Dementia awareness

The environment of dementia

Challenging behaviour in dementia

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“Spirit possession and mental health”

Here’s the wording of the flyer I received – along with my own comments for those who might be interested.

Spirit possession is recognised world wide across many cultures and by several religions. Spirit possession is often seen as an idiom of distress causing a change in behaviour and mental well being. Spirit possession is also included in the ICD 10 and DSM IV classifications of mental disorders, yet the extent to which it is recognised and / or discussed in clinical practice is less than we would expect, even in UK cities where there resides a diverse population. This one day event will consider the critical themes and debates on spirit possession from an anthropological, social, psychological, medical and religious perspective using a range of illustrative case study, clinical practice, research and short film presentations.”

The conference looks OK at first glance, couched as it is in the language of multi-culturalism and the accompanying ‘blurb’ makes it clear that many cultures and religions acknowledge spirit possession. This is true, of course, and by making this case the conference developers have created something of an equality and diversity taboo, preventing people from criticising it. However it’s a taboo that I for one am more than happy to break.

I need to be absolutely clear though. I am in no way attempting to deny the right of all people to believe what they like. So far as I’m concerned people have a perfect right to their beliefs, opinions and religious persuasions. However, accepting a person’s right to a belief isn’t the same as accepting the belief itself as true or even helpful. Nor is it the same as accepting that such nonsensical, pre-rational beliefs have any place in publicly funded healthcare provision.

It’s true that many religions propagate the myth of spirit possession. Many religious texts also advocate child slavery, male supremacy, capital punishment and the idea that the sun revolves around the earth (which, they claim, is flat). There seems little wrong with criticising any of those core doctrines of Christianity, Judaism, Islam and many other religions and so I see no problem with criticising this one either. It’s not that I’m denying a person’s right to believe in whatever myth they choose – I simply object when mental health professionals start to join in.

The stated aims of the conference are reproduced below:

• Discuss possible definitions of and different kinds of spirit possession
• Debate the key elements which typify spirit possession
• Discuss who can make a diagnosis of spirit possession and how such a diagnosis might be made
• Compare and contrast how spirit possession might be viewed by clinicians, religious leaders, healers, the “patient”, family and community members
• Discuss the value of using the patient’s explanatory model of the illness
• Reflect upon the key issues associated with defining what is “normal” and “abnormal”
• Discuss folk healing practices in different cultures and “treatment” options including exorcism
• Consider whether there is a need to enhance joint working between mental health professionals and traditional healers.

“What’s wrong with that?” I hear you cry.

Well, make yourself a cup of tea, grab the biscuit barrel from the shelf, sit back at your computer desk and I’ll tell you….

• Discuss possible definitions of and different kinds of spirit possession
• Debate the key elements which typify spirit possession
• Discuss who can make a diagnosis of spirit possession and how such a diagnosis might be made

The first three aims demonstrate the uncritical assumption that spirit possession is a genuine phenomena, not a socio-cultural myth or an individual delusion. This in itself reduces the tone of the conference from 21^st century, rational, evidence-based inquiry to blind acceptance of the worldview of nomadic herdsmen from the iron age or earlier. In a health care system that is based upon evidence and research it seems wholly inappropriate to base our discussions upon the ignorance of the ancients.

The above section also talks about diagnosis of spirit possession (not diagnosis of delusions of possession). It seems to me to be completely unacceptable to base any discussion about mental health care upon the assumption that possession (a belief system without a shred of credible evidence to support it) is a genuine, diagnosable condition. This is especially so when we consider those who have been harmed and even killed as a result of subsequent exorcism rituals. A discussion of the belief systems that give rise to such delusions is one thing – a discussion about diagnosing and treating possession itself is quite another.

The question of who diagnoses possession is also worrying. Western psychiatry doesn’t have all the answers, by any means, but at least it is trying. Medical psychiatry evolves, it changes over the years as ideas are rejected and new concepts come to the fore. These ideas aren’t always correct or even helpful but at least there is the possibility of growth, however slow that growth might be.

Religious assertions about possession are neither new nor evidenced based. Nor are they open to change. For example, the New Testament stories of possession and demons being driven into herds of swine are more or less as they were when the Catholic Church first edited them a few centuries after the death of Christ.

