Social anxiety and the challenges of exposure therapy

It struck me as I jumped into the shower this morning, in the split second as I registered that the cold was not unbearable anymore, that the problem with winter is not winter but summer.

I wrote a piece about minor mishaps a while ago. One of my points was that if a crisis remains unresolved for a while it may cease to be a crisis as one adjusts to it. Winter is the same. As long as you have somewhere to live that offers reasonable levels of warmth in some rooms, eventually your body adjusts to the cold.

And just as you’ve become accustomed to it and have your bedtime routine worked out (in my case a hottie and four doonas, as well as copious layers of pyjamas), the Earth stretches as if from a long sleep and starts to exude warmth. The blossoms unfurl, the camellias drop liltingly to the ground in their prodigal abundance. Everything wakes up, and you have to adjust again.

This is not some idle complaint. It makes me think of exposure, now a central plank of short-term talking therapies for anxiety disorders and phobias. Exposure relies on the concept of increasingly difficult forays into feared experiences. These forays are graded so there is always a carefully calibrated level of discomfort, while the difficulty of the task increases. The theory is that the sufferer learns to tolerate an ever-greater degree of risk and is therefore able to deal with an increasing number of feared situations.

Exposure is an incredibly useful concept. I’ve never practised it in conjunction with a therapist, but I have a friend who is an exponent of it (he even wrote a book about it), and I practise it in very small ways.

But the challenging thing about exposure is that it is aligned to life yet also pitted against it. Creating a list of progressively more difficult tasks is a way of creating order, but the chaos of life is constantly intruding. And, depending on your disorder, it may not always be possible to retain control over the level of exposure.

Work is an area of life where I gain valuable exposure only to sometimes lose momentum. Because my work stops and starts, I don’t often get into a pattern of work. This is bad, because once the work starts again I not only have to adjust to the discipline but I also need to refamiliarise myself with processes and even skills.

As well, I have to ‘expose’ myself to a lower standard of self-care and housecleaning, which leads to an increase in anxiety levels.

I believe that I’d be able to gradually increase the level of work I was able to take on if I could control the flow of it – but that’s not the way the real world operates.

Social anxiety is another area where the exposure levels are difficult to control. According to psychologist Dr R. Reid Wilson, this is because the unpredictable nature of social life is such that it’s impossible to grade one’s exposures; and because their lifestyle may require the sufferer to carry out social tasks that go beyond their current level of comfort. 'When you have social anxiety, events that are high up on your list of threatening situations may take place before you have mastered your lower level tasks’, he says.

Dr Wilson’s excellent website is the first time I’ve come across a therapist who identified the unique difficulties of social anxiety in this way.

Another difficulty with conquering social anxiety he identifies is that the sufferer must focus on so many anxiety management skills at once, sometimes while performing a complex task like public speaking.

One way to get around the unpredictable nature of social exposure, according to Dr Wilson, is to simulate the scary situation using friends and family. For example, you could practise public speaking in front of a group of friends, conduct a role play on bumping unexpectedly into someone in the street, or ask someone to look over your shoulder while you practise writing.

Life, the universe and exposure

The chaos of life may pose a challenge to exposure therapy more generally. Unexpected stresses or adverse events in one area of life may temporarily lower our ability to challenge ourselves in the areas we need to work on. Sometimes I need to withdraw and regroup because of some unforeseen blow.

This is not to argue against exposure but to demonstrate how important it is for the individual to be in control of their therapy. This is the view of Bronwyn Fox, a recovered sufferer of panic disorder who has written books on the issue and now counsels sufferers.

The important thing is to get in touch with your gut feeling and obey it. I have learned this lesson painfully and slowly, sometimes suffering from too much exposure and sometimes not enough. In my experience both are harmful.

If I’d known about exposure earlier, there are definitely aspects of my social and working life I would have fought harder to retain, rather than simply letting them go because they were too hard. But not knowing about exposure also led me to throw myself into situations that were too difficult, which meant I got overexposed and therefore more phobic very quickly. In both cases I wasn’t managing my anxiety well because I didn’t have the knowledge or tools.

I’m not saying that everyone can expose themselves and eventually rid themselves of their anxiety. In my case I think there are some things that are just too hard and will be for a while, and perhaps forever. However, I do want to create some sort of graded exposure program.

Exposing myself

Recently I visited an arts event alone. I’ve done this heaps of times but it was in a venue that I was unfamiliar with. I’m an expert at subtle avoidance – I’ve been practising it my whole adult life – and I noted that two very effective avoidance strategies were in play: getting there late, and sitting in the back row.

The getting there late was partly my unconscious mind at work. I just missed the tram! How convenient!

Next time I will resolve to sit in a row that is somehow more ‘threatening’ (this could mean, for example, a row where the people look interesting, or towards the front, or both) and getting there before the event starts. I might have to tackle one of these tasks at a time. Even being in a room with others and experiencing my reactions can be difficult for me sometimes. The important thing for me is to stay with myself somehow, to practise mindfulness without buying into my fears.

And soon it will be time to get exposed to a completely separate dilemma – the extreme heat of a Melbourne summer.

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Scuttling social justice – Julia Gillard and the 2010 federal election

Australia is going to the polls in a month’s time. Julia Gillard, the Australian Labor Party prime minister, looks set to win. But, in playing so clearly to middle Australia, she is using her considerable political talent to further drag the ALP away from some of its primary responsibilities: the upholding of human rights and support for the disadvantaged.

For the benefit of overseas readers, Gillard, then the deputy prime minister, shocked Australia when, following weeks of Kevin Rudd suffering in the opinion polls, she deposed him in an unforeseen overnight 'coup' on June 23–24; knowing he no longer had the numbers, Rudd stepped down rather than face a leadership ballot.

It may be that the coup wasn’t quite as sinister as it must have appeared to international observers, despite the involvement of faceless union officials and the fact that Gillard got multinational mining companies onside by ending a terrible imbroglio over mining tax soon after taking power. Rudd appears to have been stuck in a compulsive, controlling, workaholic state that he was unable to shed – some have hinted at mental health issues, and it was impossible not to anticipate the advent of some sort of personal crisis.

The event was notable regardless, being the first time in Australian history that a first-term serving prime minister had been deposed. And, as most people know, Gillard became Australia’s first female prime minister.

