"Sleep that knits up the ravell'd sleeve of care"

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Last week saw another rash of mental health stories. On Friday (24th Jan) it was the turn of the BBC highlighting the problem of stress at work. They revealed the results of research by Deloitte and MIND on workplace mental health. Among the findings was the conclusion that mental health issues at work in 2018 cost companies £43bn, a 16% increase since 2016. This sort of increase is seen across the board in surveys of need and service use.

Some will argue that this simply reflects greater awareness of mental health problems; some that modern life is increasingly stressful. Another explanation is that, because of the way we focus on feelings and see them as symptoms of mental health problems, more and more of us are seeing ourselves as having problems.

One important ‘insider’ who has come to favour the latter explanation is Dr Allen Frances, psychiatrist and former chair of the DSM-1V Task Force;

“Nature picks diversity; we pick standardization,” and “Turning difference into illness was among the great strokes of marketing genius accomplished in our time.” (see Saving Normal Francis 2013)

‘Marketing genius’ alerts us to the idea that certain sectors may benefit more than others from this way of seeing our distress. This may not be those who come to see themselves as having a problem. Watch a few YouTube videos of people talking about their problems and you’ll find that many, once diagnosed, believe they will have to battle their problem for the rest of their lives.

There is, of course, a more empowering alternative to this focus on our feelings as symptoms. It is not rocket science either. It starts with recognising the importance of our thinking and seeing thinking as the driver of our feelings. This is common sense, but a common sense we have become almost blind to because of the marketing genius. In my book, The Origin of Anxieties, I have written about the very ordinary thinking that underpins our feelings of anxiety and our anxiety problems.

If you want to rediscover this common sense, when you watch reports on mental health, look for any detail of how the person whose experience is being described is thinking. In some reports you’ll be able to see the real psychology behind the headlines. Last week’s BBC item was a case in point.

Headlining the news was Antonio Horta-Osorio the very polished CEO of Lloyds Bank. He spoke about his experience at Lloyds in 2011 after the financial crisis. At that time the bank had toxic assets of £200bn. In this age of transparency, he felt he couldn’t talk openly about it because it could have caused a run on the bank.

While Antonio focused mainly on his problem of not sleeping what he revealed was;

“I was very mindful that the bank was in a very weak position to face adversity. It was a problem that was going around my mind constantly, which led me to sleep less and less. And the less and less sleep progressively led me to exhaustion and then not sleeping at all which was a form of torture so I had to address it and I did.”

He eventually took eight weeks off to recover. However, while he focused on his problem with sleep his comments clearly show that it was his thinking that led to him not sleeping and eventually feeling exhausted. His experience reminds us that we shouldn’t see not sleeping as a symptom of a mental health problem but as a signal that we are doing some important and powerful thinking. While doing this is not unusual when we are challenged or faced with sudden changes it is clearly not sustainable.

As I argued in my last blog (Jan 16) it is helpful to shift our attention away from our feelings and symptoms and on to the thinking that lies behind them. This gives us something we can do. With practice it can transform our experience. In time it increases our self-understanding, our self-reliance and our resilience.

Prediction; while the current narrative of mental health persists the cost of mental health issues at work and elsewhere will continue to spiral, as will the felt distress of those whose self-understanding and resilience is being undermined.