That unchanging disregard for new understanding and research presumably is why few mental health professionals I know believe in such myths. There are some who do, of course, but they’re few and far between. To accept uncritically the idea of possession and then limit one’s conversation to how it is diagnosed is simply skirting around the edges of a primitive and infantile misconception. There are no spirits, there are no demons and there is no such thing as possession.

It seems unlikely that anyone would be interested in diagnosing possession unless they believed in it themselves. That means cranks, new age con men and religious clerics – hardly the most informed or psychologically skilled individuals to entrust with the care and treatment of vulnerable mentally ill people. To be frank such people are either cynically dishonest and opportunistic or terminally gullible.

• “Compare and contrast how spirit possession might be viewed by clinicians, religious leaders, healers, the “patient”, family and community members
• Discuss the value of using the patient’s explanatory model of the illness
• Reflect upon the key issues associated with defining what is “normal” and “abnormal” “

Here it gets a little trickier to criticise. Comparisons are good, aren’t they? Well – yes, they are. Only by discussing differences of opinion can we hope to develop and understand the world and our place within it. In mental health care, acknowledgement and acceptance of other peoples’ points of view (cultural or otherwise) is also extremely important.

But this isn’t really about open discussion. The terms of reference for the conference have already been set – and they’re not about questioning the plausibility of spirit possession – they’re about flogging the idea of parasitic spiritual entities to the gullible.

If I were part of this discussion, for example, I’d be talking about the irrationality of belief in spirit possession. I’d be asking for evidence of the existence of a soul and how anyone knew that there was a spiritual dimension outside of this plane of existence in the first place.

How long do you suppose that line of discussion would be tolerated before I was either quietly sidelined or asked to leave? This conference isn’t really about discussion – it’s about confirming that other people might not believe but ‘we know better’.

However, there is real value in using ‘patient’s explanatory models of the illness’. In my work with delusional people I have regularly done so but not from the position of blind acceptance, more of rational inquiry. Asking questions to help the individual reason through their problems – not reinforcing paranoid delusions about other-worldy entities inhabiting their bodies.

The most effective method for talking with delusional people I know is Socratic dialogue – a technique that helps people to examine the evidence before them objectively to reach rational conclusions about what to believe (and to believe in). We should always be prepared to accept that the person sincerely believes the things they do. But we do them no favours by buying into mythical worldviews ourselves. In fact, I’d go so far as to say that such reinforcement of delusional states probably constitutes psychological abuse.

• “Discuss folk healing practices in different cultures and “treatment” options including exorcism
• Consider whether there is a need to enhance joint working between mental health professionals and traditional healers.”

Okay, I’m a cynic – I admit it. But the above seems to me to be the most telling part of this flyer. I’d be very interested to know who is sponsoring this conference. In truth I don’t know but I wouldn’t be at all surprised to learn of significant new-age involvement.

Several unscientific, ritualistic and ultimately useless (not to mention impossible) treatments have wormed their way into NHS care in recent years. Just look at who this conference is aimed at.

“Who Should Attend?

This conference will be relevant to all interested in this field as well as all professionals, including those from Local Authorities and NHS trusts across the UK, Psychiatrists, GPs, Psychologists, Psychotherapists, Counsellors, Early Intervention Teams, CPN’s, OT’s, Social Workers, Chaplains, Community Faith Leaders & Healers, Equality Leads, Community Development Workers, Service User Representatives, Charities, Third Sector, Educational Establishments, Academics and Policy makers.”

I wouldn’t be at all surprised to learn that this is another attempt to open a market that uses public money to buy dubious and ultimately harmful treatments for gullible people. After all there are few more gullible than delusional, mentally ill people who will often jump at any explanation provided it doesn’t involve the need for side effect laden medications. Mental health professionals acknowledge the difficulties of side effects and spend a lot of time trying to minimise them or to remove the need for them through social and psychological interventions. Cynical new-age con artists use those difficulties as marketing opportunities.

Enter the aforementioned cranks, new age con men and religious clerics.

I’m amazed to see that this conference is being held in London at all. I’d have thought Glastonbury would be a much more suitable location for such blatant nonsense masquerading as serious health care.

For further information on the damage such pre-rational thinkning can do have a look at This post from Tannice which links to reports of deaths associated with beliefs in demonic possession and witchcraft. You can also find similair reports throughout my own blog category: plausible nonsense

But if you’re concerned about the protection of vulnerable groups please take a few minutes to read this. there may well be a case for reviewing some of the existing provisions but we really should be careful not to throw the baby out with the bathwater. Click the link below to view the newsletter’s contents.

http://www.thecareguy.com/news_73105.html

I had a particularly interesting time as a student.  My nurse training began in 1992 in a fairly quiet and unremarkable town in the West Midlands.  Nothing terribly significant about that. The interesting thing was related to the timing.