An election was due anyway, but Gillard was always going to call it early because she wanted to rule as chosen prime minister, rather than being seen as a pretender. Now a snap election has been called for the 21 August.

There are a few things I’ve been dying to write about Gillard ever since her surprise ascension.

Like some others, I hoped that she was more radical than she appeared, and that with Rudd out of the way she would take some simple progressive steps such as allowing gay marriage (Rudd’s a god-botherer and has always opposed this; Gillard is an unmarried atheist with no kids).

It was difficult not to assume, or at least hope, that Gillard would be a little more radical simply because she was a woman. Having slogged her way to the top in a male-dominated party, surely she would have empathy for the marginalised, and go into bat for them once she got into power? My hopes were ill-founded – Gillard soon stated unequivocally that she had no plans to legalise gay marriage.

This should have been no surprise – Gillard as education minister and minister for workplace relations was disturbingly reactionary. Despite her frequent eloquent pronouncements on her commitment to education, she seems to have done absolutely nothing to reduce the glaring inequities of Australia’s education system, a two-tier system that blatantly favours private schools and suffers from hopelessly complicated federal–state funding arrangements.

Gillard specialised in gimmicky, hugely expensive policies that caught the attention of the media as they were designed to do, before at least partly crashing and burning on their ineptitude and lack of groundwork; but she did absolutely zilch to reduce the system’s glaring inequities.

The building and computers-in-schools programs that characterised her tenure were open to the most obscenely wealthy private school, despite the fact that public education has been severely underfunded for years in Australia, resulting in rundown schools and inadequate teacher numbers and support services. The aim of the building program was partly to stimulate the economy, but, writing in The Age, Kenneth Davidson said that ‘Funding directed to maintenance upgrades according to the greatest needs would have had the same economic stimulus impact dollar for dollar and a far bigger pay-off in terms of equity and efficiency’.

Moreover, the public schools were disadvantaged in their access to the building program because they had much less choice compared with the private schools about exactly what was to be built, and no ability to negotiate the cost, resulting in ‘inflated costs and dubious projects’.

With regard to the computer program, private schools benefited while some government schools couldn’t afford to pay for the infrastructure that extra computers would entail.

Moreover, in her determination to impose a national test (NAPLAN) on skills such as literacy and numeracy and a website that would allow parents to compare the relative performance of schools, Gillard fought with the overworked teachers she should have been supporting – teachers who feared that the website would lead to the creation of divisive league tables, and that the expertise of teachers working with students with specific needs would be overlooked.

Also, Gillard had been part of the ‘gang of four’ that replaced Cabinet government under Rudd. The Cabinet still sat of course, but apart from Finance Minister Lindsay Tanner, Treasurer Wayne Swan and Gillard, they were mainly asked to tick the boxes.

This anti-democratic tendency, a recipe for poor government, was part of the reason why MPs were willing to vote Rudd out; but I didn’t realise until after the ‘coup’ that it was Gillard, as part of the ‘gang of four’, who had urged that controversial emissions trading legislation be deferred until 2013 – a decision identified with Rudd at the time, and that had signficantly contributed to his poor showing in the opinion polls.

Perhaps the most shocking development since Gillard’s win has been her willingness to use the issue of asylum seekers as a political football. This was evident in the speech she gave on the issue on 6 July, when she signalled the possibility of a regional processing centre for refugees to be established in Timor L’este (using, incidentally, the inappropriate title ‘East Timor’).

But it’s become even more blatant now the election’s been called. In fact, ‘stronger borders’ is one of the key catchphrases on the ALP’s first television election advertisement featuring Gillard. Even before her asylum seekers speech, she was talking about ‘good migrants’ like her parents, with the strong suggestion that there was another sort of migrant that people were right to abhor.

This is simply astounding. I won’t go through the history of the issue, but since the Tampa incident in 2001, which saw the introduction of the notorious Pacific Solution whereby asylum seekers were removed to the island of Nauru for their claims to be processed, these vulnerable people have suffered to keep Australia’s politicians in power. And now the ALP, already accused of trying to please everybody on the issue, are indulging in shameless dog whistling, much more so than they did under Rudd.

Some progressives claimed that Gillard’s asylum seekers speech was nuanced and not as politically insidious as the selective media quoting would have it appear. It’s true that in some ways Gillard was trying to have it both ways – stating that those wanting greater border protection should not be labelled racist, any more than those concerned about children in detention should be labelled bleeding hearts. Responding to earlier criticism by refugee advocate and respected lawyer Julian Burnside, QC, she said:

… in the context of our migration program, the number of asylum seekers arriving by boat to Australia is very, very minor.

It is less than 1.5 per cent of permanent migrants each year; and indeed it would take about 20 years to fill the MCG with asylum seekers at present rates of arrival. This is a point well made.

On the second point [Burnside] is very, very wrong. It is wrong to label people who have concerns about unauthorised arrivals as ‘rednecks’.

Of course, there are racists in every country but expressing a desire for a clear and firm policy to deal with a very difficult problem does not make you a racist.

Elsewhere in the speech she affirms as an organising principle of asylum seeker policy ‘That people like my own parents who have worked hard all their lives can’t abide the idea that others might get an inside track to special privileges’.

This rhetoric is erroneous. It strongly suggests that the opinions of those fearful of the boats are every bit as well-informed and worthwhile as those who are steeped in the issue and have serious legal and moral concerns about government actions. And it completely ignores the fact that the role of a leader is to educate and lead rather than to pander to the whims of the least educated and politically aware; and to set an example and produce a vision that can make the nation more cohesive, not less.

Those criticising Gillard for aiming her narrow policies straight at the seats most under threat in Sydney’s west are fully justified. She should be explaining to the electorate the push factors that bring the boats here, and eliciting Australia’s collective compassion – the kind that erupted so forcefully after the January 2009 Victorian bushfires.

More generally, Gillard is encouraging voters to see this election as being all about themselves and their needs, rather than promising to look after Australia’s most disadvantaged, surely one of the major remits of any labour party worthy of the moniker? She has said that voters will choose the policies most useful to them and their families, encouraging the continuation of the solipsism that thrived under Howard.

Gillard has great charm and verve, and, it’s indisputable that since Labor’s coming to power in 2007 the conviction, authority and intelligence she has managed to project in speeches and interviews has only increased, despite the rubbish that so often spouts from her mouth.

