Free Offer: Review Copy of Memoir

I'm offering 10 readers a free copy of my memoir, Compulsive Mind: A Memoir of Panic, Social Anxiety and OCD.

There's just one condition – that you promise to provide a review of the book on the Amazon website. This means that you need to have an Amazon account, and to have bought something using that account in the past.

At the moment no-one has reviewed my book on Amazon, despite it having been in the top 100 for Kindle mental illness categories many times. The fact is that many – perhaps the majority of – Amazon reviews are either set-ups, or an expression of extreme reactions to a book, whether positive or negative.

Of course I want reviews so that potential readers will have something to go on and feel more comfortable buying the book. But as a writer I also crave feedback. I would love to know what works about the book for readers, and equally what doesn't.

I want any reviews of my book to be sincere. I don't expect you to review the book positively, just honestly. And reviews don't have to be time consuming – Amazon reviews can range in length from a short article to just a few lines.

If you're successful I will send the book in the form of a mobi file, so you need to have a Kindle reader. But you don't need a Kindle – you can download a free Kindle reader for iMac, Windows and many types of smart phone and tablet, including iPad and iPhone, from here.

About the book
In this sex-saturated world, imagine for one minute that there's something you're more terrified of than anything else: love and intimacy. And that a nasty case of social phobia and low-level OCD lurks behind your terror.

This moving, often confronting memoir reveals how a devastating and complex anxiety disorder exploded into the life of an intelligent, creative young girl struggling to reach maturity in the Melbourne, Australia of the 1970s and 80s.

Adrienne McGill grew up with undiagnosed social phobia and OCD, and developed panic disorder at the age of twenty. The toll her untreated illness took on her career, relationships and emotional development is related here in sardonic, sometimes relentless prose that packs a punch.

This book is essential reading if you:

• want to better understand the dynamics of anxiety
• feel that your anxiety disorder doesn't fit neatly into the standard definitions
•  love memoirs of the 1980s
• are looking for a memoir about blushing
• suffer from more than one disorder. 

How to request your free review copy 
Write to me requesting your free copy at caetem@yahoo.com. I'm only giving away ten copies, so be quick! I'll amend this blog entry when the offer is no longer valid.

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The Afternoon Belongs to the Sleepy

I heard a saying once: the morning is for God, the evening is for humans, but the afternoon belongs to the devil.

Whoever wrote this had a circadian rhythm similar to my own – bright and shining and preternaturally alert in the early morning, lapsing somewhat around 10 am but functional till lunchtime, then going to hell in the afternoon.

The afternoon: when things that have been left unfinished in the morning are visited on the weary soul like the returning curse of a bad fairy. The afternoon, when you become an existentialist. When the garden sinks into an endless trance, except for Ferdie, the kelpie cross from the flat around the corner who, tail wagging in delight, poohs on the generous grass of my front yard.

He knows he's not supposed to, so, lacking the moral rectitude of many in the canine world, he confines his doings to areas of the yard that are outside the sightline from my office window. Perhaps he is a kind of devil – his peculiar pale-rust coat and disconcertingly light eyes suggest this – but I know the impression is misleading because, after chasing him around the corner once, I got close and thought he was cringing until I realised he had picked up a stick in his mouth and was throwing it on the ground in front of me, urging me to play catch with him. Not a devil perhaps but certainly devil-may-care.

The trouble with afternoons is that they often mean deadlines, but I'll do almost anything to avoid having to send a completed job to a client at this time of day. What horrors of sloppy diction are laid bare, what ridiculous mistakes and omissions have been left unseen by my oxygen-depleted brain when something is sent off before close of business (ie 5 pm)?

Better to be ahead of the game, to have most of the thing finished by the morning – what a shining time to get things done! My brain is like a purring engine that's just been serviced. It runs smoothly with minimal noise. Small errors that escaped my attention jump out at me. Creativity is at its height. I treasure these few hours. They are the secret to any kind of success I have in my career.