I began my training in 1992 and was part of that particular college’s second intake of students onto the new ‘Project 2000’ syllabus for student nurses. As had been the case previously participants in this ‘new-fangled’ training were viewed with suspicion and in more than a few cases undisguised hostility. ‘Traditionally’ trained nurses were frightened that we would ‘take their jobs’ and also insisted that our training would be ‘too academic’ (as though understanding nursing theory might be a bad thing). They also complained  that we didn’t spend enough time washing bedpans. I always wondered just how long they thought it might take for a student to learn how to wash a bedpan. Ten minutes seemed reasonable enough to me but I met several nurses who insisted that several weeks at least should be devoted to instruction in this most complex and delicate of tasks.

What really got me thinking last night though was the memory of a particular nursing Sister. I’ll call her Sr ‘B’.  She was the nurse in charge of a unit I had the misfortune to be placed on during my first year as a student and she was far from welcoming. So far as we students could ascertain she particularly disliked:

• Project 2000
• Male nurses
• Mental health nurses

This didn’t leave me and my student colleague, Mike much of a chance.

I remember that the majority of my placement involved being told to ‘stand over there and be quiet’ whilst Sr ‘B’ was on duty (which was most of the time). ‘Over there’ meant a corner (yes, literally a corner) a few feet away from the nurses’ station from whence we could see nothing of value and hear very little. Mike and I complained to the school of nursing about her attitude toward us but so far as I can tell this made no difference whatsoever to the experiences of subsequent students unfortunate enough to draw that particular ‘short straw’ of a placement.

Even more remarkable than this though was the behaviour of one of my tutors. Her article bemoaning the fact that her project 2000 students were qualifying with no understanding of practical nursing care tasks was published in  a well-known nursing publication. This bought into the prevailing prejudices we faced daily very well but it wasn’t especially accurate. None of her project 2000 students had made it out of the first year of training at the time, let alone qualified. The new course hadn’t been going long enough for that. It was excellent ‘grist for the mill’ for the traditionalists in the local hospital though as we all discovered very quickly when we tried to fit in and learn stuff.

Of course all this is ancient history so what’s the point of bringing it up now? Well it’s simple, really…..

Today, just as in the early 1990s there are student nurses whose careers depend upon the quality of their training. These students will go on to care for patients for many years to come and if the nursing profession is to deserve the title of ‘profession’ at all its members must be able to overcome this sort of petty prejudice.

I still hear stories of discriminatory nurses and lazy mentors that seem little or no different to the neglect and abuse that my own cohort of students experienced ‘back in the day’.  To treat the future of our profession with such disdain is not only unprofessional, it’s dangerous. The nursing profession is under attack as we speak from ideologically driven politicians. The coalition seems desperate to find scapegoats to justify the destruction of the NHS in pursuit of private profit and right now nurses are in the frame. It will be today’s students who carry the standard of nursing  tomorrow and they’ll have some pretty rough political terrain to cross. Let’s nurture them. They’re going to need it

If you have any particular needs around dementia care training please get in touch at info@thecareguy.com and I’ll try to help.

Also I’m planning a ‘Dementia Care Guide’ series and I’d be very interested to hear your ideas about what to include. Email me at info@thecareguy.com with your suggestions.

Many thanks,

Stuart Sorensen
(The Care Guy)
www.thecareguy.com

http://www.thecareguy.com

I’ve spent the last couple of days working on this – I’m not exactly an expert when it comes to websites so everything took me twice as long as it should but I’m getting there.

Have a look and let me know what you think.

Clearly the point of this website is to tempt people to use my training services so I’d really apreciate feedback on whether or not you think it will achieve that. One thing I’m already aware of is that I need to rerecord most of the ‘The guide’ movies now that I’ve had a haircut and worked out how to get the lighting reasonable. That’ll be tomorrow’s job.

Let me know if you spot anything else that needs to change.

Thanks a lot.

