Wednesday, November 30, 2005

Last month as a postgrad...

Or at least, the last month I'm paid to be one.

My supervisor told me he had just written a reference for my new job and that he'd told them he was very confident I would be written up by January. I'm glad he's confident. I'm still writing chapter 1. Er....

Anyway, this cartoon made me giggle....

Saturday, November 26, 2005

Oh my....

I called my grandparents this afternoon and got into a conversation with my gran about the X-factor and made a shocking discovery.

My granny, a woman in her 70s with a very dodgy hip is a serious Chico fan.

I just don't know what to say...but hee hee.

For the Americans and people from other countries on my blog (or those who consider themselves too cultured to watch the X-factor)...the X factor is the UK equivalent of American Idol. You know the set up, two judges gush and coo over the participants, Simon Cowell sneers mockingly, 'Really, it was like a very bad karaoke performance. I don't know why you are in this competition, ' and the audience boo.

Chico used to be a stripper, in the run up to the show he performed in Ozzy Osbourne's house and ran into the pool with a microphone. Even the prince of darkness himself said he was mad. He has a certain cheesey charm about him. Simon described last week's performance as, 'Horrifically brilliant.'

He is fun and I enjoy him being on the show - but my gran, a fan?!?!

Friday, November 25, 2005

Instructions for life

Instructions for Life From the Dalai Lama, on the Millenium

1. Take into account that great love and great achievements involve great risk.

2. When you lose, don't lose the lesson.

3. Follow the three Rs:
-Respect for self
-Respect for others and
-Responsibility for all your actions.

4. Remember that not getting what you want is sometimes a wonderful stroke of luck.

5. Learn the rules so you know how to break them properly.

6. Don't let a little dispute injure a great friendship. 7. When you realize you've made a mistake, take immediate steps to correct it.

8. Spend some time alone every day.

9. Open your arms to change, but don't let go of your values.

10. Remember that silence is sometimes the best answer.

11. Live a good, honorable life. Then when you get older and think back, you'll be able to enjoy it a second time.

12. A loving atmosphere in your home is the foundation for your life. 13. In disagreements with loved ones, deal only with the current situation. Don't bring up the past.

14. Share your knowledge. It's a way to achieve immortality.

15. Be gentle with the earth.

16. Once a year, go someplace you've never been before.

17. Remember that the best relationship is one in which your love for each other exceeds your need for each other.

18. Judge your success by what you had to give up in order to get it.

19. Approach love and cooking with reckless abandon

Thursday, November 24, 2005

I feel sick...

I am about to take my clinical psychology training application to the post office.

I feel sick as a parrot, want to vomit and I am shaking like a leaf.

I managed to find a glaring typo this morning after I had printed the darn thing 5 times. Amazing, having read it some thousand times myself, had my spelling & grammar guru of a dad, my partner, a professional proof reader and God knows how many 'I'll read your's if you'll read mine' deals with other applicants.

PANIC PANIC PANIC PANIC.

I am told this is normal. Another applicant I know off queued at the postoffice, only to get to the desk and decide she had to proof read it just one more time. So, she grabbed it back again, apologised profusely, amidst many stares, glares and giggles from the rest of the staff and queue. She read it, joined the queue again and there was much raucous from the post office staff...I will not do this. I promise myself, I will not do this.

But I can't have it sitting on my desk for a minute longer - so I am off to the post office. Wish me luck! Now to look forward to the dread of interviews or the dreadful melancholy of rejection. As you can see, its happy happy joy joy all the way with me today.

PS. Happy Thanksgiving to my American friends for this weekend.

PPS. I have a new guestmap, please stick your pin in it :)

Friday, November 11, 2005

Do something good today...

My good mate, Paul Turner's girlfriend, a qualified teacher from England, is in Malawi, teaching and caring for orphan kids and families that are victims of aids and famine.

She's blogging about her experiences here

This is her with a very very cute kid. There are lots of very cute kids she's working with who lack even the very basics - clothes, writing materials, food, shelter, a family. Even a small gift means so much to these kids. So if you can spare a few pounds or dollars...then consider dropping a gift directly to Caroline. T-shirts, pens, pencils, little notebooks, silly toys for kids who will be going to their first ever party...Send it to her at
Caroline Tredrea
CCAP Likhubula House,
PO Box 111,
Mulanje,
MALAWI

If you want to help, send things to her directly, or contact me. Paul's going out to Milawe in January and can take stuff to her directly. Otherwise, feel free to post things to Caroline. A little gift can make such a huge difference to these kids. Caroline will personally distribute anything you send.

She writes as follows....

Well, I have received a number of lovely lovely emails from people lately in support of what I'm doing but a common thread that seems to be appearing in many of them is that people still want to help. First off, this amazes me since I am still overwhelmed by the donations and support I received when preparing to leave and now the ongoing generosity is genuinely moving.

Anyway, if you did feel that you wanted to send out anything for the children here to help with school or just generally, I thought I'd write a little list of things that I know they would all appreciate so much.

