My diagnostic disaster: part two

In my last post I began relating the story of my odd encounter with a rogue psychiatrist, Dr Field (not his real name). Below is the second instalment.

When I left Doctor Field I never intended to go back. But eight years later, my brilliant career as an editor was floundering in a sea of uncertainty and self-doubt. I was at a crossroads: publishers were paying less, and wanting work done that was often beyond my expertise. I was weary of the chronic exhaustion and anxiety, not to mention loneliness and isolation, that large jobs forced on me. I wanted a style of work that was sustainable. Refusing the big jobs for the sake of my sanity, my savings were getting run down.

I needed some government help. I wasn’t going to stop working but find a niche that suited me, with a safety net underneath – a net flexible enough to allow me to work part time, as the particular payment I sought would do.

I was finally ready to admit that I had a serious, complex condition and that I couldn’t make it on my own. I was going to put my hand out.

But first I had to get the necessary documentation. This included a complicated form that had to be filled in by a doctor, stating the seriousness of the patient’s condition and that it was either stable or being treated.

This presented a dilemma; I had seen two psychiatrists consecutively for long periods of time, and I didn’t want to ask either of them to complete the report.
Neither had ever presented me with a diagnosis, probably because they did not want to encourage what amounted to an obsession with self-analysis. But nor was either of them a specialist in anxiety disorders, and they had shown little or no interest in imparting skills to help me manage my anxiety. Despite this, all three of us had assumed that the goal for me was more or less normal functioning where work and love were concerned. I could not go back to either one of them and admit my ‘failure’.

Then I thought of Dr Field, and the results of his test. I rummaged around in my filing cabinet and found it: it was all there in black and white, the extent of my pathology. This could furnish some supporting evidence, but I would need to get it from the horse’s mouth. I would arrange to see Dr Field purely for the purposes of getting a doctor’s report on my condition. And, as our approaches to drugs and psychiatry were at such variance, I would make it clear that I did not want to see him on an ongoing basis.

The determination to foreclose ongoing treatment was my first mistake. There would be a few more before Dr Field and I were through for good.

I rang up his office and his receptionist answered. I bluntly asked her if I could make an appointment to see Dr Field on a short term basis. I made it clear, probably sounding over-determined, that I did not want to see him for long term treatment.

That’s the point at which the pathologising began. The receptionist passed on this message to Dr Field, and once we were in session he mentioned this reluctance as an instance of my pathology. Already there was more than a whiff of the 1950s approach to psychiatry in Dr Field’s attitude towards me. What next, a lobotomy?

The first minutes after I sat down in front of him, however, were quite okay. The room was small with an untidy shuffle of papers and a television in one corner, the walls painted a pale apricot beige, but the vinyl armchair that I sat in opposite him was low and comfortable. I had completely forgotten the look of him, and now recalled the unexpected cuteness, the expensive suit. Perhaps it would all be alright. I told him about my editing dilemma and he tipped his head to one side, quickly, in that rather appealing way – could it be he was really listening? ‘You’ve thrown in the towel’, he said. I nodded and had to stop the tears from welling up. Was he offering sympathy? understanding?

Half an hour later he had diagnosed me with attention deficit disorder (ADD) and told me the only hope for treatment was regular doses of dexamphetamine (otherwise known as speed). He had also apologised for diagnosing me with bipolar eight years earlier. Since our last encounter, he explained, he had discovered that many patients with what he’d thought were the symptoms of bipolar actually had ADD or ADHD.

So much was going on in my head as I smiled back at him. What was the point of trying to explain my chronic low blood sugar, the brain fog I already experienced from food intolerance, my battles with caffeine and the fact that my body reacted badly to any kind of drug? How could I possibly try and crack open that wall of medical certainty and blind faith he had in the efficacy of drugs to cure all mental ills? This combination of the old-fashioned and the maverick in him was bewildering. A psychiatrist like him, willing to be on the diagnostic cutting edge, should have been as focused on the body as he was on the mind – wasn’t that the point of psychiatrists being medical doctors as well as specialists in mental disorders?

At that moment I started to become what he had set out to portray me as – calculating and false.

But at the same time I was also knocked sideways by the actual diagnosis. Somehow it made sense. The literature he gave me to read later brought it home even more sharply.

According to the literature, there are a number of forms of ADD. The commonly known ADHD, characterised by hyperactivity and low academic achievement, is only one of them. There is also inattentive ADD, associated with girls and far harder to spot, as well as hyperfocused ADD, but also a couple of others even lesser known. If anything, I had inattentive ADD. I was considered a ‘brain’ at school, but was for the most part a lazy student until I pulled my finger out for the final year of secondary school and got pretty good marks, including a standardised perfect score in English. But I floundered at uni as an undergrad, failing some subjects and obtaining only mediocre or poor marks in most others.

At the age of nine, before I knew anything about mental illness, I’d suddenly come to the conclusion that there was something deeply wrong with me. Later I had assumed that this was just the first stirrings of my neurosis. But perhaps on some level I was aware of some more basic shortcoming in my neural architecture.

On the other hand, my ADD symptoms might have been environment related (as I’d always assumed), an attempt to respond to and escape from the conflicting emotional demands of parents who were respectively resentful, depressed and emotionally distant (my mother) and needy, obsessive and controlling (my father).

Regardless, Dr Field’s methods of diagnosis were lazy and reductive. One Australian ADD site has a list of other conditions that may present as ADD and should be eliminated before any diagnosis. Dr Field did not bother to eliminate any of these. What about my chronic low blood sugar, for example? Couldn’t that have been a culprit? (In my case, I believe it’s a separate condition, but who knows how it contributed to my adolescent difficulties?) When I asked Dr Field about whether I could get a brain scan to confirm the diagnosis he said a SPECT scan was available, but waved dismissively as he said it. (I decided not to – a confirmation of ADD would encourage my self-obsession).

