“Mental health apps offer a head start on recovery” – Irish Times, 18/01/18

Over at my more medically focused blog A Medical Education, I have a link to a recent Irish Times story on apps in mental health in which my various pontifications feature….

A Medical Education

Here is a piece by Sylvia Thompson on a recent First Fortnight panel discussion I took part in on apps in mental health.

Dr Séamus Mac Suibhne, psychiatrist and member of the Health Service Executive research technology team says that while the task of vetting all apps for their clinical usefulness is virtually impossible, it would be helpful if the Cochrane Collaboration [a global independent network of researchers] had a specific e-health element so it could partner with internet companies to give a meaningful rubber stamp to specific mental health apps.

“There is potential for the use of mental health apps to engage people with diagnosed conditions – particularly younger patients who might stop going to their outpatients appointments,” says Dr Mac Suibhne. However, he cautions their use as a replacement to therapy. “A lot of apps claim to use a psychotherapeutic approach but psychotherapy is about a human encounter…

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“Shouting about humankind being part of nature may mask a fear that it is nothing of the sort.”

From Peter Reason’s “In Search of Grace”, a passage on a theme that has often occurred to me. Philosophically, one can unpick the concept of “nature” and any separation between the world of human activity and the natural world. This idea often accompanies beliefs that an interest in nature is a recent phenomenon of industrial societies This passage, and the David Cooper quote, resonate with an intuitive sense that there is a gap between the human and natural world. Later in the book, Reason discusses the experience of a storm and how this, in something of the manner of Dr Johnson’s “I refute it thus” – confronting the visceral reality of the natural world:

Part of the problem is that our reflective consciousness is so thoroughly self-absorbed: our interest and attention is focused almost exclusively on ourselves and those closest to us. At our best, we may feel part of a fellowship of humanity or a human family. While our understanding of evolution and ecology tells us that we are also part of the community of life on Earth, we rarely fell that in our bones or in our hearts. However much we may assert that we are all part of the same universe, that we are part of the evolution of life on Earth, we still find it difficult to overcome a sense of estrangement, or otherness. As philosopher David Cooper puts it, “Shouting about humankind being part of nature may mask a fear that it is nothing of the sort.”

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“a confidence man, ivory poacher and all-round rogue “

The opening line of John Seabrook’s Wikipedia bio is pretty impressive, but here we find a better:

Pseudonym of UK-born author William Lancaster Gribbon (1879-1940), who emigrated to the USA in 1909 after his early life as a confidence man, ivory poacher and all-round rogue in British Africa had culminated in a prison sentence.

The context I found this quote was, incidentally, posting on my other blog A Medical Education a passage from Mundy from a 1922 novel that describes synaesthesia. Here it is, from “Jimgrim and a Secret Society“:

Did it ever strike you that sound has color? The din that bell made was dazzling, diamond white, reflecting all the colors of the prism in its facets. When I spoke of it afterwards I found that Grim had noticed the same thing.

Two years ago I found a passage from John Buchan’s 1932 The Gap in the Curtain which also described synaesthesia:

The Professor elicited from the coy Reggie that in his childhood he had been in the habit of seeing abstract things in a concrete form. For Reggie the different days of the week had each a special shape, and each of the Ten Commandments a special colour. Monday was a square and Saturday an oval, and Sunday a circle with a segment bitten out.; The Third Commandment was dark blue, and the Tenth a pale green with spots. Reggie had thought of Sin as a substance like black salt, and the Soul as something in the shape of a kidney bean.

“a media to look at rather than to read”

This article from Politico on Robert D’Agostino, the man behind the website Dagospia, is an interesting read on both Italian media/politics and the general mental landscape of the internet. I was struck by a phrase from the journalist Filippo Cecarelli, quoted in the article:

Ceccarelli, the La Repubblica journalist, credits Dagospia’s success to two factors. D’Agostino’s was one of the first media outlets in Italy to grasp the potential of the web. And it was the first to understand that the web was a post-ideological visual space.

“Dagospia is a media to look [at] rather than to read,” said Ceccarelli, who wrote the foreword to one of D’Agostino’s books.