But let’s be clear: there was nothing progressive about Rudd’s Labor party, and there’s nothing progressive about Gillard’s. Below are just a few examples of straightforward social justice actions Rudd and now Gillard have failed to take, apart from not allowing gay marriage. Not all of these would have involved the magic millions or billions that both these politicians love to announce; but they would have produced greater social justice for Australia’s most needy as well as improving environmental outcomes.

* No carbon tax

* No mandatory staff–resident ratios in aged care homes (such ratios exist in hospitals and child care centres), leading to a shocking lack of skilled nursing care and other staff for frail, ill aged people. This is despite a 2009 Four Corners report in which the Minister for Ageing, Justine Elliot, promised that the government would consider the issue as part of its review of aged care funding. In May this year the NSW Nursing Association had to call for such mandatory ratios – all the government had offered in the 2010 budget was ‘$500,000 to conduct a research study on staffing levels, skills mix and resident care needs in Australian residential aged care facilities’.

* No rescinding of the regressive changes to education funding made by Howard. These gave more money to wealthy private schools at the expense of government schools.

* No real increase to unemployment benefit (Newstart allowance), which has long given up even attempting to adequately cover the excessive costs of market rents. Because increases are measured against inflation and not male wages as the pension is, the dole will continue to decrease in value against the pension. The May 2010 budget refused a request by the Australian Council of Social Service for an increase of $42 a week for the Newstart allowance; this request was ignored. But in refusing the increase the government was also ignoring its own Henry report on taxation, which stated that ‘a single person relying on an unemployment allowance is well below the OECD benchmark for poverty’.

* No attempt to ditch the 30 per cent government rebate on private health care. Instead the government tried to make the 30 per cent rebate means tested (the rebate results in all taxpayers subsidising, for example, dental care for the wealthier while there is no national dental scheme for the poor, whether or not they pay tax. The bid to means test the rebate failed anyway because of a hostile Senate, partly the result of a preferences deal Labor had done with the conservative Family First).

* No change to the shocking lack of residential and respite places as well as educational services for children with severe disabilities.

* No change to outrageous tax breaks for property owners, with the result that tax-paying renters subsidise the wealthy. Negative gearing, which enables property investors to claim losses on their investments as a tax deduction, has encouraged property investment, thus helping to lift the cost of housing out of the reach of first home buyers. Home owners who live in their homes are exempt from capital gains tax.

* Not withdrawing our troops from Afghanistan. Despite the bravery and skill of our troops, Australia’s involvement in this war serves the sole purpose of maintaining the relationship with the US, which is supporting the very same corrupt, greedy warlords whose mass murdering, raping and pillaging contributed to the rise of the Taliban.

Despite this dereliction of duty, the government boasts about the tax cuts it has managed to budget for, while promising to bring the budget back into surplus within three years – on the backs of Australia’s most needy and marginalised, truly the forgotten ones in this election.

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‘Richmond’s not in his room!’ – Why I love the IT Crowd

I have spent too many hours of my life splayed out on the loungeroom floor watching reruns of a sitcom that has grabbed and colonised my heart, soul and mind. It’s called The IT Crowd and its controlled ridiculousness is keeping me semi-sane during what is proving to be a rather grim winter. This British comedy is written by the unfairly talented Graham Linehan, cowriter of Black Books.

Moss, Roy and Jen constitute the IT department of the chaotic but phenomenally successful Reynholm industries (that the company’s raison d’etre is never specified is a running joke of the show; one fan has set up a spoof company website). Stuck in the basement of the Reynholm tower, they’re cut off from the other workers in their airy offices who enjoy stunning views of London.

Moss and Roy are hapless nerds while Jen, their ‘relationship manager’, sees herself as their bridge to the normal world but too often is marginalised herself by association.

Then one day Jen spies a red door in the basement, and, as in Bluebeard’s castle, is only more determined to discover what’s behind it when Roy and Moss warn her that all hell will break lose if she does. After the initial terror of encountering Richmond, an unearthly Goth, she settles down for a chat with this sweet-tempered former high-flyer who has been banished to the server room because of his infatuation with the extreme metal band Cradle of Filth.

‘Richmond’s out of his room, he’s not in his room, he’s supposed to be in his room, why isn’t he in his room?’ laments Moss, his love of routine and predictability thwarted, the British pronunciation of ‘room’, less drawn out and therefore more formal sounding than the Australian version, adding weight to his objection.

Moss, despite Graham Linehan’s denials, is clearly meant to be an Aspergers person. Not only does he thrive on routine but he’s technically proficient to the point of genius, socially clumsy, and entirely oblivious to nuance and Machiavellian craftiness; he even walks and holds his head in a way that is awkwardly wooden.

However, given that Moss’s most salient and attractive quality is his childlike need for certainty, it’s highly unlikely that the character represents an accurate portrayal of an Aspergers person. Yet it’s his childlike aspects that contribute most to his appeal, and perhaps they defuse the kind of criticism you might expect such a portrayal to evoke in the Aspergers community – I couldn’t find any criticisms of the character on the web, although that doesn’t mean they’re not out there.

Another reason for the seeming lack of criticism could be that while we often laugh at Moss’s unintentional funniness, we also chortle at his deliberate jokes, delivered in a self-consciously signature style that fans find adorable.

And generally speaking, Moss suffers far less than the other characters; he’s naturally cheerful, wins out against bullies (as in the first episode in the third series) and is canny enough to take advantage of amorous and financial opportunities (returning the attentions of a glamorous female psychiatrist in the first series; unintentionally stealing money from thieves in the third).

Like many women and probably men, I’m in love with Moss. This is partly because the actor who plays him, Richard Ayoade, is a very attractive man, with large brown eyes, a snub nose, finely sculpted cheekbones and a cherubic mouth; because Moss’s social incapacities make him so vulnerable that he arouses maternal instincts; because his character, and the actor who plays him, are both extremely funny (and sometimes their personalities seem to blend together, as if Ayoade and Moss were in league with each other); and because the childlike aspects of his nature promise a temporary, atavistic return to childhood.

Yet I couldn’t find much on the web about Ayoade himself, except for a frustratingly short beginning of an interview that seemed to suggest that he himself might suffer from Aspergers (he mentions a difficulty in maintaining eye contact with the interviewer while speaking) but in fact appears to show him in a very understated role in a satire.