And a few more things about ADD before I leave the subject – I’ve done a bit of reading on brain plasticity, and I believe there are many types of brains, as well as many ways people can improve brain functioning. Even if I had no physical health problems, I don’t believe the kinds of drugs that are prescribed for this condition – basically stimulants – are the answer in most cases. I say this because the fact that I’m an editor suggests that my brain has changed quite considerably already simply by the work I’ve done, and practices such as meditation and mindfulness can help further. I’d like to see a situation whereby with every diagnosis of childhood ADD, parents were given appropriate exercises for their children and if possible software programs to literally retrain the brain – this kind of treatment is already available with some kinds of learning disorders.

But it truly scares me to think of the number of children being diagnosed with this condition who may simply be suffering from food intolerance or low blood sugar. However, that doesn’t mean the condition doesn’t exist.

Anyway, just as the literature suggested was typical for an ADD person (the extent to which I fitted some of the ups and downs and brain states described was chilling) I caught the tram home thoroughly discombobulated. Dusk had fallen and as I stood in the swaying, brightly lit tram among the suited commuters clutching their mobiles, my mind was busily rewriting my entire life story – my difficulties, social and otherwise, made more sense than they ever had.

But in my bag was a prescription for dexamphetamine.

My diagnostic disaster

I have read a few different stories about bad psychiatric diagnoses on the blogosphere and have been planning to tell my own weird tale. Grab a cuppa, sit back and listen to my odd encounter with the enigmatic Doctor Field (not his real name).

I first have to briefly explain the system in which psychiatrists work in Australia. The majority are in private practice, but they operate under Medicare, a taxpayer-funded national medical system.

This means the government provides set subsidies for all classes of consultation, but the psyches themselves have their own industry-recommended rates and it’s very unusual for them to charge only the amount of the government subsidy (that’s known as ‘bulk billing’). With some psyches willing to negotiate reduced fees, these days you might be paying anything from $30 to $100 or more per visit after the government rebate.

(You can now get a rebate for consultations with psychologists, but that’s a different story.)

Of course there are doctors working in the public psychiatric hospital system, which is very underfunded in Australia. Rural mental health is in the main poorly serviced, partly because many psychiatrists and psychologists simply don’t want to live in the country.

Anyone who lives in a large city like Melbourne and can afford to pay the amount over the Medicare rebate will have some degree of choice in accessing a psychiatrist. But they may have to wait a while if they want to see a particularly popular one, and really good female ones are especially thin on the ground.

I first went to see Dr Field way back in 1999, on the recommendation of Janine, a friend of mine. It was my own stupid fault I ever got ‘involved’ with him. I knew he was really into dispensing drugs – he’d put Janine on Epilem, a drug for epilepsy, because she had anger issues (she’s very mild, this friend – it wasn’t a behavioural issue, more about how she felt towards others).

I’d just finished up with my previous psychiatrist. She’d given me the structure and discipline to complete a post-grad degree but was next to useless when it came to what was at times an extreme form of social phobia. I started a full-time job after the degree but had to leave the job 3 1/2 months after I started because I wasn’t coping. At the time I was hopeless at managing my anxiety and panic disorder. It was a crucial period of my life and between us, my psyche and I stuffed it up.

By the time I left the job I’d gone downhill to the extent that I would get panic attacks almost every time I had to speak to an authority figure on the phone. I was looking around for a psyche and this time I wanted a man, to help me deal with my issues with men. Janine was seeing Dr Field in a therapy group she attended three times a week, and she thought he was brilliant.

So I went to his rather cramped, untidy ‘rooms’ near the CBD. He looked to be in his late fifties and had a heavy body bursting out of an expensive suit. His face was set in folds and, disconcertingly, the tip of his tongue protruded ever so slightly from his mouth. He was oddly cute: when making a point he tilted his head to the side and his eyes disappeared into the folds of his face as he gave his quizzical smile.

One of the first things he did was give me quite a long written test to fill out. This was to enable a preliminary form of diagnosis – ie what the practitioner would be likely to find in the patient, given the results shown. It’s odd but some of the extreme findings comforted me in an ‘I told you I was ill!’ kind of way.

Supposedly I had some indications of psychosis and paranoia, as well as the expected anxiety, and some unpleasant character traits that were a little bit too accurate for comfort. (For the record: I don’t and have never had psychosis.) Interestingly, following my job trauma, there were also signs of post-traumatic stress.

But the key thing he did, after either one or two consultations, was diagnose me with a mild form of bipolar. He believed my friend Janine had this mild form and, like her, he wanted me to go on Epilem.

Doctor Field is a maverick. He gets a bee in his bonnet about a particular pathology and sees everyone through the lens of it. I know that because it’s what he did to me. He believes – well, he did at the time – that this mild form of bipolar is incredibly common and under-diagnosed, and commonly expressed in unreasonable feelings of anger. But his diagnostic methods weren’t that sophisticated. I remember him asking me blatantly leading questions like ‘do your thoughts race sometimes?’

Anyways. I took the Epilem and got predicably freaked out about the fact that it made me vaguer than usual (this effect would probably have reduced if I’d continued to take it). I remember absent mindedly parking in a No Standing area and being furious when I got a parking fine (so much for the drug reducing my anger!). I immediately stopped taking the Epilem. I went back to Dr Field and told him I’d taken myself off it because it was making me vague. He called my reaction ‘hypomanic’ (it was certainly impulsive, but I was never going to warm to the Epilem and should have said so from the beginning).

We were fated to part company. He tried me on Prozac, and that was a disaster. Combined with the strong coffee I’d started drinking again – it was poison to me for a variety of reasons – I became a walking panic attack.

