Tuesday, December 9, 2014

Allergies, FODMAPs and Food Confusion – Part 2

In my last entry I gave an update on my food intolerance, and low blood sugar and the sometimes contradictory diets that are out there to deal with these kinds of problems. This time I’m writing about the treatment that’s available – and why I don’t take advantage of it.

There’s a clinic in Melbourne’s outer east that orders faecal tests and then sells tailored probiotics depending on the results. I’ve wondered for years whether this was the optimum solution for me, and instinctively mistrusted the bog-standard probiotics you see in health food stores. And I’ve hated myself for not choosing the faecal test option, assuming the problem was self-defeating stinginess. But now that I know myself better, and can reflect on my experiences, I understand the reasons for my reluctance.

It boils down to this: the fact that mainstream medicine has so few answers leads to another problem -- beware the ones who do.

Beware them because they can see the miles-long queue and they have prepared for it. Their doctors are in demand and very important! They have their neat little administrative systems and payment schedules you have to fit into, and you’d better fit in if you want help.

Not only that but they want to flog you all the supplements they recommend you take. There’s a conflict of interest right there: rather than being designed for you as a whole person – your budget, your condition, your needs – they will squeeze you into one of their categories so they can sell you the maximum amount and make big dollars.

And they charge like wounded bulls because they know their patients have few alternatives. Actually it’s not just their fault that the out-of-pocket expenses are so outrageous. Medicare doesn’t cover the battery of tests they will order, or the extended consultations, or the supplements.

But these clinics then add insult to injury by charging for outrageous stuff like supplying medical records. There’s none of that old-fashioned genuine relationship between even the busy GPs and their patients. These clinics are money making factories.

They’re like the psychiatrists who are obsessed with your symptoms but don’t give a flying fruitcake about you – the person.

There’s a lot of irony in this. You search around looking for individualised treatment because mainstream doctors haven’t a clue about your dietary problems – then you find yourself within a depersonalised system that has already decided what’s wrong with you and what the remedies are before the doctor has even seen you.

Actually it’s not dissimilar to the way some specialists behave. I won’t go into details about the arrogance of a certain derm I used to see, but at least he was always very punctual – he had his own strict rules as well as imposing them on his patients.

I haven’t been to one of these allergy doctors for decades but I tried a few in my twenties and early thirties as well as naturopath–homeopaths and Chinese doctors. Over those years, while I wasn’t constantly searching, I probably spent thousands on a cure. These days I have zilch faith in homeopathy and I am sure herbs help some conditions, but not mine.

I could afford to pay for the treatment in the allergy clinic in outer Melbourne. I just don’t want to take the risk. Yet I admit to myself that if I had unlimited money I would probably try it. It’s the fear of throwing away good money on yet another phoney cure that haunts me.

Wednesday, December 3, 2014

Allergies, FODMAPs and Food Confusion – Part 1

Sometimes my whole karma seems to be about having conditions that are obscure, invisible, not recognised by mainstream medicine and difficult if not impossible to treat. I’ve never felt I fitted into the patient paradigm for any of my ills, and when I’ve tried to squeeze myself in, it hasn’t always worked – which isn’t to say I haven’t received some valuable advice over the years.

(It strikes me that one day I’ll die, and presumably of something recognisable by medical science! Now I have the image of a confused doctor trying to work out how I kicked the bucket.)

I have written in this blog before about my low blood sugar and food intolerance problem, and how it doesn’t fit into any of the definitions or recognised treatments. Actually these days that’s not quite true but treatment remains complicated. Let me walk you through it ...

I have functional hypoglycaemia, a condition that most doctors know little about despite the fact that it’s a precursor to diabetes. I’m so sensitive to carbohydrates that even brown rice makes me tired. Low blood sugar is often sheeted home to the overgrowth of a bacteria that lives in the gut, Candida albicans, leading to a syndrome known as ‘leaky gut’.

Mainstream medicine has never recognised Candida overgrowth or leaky gut as legitimate medical conditions. Another possible reason for hypoglycaemia is adrenal exhaustion, but mainstream medicine doesn’t recognise this either.

However, there are people who do – and they are mainly, in Melbourne at least, naturopaths. And one of the things they sell for adrenal exhaustion is bioidentical hormones. Some pharmacists sell them also. The one actual doctor I could find who flogs them in Melbourne had some truly appalling comments written about her standards of service on a doctor review website.