The zombie-like nature of afternoons can be minimised by judicious planning. The trick is to reserve this time for things that require only small amounts of either mental or manual labour. It’s quite a good time for starting new work tasks – to freewheel a bit, do some basic research, produce creative insights and provide an extremely rough first draft, but not to draw all the threads together or supply rigorous logic. One non-professional task I like to do in the afternoons is weeding the garden – it's mindless and refreshing. Clearing out the email in-box is also a productive way to pass the time when blood-sugar challenged.

Since I started taking antidepressants there is an added complication to the afternoon. At around 5.30 pm I like to stop work and fling myself onto my comfortable old couch under the large window in the spare room. It’s the lightest, airiest room in the house and I can't be seen from the couch when I'm lying on it because of the upward slope of my front yard (but I can poke my head up and check for Ferdie's arrival).

It's a perfect place to read by the bright light of the late afternoon sun, except that, with the drugs in my system, between 5 and 6 is the time my mental energy is at its lowest. Yet when I close my eyes, hoping for half an hour of sweet oblivion, my brain seems to be trapped in a halfway house, too tired to think but not tired enough to sleep. It feels a bit mangy, a bit old, as if it doesn't know how to either turn itself off or keep itself on properly. TS Eliot wrote:

We are the hollow men
We are the stuffed men
Leaning together
Headpiece filled with straw.

He seems to have uncannily predicted the effects of Luvox on my early-evening mental state.

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A Few of My Favourite Sayings

Some aspects of getting older are boringly predictable. You find yourself, like generations past, lamenting the language young people use – the poor grammar, the ridiculous sayings, the odd pronunciations. It puts things in perspective to realise that the Ancient Greeks had a similar complaint; the poet Hesiod, thought to have been active between 650 and 750 BC, railed about the ‘frivolous youth of today’.

I sound like on an old fuddy-duddy. Does anyone use that expression any more? As part of my editing work I recently watched a video of kids in a classroom reading out loud together the story of the billy goats Gruff. The wicked troll yells to the goats ‘Be off with you!’ I found myself pleased that the kids were being exposed to this quaint expression.

Anyway I was not going to spend this entry complaining. Except for one use of ‘like’ I hate and probably everyone my age does too: ‘like’ instead of ‘said’, as in:

She’s, like, ‘He’s not my boyfriend any more.’

And I’m like, ‘Since when?’

I don’t like ‘like’ in this context because it makes speech unnecessarily drawn out, clumsy and difficult.

Why not use ‘said’ or, if you want more immediacy, ‘she says’? Even, if you must, ‘she goes?’ Both trip off the tongue.

I had to get that out of my system. The main thing I want to talk about is sayings I actually, like, like. And interestingly, many of these come from the USA, so often decried for spreading  grammatical no-nos (‘lay’ instead of ‘lie’, not saying ‘of’ after ‘couple’, removing ‘-ed’ from participle adjectives like ‘old fashioned’ and ‘cliched’ so they become nouns, eg ‘a cliche piece of writing’, ‘an old-fashion girl’ – okay, no more complaining). (I hope my US blog readers will forgive this outburst, which I’ve needed to get out of my system for some time – there are many things about US English I prefer, eg ‘jail’ instead of ‘gaol’.)

So here’s my list of favourite sayings for your linguistic delectation:

Here’s the thing.

Why do I love this so much? It’s incredibly economical, not to mention understated. There’s also a bit of empathy in it.

It says, in only three words, ‘That’s all true, but there’s another factor that trumps all that, and I’m about to tell you what it is.’ It’s a polite yet unassuming signpost that prepares the listener for what comes next. What’s not to love? (This latter saying is something I’m not crazy about, but I don’t hate it either.)

Moving right along ...