Soon I left Dr Field and found a kindly male psychiatrist, an elderly Freudian who probably did not pathologise me enough. Eventually he put me on another antidepressant and it did help. And eventually I left this psyche, not cured by any means, not happy or fulfilled, but convinced I had gone as far as I could with psychotherapy, and drugs for that matter.

So what the hell was I doing sitting in Dr Field’s office eight years later? And what would he diagnose me with this time? Tune in next week for the next instalment!

Weather report

It’s hot in Melbourne. It’s been hot since last Saturday. You suffer, you endure, and then it starts to get to you, not just physically but emotionally. Apart from two days that are expected to be 27 and 28 (but will probably be revised up) it’s going to be hot for another week. Already we've had five consecutive days with temperatures over 32 degrees, rivalling the 1896 record of six consecutive days with temperatures over 30 degrees -- but possibly creating a new record because the 1896 temperatures may not have been over 32 degrees.

Luckily the nights have been cooler. My scientific friend tells me it’s the minimum temperatures you have to watch in a heatwave rather than the maximums. Late yesterday afternoon brought a cool change of sorts; I pottered round the laundry and backyard, handwashing, weeding and guiltily attending to my fast-wilting plants. I opened the windows and doors to let the cool in. Later that night I stepped out the front door and just stood on the porch with my hands stretched out, the feel of cool, breezy air on my skin like water, the wonderful sensation of being too cold.

The internal weather has been just as difficult. A few weeks ago I wrote about a date with a certain Gentleman; now I feel compelled to reveal the outcome. Nothing happened. There – I’ve said it. But in writing it I realise now that I really believed something would.

At the end of our first meeting, standing out the front of the café, I turned away during that horrible split second when you are trying to communicate your general impression and perhaps negotiate a second meeting. I hate this moment and was childishly trying to avoid the uncertainty and embarrassment of it. Afraid to show vulnerability, I didn’t give him my phone number, saying hurriedly something like ‘we can email’. Later I tried to remedy this by sending an email telling him I’d enjoyed meeting him and would like to meet up again. But perhaps the damage was done.

Or perhaps all along I was unconsciously protecting myself from a painful short-term fling that would lead nowhere.

Anyway, he replied to my email and said that he’d be interested in meeting up again, although he sounded pretty low key. I knew he was going overseas; he’d told me early on that he was planning a trip to Johannesburg to visit his ailing mother, and was coming back on 2 November. During those weeks I walked around clutching the thought of him to me, keeping him as a little prize for the future, a pocket of sexual adventure, enjoying the idea of him in absentia. I was pleased that the onus was on him to contact me when he came back: I would find out what he really thought of me.

And magically enough he did – an email appeared in my Inbox on 2 November. But this email was even more low-key and non-committal than the earlier one. He’d just got back, was very tired but thought he’d better drop me a line. Later I would wonder why.

I wrote back effusively, telling him I hadn’t gambled on the Melbourne Cup, that it was deathly quiet because of the four day weekend, and asking him about his trip. What I didn’t do was ask him out on a date. I’d already done that in a way – now it was up to him.

That was over a week ago. Since then – nothing.

Of course, I don’t know why he’s been silent, and probably never will. Perhaps he never liked my pics (he took five days to reply after I sent them before we met) and was just being polite. Perhaps he sensed my underlying pathology at our café meeting and wanted nothing of it. Perhaps he read too much into my instinctive turning away as we farewelled each other outside the café. Or perhaps none of it has anything to do with me; he’d described his mother’s physical and emotional collapse during our chat – who knows what the situation was when he got there?

I’m not heartbroken – how could I be after one meeting? – and not even heartsick. But I’m worried about what this meeting says about me and where I’m at with personal relationships. Perhaps, at the moment, they are just too hard.

If I do decide to venture into that territory again, though, there's one thing I've learned that I'll definitely be bringing to my next dodgy or even not-so-dodgy website date. Don't hesitate, or wait for the right time. There's no time like the present. Strike while the iron is hot, because she who hesitates is lost, and a bird in the hand is worth -- well, you know the rest.

Selling homelessness: the housing affordability crisis in Australia

More than 105,000 people are homeless in Australia on any given night, but the true number is likely to be higher. Homelessness is not confined to those sleeping rough – it includes anyone in insecure, substandard accommodation. Homeless people may be ‘couch surfers’ who alternate between different friends’ houses; those living in temporary accommodation such as a refuge, emergency shelter or motel; or those living somewhere that is physically or emotionally unsafe because of a lack of alternatives.

Rather than focusing on the homeless themselves and the personal reasons for their predicament, I’m interested in the role of housing affordability and availability, both for those who rent and those who own, in contributing to homelessness. Until the government considers these issues its efforts to reduce homelessness will be in vain.

Of course, the global financial crisis has probably increased homelessness and housing stress in Australia. The rise in unemployment and the government’s stubborn refusal to increase Australia’s clearly inadequate dole payments have probably left more people sleeping in their cars or living in cramped conditions with relatives, something that has become widespread in the US.

Housing affordability
But housing affordability was a problem before the GFC. The International Housing Affordability Survey found that housing affordability in Australian cities was among the worst in the world. The report rated seven of the eight major housing markets in Australia as severely unaffordable. While there was a slowing in the growth of house prices following the crash, Australia’s ‘housing bubble’ looks set to get worse despite the fact that unemployment is still rising. Housing affordability slipped by 3.3 per cent in the September 2009 quarter while a report released in October predicted that house prices in Australia would rise by 20 per cent in the next three years.