Ayoade seems to lack his own website, despite what is clearly a huge fan base out there. The Channel 4 website for the show has clips and episodes that are frustratingly off-limits to Australians (I can understand the downloadable episodes being off-limits, but why the clips, including an interview with the actress who plays Jen?).

Despite Moss’s vulnerabilities he succeeds in life (if not romantically), partly because Jen and Roy both protect him from himself; he needs them to smooth the social waters, just as his esoteric knowledge is vital to the company but also occasionally useful to Jen and Roy.

Soon after Jen joins the IT department Roy and Moss are about to complain to the CEO, Denholm Reynholm, that Jen has no understanding of IT and they don’t want her as their manager. But as the three sit opposite Denholm while he barks to his inferiors on the phone, his conversation makes clear that he will ruthlessly sack any team who can’t ‘work as a team’ (gloriously sending up company-speak).

Knowing that all three of them will be sacked if the complaint goes ahead, Roy and Jen have to drag Moss away, assuring Denholm they had only come to the office to install voice activation on his computer. Moss can’t understand why he and Roy aren’t going through with the complaint; he just hasn’t been able to transfer the meaning of Reynholm’s phone conversation to his own situation. But later, in the second series, Moss demonstrates the usefulness of his peculiar genius; he’s able to tell by smelling it that the creepy new boss of Reynholm Industries, Douglas Reynholm (Denholm's son), has put Rohypnol in Jen’s tea.

Prisoners of gender

Aspergers is associated with maleness, but Moss isn’t the only one burdened because he’s male; all three main characters are ‘prisoners of gender’. They are extreme in their habitation of gender roles and they all suffer for it.

Roy is a standard nerd who tries hard to succeed romantically (a cause for much of the comedy) but always fails. The harder he tries the more ludicrous he appears; in one episode in the first series, with carefully pomaded hair and an oversized retro jacket, he attempts to proposition a girl while oblivious to the fact that a dollop of shit or chocolate (it’s deliberately never made quite clear which) is sitting in the centre of his forehead.

Jen is female in a way that is ludicrously stereotypical. When suffering from the monthly arrival of ‘Aunt Irma’ the cure lies in a girls’ night in, with Roy and Moss playing at being her faux girlfriends, all three dressed in terry towelling robes and watching predictable old chick flicks like Beaches and Steel Magnolias.

This should be offensive but largely isn’t because Jen’s workmates are equally stuck in their extreme masculinity. In fact, there’s only one moment when I was truly offended by the show’s portrayal of her.

It’s in the episode in which Jen becomes obsessed with a pair of red high-heeled shoes that are three sizes too small for her. While in this state of obsession she becomes incoherent. When asked for an idea about combating stress by the hyperactive Denholm, she responds ‘What? Shoes …’. But, back in the basement, while she’s mumbling about the shoes, when Roy calls her a ‘crazy bitch’ in an affectionate, condescending tone as he walks her into her office, it’s too much for this feminist to stomach. And the stereotype of women being obsessed with shoes is overwrought.

Return to childhood

Yet the whole show is overwrought, regularly venturing into surreal territory, making it difficult to be offended by the stereotyping. It’s basically a child’s world where the everyday and the magical are seamless parts of a whole, and where reality is often viewed as a series of extremes.

It’s a world of play, the unknown and the novel, girded by the iron certainties that children cling to because they are still so ignorant of its machinations, but also bounded by the terror that lurks when Roy and Moss enter social situations they aren’t equipped to deal with, and when Jen enters emotional situations in relationships that always seem to end badly.

This is why Moss is so vital to the show and why he is in some ways its central character; he’s a child who hasn’t grown up. His literal view of the world, his inability to understand nuance and sarcasm, in some ways reflect the child’s brain. Watching the show is an invitation to re-enter childhood.

And this is why Richmond is also an attractive character. Gentle and softly spoken, if a trifle melancholy, he adds to the fantastical nature of the show. Yet there is something very traditionally British about him; the way he speaks to Jen at his first appearance, not to mention his 19th-century costuming, has something of the period hero, as if Mr Rochester had blended with Bertha Mason to create not the madwoman in the attic but the sane gentleman in the basement; even his name has a 19th-century flavour.

As a social phobe I can’t help identifying with Richmond, stuck in the IT server room, not even the basement proper but a room off it, a secret room with a forbidding red door. Once out of his room, Richmond is ‘allowed’ to flutter freely around the basement in the first and second series but he never makes it back upstairs, although in the first series Jen tries valiantly to persuade Denholm to have him back.

A continuing obsession

I regret that this little world that Graham Linehan has created lives only in his head and those of his fans. I can’t bear that these characters do not actually exist, especially Moss and Richmond, although on some level I believe that they do. I'm hungry for information about the actors who portray them because that is a way of refusing to believe they aren’t real; the last thing I want is to see them in other shows playing different characters.

And for good or ill, I’ve watched each episode of the first and second series so many times on DVD that I now have the funniest sections on standby in my head; I’m liable to start smiling to myself for no reason as I ‘play’ one back, which has both advantages and disadvantages. (The third series has aired on the ABC and Australian fans now await the fourth, which is currently being aired in Britain on Channel 4.)

I don't have the DVD of the third series, but recently I realised I could watch repeats of whole episodes on Youtube. Yet watching the show on my PC doesn’t do it for me at all; it’s not just the poor quality of the footage but the fact that I don’t associate sitting at my desk with leisure. I love the whole DVD experience of sinking against cushions and losing myself in three indulgent hours of comedy paradise.

However, having now seen the first and second series in full, I think the content of the third series, which I originally watched on telly, isn’t quite as good, and it’s not just the Youtube factor that’s making me feel that way. The show’s becoming more like Seinfeld by the minute; Seinfeld is not surprisingly one of Linehan’s inspirations, and worth imitating, but the particular magic of character-based dialogue needs to be preserved.

Just one tiny example: when Jen and Richmond have their first conversation, Richmond says of Roy and Moss ‘I don’t know their names’. In the context this line is simply brilliant, illustrating how cut off Richmond is from the world and yet how self-chosen is his exile; Roy and Moss are no more than functionaries who form part of the background of the catastrophe he finds himself in. Why this is so funny is difficult to pin down, but it has a lot to do with the rarefied worldview of this underrated and now sadly lost character – somewhere between the second and third series he ‘got scurvy’ and was never seen again.