PLEASE NOTE: I AM NOT ASKING FOR ANYTHING AND DON'T WANT YOU TO FEEL OBLIGED TO DO ANYTHING. THIS IS JUST IN CASE YOU WERE ASKING ABOUT WAYS TO HELP.

First off, any packages that you want to send out, can be sent directly to me at the following address and I will distribute where the need is greatest.

Caroline Tredrea
CCAP Likhubula House,
PO Box 111,
Mulanje,
MALAWI

Please note that the postage costs soar with parcels over 2kg, so if want to send out more than 2kg, it pays to sent two parcels! Also although packages have generally arrived within 2 weeks so far, the postal service (as with all the other services here!) can be hit and miss!

And so to things that would go down well here...

* Children are often without pencils or pens so any type of writing materials will be appreciated.
* There are NO reading or story books at the school. Children are taught from STD1 in English so any kids' English comics or light reading books would be greatly treasured by the recipient.
* Tiny toys such as the plastic ones you might put in children's party bags in the UK. I remember seeing bags of about 10 in ASDA for a pound or so. Oh, and playing cards or travel games that I can play on street corners with kids rather than trying to make conversation in basic English and it drying up within 30 seconds would be handy for me!
* (girls are not allowed long hair so hair accessories and the like would not really be used)
* T-shirts and things are tricky because once word gets around, 1000 children appear at the door wanting one. However, some of the children's clothes are in a terrible state - more holes than t-shirt, especially the little ones, so t-shirts for ages about 4-10 would find good and appreciative homes.
* Little non-perishable treats such as Haribo are like gold dust!

I'm organising a party for my class on 12th November, for most of them it's their first party, and although post wouldn't reach me before then, I am just appealing for any games ideas that would work during my party. I have had a good think but I get stumped by the following restrictions;

* There are 120 of them and if we wait for them to have a go each, we'd be there till November 13th.
* There is no electricity
* I am still not yet fluent in Chichewa so games should keep language to a minimum
* There are no chairs or tables so musical chairs etc are out the window.

Any ideas, please let me know!

I think that's about it. I hope you find these ideas useful. As I said before, please don't feel obliged to send anything, these are just ideas and I appreciate so much the generosity of people in the past.

Reality bites...

I'm staring blankly at my application for clinical psychology training. Thus far, the one thing that has kept me going through my PhD - the possibility of getting to work with people at the end of it and suddenly I'm shitting myself.

I mean. Firstly, I am applying to courses in places I have never been before because they look kind of interesting. I'm not even sure I could place Norwich accurately on a map. I have a vague idea of it being on the right hand side, around the middle-ish.

Not only that, but I am opening myself to the possibility of moving anywhere with about a 50 mile radius from any of these courses (with the intention of buying a house), and thinking, 'OMG, I have no idea how to buy a house.' My 'rents will be getting many many phone calls.

I keep swapping and changing my mind about which courses I want to do. I cannot get my form to look 'just so' - perfectionism is paralysing sometimes!

Then the self doubt comes in. Am I really cut out to work with people? I get pretty narked off with people sometimes. Do I have the stamina to go through another doctoral level degree? My current one regularly has me loosing sleep, crying and swearing at the computer.

Will I dig commuting long distances to placements? Will I cope with the driving? And what if I'm no good at "therapy"? I could be crap...the first time I did a research interview I was shaking. The interviewee had to make me a cup of tea! Even now, when my participants cry, I feel really awkward. Don't do tears I'm afraid. That's pretty poor show for a psychologist.

And if I don't get on a course, what do I do?!?! There's nothing else - and I can't do research! Social work - God save me!

ARGH!

O n e t h i n g a t a t i m e . . . . . .

Thursday, November 03, 2005

ADHD - the big debate



I've spent the past 3 years of my life studying ADHD - more specifically, I study how family factors impact on children and parents' attitudes to medication - particularly around issues of stigma associated with taking medication. ADHD is a real hot potato at the moment. Some don't believe in it, some are adamant that it is a neurochemical disorder and therefore can only be treated by neurochemical means. Others say it is a social construction, designed to oppress masculinity.

Recently I have been feeling frustrated...Let me re-phrase, at times I have been feeling downright angry at my own situation as a psychologist in an increasingly medical-model dominated (did I say dominated, I mean monopolised) research group. My skepticism has been growing at an exponential rate. So I thought I would record my random thoughts on my blog and invite my blog readers - informed or not, to comment. I know there are some people with ADHD who read my blog, at least one other psychologist and goodness knows who else. So please...Feel free to contribute.



I will talk about genetic and neurochemical approaches to ADHD and their limitations. I will talk about the implications of research funding for the kind of research we do and how we interpret it. I will take about the critical voices and how perhaps they aren't quite so critical afterall. I will talk about a need for genuine reflection on the social and cultural aspects of ADHD and ask if there are other ways of responding outside the medical model. And as this is my blog, not an academic paper, I will intersperse it with little cartoons for amusement value...enjoy!



Ok, so. Firstly there is some evidence for a genetic basis but equal evidence that genetics are far from being the whole story. Whatever the genetic component of ADHD, it is entangled with other environmental and social factors and this should never be forgotten in genetic research.

