "When's straight-white-cis-male history month, hmm?" it's rather like a middle-class kid saying "there's a mothers' day and a fathers' day, and even a grandparent's day; so when's kids' day?"
    To which I'd say:  In most middle-class communities, every day is kid's day.

    Privilege can be a bit insidious.  The privileged don't always intend to be so thoughtless, though; sometimes it's just a lack of exposure making empathy more distant.  But that doesn't mean that thoughtlessness should just be accepted.  Far from it; in fact this is kind of the point, here.

    An example.  My spouse isn't a bad dude by any means, but he sometimes just needs a little reminding.  Recently, he was complaining about characters in e.g. rebooted fiction shows being changed from straight to lesbian, or whatever.
    And I pointed out that it's about representation.  So, then he started to say, "but what about the rest of us?"
    I shut that shit down (before he'd finished the thought, honestly), with: "You don't need visibility, my love; you've had it throughout all of history!"  He conceded.
    (He's a straight white cis guy, if you didn't already figure that out.  The only privileged thing he's not is middle-class, as we're a working class family.  And it's more or less the same for me, as I'm a cis white woman.  But I feel I get it more because I'm bi and pagan and I consider myself to be both disabled and neurodiverse.)

    Cameron Esposito, comedian and author, said on episode 227 of the Morbid true crime podcast:-

    "When the straight cis white dude is like: 'cancel culture is coming for me', it's like: no, some of the stuff that's been hurting you is that other people now want space.  And you feel hurt that, like, a trans woman wants to be seen as a woman.  That hurts you because you've had 100% of the power and now you feel threatened.  You're betraying showing yourself.  The cancel culture ... you're just receiving feedback that people think you actually still have more power than this person."  [Emphasis mine.]

Black Lives Matter
    I don't know who to attribute the point to, unfortunately, but someone said the following. To paraphrase: responding to the phrase Black Lives Matter with "all lives matter" is rather like standing up at someone else's birthday party and making noise about how you have a birthday too.
    (I think I heard somewhere that the slogan was originally intended to be Black Lives Matter Too but there was a character limit.  I think it's more powerful as it is.  I don't even know how to speak about the fact that a variation of the phrase has been co-opted by opposing ideologies, so I will recognise my own limitations, here.)

Slow going, becoming woke
    I was attending a theatre the other month named The Mayflower.  And I overheard a woman seated near me talking about how it was named after the pilgrims who voyaged to America.  She said: "I don't know if that's the best thing, to name it after a bunch of people who went over there and, you know, mistreated them and stuff."
    Maybe I'm being overly critical (or even a bit 'woker-than-thou'), but it felt like something a person might say to try and impress someone else.
    And I thought: I bet you don't even know that Britain was still in very recent history paying funds in respect of compensation to former slave owners*!  And that the descendants of the slaves themselves received and still receive jack shit (other than the fear of discrimination, and even shittier outcomes of racism).
    (Okay, I only know this from a Black History month talk I attended in my lunch hour at work a year or so ago.  But I feel like that's a very significant thing that the public ought to know and yet it's been kept very hushed!)

Some progress is better than no progress?
    I guess the fact that that white woman had that thought (even if only to try and impress her date), it's still better than just never considering other communities' experiences at all.  There would've been a time -in the not too distant past- when that thought wouldn't even have entered most white womens' minds (my own included, if I'm completely honest).

Backsliding, though
    Within my lifetime it previously felt as though we'd made progress in the realms of inclusion and diversity.  And we had.  But news coming from the US in particular ever since Trump's first presidency, and more so during his current one, highlights backsliding in the worst way.
    One of my favourite artists, P!nk, back in 2006 had something to say which I really respect.  I still frequently have to remind myself that Dear Mr President was written about a whole different president.  Then again, I still sometimes have to remind myself that Trump as US president was not just a Simpsons gag, but actually a reality!  A distressing, dystopian, nightmare reality.
    Between Trump administrations, I'd wanted to hope that things would improve again under Biden & etc.  But then there was the overturning of Roe v. Wade, which was very discouraging to say the least.  It worries me that the UK sometimes seems to follow in the footsteps of the US.  And it fill me with dread that the Reform party seems to be gaining such ground over here (**).

Solidarity
    In trying to find a more positive way to wrap up this post, I almost subtitled this paragraph Fight the Good Fight.  But then I searched the phase and discovered it came from the bible/a Christian hymn.  So I didn't want to promote those connotations here.
    Instead, at the risk of coming across a little bit Monty Python, I'm going for: solidarity.
    And actually, since Monty Python brought us some truths within the comedy: "Supreme executive power derives from a mandate from the masses."  There's a joke there about being oppressed, but that feels like inappropriate timing.  Maybe it's better just to give a whistle for now.