Meanwhile, the rental market is mean, lean and ruthless. In Melbourne, for example, only 9.1 per cent of dwellings rented out in the June quarter were affordable to lower income households, a huge reduction from four years earlier, when 29.4 per cent of homes were affordable for this group.

One reason for the blowout in housing costs – but not the major one – is unbridled immigration without the necessary planning. Last year Australia’s population grew by 1.9 per cent, one of the highest rates in the world and ‘unprecedented among developed nations’. It is forecast to surge from 22 million to 35 million in 40 years. There is simply not enough housing stock (let alone natural resources) to bear such an increase.*

Two other reasons for housing unaffordability, probably more salient before the GFC, are the deregulation of the loan market, making loans easier to get by those who might not be able to afford them; and the self-reinforcing effect of speculative booms. But these reasons are themselves underpinned by the main cause of Australia’s lack of affordable housing – the government’s generous tax treatment of home owners and property investors.

Labor promises to reduce homelessness
When the Labor government came into office, Kevin Rudd made a personal commitment to tackle the problem of homelessness, labelling it a ‘national obscenity’. The Road Home, the government’s White Paper on homelessness, was released on 21 December 2008.

The White Paper outlines the government’s National Affordable Housing Strategy. The strategy includes an ambitious commitment to halve homelessness by 2020 and ‘offer supported accommodation to all rough sleepers who need it by 2020’. It promises $6.1 billion over the five years from 2008–09 for measures such as ‘social housing, assistance to people in the private rental market, support and accommodation for people who are homeless or at risk of homelessness, and assistance with home purchasing’.

The strategy involves agreements with the states and territories, which are required to provide some funding and are responsible for improvements in services that they run or administer. The White Paper includes interim targets and also accountability measures that the states and territories are required to report on annually.

However, even a quick look at the targets reveals an interesting contradiction. While Australia’s population is set to explode in the next 40 years, it seems that the government is only interested in reducing homelessness as a proportion of the total population. The White Paper states, as an interim target, that:

By 2013, the rate of homeless persons will need to be around 40 homeless persons per 10,000 population or better if we are to achieve our 2020 goal.

Other interim targets for 2013 include:
• The number of people engaged in employment and/or education/training after presenting at specialist homelessness services is increased by 50 per cent
• The number of people exiting care and custodial settings into homelessness is reduced by 25 per cent
• The number of families who maintain or secure safe and sustainable housing following domestic or family violence is increased by 20 per cent.

But some of the targets – and they are very specific – deal with absolute numbers, for example, ‘by 2013, a decrease of 7 per cent in the number of Australians who are homeless to less [sic] than 97,350 people’ and ‘the number of people released from [care and custodial settings] into homelessness is reduced by 25 per cent (3,552) by 2013’. It seems there is a fundamental confusion about the ambitions of the White Paper – does it aim simply to reduce homelessness proportionally, or to reduce the absolute number of homeless people?

Our worsening housing shortage
Australia already has a significant housing shortage. According to the Business Spectator of 26 August 2009, BIS Shrapnel estimated that ‘Australia’s dwelling stock deficiency … will peak at 160,000 properties by 2010’.

And of course it’s the disadvantaged who are missing out. The same article quotes the National Housing Supply Council, which released a report in March 2009. The report estimated that back in June 2008, 85,000 new homes were required to address ‘homelessness and low vacancy rates in the private rental market’.

The rental markets in Australia’s major cities have been constricted for years now. In Melbourne, for example, the trend metropolitan vacancy rate for the June quarter 2009 was only 1.3 per cent, compared with 3.6 per cent for the period from 2000 to 2005.

Given that the government plans to drastically increase Australia’s population in an already tight housing market, it seems inevitable that the total number of homeless will continue to increase. And ironically, one of the underlying reasons for homelessness – excessive immigration – will provide justification for the government’s failure to reduce the total numbers.

The Housing Industry Assocation acknowledges this problem. Citing the projected population increases, it warns: ‘already Australia has a substantial gap between the supply of dwellings and the underlying demand for dwellings. The gap is set to widen further with obvious consequences for house prices, rents and affordability.

‘Not only will there be a greatly increased demand for accommodation, Australia is faced with further strains on urban infrastructure, health and education to meet expected increases in population.’

If that’s the case it says something very important about us as a society. While refugees and family reunions – the most legitimate targets for immigration – account for some of the intake, roughly two-thirds of Australia’s permanent immigrants are skilled migrants. These people can afford to pay hefty application fees and have skills Australia needs, and so are not likely to be among the most disadvantaged when they arrive. But given the lack of housing stock, and the inadequate supplies of new social housing even with the government’s targets, market forces will mean that the wealth needed to access what housing there is, whether by renting or owning, will increase. As the population increases, more disadvantaged people who are currently at the bottom of the housing ladder will fall off it entirely.

Just as job seekers sometimes give up on the labour market, would-be renters become discouraged if they are repeatedly unsuccessful in finding somewhere to live, leading to overcrowding as they outstay their welcome with relatives. Alternatively, they may pay huge proportions of their income on rent in overcrowded share houses with what was once living space becoming makeshift bedrooms. Meanwhile the slum is making a comeback.

As a society,we seem to be accepting that excessive skilled immigration will bring greater housing disadvantage to a number of Australian citizens. These citizens may include newly arrived refugees, the mentally ill, the old, the unemployed, the physically disabled, the addicted, and the sick. This is the unspoken trade-off the government is willing to make.

Yet the government will be able to claim success if a lower proportion of people in a grossly inflated population are homeless!

Regardless, the housing strategy is already running into problems. The Age reported on 28 August that, due to a ‘$1.5 billion cost blow-out’ on the schools infrastructure program, the government would be cutting $750 million from its $6 billion plan to build 20,000 new public housing units. While most of that cut was due to lower than anticipated costs, the number of new homes built was to be cut to 19,200.

