Duty of care

Dr F writes – Burn out is not the same as PTSD although there may be superficial similarities. To say one is a form of the other conflates and devalues both conditions. It’s all in the word Disorder. Burn out sounds like a descriptive term and does not have the kudos of, say, Chronic Occupational Stress Disorder, COSD.

The British psychiatric community initially opposed the concept of PTSD seeing it as American preoccupation with litigation. Occupational health similarly oppose COSD because it implies a failure in duty of care on the part of the employer.

If you can’t hack it, just quit. It’s not our fault (if we have ground you down and destroyed all the interest and optimism that originally drew you into this career)

At Fulbourn in 1976, Dr C deliberately recruited the idealistic young that drifted through Cambridge to become the “Social Therapists” on his wards. It was some years past the peak of Anti-Psychiatry, but there was still sufficient distrust of over-qualified psychiatrists, for them to be pulled back to some instrumental role, whilst the under-qualified, who were obviously more in touch with what mattered, were pushed to the front.

It was interesting to watch how faced with the task of bringing about real change (an oxymoron in psychiatry), the idealistic youth became progressively disillusioned, only to be quickly replaced with a fresh cohort of hip holistic therapists. Of course what was completely lacking was any dynamic supervision, so that, oblivious to the counter-transference, the young untrained waded into enmeshed rescue fantasies, acting-in with disastrous consequences.

But I don’t think their experience was traumatic since they were so self-obsessed that they saw their failure as vindication of their struggle against the establishment.


It’s “Time to end the shame around Mental Health”. I don’t like the word shame. It’s easy to say let’s end the shame. Shame is like a guilty secret and now you’re a failure for not being able to “end the shame” as if it was as easy as that. Like “Jesus saves”, saves what?… it’s meaningless.

But I’m mixing up shame and guilt. Guilt is the judgement of the critical super-ego; shame is the failure to live up to the ego-ideal. Jesus, of course, was the embodiment of the ego-ideal, which superseded the vengeful critical super-ego of God (the Father!).

Maybe it’s time to stop the fear of judgement from the totalitarians of the left.

Service Users, Resource Centres, Care Plans… now don’t get me started. Shame on you David!

The ones the wolves pull down

Just love this song by Garth Brooks

I been all night drivin’ heifers
Closer in to lower ground
Then I spent the mornin’ thinkin’
About the ones the wolves pulled down

Sometimes it’s before your time is up.

Green minestrone

My mindfulness moment now… So many tangential thoughts. But did anything happen today?
I went swimming in my new swimming trunks, and did eight lengths. So hard to breath under water.
I read my book, The Remains of the Day, in the early hours. I just love the time before dawn.
I did my blood pressure, which is a little higher today than yesterday. I’ll do it again tomorrow. Currently reducing meds.
I won’t get a dog. That will just be a memory of a very sweet time. Lenny, my lovely dog.
I won’t get a girlfriend. It’s all too complicated. Dogs are better, but not at the moment.
Really interested in my academic reading. Struggling a bit to organise my notes and produce any writing. Too many things to write about. Not enough time left. Too many blind alleys.
I love language.
I practised the piano today, sight-reading a transcription of an improvisation of All of Me. Then I had a go at improvising the tune myself. Not good, but it may get better.
Going to cook a green minestrone with what I’ve got in the fridge.

Remains of the Day

Night driving on cruise control. Feeling sleepy and pulling over to nap in lay-bys, the car rocking when lorries pass. The waste land of all-night service stations, 24/7 coffee and fast food. Cravings for a bacon sandwich.

Nice opticians in Radlett. Initially intended to check out both, but first was friendly and competent. I must have come across as bubbling, loosing my own glasses amongst the new ones on display. Wacky David. Afterwards I decided not to have lunch at Elstree airport and instead went to Colney Fields where I bought a large quantity of discounted alcohol. I must have gone into M&S because I remember seeing a poor middle-aged sales assistant, flushed, trying to catch my eye and sell something. Maybe he just went home and drank. What other options does he have.

In my book, the Remains of the Day, the protagonist has just retired his father. The book, so far, is very depressing but maybe there is some reversal at the end. Does he rebel, does he throw off the servant role and live his own life. Dignity, respect, so old fashioned. We no longer respect our elders, our betters, anyone.

Trying to recapture a rhythm to the day. But I’m writing now, and I read and I’ve played the piano, and gone to the gym, and worked hard on my studies.

Seafood Chowder

Ry Cooder LP on my vinyl deck. World music, fusion. Accessible, brilliant, brilliantly digestible.
Soup tonight, vegetarian, slightly creamed up with a packet of Ainsley Harriott’s New England Vegetable Chowder. American chowder, like the Seafood Chowder from the store near the Whitby ferry just outside Seattle.
First day of summer. 23C
Thought (memories, anticipations) of Port Eliot, four days under canvas. Alternatively sunburned, washed out or blown away. Can’t wait. End of July.
Thoughts of night driving. Long distance lorry drivers, hitchhiking through the night, going west.
Thoughts of getting a dog. Plan a visit to Verstone stud in the Lake District.
Wild oats in the corn field, and some barley.
Keep going. Forgive myself and get started again. No other way. Desiderata. Hait Ashbury, 1968.
Complex Crossings


May flowers in the meadows
Neighbour, Mat, talking about dogs
Tommy John underwear ads on CNN
What else happened?

Surfeit of health

The good news is that my health has improved so I’ve got years ahead. I’m suffering from a surfeit of health! Damn? The clock ticks so slowly.

Dr C said it was normal, normal for your mood to take a dip after good news. He’d seen it a lot. The cloud lifts but you sink, or at least you may do for a while.

It’s as if I invested in a certain sort of reckoning, in coming to terms with finality or at least trying to. I had started to live outside myself, in the world that will survive my existential annihilation. I even saw my life as just a line on a Gantt chart, alongside all the other lines. A sum total.

Now what?

Dawn chorus

Bluebells and small white flowers
Piper reducing engine revs on base leg before final.
Yesterday, after the storm, there were dark grey clouds down to the ground to the south.
Set alarm for 0444, ie 0529 minus 45. Deep blue of sky at first point of dawn. Even earlier, the dawn chorus starts. Magic.

Friday evening

Nala and Mat in flat 1
Cricket on the green near the pavilion where I voted yesterday.
Lamborghini vroom, vroom… Then boy racers from social housing
Wild grasses, wellies, off-piste, woods, walks, birdsong, rain, corn fields
Families, children on bikes
Cat hut
The virtual dog walk
Cut down tree trunks. The teddy bear’s picnic.
Invertebrates, common ancestor 600 Mya