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Dealing with Birthday Depression and Birthday Sadness: An Update

Do you get depressed or sad on your birthday? Almost a year ago I wrote a blog entry on birthday depression. This entry has easily had the most hits and comments of all of my posts, suggesting that birthday depression is a huge issue for many and one that is rarely acknowledged.

If you’ve found this blog by googling ‘birthday’ or ‘pre-birthday depression’, please read this earlier entry first. It’s about feelings of depression that can emerge both before a birthday and on the actual day. These feelings can be powerful and debilitating.

Those commenting on the entry were wonderfully honest about their experiences and helped me clarify some of my thoughts about this issue. A year later, I felt compelled to write an update to expand on my ideas about this feeling and describe the emotional landscape on my birthday a year after writing the first entry. Thanks to all the commenters – the brief summing up below has benefited from your shared experiences.

Why do I feel sad on my birthday?

There are many things going on when a birthday comes round:

• The work and stress involved in planning a celebration
•  the desire to have a good day
• the need to feel significant and to be acknowledged by loved ones
• grief at dreams that haven’t come true
• childhood memories of happy or unhappy birthdays (not necessarily conscious)
• general dissatisfaction with life
• for those who have children, the desire to model happiness on the day.

But there is often a huge gulf between the expectations of feeling good and the circumstances of the birthday itself. You may also find yourself dealing with underlying feelings of grief and  low self-esteem.

As if that's not enough, many of us  feel compelled to berate ourselves for feeling bad. After all, this is our special day and we should be enjoying it - shouldn't we?

No wonder, then, that it's hard to get a handle on what birthday depression actually consists of. It can feel mysterious and inaccessible, as if a well of grief were closed up somewhere in the psyche that can't be experienced directly.

Some suggestions

Because depression is a catch-all term that can mean different things, I’m reluctant to give advice about it. The positive feedback I’ve had about the last entry was because it didn’t try to help people avoid the depression, but just described the feeling from my perspective. So I’ve decided instead to simply include some suggestions for coping. Please bear in the mind that not all of the following may apply to you – as the 12-steppers say, take what you like and leave the rest.

• Don’t fight birthday and pre-birthday depression. Expect it, treat yourself gently when it comes, and be aware that it does pass.
• Keep bringing yourself back to the present. Be aware of your body in space, your breathing and the things around you. If you feel like crying, do.
• Plan some treats for yourself - buy yourself little presents and give yourself favourite experiences.
• If you’re planning celebrations and you’re feeling very down, try to make them on a scale that you feel comfortable with. You can always see friends separately rather than together, and spread birthday meetings over a few days or a week.
• If you're feeling really anti-social, don't feel you have to spend the day with others. If you do spend time alone, do something you enjoy or treat yourself in some way.
• Know that grieving and sadness have their own timetable, and can’t be rushed.
• If you are feeling significant distress, share it with someone else who you can count on to be understanding, or get help.
• Notice any small ‘gifts’ that come your way from the world. This doesn’t mean being endlessly positive or trying to make yourself feel grateful. But through the sadness it may be possible to see the bits of the birthday that are good, even if these are small or unexpected. (Sometimes the sadness can make these things stand out more.)

My experiences of birthday depression a year later

I didn’t really get full-on birthday depression this year, which was surprising because I fully expected to. Instead I got angry in the week before my birthday, while on the day before, and the day itself, I could feel a low-level negativity and annoyance, like a bad taste in my mouth that wouldn’t go away.

Depression is a catch-all word for a huge range of emotions and conditions. I’m not sure why I didn’t get significantly depressed, but I’m wondering whether the depression that swamped me last year, and to a lesser extent in previous years, was really a kind of grief. Perhaps I have been grieving for a lost life and now the grieving, while strictly it won’t ever end completely, is at a much lower level.

The anger before my birthday expressed my continuing dissatisfaction with my life today. This tends to wax and wane, but while the energy of anger can be freeing, it did get a bit self-destructive and over-the-top before it simmered down.

I did notice a couple of things about my birthday this year that clearly contributed to the negative feelings. I’ll detail them below, but I suspect that the nature of birthday depression is that it’s very individual, focusing on whatever circumstances are present for the sufferer.

Why I felt down this year – the main suspects

One thing I noticed is how much time it takes to organise a birthday. (And this is someone who doesn’t have to organise a huge party or any large gathering, and has flexible working hours!) I do have to buy my main present (from my parents) and arrange family get-togethers, but this year at least there were virtually no food or cleaning preparations. Yet the birthday still took significant time and energy to plan. I think this is one reason for the negative feelings: my birthday sucks up time and energy when I'd rather be ignoring it altogether.

This in turn brings up feelings of doubt and anxiety about whether I'm deserving of this kind of time and attention, and whether other family members believe that I am.

And this question relates to something else I noticed about this year's birthday – that family members stuck to their usual roles rather than trying to be nice.

Too often in the past I’ve used this blog as a flogging post for unsuspecting family members so I won’t do that here (well, perhaps only a tiny bit). Although I’d deliberately lowered my expectations this year, I still hoped that a couple of ‘recalcitrant’ family members in particular would make a ‘special effort’. Instead, the usual sabotaging non-verbal messages prevailed. And while I wasn’t exactly depressed about this, it fed the sense that I wouldn’t be sad when the birthday was over.

And of course there was the age thing – turning 47.  It’s not so much about looking older, although I’ve feared that in the past, and no doubt will again – it’s about the knowledge that although I haven’t lived much of my life, or barely begun to realise my potential, mother nature and the ageing process are not going to make an exception for me.

The ‘end’ is drawing closer, inexorably – the numbers don’t lie. And yet I’m just beginning to understand the nature of the health issues, mental and physical, that are holding me back. Plus, even though my understanding is growing, these factors are still significantly restricting my life. What I’m getting at is that age itself is a ‘health issue’, and I fear that I’ll never sort the other issues out before age takes over everything!

Anyway, my birthday is over for another year and there is a huge sense of relief in returning to ‘normality’, or my version of it, once more. (Plus, I did get some wonderful cards and gifts that will result in a low-level spending spree at an anonymous but obscenely large shopping mall in a south-eastern suburb of Melbourne.) I wish everyone well who is going through this.

Please note: birthday depression is another term for birthday sadness. If you are having suicidal thoughts or think you may have clinical depression, please speak to your doctor or a family member, or ring one of the numbers listed here. Please reach out and seek help if you need to.