I have always loved this expression, ever since I first heard it said in first year uni by a friend of mine. Again, it’s very economical but with some very low-key humour in there. It basically says ‘What we’re talking about is a bit embarrassing so let’s drop the subject.’ But this ‘translation’ doesn’t begin to describe the essence of this phrase, which has a dramatic performative quality that is humorous but not so easy to deconstruct. I think of an overanxious teacher in front of a classroom of students with their ears wagging at some salacious reference, and the teacher saying brightly ‘moving right along, does anyone know how to  ...’ There’s a note of panic, of let’s-get-out-of-here-before-we-get-tripped-up, a hint of awkwardness in the face of dauntingly  sexual[?] overtones. But users of this phrase are not usually as embarrassed as the teacher; rather, they’re ironically performing the teacher role, implying ‘I may be in fact a little embarrassed at what I’ve just said but I will laugh at my own embarrassment.’ Despite the postmodern complexity, this expression manages to be fun and lighthearted.

The ego has landed.

This is a pun on the title of a bestselling book, The Eagle Has Landed, a war thriller by Jack Higgins. I’m like a child with some humorous sayings – no matter how many times I hear or say them, I still find them vaguely funny, and this is no exception. Applied to anyone with an inflated sense of self-worth, its humour lies in its applicability to that particular individual, so there’s a freshness to the saying each time. Most recently I found myself thinking it when watching a documentary about an English plastic surgeon, originally from Pakistan, who was returning there to do some altruistic cosmetic surgery on the faces of female victims of battery acid attacks. Much as I admired this man it was clear from the first frame that he was, as we say in the Antipodes, ‘up himself’ (a saying I’m also very fond of). As usual I found  it funny to pronounce ‘the ego has landed’ about this man, despite his kindness. The present tense of ‘has landed’ gives the expression a drama and immediacy that I really like.

You don’t care for that.

Ah, how I love this one. I first noticed it as something distinctively American in a memoir written by one of my favourite authors. It was in a piece of dialogue between the author and her very empathic psychiatrist. She is revelling in a heightened mood during a bipolar episode and doesn’t want to come down to Earth: he’s trying to convince her to take her mental health seriously. It’s old-fashioned and euphemistic – instead of saying ‘don’t like’ or the stronger ‘hate’ or ‘despise’ etc,  you say ‘don’t care for’.

Why is this euphemism attractive to me and not simply annoying? Because of the word ‘care’ perhaps? Or the fact that regardless of whom the subject of the sentence is, I, you or a third person, there’s a charmingly old-fashioned delicacy and politeness to it? It seems to want to spare the listener rather than, as in the case of ‘moving right along’, the speaker. It refers to a sensibility that can discriminate, and is discerning: what we do or don’t care for being what we like and dislike (or, I suppose, care about).

The young – always with us

I couldn’t find this on Google – apart from the more general ‘always with us’ – which upset me a bit because if I can’t find something on Google I tend to think I’ve made it up. For some reason I’ve always assumed that this old-fashioned expression is British. If that’s so, it expresses what is a cliche of various aspects of the traditional British sensibility – an acceptance of adversity combined with a difficulty in enjoying life.  There is a resigned tone to this saying, but also, importantly, a radical acceptance. I can almost see a middle-aged woman in a flowery hat and with one of those rectangular sixties handbags hanging off her arm sighing as she says it. It could be in response to just about anything – a child acting up, or a teenager being too boisterous or simply saying something funny or striking. It is not a complaint but an observation that has something of the long-suffering about it as well as a subtle sense of a close community, and one that is headed by its elders.

I have it.

Okay, so this expression may seem so incredibly inane that its inclusion is incomprehensible. Bear with me. This is a US saying; Australians say 'I've got it' instead. This is an ugly expression, hard on the ear. How infinitely more elegant is 'I have it'! Give me that any day. Once you've given it to me, I can say 'I have it'.

There are plenty of other expressions I’m vaguely fond of but none that tickle my fancy like these ones do. Readers are more than welcome to send in their favourite expressions, and to pick my grammar apart and highlight any errors!

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Back, Again: The Tyranny of the Bad Back

I started writing this piece sometime in mid-January after being temporarily debilitated by a minor back injury. It’s all better now but I’ve learned a lot from my experience.