It is something of a commonplace to describe the Internet as a medium that privileges the visual over the written (although I recall in the early days of the mass availability of the internet pieces claiming we were entering a new epistolary golden age) – but something about this passage (and possibly the context, with the description of D’Agostino’s eclectically decorated apartment and the febrile world of Italian politics) resonated. It certainly would have appealed to Neil Postman with his concern with how we were amusing ourselves to death via media ideal for entertainment rather than reflection

I was also struck by a quote from D’Agostino himself:

In D’Agostino’s view, Italy is run by “powerful bureaucrats” who direct elected politicians and ministers from behind the scenes. His bottom line is that Italy has always been and remains a feudal country.

“In a serious country Dagospia would not exist,” said D’Agostino in an interview in his Roman mansion. “But in Italy news gets buried.”

I recall hearing Italians self-deprecatingly observe that other nations were “serious”, not them. I suspect this may be a universal perception – that other nations Do Things Better.

Reading on the bus: a literary bus conductor from Arnold Bax’s Farewell My Youth.

Up until about 10 years ago an awful lot of my reading was done aboard the vehicles of Dublin Bus. I quite often come across bus tickets used as bookmarks in old paperbacks.

I presume that I was far from the only one to do this (and even in the smartphone age there are no doubt still readers of physical books on the buses). It would be interesting to track down literary descriptions of this literary activity.

Reading Arnold Bax’s Farewell My Youth, I came across a brief anecdote from the author’s years as a student in the Royal Academy of Music in London (he was there from 1900 to 1905, from the context of the passage it seems likely this was towards the latter end of this time but one can’t be sure) :

Meantime in every hour not devoted to music I read feverishly all the literature I could come upon, poetry and prose, British and Continental. Clifford once announced that “Arnold has read everything, though no one has ever seen him with a book in his hands.” A picturesque exaggeration, of course, but, thought I not care to boast of a critical faculty, my soul certainly adventured greatly among masterpieces.

I was one day eating up Epipsychidion on the top of a bus bearing me to the West End when the conductor, who had already collected my fare, suddenly reappeared at my side. Said he, “I see’d yer readin’ poetry just now.” Then bending confidentially to my ear, “Now, I’m pretty ‘ot on poetry meself! Pertickler partial to Dryden I am. Cor! that’s the bloke that can write! Gran’ stuff!

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I wonder how many other London bus conductors have spoken as rapturously of “Macflecknoe” and the rest.

“The pilgrimage is not all plain sailing, not all peak experience” – Peter Reason on the messy human reality of pilgrimage

“The pilgrimage is not all plain sailing, not all peak experience” – Peter Reason on the messy human reality of pilgrimage

One of the charms of Peter Reason’s In Search of Grace“ is his human honesty at the gap between the lofty ambition of pilgrimage and actual experience. At the very outset of his voyage, he writes of “the repetitive anxiousness that so often comes in the small hours … I lost all sense of why I was on this journey; all sense of pilgrimage disappeared.” He expands on this theme:

It is not uncommon for travellers to feel resistant at the point of setting out. For years the French writer and traveller Sylvian Tesson had wanted to spend the winter in a small cabin in Siberia. In Consolations of the Forest he writes about the challenge of rousing himself from bed on the morning he is to set out and wonders if he will undermine his own desire. In The Snow Leopard, Peter Matthiessen describes the calamitous weather and uncertainty about porters at the beginning of a trip in the Himalayas. The forthcoming journey is losing all sense of reality and he asks “where did I imagine I was going, where and why?”

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I suspect that in order to gather the energy for a significant journey we have to idealise it in our minds beforehand. There has to be a grand purpose to make it all worthwhile. So I have described my voyage as a pilgrimage (rather than a sailing cruise) I had thought of it as a “deep ecology homage” But once I set off, these worthy ambitions ran up against the unrelenting and sometimes frightening reality of the wild world. The high-minded purposes become meaningless and difficult to hold on to. The pilgrimage is not all plain sailing, not all peak experience. We can only engage with the world on its own terms, terms that include inclement weather, the contingency of plans, and the unreliability of equipment. And they meet with my fragility as a human being; my mistakes, my indulgences in emotions, my fear, the gap between my high expectations and the reality.

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There is something of the ridiculous in this. I boldly wrote that on pilgrimage we leave the comforts and habits of home in order to meet the more-than-human world more directly. But I was discombobulated when I had to live through what this actually means in practice. The grand purposes with which the pilgrim sets out will only survive and deepen as they are tested against experience.