    Finally (and less cheerfully, again), ableism is going to feature in another forthcoming blog post.  As I've been on the receiving end of it recently, and I did not like it one bit.  I think I might be ready to stand up and (ugh) be counted as a visible disabled person (albeit with non-visible disabilities!).

    PS if this comes off as virtue signalling, I really hope no-one will take any significant offense -- if even one person explores the links etc below and educates themselves a bit more on the issues, I'll consider that this post has achieved something worthwhile. 

Resources and causes to consider supporting:-

~ Search: Accidental Courtesy documentary, and Daryl Davis, online
~ Action for Race Equality
~ The Black Curriculum
~ Black Lives Matter UK
~ Blueprint for All (formerly the Stephen Lawrence Trust)
~ Guardian article: The year of Karen: how a meme changed the way Americans talked about racism | Race | The Guardian
~ Human Rights Watch | World Report 2025 (unable to find a 2026 one at the time of writing)
~ The Privilege Walk
~ Race Equality Foundation
~ The Runnymede Trust
~ Stand Up To Racism (disclaimer, though: has been accused of being a 'front' for the Socialist Workers Party, which in turn has been accused of covering up sexual violence)
~ Stephen Lawrence Day Foundation: A Legacy For Change
~ Windrush 100 -- Windrush 100 seeks to deliver the vision of a fair and equal Britain that the Windrush generation would have been proud to see
~ Book: Maybe I Don't Belong Here by David Harewood (there's also a documentary featuring David called Psychosis and Me, but doesn't cover the racism aspect of David's experience as much as the book does.)

*see https://taxjustice.net/2020/06/09/slavery-compensation-uk-questions/ and
https://www.runnymedetrust.org/publications/reparations

**take a look, if you feel the same, at: Forward Democracy.

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Resources for bereavement/grief & loss

    A number of my past posts have contained lists of online resources, but this one is going to consist entirely of a list.  Because I've been researching this lately, and I didn't find it the easiest thing to do.  So if it helps just one person out there, I'll be pleased.

(Note: these resources are UK ones, but websites, at least, should hopefully be available from outside the UK.)

• AIM Mental Health Bereavement and Loss
• AtaLoss.org: UK wide bereavement signposting and information website
• Cruse Bereavement Support
• Bereavement and traumatic events - Every Mind Matters
• https://www.thegoodgrieftrust.org/
• Grief Chat dedication page Remember someone special
• Griefity app, on Android
• How to cope with grief | Hospice UK and Support with a bereavement | Hospice UK
• Hub of Hope | Mental Health Support Network provided by Chasing the Stigma
• https://www.mind.org.uk/information-support/types-of-mental-health-problems/bereavement/
• MuchLoved | Free online grief chat service
• NABS
• Get help with grief after bereavement or loss - NHS
• 7 Cups Grief forum Grief & Loss Community Forum | Online Grief & Loss Groups | 7 Cups (note: avoid paying any of the "therapists" available on the site as they may not be who they claim to be, and do not bother trying to engage with the volunteer 'listeners' available on the site, either.  However, the forum and the sharing circle events can be helpful.)
• YouTube -- search the channel
  www.youtube.com/@TherapyinaNutshell for the keyword: grief, or bereavement

Cancer specific resources:

• Sue Ryder | Grief support services
• https://thelossfoundation.org/

General resources:

• Betwixt app, on Android
• Living Life to the Full | Self Help Resources
• NHS 111 - for urgent mental health support that isn’t a life-threatening emergency, call 111 (in England) and select the option to speak with a Psychological Wellbeing Practitioner (PWP). Visit the NHS 111 website for support and more information.
• Mental Health Foundation | Loneliness
• Free downloadable Mindfulness Journal: 5-Minute-Mindfulness-Journal.pdf
• Mind - Side by Side forum
• https://www.redcross.org.uk/get-help/get-help-with-loneliness/wellbeing-support
• In the United States: https://www.crisistextline.org

See also the collated general mental health resources already published in previous blog posts: https://portraitofperpetualperplexity.blogspot.com/2026/02/weathering-storm.html (there may very likely be duplication with the above).

    I don't know if it's possible to bookmark a blog post, so I've also published the above list as a Blogger page and linked it here.

🕯 Rest in peace Dad  🕯

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