Tax benefits for the rich at the expense of the poor
But the main reason for the housing affordability crisis in Australia is government tax policies that favour owners and property investors, resulting in the loss of literally billions in tax revenues – billions that could be used to build affordable housing. The main culprits are the capital gains tax exemption and the land tax exemption for owner-occupied housing; negative gearing for investment properties; and the discount on capital gains for investor properties.**

These tax benefits result in an obscene government subsidy to wealthy home owners at the expense of the poor. The Senate Select Committee on Housing Affordability, reporting in June 2008, estimated that these concessions came to a whopping $50 billion per year. If you add the exemption of owner-occupied housing from the asset test for the age pension, that’s another $10 billion. Compare that with the paltry figures the government has promised to combat homelessness; now imagine what would happen to the texture of Australian society, its cohesiveness and degree of income equality, if only half that huge amount were spent on social housing!

As commentators quoted by the Senate committee point out, such figures may reward existing home owners but they do nothing for the institution of home ownership itself.

Small investors welcome the housing bubble because they are making more money, and owner-occupiers also welcome the rise in their property prices. But those with children must watch them struggle to find a decent rental property, struggle to get into the housing market, and then struggle to maintain huge mortgage payments.

The problem of negative gearing
Negative gearing occurs when an investor borrows money to buy a property, but the interest payable on the loan is higher than the income gained from the property. The investor is able to claim the loss against taxable income. (Investors also get a discount on the capital gains they derive from the property.)

Negative gearing has been slammed by many in the welfare sector because it gives favourable tax treatment to those who already have a first home and are investing in a second one, as compared with those who are buying their first home.

The Senate Select Committee on Housing Affordability admitted that negative gearing was encouraging investors at the expense of home ownership, reporting that ‘investors now account for about a third of new home loans’.

But trying to get rid of this tax has proved electorally unpopular, and it is a truism that it increases investment in private rental properties and therefore the amount of rental stock available. This comforting idea is illusory. Most of the investment fuelled by taxpayer-funded negative gearing goes into existing housing stock – it’s not being used to buy new houses.

The tax benefits available to property investors – negative gearing and capital gains discount – are supposedly needed to make the investment worthwhile because the properties are so expensive to buy in the first place. But because these benefits have increased demand for investment properties, negative gearing is itself partly responsible for that expense.

In September 2009, the Brotherhood of St Laurence released a report it had developed jointly with the Australian Housing and Urban Research Institute. The report confirmed that the government’s tax policies made housing more expensive for disadvantaged Australians. And it found that for households in the top 20% of incomes, the average annual benefit of the exemption from capital gains tax on owner-occupied housing was worth $8,000 – almost seven times the average of $1,200 in subsidies for housing expenses that the government pays households in the lowest 20 per cent of incomes. It offers the following example:

Wealthy negatively geared property investors in the top 20% of incomes are getting around $4,500 from tax benefits in relation to investment properties. However, people from the poorest households who receive the top rate of Commonwealth Rental Assistance gain an average subsidy of just $2420.

Another reason that the capital gains and land tax exemptions are wasteful is that they also encourage people to invest extensively in their homes as a form of saving; for example, building a larger home than they actually need.

Reforming the housing market
In order to increase housing affordability and accessibility for the most disadvantaged, and to favour first home buyers over property investors, the Brotherhood has called for the following changes:

Remove the capital gains tax exemption on homes worth more than $1.1 million.

Combine the introduction of taxation of imputed rent and capital gains with mortgage interest deductibility [to benefit first home buyers].

State governments should consider removing the exemption from land tax for very expensive owner-occupied dwellings while at the same time removing or reducing stamp duty on lower-priced homes.

Any resulting revenue gain should fund measures to make housing more affordable for those in need, including providing more public and non-profit housing and more generous support for those on rent assistance.

Give pensioners in large houses tax breaks so they could let out part of their houses without being penalised.

Other options
The government needs to:

immediately double its commitment to new social housing and reinstate the urgency with which it originally seemed to be tackling the housing crisis, expediting the implementation of its National Affordable Housing Strategy and putting pressure on the states to prioritise this area

conduct an inquiry into immigration policy that takes account of Australia’s housing availability, its already overstretched infrastructure, the limits of its natural resources such as water, and the implications for the disadvantaged of excessive immigration

increase its commitment to providing adequate skills and training in needed areas, which would also reduce unemployment.

Improving the rental market
Change tenancy laws to encourage European-style long-term tenancies as an alternative to owning.

Immediately outlaw rent auctions.

Make it mandatory for landlords to make their own decisions about who lets the property, rather than property managers who are often young and prejudiced.

Coordinate tenancy laws across the states so that blatantly unfair practices, such as the requirement in Queensland that all renters go on six-monthly leases, be abolished.

Places caps on rent increases, abolishing increases based purely on market forces.

A fairer go in the housing market
Putting the 'fair go' back into the housing market would not benefit the disadvantaged alone. Everyone, even the richest, gains from the social cohesion, lower crime rate and stronger community spirit that a more equal society offers. Bring it on!



* I fully acknowledge that this is a touchy issue, given Australia’s shameful history of openly discriminating against non-Caucasians during the years of the White Australia Policy (the discrimation was so blatant even the Brits were embarrassed by it). Those opposed to immigration in Australia have traditionally been on the right and motivated by a fear of the other. We are, as many are proud to say, a nation of migrants apart from Indigenous people, so who are we to turn others away?

For the record I’m not against immigration as a concept and think that Australia should favour refugees from all races (including asylum seekers who arrive by sea) over skilled migrants. However, I do think we need to look seriously at reducing future increases to the skilled migrant intake and start to plan how we are going to house, feed and provide water for our growing population.