Stuart

I almost never just reblog other people’s articles without comment but this one is so important I think it deserves all the exposure it can get.

https://submissions.epetitions.direct.gov.uk/petitions/20968

“Pats Petition goes past 11,000

 Apparently this blog has been voted by the This Week In Mentalists’ readers as the best nursing blog of 2011.

Actually I think that it may be a little ironic given that most of my nursing related content was shifted early in December to the new blog :

http://caretraining.wordpress.com/

but I’m not about to turn it down on a technicality.

Most of the old content from this blog has been arranged by topic and converted into PDF guides for free download from the care training blog freebies and downloads page.

I can thoroughly recommend clicking the awards link as it links to all the other winners and runners up too and there are some excellent blogs included. I’ll be exploring those that I don’t yet know about myself over the next day or so as well.

All that aside though I’d just like to say a really big thankyou to all those who voted for me. I didn’t even know I’d been mentioned at all, let alone won.

Thanks guys.

Cheers,

Stuart

http://twim-blog.org/2012/01/01/the-2011-twim-awards-the-results/

Yes, I know – I shouldn’t take the bait but I strongly suspect that this one is designed in fun so it’s not so bad. In short there’s a new Poe on the block.

For those unfamiliar with the term a ‘Poe’ is an example of Poe’s law which says:

“Without a winking smiley or other blatant display of humor, it is impossible to create a parody of Fundamentalism that SOMEONE won’t mistake for the real thing.”

The idea is that any outrageous statement, even a satirical parody is just as likely to be sincerely meant as any other. Poe’s corollary is that…

“It is impossible for an act of Fundamentalism to be made

that someone won’t mistake for a parody.”

Both quotes are taken from wikipedia here:

http://rationalwiki.org/wiki/Poe’s_Law

Festive Poes have become something of a tradition on the internet. In my opinion this Christmas’ best Poe has been a new Twitter account from someone who may or may not be from Texas and who may or may not know a great deal more about evolutionary science than he or she lets on.

The account is allegedly run by someone using the name ‘Patrick’ (@LoveGod50) who has entertained many of us, including grabbing the attention of @RickyGervais with his/her antics. ‘Patrick’ has also linked with @Godswordislaw who predicts the ‘rapture’ for New Year’s Eve 2011 so not long now folks.

Highlights of ‘Patrick’s’ Poe include:

Darwin had no knowledge of science;
The earth must be only 6,000 years old because otherwise we’d have run out of water:

http://t.co/fGuvo7KN

Other highlights include fossils created by God as fossils but then abandoned by God as they posed a threat to mankind;
The fossil record doesn’t support evolution (this quote from a professor of paleontology writing 125 years ago when the fossil record was much less complete than it is today)
No recorded history over 4,000 years old proves the earth is only 6,000 years old. Of course records do exist from before 2,000 BC (ancient Egyptian for example) and even if they didn’t that proves nothing about the age of the earth;
The best of all – all those who disagree with @LoveGod50 will burn in Hell.

Don’t misunderstand me though – I’m not trying to slag off Patrick’s religion. On the contrary this post is here to express my admiration for an excellent Poe. I’m not sure how long the twitter account will be ‘up’, Poes often get deleted soon after they are exposed but if you would like to see a work of pure, manipulative genius have a look at @LoveGod50 on Twitter. ‘Patrick’s’ lecture on evolution last night (26/12/11) was a joy to behold.

For geeks like me who are interested in evolution it really is excellent. Brilliantly satirical stuff.

‘Patrick’ breaks all the rules of reasonable debate as described here…

and indeed represents one of the best parodies I’ve seen so far. Well done ‘Patrick’ – whoever you really are.

Update 29th Dec 2011

Unfortunately this Poe has now evolved into a satirical prophecy platform predicting the rapture on behalf of @GodsWordIsLaw (AKA Keith as mentioned above). Keith is a homophobic, discriminatory zealot who really seems to believe in the most brutal & murderous elements of the Old Testament (including singling out gay men, atheists, Jews & Muslims).

Joining Keith in his rapture prophecy is, in my view the point at which this Poe stops being funny & starts to be very irresponsible. Gullible people really do kill themselves & their children when rapture is prophesied. I blogged about this phenomenon at the time that Harold Camping prophesied the rapture earlier this year.

http://stuartsorensen.wordpress.com/2011/05/22/rapture-the-cult-of-death-the-murder-of-the-innocents/

I’m sorry ‘Patrick’, your Poe was amusing at first but this is going too far. Very irresponsible indeed.