Secondly there is evidence of neurobiological correlates to ADHD symptoms. These shouldn't be ignored, but in themselves I don't think they legitimise drug therapy.

Thirdly, medication (e.g. ritalin) does have a beneficial impact on children who have been diagnosed with ADHD. We know this both from clinical trials and from the experience of countless parents and children. HOWEVER, the is a real issue of publishing bias. Almost every researcher in this field (myself included) is funded, at least in part, by pharmaceutical companies. Basically no drug company money, no jobs.

Whether we are aware of it or not, the fact that most research and most researchers are dependent on financial contributions from the pharmaceutical industry effects what we publish, what we research, how we research it and how we interpret it. I've yet to hear a drug-company funded researcher really give an open and critical reflection on these issues. More to the point, I do not feel comfortable bringing up these ideas within my research group as I know they would not be welcome. They would be deemed wacko and far too political. I think, that says it all really. My PhD research has not encouraged me to think critically around these so vital issues.



There are people who write very critically about ADHD and drug treatment. However, most papers in this field are highly emotive and fail to seriously engage with issues of genetics, neurochemistry and research highlighting the potential benefits of medication. I suspect the motivation behind most of the opposition is a philosophical objection to psychtrophic medication rather than a pure concern for child welfare. Let me be frank, the critical psychologists aren't helping themselves be heard, and IMHO, their over-emotive and scientifically inaccurate ranting represent a serious barrier to intelligent dialogue and discussion.



Nevertheless, I think many of them have points that are worth listening to. As a disorder, ADHD is shockingly ill-defined and it is really more of an umbrella term for a set of behaviours and cognitive symptoms that are currently socially devalued. ADHD is culturally defined and constructed - lets never forget this. ADHD symptoms are problematic in a social context. The history of psychiatry should humble (or maybe even humiliate) us into a bit self-critical reflection every now and again! It wasn't that long ago we thought gayness was a psychiatric disease and transsexuality is still in the diagnositic handbook! (That's a whole other discussion - but I think it ought to be removed - sharpish!)



It is possible that the social disapproval and resulting stigma and systematic exclusion of children who have ADHD symptoms may cause more distress than the ADHD symptoms themselves per se. Therefore the social-constructionists amongst us really do have an important contribution to make, and I think we do need to think on a systemic and community level regarding ADHD. Are the demands we put on our children reasonable? Do we allow our children space to be themselves (whatever that means)?
Do we utilise our children's natural abilities and aptitudes in order to maximise their enjoyment and development? Personally, I'm very interested in interactive and kinetic teaching methods and how these might help a lot of children learn in a more dynamic way that suits their temperament and fosters their unique talents.



In discussions with psychologists, social workers and teachers, I have often encountered an incredibly negative reaction to medication for ADHD. Again, I suspect this is an emotional, philosophical reaction. Parents are often blamed and medication is seen as an easy option. However, I think parent-blaming is unacceptable and the vast majority of parents I know, think long and hard and really battle with themselves before accepting medication for themselves. Often it is used as a last resort (which may not be particularly helpful or wise.)



At the moment, there was very little evidence as to the effectiveness of psychosocial interventions for ADHD. BUT, success in psychosocial intervention trials is often measured in medical model terms, focusing on symptom reduction. Psychosocial intervention needs to be tailed to the individual, familial, social and cultural situations of each child & family (and school for that matter). Therefore, randomised controlled trials may not be the ideal methodology for research in psychosocial intervention, and measuring success in medical model terms is outright ridiculous as our aim is often to reduce the distress associated with ADHD symptoms rather than "curing" the symptoms themselves.



With regard to medication, I do think there is a need for serious reflection and discussion on the social and psychological impact of taking psychotrophic medication in childhood (and in adulthood - and for any kind of mental disorder). Personally, I am convinced that taking medication has psychological and social repercussions for the individual and for society quite separate from the pharmacological effect of the medication itself. (Is this hard to explain, because I once attempted to have this conversation with my supervisor and he acted like I was suggesting leprechauns were real?). What does taking medication for behaviour mean to a child? To a parent? To a teacher? To a peer group? How does it impact on a child's sense of self? Does is lead to stigma? These are very real issues not only for people who take medication or whose children take medication - these are issues for all of us and how we all think about our own behaviours and our own interaction within society and response to those individuals who find themselves diagnosed with a mental illness or taking psychotropic drugs.



Finally - where is the ADHD advocacy movement? In autism there is a growing movement seeking to value neurodiversity. I recently read an article written by an autistic man who insisted he wasn't a man with autism (the current language in vogue amongst the politically correct) but an autistic man. His autism was a part of his identity and he was proud of it. That's challenging to me as a psychologist about to take a job where some of my clients will have autism.



But what are the unique skills and attributes of children and adults who could be diagnosed with ADHD. How can these be valued and encouraged within our society? Many adults and older teenagers I have met with ADHD say they would never want to be "cured" - but where are their voices, and will researchers, psychiatrists, psychologists, teachers and parents be brave enough to listen?