** Please note that I am not bagging people who invest in this way and are simply responding to government tax policy. My own parents have a small investment property and their ordinary-sized house, in a sought-after suburb and on a large block, is now worth over $1.5 million. I am lucky enough to benefit from the fact that my landlord is not still paying off the property I rent, but is an outright owner, so was not affected by the high interest rates before the GFC.

Tripping myself up -- again!

I've been away from this blog for a little while because of broadband issues (all fixed) and work busyness (ongoing, although workwise I'm in a state of suspended animation at the moment.) But while I haven't been writing the blog I've been dreaming up possible blog posts. And every time I think I have one ready to write, something in my life changes and I have to rethink what I was going to say.

The most recent change was a little 'setback' I had in a work context recently. And this has made me take a fresh look at how I approach my life in general. Even as I'm writing this I'm not sure how to change. I just know I have to.

When I have a setback such as the one that occurred (perhaps later I'll be able to describe it in more detail, but it's too close at the moment), a familiar process follows. I go through a a day and night of utter self-loathing and despair. I become a dual personality -- the 'naughty', shamed child who sabotaged a combined parent-and-adult figure, and the angry parent-adult who sees the child's 'misdemeanour' from the point of view of a shocked, judgmental world. The 'parent' feels the shame but has to somehow bear it, and try to mediate the consequences of the sabotage.

As I write this, I understand that the anger of the 'parent' is part of the problem. I also know that the 'child' badly wants attention. But how do I square my psychodrama with the need to appear adult to the outside world? I know I'm supposed to love my inner child, but what does that actually mean when it has an embarrassing 'tanty' that appears to threaten my already limited professional life (and certainly my image)?

What baffles me is that, despite all the self-growth I've undertaken over 25 years, this dynamic -- a neurotic need for attention that becomes a sabotage -- hasn't changed all that much. (I think this blog entry itself is becoming a bit of a tanty!)

The fact is, I'm extremely high maintenance, and I do try to lead a balanced life, but I probably need to manage things better. This is what I think I'm struggling with. I've been avoiding starting to meditate for months now, and even do a very relaxing mindfulness exercise instead, but there's no substitute. With my many problems, meditation helps me on so many levels. Not doing it is part of a more subtle self-sabotage.

Blood sugar is also an issue. It affects me not just by increasing anxiety, but lowering my self-esteem when I'm vague and forgetful because of it. My diet is limited but I put little if any effort into trying to make it strict but interesting, rarely cook anything remotely appetising, and I've been getting a bit slack lately with the kinds of foods I eat. So it's time to take stock, literally, and start looking after myself in that department. What I've been avoiding, I think, is the realisation that I probably need to eat more meat. As an animal lover I don't like the fact that I have to eat meat at all, but I have more energy and focus when I do.

The other things to do -- and these are the hardest -- are: refuse to beat myself up; talk to myself kindly; and be nice to myself.

I'm sorry that this entry is so self-obsessed. I have planned and half-written entries on other issues. But sometimes I'm shocked into the realisation of my vulnerability, and at such times I need to remind myself of the need to ramp up my self-care -- again!

On the loneliness of dogs

It’s almost two years since I started walking my sister’s cocker spaniel, Jordan, three days a week. Predictably for someone with social anxiety, we stick to a rigid routine – 11.30 to about 12.15 Monday, Wednesday and Friday (going at other times, and encountering an unpredictable mix of people, would be traumatic, although very occasionally I do a Saturday instead).

I’ve mentioned before in this blog some of the ways Jordan has changed and helped me, not least by simply being a companion to take to the park. And he’s a great distraction when I’m chatting to someone – if an awkward social moment arises, he’s liable to do a pooh, sending me scrabbling for my trusty plastic bag.

But being Jordan’s friend is not without its own problems. Least of all the sadness I feel at his closed-in, often miserable little life.

I’ve complained in this blog previously about how little his family care about his emotional welfare, all too happily piling into the car without him and zooming off to some child- and in many cases dog-friendly destination. He’s left pining for hours on the front porch or, if the weather’s good, barking desperately at innocent strangers as they walk past. The family is too lazy to train him so when they have guests they simply tie up the poor little bugger.

It would be easy to query why my sister and her family, obviously not dog people, have a dog at all, and why they keep it, having discovered the effort involved. Wouldn’t it be better to relinquish it humanely, for example by placing the dog with a rehoming program, or trying to find a new owner among friends or family? But I think the answer isn’t that difficult.

For a start, that so many non-dog people do indeed have dogs illustrates just what joiners we humans are. Non-dog people who get dogs do so because other people, often their friends, have dogs. And because they are non-dog people in the first place, once they have the dog and have begun to neglect it, they don’t really care much about the effects of their neglect on the dog.

It’s therefore logical for them to keep it languishing, just as one holds onto an expensive designer dress one has bought on sale and never wears. (Of course I know that many people do abandon their dogs in cruel ways and this represents another level of callousness altogether.)

I’m being a bit unfair. There’s often, as in the case of Jordan’s owners, a great deal of affection for the dog. My nieces love Jordan, and he gets cuddles and inside-time at night, as well as some inside-time during the day when my sister’s not working, at home for a while and not too busy.

But it’s a selfish affection. Apart from the narrow obligations of providing food, a place to sleep and basic veterinary care, neither my sister nor my brother-in-law feels, or fosters in the children, a sense of responsibility towards Jordan. My nieces are never made to feed or play with him, for example. An opportunity to teach the children about reciprocal love is wasted: the dog gives love, and the family benefits from that love, but they’re not particularly interested in how their own lives and love could benefit the dog. This kind of love for a pet is ultimately narcissistic.