Would you like to share your story of birthday depression? Head over to the Birthday Depression website and share your story with others experiencing the same thing.

If you'd like to know more about birthday depression, I've written an ebook about it, also available through the website.

For a short time if you share your story I'll send you a mobi file of the book for free. 

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Progress report: diet, dogs and trying to meditate

I’ve been meaning to write something about the changes I’ve noticed since going on an incredibly strict food intolerance diet, and thought I'd combine a progress report with a couple of other ‘developments’.

I’m on a strict version of the Failsafe diet, which rules out all food additives as well as two groups of chemicals that occur naturally in foods: salicylates and amines. My diet is also gluten-free, dairy-free, yeast-free, fruit-free, and sugar-free (the first four of these additional restrictions are necessary for some Failsafers, but not all).

I’d been on a diet that had these four restrictions as their basis for many years (though with plenty of ‘lapses’) but never tried to avoid salicylates and amines (in no way am I suggesting that others should follow this diet, especially the extreme version I’m on!).

Researchers have found that not only does the Failsafe diet improve the symptoms of ADHD but it also improves behaviour and mood including depression. Food intolerance has also been linked with a number of other mental disorders.

So, even though an outbreak of hives drove me to this extreme rather than my mental ups and downs, I was curious as to what effect the diet would have on my overall mental and cognitive state now that I’ve been on it a couple of months.

So what changes have I noticed? My memory is definitely better. I’m retaining more of what I read. My thinking is sharper. My mood is also better, except on overcast days. I still get sad a lot, but it passes. I generally feel more positive.

I’m less angry. I noticed this when catching up with a friend recently. She’s a lovely person but a bit chaotic, and sometimes I’d get annoyed when she complained about her life. Last time I met up with her I was amazed at how calm I felt.

My concentration isn’t all that much better, though, mainly because my mind is less tired and quite ‘busy’. In fact, if anything I feel more concerned about particular activities that feel vitally important (for example, writing comments on political opinion sites!).

This feeling is quite compulsive – it’s been there for years in anything related to work or effort; but I think I’m just noticing it more because my thinking’s clearer, and it’s strengthened the sense that I may have a form of OCD, albeit not focused on things like germs and counting. The obsessiveness is also centred on what’s wrong with my body and mind – yet I’ve been less focused on my bodily imperfections lately, though winter could be the cause of this rather than the Failsafe diet.

I still have social phobia. However, there has been a small decrease in my physical anxiety.

The Failsafe diet dismisses sugar as a contributor to children’s behavioural and mood problems. Instead, it links hypoglycemic symptoms with salicylate intolerance. Failsafe also dismisses the scientifically controversial phenomenon of leaky gut, which some believe can cause and worsen food intolerances and an overgrowth of Candida, a type of yeast.

I still have low blood sugar, although I have to admit it seems to be less severe. I don’t know whether or not I have leaky gut but I still feel more tired, vaguer and quite depressed on overcast days, and I still get PMT during which my hypoglycemia is significantly worse. And, sad to say, I still have rosacea – being on an amazingly restricted diet hasn’t stopped me having red, rashy cheeks.

All the changes I’ve experienced are subtle – I don’t feel transformed, just a bit stronger, and I wouldn’t have the confidence to make a major change like applying for an in-house job.

My family and other animals

Sorry about the hackneyed heading, but it was just too relevant not to use! I have ongoing ‘difficulties’ with my family of origin, and these have deepened in recent years because two of my sisters acquired dogs and I wasn’t happy with the treatment of these unfortunate canines. I’m still not, but I wanted to report some progress on that front (I’ve changed everyone’s names).

There are two dogs in this saga. Jordan is a lively, mischievous, ginger-coloured, mostly-cocker-spaniel owned by my older sister, Andrea, and her husband Richard. There’s been ongoing disagreement between me and Andrea and Richard over the treatment of Jordan, who I used to walk regularly.

Sarah is a quiet, chocolate-brown, rather resigned retriever–wolfhound(?) cross who nevertheless transforms into superdog when someone throws a ball in her direction. She’s owned by one of my younger sisters, Therese, and her husband, Tony.

A particular incident around Easter sparked the latest dog fight. Sarah was left alone in Therese’s backyard for the four-day break, with my father visiting and feeding (and playing with her briefly) twice a day. On one of those days she came to my parents’ backyard for most of the day (they live down the road from Therese) and I walked her, and along with my parents gave her some attention.

Sarah is a challenging dog. Loving and calm around children, she hates most other dogs, and anyone who walks her must carry a bottle of water to spray into her face if she becomes aggressive towards a passing dog.

I had never seen this side of her and, thinking it couldn’t really be that bad, didn’t bother with the water on the Easter walk I took her on. But then we passed two dogs and a cat, luckily safely behind the neighbour’s front fence. Sarah suddenly lunged towards them, barking furiously while I pulled desperately at the leash to maintain control – she’s very strong and whimpered angrily when I finally managed to restrain her.

Clearly Sarah suffers from a lack of socialisation – this had soon become apparent after my sister found her through a rehousing service (she was already at least five years old). She had also become quite overweight since I’d seen her last, and was constantly panting even when lying down. All this, combined with my sister leaving her in the backyard over Easter, gave me a sense of despair about her situation that left me wanting to distance myself from Therese.

Since the arrangements to stop walking Jordan ended just after Christmas my relationship with Andrea and Richard hadn’t really improved much (this is beginning to sound like Days of our Lives crossed with Animal Rescue).

Anyway, last weekend I finally caught up with the family, after not seeing some of them for almost two months, at Therese’s place for a Mothers Day gathering. And there were some tiny but significant miracles.

The first one was that after delivering the family to Therese’s place, Richard went back to his place and brought Jordan back with him. Smelling Sarah even before he got to the front door, Jordan skidded frantically through the house to the backyard. He spent the afternoon there with Sarah and occasionally some of the children, trying to steal Sarah’s ball (by some quirk of fate, Sarah actually doesn’t mind Jordan, although she got a bit aggro at one point when he grabbed the ball).

The second miracle was that Sarah herself was looking much better than when I’d seen her last – leaner and healthier. This was because my oldest niece, who’s 16, had been taking her along with her on her runs, and Sarah apparently is too distracted when she’s running to bother about other dogs.

Jordan hadn’t forgotten me. As soon as I went outside he dashed towards me and, as I stroked his head and scratched his chin, stayed by me with a look of relief on his face. Our reunion, after almost five months, was much less gruelling than I’d rather melodramatically anticipated, but I still felt a level of guilt at having abandoned him.