Apparently it is a loophole in the law that allows the unregulated sale of these hormones, which can actually raise levels of the hormone in the blood to dangerous heights – this article was enough to put me off (it's eight years old but the situation appears to be unchanged). So I crossed that possible treatment off my list.

It’s a bit rich for mainstream medicine to complain about underqualified practitioners flogging unregulated substances when it has shown itself thoroughly uninterested in conditions such as LBS and glandular problems that don’t appear on standard blood tests.

A swag of fairly recent diets – all very distinctive and contradicting each other – do provide some help.

The Failsafe diet is designed for those with sensitivities to common chemicals found in foods, especially salicylates and amines. It’s been particularly useful for conditions such as ADD and poor behaviour and school performance in children. It recognises that additional intolerances, such as sensitivity to gluten, fructose and lactose, may also exist. 

Unfortunately this diet refuses to believe that Candida and related sugar sensitivity exist – so if a kid reacts to soft drink, it’s always just the dodgy food colouring and never the sugar. I just don’t believe that’s true for every single kid (and certainly not for me). I’ve written about this elsewhere.

Then there’s the notorious paleo diet. Truth to tell I hadn’t been thinking about that much lately until I watched a program that talked about how harmful high-carb diets were for those with diabetes – even if they were supposedly ‘good carbs’. Protein is good for low blood sugar also, and I do need to eat more – just not from cows or sheep.

Finally there is the FODMAPs diet. This is a mainstream diet that has scientific legitimacy, designed for those with irritable bowel syndrome. The premise is that some foods contain a collection of molecules (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) – no wonder they abbreviated it to FODMAPs – that some people can’t digest. They ferment in the bowel after being guzzled by the resident bacteria.

it basically boils down to fructose and fructans, galactans, lactose, and sugar alcohols like sorbitol. These carbs are found in a large number of fruits, vegetables, legumes, grains and other foods. The actual diet is highly tailored to each individual and should be devised in consultation with a dietician. It starts with a strict elimination diet followed by slowly introducing food types into the diet to test them out.

Interestingly, this may solve a mystery that has hovered around allergy medicine for years – why some folk claim to be intolerant of gluten even though they don’t have coeliac disease. Wheat and rye products contain fructans, one of the FODMAPs carbohydrates.

At first blush FODMAPs looks similar to the anti-Candida diet. In fact it’s anything but. You can apparently eat sucrose – white sugar – on FODMAPs, an absolute no-no for low blood sugar and Candida. Traditional sour dough is okay on FODMAPs too as long as the grain is allowed, while any sort of fermentation is out in the Candida diet. And hard cheeses are better than soft cheeses on FODMAPs because the former contain less lactose – the only allowed cheese in the Candida diet is cottage.

FODMAPs also contradicts the Failsafe diet with its list of allowed vegetables – there is some overlap but also many differences between it and the list of low-salicylate vegetables.

Confusing huh?

Sunday, October 19, 2014

I Capture the Castle

It’s now five months since I moved to my new flat, on the first floor of a modest block about eight minutes drive from the beach – and I can finally declare the experiment a success.

The whole thing was so rushed that for many weeks it felt as if I was living on faith in the future alone. I can now report that the future is starting to come through.

For the first time in years, I chose a place using my gut feeling. I chose a place that felt right even though I could have found a million reasons to turn my back on it and continue my search.

At 51, the moving process was so wrenching that there were countless times when I convinced myself I’d made the wrong decision. And times when, if I’m frank, I lost the plot completely. As the flat revealed its myriad small faults, it seemed like I’d jumped out of the frying pan and into the fire. But I was wrong.

The other day I met the owner of the flat opposite, doing some basic renovation before selling it. She lived in her flat before my time and seems to have partnered since. The family who were renting that flat when I moved in had moved downstairs to the flat below it a few months ago; since then she’s been unable to get tenants and has decided to sell (I couldn’t help wondering how much rent she was asking).

She invited me in to take a quick sticky beak inside her place to see the differences and similarities and for the first time I was able to talk to someone about how great this area is. We both gushed about its many hidden delights, and how astonishing it is that the masses haven’t yet discovered it. For her this now translates into worrying that she won’t get a good enough price for her place; for me it’s affirmation I made the right decision to move here.

‘I used to walk to the beach’, she told me. ‘And to the Elsternwick shopping centre.’ She used to study in a tiny postage stamp sized park which is around the corner, a sweet little triangle of land that features a summer house.