I see that narcissism in myself sometimes. I’m gratified by how much Jordan loves and needs me, by his refusal to judge me for coming by just three times a week, taking him to the park for a frolic and then effectively abandoning him to his loneliness. Truth is, I’ve had to learn to be callous to keep going on in my limited role. And often when my bucket of concern threatens to overflow to every chained-up, filthy mutt, every overweight, underloved pooch, every dog I see staring out with a mixture of gloom and wretched hope from behind a suburban front gate, I must empty it out for my own sanity.

But I’m not trying to make out I’m a saintlier person than my sister; perhaps I’m just more self-aware. Although I’m a dog person, I know myself too well to take on a pet full time.

I also know that, paradoxically, it is easy for me to spend time with a dog, whereas it’s more of an effort for non-dog people like my sister. Truth is, I could sometimes spend hours patting, comforting and playing Fetch with dogs. It’s so easy to make a connection with them: to see in their pining, eager eyes the simple language of need and love. And it’s not hard to make a dog happy, to answer that need, even if momentarily – all you have to do is scratch it under the chin, stroke its neck and tell it what a sweet and good boy or girl it is. Humans are so much more complex (although perhaps I am made momentarily happy by giving love to a dog).

Recently I wrote a letter to my sister detailing my concerns about Jordan. I was trying to make her understand that incorporating Jordan into her life (including giving the children some responsibility for him) was better than seeing him as a separate duty that she would get to when other priorities had been dealt with, and would actually help her and the family as a whole. All it would take to include Jordan in the family to a greater extent, I urged, was a little bit of planning.

It went down like a firecracker during a monsoon. In fact, there was no response to the letter at all until I broached the subject. This was when I went to pick up Jordan for his walk on the last day of the school holidays. He’d been playing with my nieces outside, but now they were off somewhere fun, and he’d be home alone as soon as the walk was over. We all stood in the backyard, Jordan already on the leash. My sister did not want to talk about the letter, except to say ‘please don’t do things like that’.

‘He’s clinically depressed!’ I yelled as she walked towards the car.

‘Aren’t we all’, she replied.

Dogs are a wonderful resource that our local communities could benefit from in ways that also assisted the dogs themselves. We don’t need more dogs, in fact we probably need fewer, but we should make better use of existing dogs. This is not simply being dog-centric: I think we’d become a more caring society as a whole. Just as retired people can do countless good in the community, lonely dogs could be utilised for many purposes.

So how could we improve the situations for dogs, and make things easier for their busy owners? Below are some suggestions for drastically reducing the amount of bored, unhappy, unhealthy dogs in our community (some a bit outlandish, I admit).

Some suggestions for a dog-friendly world
It should be much harder to own a dog than it is at present. In a screening process as is used in adoption, you should have to prove your suitability, that of your home, and that you are able to spend a certain percentage of time with the dog. If not able to spend enough time at home, prospective owners should have to guarantee the regular use of dog-minding or pet-walking services and prove they had the money to spend on such dog services.

To compensate for the difficulty of dog ownership, dogs could be seen as community assets, and moves made to share them among the community. A non-profit service could be established to link people who like dogs (including older people) but don’t want or can’t afford their own with people who can’t walk their dogs due to age, illness, disability or busyness. These would not simply be casual walkers but would have the opportunity to establish a relationship with the dog, eg playing with and walking it several times a week. For example, disadvantaged families without a parent at home during the day, such as single parents, could form a relationship with a dog that they took out on weekends.

Puppy farms should be banned and pet shops not allowed to sell animals.

All dog breeders should need to have a licence and their premises be subject to regular inspections.

A free service for new owners, rather like the maternal and child health nurse but ideally made up of volunteers, could be established. These trained volunteers would pay a once-off visit to the home to help the family adjust to the puppy or dog by offering expert advice and guidance. They would check that sleeping arrangements and diet were suitable for the size and breed of the dog, and offer advice and help with issues such as house training.

Governments could fund the use of dogs (and other pets) as therapy in prisons and aged care homes, with these institutions having their own in-house pets where possible.

I know some of these suggestions are a bit 'out there', but it's time to think outside the off-leash area of the park! The dog walking and day care industries would flourish if there were tougher rules about leaving dogs alone for hours, the dogs themselves would be happier, and so would the humans who love them.

The mysterious life of the psyche: on watching United States of Tara

I hope this blog doesn’t turn into a cut-price television review column, but I’ve been watching the new comedy drama series United States of Tara and had some thoughts about it I just had to share. That Tony Collette recently won an Emmy for her knock-’em-down performance in the series only adds to my need to comment on this innovative show.

For those who don’t watch it, United States of Tara is a US series about a woman and her family struggling to cope with her mental illness – dissociative identity disorder (DID). It’s currently screening on the ABC in Melbourne.

Apart from ‘herself’, Tara’s psyche contains four distinct characters or ‘alters’, one of whom she may temporarily transform into at any time. Each dresses, speaks and acts in their own unique way but most are aware that they’re inhabiting Tara’s body; meanwhile she herself disappears, mentally speaking. Any one of them is most likely to appear when Tara is under stress, and while they are incredibly disruptive, their behaviour indirectly expresses Tara’s own feelings, conflicts and motivations.

Although the show’s makers consulted extensively with DID experts and patients, it does not pretend to be an accurate portrayal of the disorder. The workings of the disease can be more subtle than the obvious ‘switches’ made by Tara’s psyche. And Collette’s depiction of the multiple personalities is highly theatrical; in contrast, alters, apparently, are created by the sufferer as a kind of emotional shield, so tend not to draw attention to themselves.

As well, Tara's alters are always perfectly reflected in her appearance, with meticulously appropriate costumes, props and hairdos, to an extent that it would be impossible for any individual with a complex mental illness to achieve. For example, where did the latest alter, Gimme, who appears to be all Freudian id, get the bright red plastic poncho?