It was good to see him as his same old self, and he was happy and active. Also, I knew that since I’d stopped walking him, Andrea had been taking more responsibility for him. I know he doesn’t get walked enough, and she doesn’t like the whole social scene at the park and so avoids taking him there, as she’s told me. But he seems better integrated into the family. He also spends a fair bit of time inside, I’m told.

Sure, I wasn’t happy as it began to get dark and the two canine pals forlornly stood sentry at the back door, soulful eyes watching the fun inside, cold and lonely and wanting to be part of their human packs, with me going outside to pat and soothe every now and then. But I’m happy about the progress that’s been made, and I just hope it can continue.

Good morning, meditation

I also wanted to report on my recent experience of trying to meditate. When I look back over my adult life, it could be viewed as one long failed attempt to meditate. It seems that when I do start meditating regularly, every time something out of the ordinary happens – I get a cold, or a really difficult job comes up, or a major event looms – I give up meditating. I’m talking about 5 or 10 minutes a day here, not anything heroic like half an hour.

But in all my attempts I’ve come to realise some important things.

There is absolutely no point in me waiting to meditate till 6 pm, which I’ve tried to do in the last year or so. It’s not that I can’t find the time then; my brain just isn’t in the right state for it.

The only thing that works for me is to meditate just after I get up in the morning and before I leave the bedroom. As I’m a morning person this is the best time for my brain; I’m definitely at my freshest, even if I haven’t slept that well. But the other reason is that, because I know if I don’t meditate immediately I won’t be doing it later in the day, it’s much harder to put it off and make excuses. I also know that it’s good for me to start the day that way before I compulsively go to my office and turn my computer on.

Another thing I’ve realised is I don’t have to wait for meditation benefits. I get them right away. Yes they’re subtle, but meditation is like daily medicine.

And the best thing? All the times I’ve stopped and started mean that when I start to meditate again, my brain already has some skill that it’s retained from the last time. So all the stopping and starting hasn’t been a total waste of time.

So far, I’ve managed to meditate first thing in my bedroom, for 10 minutes at a time, for five days in a row. I know that sooner or later there’ll be some crisis that may threaten this, but now at least I can’t fool myself and say ‘I’ll do it later in the day’. It’s first thing or not at all.

(BTW, the picture above isn’t of Sarah, but it was too appropriate to resist.)

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A simple but totally unproven exercise for getting to sleep

(I was very bored with the layout of my blog, so chose another template and mucked around a bit with colours – any feedback welcome, including feedback on readability. I’ve also rearranged the links and added subject headings. Lastly, though you would never know it, I got rid of quite a few labels, but the list is still too long.)

I developed this sleep exercise about a year ago, based on some reading I’d done on the brain. I decided to include the exercise in my blog because I’ve been having sleeping problems for the last few months and hadn’t been doing the exercise for a while. I tried it again recently and it seemed to work. I thought it was worth putting in the blog, but I’m warning you it sounds very silly, and is probably based on childhood memories of sci-fi films.

I would be very interested to know if it does work for anyone else (and if it doesn’t), or if readers make their own adaptations.

The exercise

• Do this exercise slowly.

• You can do it more than once at a time.

Picture the frontal cortex of the brain being turned off (picture the frontal area of the brain, along the forehead, being plunged into darkness as ‘electric lights’ are switched off).

Picture the visual cortex being turned on (picture the centre of the lower back of the head lighting up as if an electric light is going on).

Imagine you are a director giving instructions to an operator sitting at an operating panel that includes buttons. Picture the operator carrying out the following instructions as you give them.

• Produce 200 mg GABA ( as you ‘give the orders’, picture the operator punching the amount in, the substance, and then an ‘Enter’ button).

• Produce 200 mg melatonin (as above).

• Produce 200 mg tryptophan (as above).

Now order the operator to ‘Activate the sleep process’. Picture the operator slowly moving a large lever, like a gear stick, in a downwards motion.

Now, gently focus on any images your brain is producing rather than words. Let the images turn into dreams.

Please note the following:

• This exercise has no scientific validity – it’s only been tested on me.

• I don’t have problems getting to sleep, but waking up too early in the morning and being unable to get back to sleep. I therefore use this exercise in the early hours (4 am to 6 am), and it doesn’t plunge me into deep sleep but light dreaming.

• Part of the reason it does work for me may be habit – ie my brain now sees this exercise as a signal to move into sleep mode.

• It does seem to relax me a bit, perhaps because it occupies the mind.

• If I’m really alert it won’t work – sometimes it acts like a test as to whether it’s worth trying to sleep or just giving up and getting up.

• The exercise is based on my very limited and probably completely inaccurate knowledge of the human brain. The frontal cortex is the seat of active thinking, and the visual cortex is active during sleep.
  

• The exercise refers to sleep-inducing substances that the body produces, and I am in no way recommending that people buy these as supplements.

• The ‘amounts’ of these substances are totally arbitrary.

• Everyone’s different – if trying this exercise produces distress, stop.

I know this exercise is daggy. But it works for me, and I thought it might at least inspire others to make up their own exercises.

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The Age newspaper loves Greens policies, but hates the Greens

This blog entry is a letter that I sent to the Age newspaper this morning, objecting to the newspaper's coverage of the Greens on the previous Saturday. For overseas readers: the Melbourne Age has always been a progressive newspaper but struggles to maintain its role under the current management of its owners, Fairfax Media.

Last year the ALP government failed to get its legislation for an emissions trading scheme (ETS) through the upper house. The scheme was never popular with progressives but was even worse after amendments made following negotiations with the main conservative opposition (the government refused the Greens suggestion of a carbon tax).

With an election due around November this year, the ALP has shelved any reintroduction of the ETS until 2013. Two columnists in Saturday's Age managed to have a go at the Greens for opposing the legislation in the Senate.

I’m writing a general letter of objection to the coverage of the Greens and their policies on global warming in the Age of Saturday 1 May 2010, but also directed at the two columnists concerned, Tony Wright and Ross Gittins. Tony Wright’s column appeared in the Insight section of the paper and Ross Gittins’s appeared in the Business Day section (the business commentators seem to be Fairfax rather than Age journalists – this in no way lets the Age off the hook). For the record, I’m not a Greens member but I support and vote for the Greens.