There’s also another park just over the main road, in the neighbouring suburb of Brighton. I’ve only just visited it during the day in the last week, although I’d walked past it on an evening stroll. She used to go there too, she said.

Being able to escape to the beach, even though it’s a bayside beach with industrial elements in the distance, is magical. In the last decade or so the various councils have put money into their foreshores and there are some lovely native grass plantings and inviting timber benches along the walkways. Sometimes I just drive to the shore, get out of the car and stare at the sea for five minutes. Other times I go for walks along it that surprise me with their length – the sea air seems to give me energy. The beach has become my sanity, my touch point.

After our chat I appreciated my place even more. My living room looks out onto two huge trees in the yard of the tenants below me. It’s a lovely view on sunny afternoons when the sun makes patterns on the opposite wall; later as the sun sets I’ll be able to see its orange aura sinking in the west. There’s so much light in this place and it is several degrees warmer than the old place so that I am saving a fortune in heating bills.

I’m so unused to feeling lucky in my life. My constant mantra is a sense of being hard done by – a classic victim mentality. It is unusual for me to feel the emotions of triumph and mastery. Perhaps I perceive these emotions as dangerous, even politically incorrect. When I ‘win’ and something good happens, there is a fear that someone else ‘loses’. It’s creepy to think that one of the hidden self-destructive ideas that I may have taken from my Catholic childhood is that it is fairer on everybody else if I take the dregs of life and don’t strive too hard to gain an advantage. Of course, things can go too far the other way – there is a balance to be struck when it comes to self-interest and perhaps I’m finding it for the first time.

Soon after I moved in to this place, one of the flats downstairs got sold to a brash thirty-something man who, without bothering to inform anyone, started to renovate the bejesus out it (this is the flat my upstairs family of neighbours would later move into, probably for the small yard). One morning suddenly the place was alive with buzz saws, crashes and bangs, and labourers chucking out fixtures and throwing them onto the skip out the front.

In the coming weeks our shared lobby would see an endless stream of noise and activity. But the owner never put drop sheets down. Workmen traipsed back and forth across the carpet and the square terracotta tiles. The tiled area starts inside the lobby, then continues outside, forming a walkway to the front entrance of the block.

The tiles and carpet would never be the same again. I surmised that all the flats in the block must be owned by investors – none of the owners seemed to know or care about the damage to the common property. At one stage the owner had a contraption set up on the patch of grass outside the security door, where the new kitchen and bathroom tiles he was installing would be dipped in cement and then taken into the flat. Drip, drip, drip on the terracotta tiles, not to mention that patch of grass turning into mud although moss and grass have since grown back.

The terracotta tiles now have cement stains and skid marks. The ones on the walkway from the street have new cracks and chips.

But the whole thing did get cleaned up. One day the daggy coronet carpet no longer had plaster flecks all over it. Same with the tiles, although to this day they’ve never been mopped. Inside the flat, though I never got a proper look, I glimpsed a beautifully renovated place with meticulously chosen fittings.

And since that day my mind has turned  the damaged terracotta and the neat but faded patch of carpet outside the front door of the renovated flat – carpet that now has a pale layer of ground-in dirt – into a metaphor.

That transformation mirrors my experience of moving house. The lack of method, the speed of it, the sense of being thrown out of one place and into another. I paid a high price for that speediness, but the end result was good.

For the first weeks there was psychic and physical exhaustion. With all the packing and lifting of boxes I’d damaged tendons in both arms, and for the first two or three months lived in terror I would lose the ability to do basic things. The damage was then worsened by RSI. Both arms are a lot better now. But even while I was most worried about them I thought of them as war injuries sustained in the process of my hero’s journey.

The roughness of things, their natural decay. I will damage this house, I accept that now. My kitchen and bathroom both have white ceramic tiles on the floor. There were already cracks on them and I dutifully photographed these when I first moved in. But I have noticed small chips since then and wondered if I did them and if so how. Why worry? Life is wear and tear. 

Things get damaged. My tendons got strained, and I escaped my dungeon.

In my twelve-step peer support group we are urged to ‘accept disorder in lesser things’ while recovering from mental illness. For many weeks I accepted a surface disorder while I was improving the underlying order of my life.

I certainly don’t want to discount the shortcomings of this place. The main one that I haven’t solved yet is sleep. There are two things interfering with this: the excessive light in my bedroom that the venetians don’t cut out and the fact that the soundproofing is absolutely non-existent – Victorian soundproofing standards became incredibly lax in the seventies, when these flats were built.