However, that’s all by the by. As even the mental health experts agree, it’s meant to be entertainment.

The reason that I find the show compelling is that every Wednesday night at 9.30 pm I see a woman’s dodgy unconscious causing mayhem in her own life and those of her loved ones. And I see a human being and her family doing their best to cope with the after-effects.

Tara is never portrayed as stupid, weak or childish. She’s a fully fledged person with a career (she paints indoor murals) a family, and the usual concerns of an adult. Her mind, or aspects of it, causes her and her family great difficulties but she is never blamed for them in a lasting sense (her children sometimes blame her momentarily, and her needy sister, Charmaine, sometimes has to be reminded that she is not simply seeking attention).

The subtext seems to be that the kids – Marshall, a sweet, sensitive 14-year-old and Kate, a promiscuous, prematurely tough 15-year-old – will sometimes act out and indeed may suffer psychologically, but in the end have the maturity to keep loving their mother despite her sabotaging alter egos. And Tara’s cute, beefy husband, Max, has endless buckets of concern and love to offer her.

It’s a pretty good model for viewing mental illness in our society. The sufferer is not morally weak for succumbing to illness, just unlucky. Family members are affected by the illness but in the end rally around and some semblance of order is maintained.

But the series is even a bit more sophisticated than this in its portrayal of mental illness.

It’s very common these days to portray psyche disorders as being purely biochemical in nature, with little if any basis in past experiences. There are many instances where this may be the case, particularly when it comes to illnesses such as schizophrenia and bipolar. But in many other cases, I believe that mental illness has its own logic and is caused by predisposing factors interacting with particular life experiences.

The form that the illness or disorder takes may be determined by the fact that it performs a particular function for the sufferer (for example, enabling psychic survival), rather than being an accident. But the illness is not merely a product of the past – it interacts with the sufferer’s current circumstances as an out-of-date coping mechanism that takes on a life of its own.

The accident, if you like, lies in being predisposed to this form of coping, or even highly sensitive, and having the particular life experiences that led to the original need for such a mechanism. Again, the victim is not to blame. (I’ll reiterate that I don’t think all mental illness has this meaning and function; I’m just worried that all disorders now seem to be portrayed, in the media at least, as being due solely to biochemistry).

Thus, Tara’s disorder is a result of trauma she experienced at boarding school (which incidentally neatly lets her parents off the hook!). Presumably she had a predisposition to the kind of disassociation of which the disorder is an extreme example, but her recourse to alternative personalities is an attempt to deny as well as manage this past trauma.

Yet Tara’s illness also has meaning in the present as a way of dealing with the various difficulties she encounters as an artist, a wife and a parent. If she’s feeling under stress in her parental or domestic role, Alice, the perfect 1950s housewife, rocks up to restore domestic harmony. If her daughter’s acting up, Tara turns into T, the pot-smoking teenage nightmare, forcing her daughter to assume the role of carer. And if her relationship with her husband gets too complex or her children need defending from predators, Buck, the boozy, gun-loving Vietnam vet, makes an appearance.

Again, this doesn’t mean that the sufferer of mental illness is weak or bad. Instead, like all of us, they have an unconscious mind with its own agenda, one that may be contrary to that of the ego.

There are things I don’t like about the show, and my criticisms about it risk sounding hopelessly old-fashioned. But I think what I’m actually opposed to is a kind of solipsism in the characters that poses as sophistication. In trying desperately to be cool, the show wants the characters to be at various times self-obsessed, socially inappropriate, rude and offhand.

There’s heaps of swearing, for example. Don't get me wrong, I’m happy with strategic uses of ‘fuck’ and other expletives. But for me they lose their potency if used too often. I also don't like the disengaged way Charmaine and Kate talk about sex. In the presence of Marshall, a shy gay kid who at this stage is yet to have his first kiss, Kate says of him that ‘he’s chasing cock’, and neither Tara nor Max reacts negatively. The character of Charmaine is particularly narcissistic in the face of her sister's illness, in a way that the show sometimes seems all too happy to endorse (at one point she co-opts a family gathering by pulling her shirt open and displaying the results of a botched boob job).

I know that the show is trying to demonstrate that underneath all this ‘attitude’ the characters are struggling, that they act out in order to cope. It’s also trying to be naturalistic and to avoid being overly sentimental in its portrayal of modern life. And it’s understandably opposing itself to the pious, idealised image of family life peddled by America’s religious right. It must be acknowledged, too, that Charmaine's inability to comprehend that Tara is ill is a common reaction of siblings to mental illness.

But what's actually being portrayed here is the way that pornography and digitisation have combined to produce a new, sexualised uber-consumer, with Kate and Charmaine its most obvious avatars.

This new subject is not confined to the US -- the UK hit movie Love, Actually also portrayed elements of it. But I think in United States of Tara it's combined with a US tradition of straight talking and individualism in an unfortunate way, so that the characters are sometimes applauded for verbally abusing each other (this occurs to a much worse degree in the comedy film Knocked Up -- I don't for a minute believe it comprises an accurate portrayal of Americans, which makes it all the more disturbing). It's a shame, because at times the show is in danger of making some of the characters so unlikeable that I stop sympathising with them.

Still, I’ll definitely be watching United States of Tara for the rest of the series, and hoping the ABC buys the second series. (The story line is continuous, too, which keeps up the suspense). In so many ways it’s infinitely more enlightened than a thousand silly sit coms.

(Oh dear -- I've just realised that although I'm more or less the 'disordered' one in my family, I'm much more like the attention-seeking Charmaine than Tara -- eek! Perhaps that's why I dislike the former so much.)