It’s fascinating that the only direct endorsement of the Greens’ carbon tax proposal is not only buried in the business section of that edition, in Paddy Manning’s column, but seems to have produced a flurry of opposing opinion by other columnists (a spurious attempt at ABC-style ‘balance’?). Manning’s endorsement is also months after the fact – I’m not objecting to the views of this columnist, but to the Age’s willingness to publish a point of view that supports evidence-based policy only when that support is given far too late to matter.

In contrast, the coverage of the Greens in the columns by Gittins and Wright would have conspiracy theorists who fear anti-Greens censorship tearing up their Age subscriptions. It seems that the Age wants to have it both ways: present itself as a progressive paper by criticising government and opposition policies; then trashing, or more usually ignoring, the one party that offers a clear alternative. The ethos seems to be: ensure business as usual while enabling readers to feel vindicated in their anger about the complete inability of the large parties to pursue policies that are genuinely in the national interest.

The media is part of this deterioration in our democratic process. One of the problems is that journalists such as Wright and Gittins have taken on, to some extent, the twisted mindset of politicians. According to this mindset, there are two realities: what’s actually going on in the world; and the need to create an impression of government activity and relevance through spin. This second, alternative reality, born of the Canberra hothouse, is considered by the politicians to be far more important than actual reality, and is one of the major reasons the Labor government has failed to move effectively on just about every issue it has tried to tackle.

Unfortunately, some journalists also come to view this alternative reality as far more important than the real world. It is certainly much more beguiling, because it’s far easier to commentate a never-ending football match than to take a strong stand on matters such as democracy, human rights and social justice.

Take Wright’s column. He starts off in the real world, by giving an impassioned description of a recent Catalyst program that highlighted the effects of global warming on Antarctica’s ice sheet. He then turns his attention to government and opposition behaviour towards climate change, bemoaning the fact that ‘hardly anyone seemed to give a stuff’.

It would be logical for Wright to support the policies of the party that has done far more than either of the larger ones to both alert Australians to the true extent of the dangers of global warming, and to offer policies and targets that actually square up with the science and set us on the road to a renewable energy industry. But in his upside-down version of reality, the version he’s absorbed from the political spin-merchants, the leader of this party, Bob Brown, is an irrelevant ideologue. And the only one left with real integrity is the man who, at the time when the government’s climate change policy was being negotiated, made what was already a dog of an emissions trading scheme even worse – Malcolm Turnbull:

Bob Brown’s Greens … well, they just kept being the Greens, complaining that the government hadn’t taken their proposals seriously, which is another way of saying that they had played themselves out of the equation.

About the only politician of simple integrity still standing was Malcolm Turnbull.

This is outrageous. In implying that Bob Brown lacks integrity, Wright is denouncing one of the few politicians in the federal parliament who actually has any. (Brown’s opposition to unfair increases to parliamentary salaries is just one example.)

In contrast, Turnbull’s principles in relation to the ETS, principles which Wright lauds to the skies, were based on ensuring that the coal industry continued to flourish in Australia till kingdom come.

It’s disappointing for a reader to feel she is more cluey than the paper’s national affairs editor. The ETS (both pre- and post-Coalition versions) was a dog because:

• it offered compensation to polluters, doing the opposite of what an ETS should do, which is to encourage alternative energy, not to enable ‘business as usual’. The Age itself has reported that most of the compensation specified in the ETS legislation was unnecessary

• it locked in, for the long term, both this compensation and a low emissions reduction target, with the distinct possibility that if the government increased the pathetic 5 per cent target, it would be liable for a commensurate increase in compensation to the polluting industries

• the 5 per cent was a furphy anyway, because much of the reduction would have been obtained from investment in overseas carbon sinks

• the 5 per cent was an absolute target, discouraging citizens from making their own changes – for example, if I had switched my electricity supply to green energy, that would have increased my electricity provider’s ability to pollute elsewhere

• no one understood it!

Eminent climate scientists agreed that the ETS would be useless, as the Sydney Morning Herald reported.

Wright knows that the Greens were never merely naysayers, but offered a positive alternative, a carbon tax that might have squeaked through the Senate with the support of at least one of the two renegade Liberals and Nick Xenophon. Wasn’t the carbon tax option preferable to what’s happened now, with any action on carbon emissions being shelved till 2013?

This style of commentary illustrates the dangers of political commentators having the main say on climate change in the mainstream media. If the Age is to be relevant it needs to have a qualified science writer weighing up the parties’ climate change policies, not glorified football commentators like Wright.

Let’s now turn to Gittins. He makes an astounding claim in his column, yet doesn’t even attempt to back it up:

But why did the Greens pretend that 5 per cent was nothing when they must have known it wasn’t true? Because it didn’t suit the line they were running. It proves that the ever-virtuous Greens as [sic] just as capable of lying with statistics as the mainstream parties are.

Gittins produces no evidence to ‘prove’ that the Greens are ‘lying with statistics’ – he simply makes the assertion.

In considering the 5 per cent target too low, the Greens were merely listening to the climate scientists. The 5 per cent target has absolutely no relevance to climate science.

Similarly, Gittins seems to think that judging emissions reductions using per capita (head of population) measures would be a good thing. This is simply ludicrous because it would make targets meaningless as far as the actual climate is concerned. (In fact, the pollies would love it if they could use such standards to measure reductions in emissions, especially given Australia’s increasing population, and a couple have tried to do this.)

Again, it’s all about politics, not reality. Tony and Ross, isn’t ‘the greatest moral, environmental, economic and scientific challenge of our time’ worth more than a 5 per cent emissions reduction (on 2000 levels, by the way) and a bag of gold to the big polluters?

A newspaper in which the ‘ever virtuous’ Greens are treated with contempt because they’re more truthful, and the coal-friendly, Machiavellian Turnbull magically becomes ‘the only politician of simple integrity still standing’ may be terminally endangering its reputation as a progressive force.

It’s a shame, because the Age could be building strong customer loyalty based on an unswerving progressive vision, and on a genuine interest in engaging with its readers, rather like the UK’s Guardian. Instead, it seems almost entirely concerned with the advertising revenue it receives from the large parties. Many readers have already migrated online to sites like Crikey and New Matilda in response to the Age’s inability to respond adequately to the slow dismantling of democracy that Howard began and that Rudd has continued to engineer.

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