It’s not just the degree of noise I fear but its unpredictability. The neighbours are mostly quiet daring the week but every and now then it sounds as if someone’s clomping around the bedroom below mine on stilts. I was letting myself get very unsettled by this and it got to a point of crisis.

Then I realised I had to start changing my thinking about it. I had to stop telling myself how terrible it was and accept that sleep was hard for me, but insomnia wouldn’t kill me. I still sleep badly but I accept that now, and am getting better at sleeping without ear plugs. I can always catch up during the day if I have to. I know that’s bad sleep hygiene but sometimes 
I’ve just been too tired to function without a nap.

If life can get worse, I am discovering, it can also get better. I’ve still got a long way to go but moving house has definitely been a step forward for me.

Monday, September 22, 2014

Book Review: Shy: A Memoir by Sian Prior

An attractive, forty-something woman peers around a gallery, trying vainly to find her partner in the buzzing party crowd. ‘A familiar sensation was sweeping through my body’, Sian Prior writes. ‘It was as if someone had spiked my drink so that instead of sparkling mineral water I was now sipping a kind of effervescent cement’. Unable to spot a familiar face, she starts to sweat and her stomach churns. Alight with panic she flees the party, not even recognising the ‘calm, confident blonde woman’ she glimpses in a mirror on the way out.

Prior, a successful arts journalist, choir master, public speaker and media consultant, suffers from crippling shyness. But this Renaissance woman is also a published author and writing teacher, and the incident jolts her into an exploration of the paradox of her life – that someone so comfortable in the public spotlight could also be felled by terror in unstructured social situations.

That paradox makes this book unique. Its author was born to tell her own story of shyness because her professional persona is the perfect vehicle for spreading the message.

Shy is no conventional memoir, but nor is it a self-help book. Prior ditches a chronological account of her life and replaces it with a panoply of elements – interviews with psychologists (including her own mother, Margot) and her own research; playful lists; play-offs between incidents from her past and theories of shyness – to present a frank account that is often funny, sometimes poignant and always engaging.

Although the result can feel anarchic at times, it works beautifully; experience and vivid recollection step in where the research evidence is simplistic, suggesting both the strengths and weaknesses of scientific definitions.

To cope with the shyness she has battled all along, Prior developed a persona she calls ‘Professional Sian’ – a confident, polished performer who knows how to fake it till she makes it.

But ‘Shy Sian’ surfaces when there is no script, no structure. And for Prior this has meant a lifetime of lost social and romantic opportunities  – from Sally, the school friend round the corner who the young Sian is too scared to visit, to ‘the beautiful dark-eyed boy glimpsed in the stairwell of my first high school’. She has missed out not just on sex but ‘the subtle semaphore of attraction’.

For Prior, shyness is as much about fearful thoughts – what she calls the ‘what ifs’ – as it is about the intensely discomfiting physical symptoms: ‘armpits drenched, throat clenched, locked in battle with myself’. While travelling in Europe in her twenties, Prior develops a stubborn throat lump: ‘Lying on my hostel bunk in the night I would feel it resting there, nuzzling at my vocal cords’.

There is a central narrative here that anchors Prior’s account to the recent past. For ten years she lived with the musician Paul Kelly (whom Prior calls Tom in the book) – an Australia folk hero, one of our national bards. She reveals their slow-burning courtship, which blossomed into a shared life, and the cocooning effect of this relationship on her sense of self.

Her relationship with Tom and other life experiences are held up to the light to examine what shyness isn’t as much as what it is. Is it genetic? What is its relationship to social phobia? Is it the same as introversion, or can a shy person be an extrovert? How does Tom’s fame relate to Prior’s own contradictory stance towards being in the spotlight? Is shyness related to hypersensitivity? She explores the positive character traits that go with shyness, like empathy, conscientiousness and a willingness to listen.

Then the unthinkable happens and Tom announces he is leaving. Suddenly the very rejection that all shy people fear has come to pass.

Upheaval follows, but it is viewed in the light of a formative childhood event – deepening the examination of the origins of shyness in ways that take it far beyond the biological.

Prior’s writing is fresh, visual, funny. She has a sharp recall of the quotidian detail but also the insight and hard-won wisdom of someone who has battled to live a socially and emotionally fulfilling life in the midst of a sometimes crippling fear.

Yet there is something implicit in this book that Prior herself doesn’t pay much attention to. Given the rise of positive psychology, I looked for the protective factors that enabled Prior to seek out significant relationships and pursue professional success.

