Poor George

On 10th October 2018 the BBC Today programme (Radio 4) had a feature about mental health.

Two young people talked about their experiences. One of them, George Hodgson, described a period of difficulty he’d had when he was 16. He said he “became ill”. “It came on very quickly….I started having panic attacks every day. It was so severe, so intense. I went to the GP with my parents. The GP said I might have anxiety disorder and panic attacks.”

He was referred to the local Child and Adolescent Mental Health Service (CAMHS) and was seen two weeks later. During those two weeks George said “I severely deteriorated. I was washing my hands 50 to a 100 times a day because I thought everything I touched had drug traces on it. The panic attacks worsened. I didn’t leave the house.”

At the CAMHS assessment he was told that he would be helped “to get through this”. However, he was then told there was a 40 week waiting list. George understandably said he felt far worse leaving the appointment. Fortunately, George was able to seek help outside the NHS.

This is a brief account of a very difficult time for George. We don’t know all the details. However, on the face of it this is a tragic story. If like the BBC we don’t ask questions about the detail of how George was dealt with it can seem outrageous. Mishal Husain, the BBC interviewer, mentioned the oft-quoted, but rarely challenged idea, that there should be parity between physical and mental illness. She asked where the help was when you are told you need help, but she didn’t challenge any of the ideas implicit in George’s narrative.

However, there are some important questions that could be asked;

Why did George describe himself as ill rather than anxious? Did he think that anxiety was something that people suffer from and have no active role in? Did he and the family not realise that anxiety is an activity with a very simple purpose; we want to know what will happen. We worry about something we feel is important. If we convince ourselves it will happen and believe it would be a disaster we will feel very anxious. But none of us have crystal balls and much of what we worry about is very unlikely.

Did the GP simply tell George “you might have anxiety disorder and panic attacks”? Did the GP see these as illnesses rather than the result of a troubled soul trying to make sense of their situation? Did the GP consider what effect his message would have on a young 16-year-old? Did he offer any psychological insight to George or his parents –for example, a simple common-sense active understanding of what anxiety is?

The answer to the last questions is presumably not as George had a terrible two weeks waiting for his assessment appointment. But what was George doing and thinking during this two weeks? Again presumably, George was entertaining bigger and bigger negative thoughts as many would and do in his situation. Had anyone shown George the simple connection between our big thoughts and the emotions they lead to? Had anyone reassured him and encouraged him to take responsibility for the way he was thinking? Had the parents been deskilled and side-lined by what the GP had said and the thought that George needed so-called expert assessment?

In a different world George would not have been told he was suffering from a condition called anxiety disorder. Instead he could have been told how anxiety is a pattern of thinking that any of us can engage in at any time. It is only thinking about what might happen. When we do this we can imagine all sorts of outcomes – but we don’t need to. Anxiety could and should be seen as something we are doing – it is not something we have. But this is an alien idea to our culture. In many ways George’s experience is a reflection of this culture. For this reason we can be sure that many more people will be distressed like George for the sake of ideas.

George’s experience is understandable and in no way can he be blamed or criticised. It was based on his not knowing what anxiety is – not understanding it as him worrying what he had done and imagining where it would lead him. We cannot expect young people to know these things if everyone around them and the culture more generally is seeing episodes of intense anxiety as an illness akin to a physical illness.

George was brave and continues to be. He said he is campaigning for mental health and running a fashion brand to raise awareness. Given his experience one might wonder why he would want to encourage others to believe they were suffering from a mental health condition and needed help – help that is essentially misleading and disempowering. His final statement on radio 4 was;

We can “never say we’re cured from mental illness, we just learn to cope with it.”

This is not true and it is not such a great idea to promote to others. When we have had a distressing episode, it would be better to leave it behind. If we don’t it can follow us like a shadow. If we can understand the power of our thinking, we stand a better chance of doing this.