Without diminishing her pain, I was also interested in the class aspects of her success – her psychologist mother is an obvious factor, as is her immersion in the world of classical music and love affair with the clarinet. But what about schooling – was a private school, with its small class sizes and individualised attention, a strengthening influence?

Prior, intent on exploring a trait that has been hidden and denied in her public life, seems mostly oblivious to these broader questions, although two things stand out that will be useful to anyone who is shy. ‘Professional Sian’ first came into being because Prior was able to find, in a high-profile environmental job, a cause far larger than her own insecurities. She also singles out a passionate curiosity about other people and the world as an incentive to push past her fears.

In public appearances since writing the book, Prior has discussed how risky it felt to break the illusion of her professional competence by publishing Shy. While her discoveries did not lead to the cure she originally hoped for, they have enabled a new-found acceptance, and Prior claims she is no longer embarrassed to be shy.

While Prior’s level of professional success may seem out of reach to many of us shy people, I found this encouraging rather than dispiriting. I suspect most of us have our own version of Professional Sian, and although she may not be as reliable or fearless as Prior’s version, this writer offers a bold role model for risk taking and a path to self-acceptance that many readers will benefit from.

Monday, September 15, 2014

Helping people with mental illness into the workforce

How can we encourage people on disability support pensions to work more while not hitting them with the big mean stick of loss of income support? Here's an opinion piece I've written on this question.

Please feel free to comment and share!

Sunday, August 24, 2014

Dreams Hold Key to Life's Puzzles

Pic: La Citta Vita
This morning I woke with the gradual wash of a dream pulling back its hold on my brain so slowly that I was able to catch the salt granules of its content before they dispersed.

It was a healing dream, creating a synthesis of past and present in an elegant, compact way. Everyone’s unconscious is a skilled novelist in its ability to find patterns among all the disparate memories and sense impressions that people our minds.

The dream took me to a disco nightclub that was incredibly fashionable, and there I swanned around with two people from my past – yet it was set in the present. My age didn’t stop me from being relevant and accepted in this ubercool place. The two people I was with were among those I shared a house with for a short time in the then edgy suburb of Fitzroy in 1983. I have fetishised the inner city ever since this time. It represents my personal Eden, my lost paradise, my Shangri-La.

I suspect most of us have more than one of these lost worlds. My dream brought two of them together and in doing so it allowed a psychic healing.

For this dream nightclub was located in the daggy suburb of Glen Iris. In real life this was where my maternal grandparents lived when I was growing up. Their tiny orange brick veneer not only housed the remains of their own family (my mum was the oldest of eight kids) but hosted a growing horde of grandkids. The suburb was boring and middle class in that unpretentious seventies way that is gone forever – hardly the place for a nightclub!

But Glen Iris was more significant than that, because my grandfather ran a tennis clinic every Saturday morning at the tennis courts of the parish primary school. The famous ‘Mister Mac’ taught kids from all over the area, and from all social classes. Some of them came from the posh private schools, some from the humble Catholic schools and some from the ‘state schools’ as the public schools were called.

This was a cushion for a shy child. Not only did my older sister attend the clinic but some of my cousins. I had a secure base from which to socialise.

This earlier childhood experience, I now realise, is why I have obsessed about Fitzroy and its gentrification for so long. Fitzroy represents a  part of my past that I will never get back – a communal household that only lasted six months but was a cushioning influence on a harsh and lonely life in my final year of a university arts degree, where I struggled with lack of motivation, immaturity, social terror, loneliness, undiagnosed eating issues. The decrepid terrace house, before it too became frightening, was a social refuge.

The dream was bringing these two, seemingly disparate periods of my life, together. It was telling me not to worry about my own personal loss of the inner city any more, as well as the larger cultural loss caused by gentrification. For that seminal experience in Fitzroy – that unique sense of community – had already been experienced, much earlier, in a much daggier suburb. And I could therefore experience it again.

I don’t have to live in the inner city to experience community. Thanks to my peer support program, my growing up is happening right now, right here, in Gardenvale and Elsternwick.

The unconscious is incredible in its ability to show us what is happening on a psychic level. Once we start paying heed to its puzzles it rewards us with greater detail, more overt symbolism and sharper recall.

But the dream also gave me another gift. I have started writing about the social causes of mental illness. Not that there aren’t biological and genetic elements – of course there are – but a return to biology, which some psychiatrists are keen on to the exclusion of other factors, would be  a hugely backward step.

Lack of community is one of those factors, perhaps the most vital.

The dream – not just its content but its healing and synthesising qualities – seemed to be telling me I am right to pursue this line of thinking.

Because in those two different stages of my life, I experienced the strength and ballast of true community, and it gave me some protection.

And now peer support is performing this function once more as I slowly, gingerly, reluctantly, take my hesitant steps into the wider community, even as I witness that fragile community being fractured, thinned, diminished by the log cutters of neoliberalism.

Community on the macro (government policy and spending) and the micro (peer support and self-help) levels is worth not just safeguarding but enhancing. It’s not just a tool in mental health, it’s the very basis of it.

Monday, August 4, 2014

Back after a Blog Break

Apologies for the long gap between blog posts of late. And for also deleting a previous post – something I’ve not done previously, as far as I remember. An explanation for both is needed!

First, about the break. I’ve started to get a couple of my comment pieces published online. This is fantastic – however, a few caveats. I’m not getting any editing work, and the number of hours that go into an article isn’t commensurate with the pay (who’d have thought?).

I’ve had three articles published in online newspapers/journals, and two of these were on paying sites (well that’s what they’ve promised). Of course two paid gigs do not a writing career make!

If the editing work starts back up (and it’s usual for me to have gaps, especially at the beginning of the financial year) then it would be a nice little combination – the writing satisfying the creative genie, the editing work channelling the left-brain-dominated control freak (and paying much better per hour).

But it is great for my confidence. Truth is it couldn’t have happened earlier.  I just wasn’t ready. I can’t help wanting to use the word ‘maturity’ at this point, which is a bit sad considering that I’m 51 years old.

Blogging alone has helped develop my writing – just doing it – but the willingness to bend my own concerns to the needs of the journals just wasn’t there earlier. Getting my point across in 800 words or less? Where did these people get off? Any subject I was interested in required at least 2500 words.

Now I am slowly developing the art – not unlike haiku, or any kind of poetry – of making my points succinctly. After a while you realise that it actually takes less time to write a short article than a long one, so it’s an advantage.

But it’s bloody exhausting in a way that blogging is not.

Now about the little um blog entry deletion. Self-censorship? Perhaps.

The entry was about the revolution underway in the mental illness treatment community. These changes are both exciting and controversial. (As an aside, there doesn’t seem to be a consensus in the psychiatric community at the moment about what causes mental illness, and this in itself is all at once interesting, promising and disturbing.)

I originally started the article before moving house in May, and then other concerns intervened. When I went back to it a few months later I didn’t really think the issues through before completing and publishing it. Much of the impetus had come from reading the book Anatomy of an Epidemic and the blog Mad in America.

But the issues that these changes bring up are challenging and potentially life changing for many people. As someone with OCD, who is always concerned about the effects her writing may have on others, I’m more aware now of the caution that it is preferable to exercise when covering this area.

I’m probably overly cautious, but that’s my hang up – the internet is scary in its ability to disseminate information, and change the way people behave, very quickly. When it comes to mental health, that makes writing about it a big responsibility.

The other thing that made me pause for thought was that the health system in Australia is so different from the American one. The Australian system is a chaotic hotchpotch of public and private services, and everything in between, while the US system is, in my understanding, almost completely controlled by health insurance companies.  It’s quite possible that there is more mismanagement and a greater reliance on drugs in the US, and therefore much more angst among consumers. In fact in Australia some of the new approaches, such as peer support, are being adopted by mainstream services, which is very exciting.

This doesn’t change the fact that the public system in Australia is desperately under resourced. My impression from the limited reading I’ve done is that psyche hospitals, which should be soothing, welcoming havens for recovery, are for the acutely sick only, and that after being stabilised on drugs you get kicked out quickly, leading to a revolving door syndrome for those without adequate community support (there are good community services available in some areas, but I’m not sure how comprehensive these are, and they are in flux right now).

The other problem is that I don’t find myself in either of the major narratives – the biological idea of illness and the anti-psychiatry push. Not that the anti-psychiatry movement denies the existence of acute mental suffering at all. It's just that for me, labels themselves aren't the problem - it's the kinds of treatments that they too often give rise to which need monitoring and review.

Anyway I am not going to weigh into any debates for the minute. I am very interested in writing about  new treatments, but my OCD is a factor that I need to take into account. Still, it is an exciting time that may well lead to a synthesis of the best of old and new treatments.

And whether my other writing leads to a new 'career' is something that only the future can reveal!