I half-sit, half-lie on my right side. My torso is twisted awkwardly, my arms crooked, palms pressing into the sheets on either side of me. The sheets are tangled. The lamp casts its sickly yellow glow over the small room. My hands depress the hopelessly too-soft mattress beneath me. I’m wondering what to do with them next, which part of my body to use to haul my torso up and behind me so that I am sitting on the edge of the bed – the vital position before I can get up from it.

I’ve managed to sustain what is probably an abdominal strain. There are a number of abdominal muscles, and I think I’ve pulled the deepest one on my left side, the transverse abdominal muscle, which is involved in coughing, laughing and sneezing. It’s a strange injury – in my case there’s little pain, apart from soreness, as long as I keep still and sit or stand in the right position. The killer is the accompanying muscle spasms – an involuntary clenching high up in the wall of the chest when I so much as bump into something or move too suddenly (this clip from the IT crowd captures both the feeling itself and the dread of the feeling).

I must have a mild strain because I can breathe without pain (although laughter and coughing present problems) and even the muscle cramping isn’t all that painful. It’s just weird and scary, makes me feel like an invalid, leads to soreness and stiffness, and reminds me that something is awry.

I have an overly soft and comfortable bed, and having to lie in the one position on my back all night since the injury has been disastrous for my lower back, which is probably a map of muscle knots and old strains. I’ve had to stop doing my daily exercises too of course, further weakening my back. The spinal chickens are coming home to roost and I, it seems, am a sitting duck. Since the days after the strain, I’ve gradually lost mobility, and now hobble around like a superannuated courtier in a Shakespeare play. I think of my grandfather, his pot-bellied body stooped and pain-ridden in the weeks before he died of cancer.

Without my back able to propel and support me, my entire body image has changed. I feel fragile, elderly, vulnerable to further injury. I am hopelessly separated from the bulk of humanity, which, on the face of things, appears to take its collective back for granted, while at the same time feeling more bonded with the human race – for who among us hasn’t, at one time or another, had a back strain of some description? Despite the fact that my problems are all muscular, and therefore minor in the scheme of things, I am scared of the future. I want a prognosis. Worse than all of this, I am missing out on precious summer days, the kind so warm they give you the illusion that life will always support you, that you need nothing. Half the time I’m so worried I can't even read.

Frightened to laugh or cough, a thousand giggles and splutters are trapped in my tummy and facial muscles. Ricky Gervais, in a repeat all the way from 2004, causes me pain when he speculates about the attempt to fix Humpty Dumpty. ‘Horses? Why would you use horses – to fix an egg?’ he queries in his slow, droll way, drawing out the absurdity through superb pacing. ‘And all of the king’s horses? What if there was an invasion? Oh, we can’t send the troops because they’re trying to put an egg back together.’

I’m terrified something else will go wrong. I am hanging on to my independence, but last night it was a struggle to do the dishes. Further debilitation would mean a return to the family home, the worst outcome possible for my sanity.

How stubborn this injury is. In the past even the most debilitating back strains (usually lower back) have only been at their worst for a matter of days. Rest has always been the magic, quick cure for any problems. Yet rest doesn’t seem to be having the desired effect this time, or perhaps the progress is just too slow to measure. In fact, the abdominal strain is improving, albeit at a glacial rate, but my back seems to be getting worse.

In desperation, I go to the first physio I can find. Truth to tell, this one is participating in a scheme by which my extras health fund pays the entire fee for the first visit. But we won’t go into that, and I battle to avoid it during the session. He keeps asking how I found the clinic. Who cares? I trust him, he’s excellent at what he does; the clinic is his practice (whatever that means in relation to a group clinic) and he’s been a physio, the receptionist informed me when I made the appointment, for thirty years.

He can see there’s nothing seriously wrong. ‘I want you to feel relaxed and that you can walk around without worrying’, he tells me. By the end of that first session – not more than around twenty-five minutes long – I do walk out normally, if slowly and gingerly. I no longer cringe in fear at the dreaded spasm. That night I have one more of these horrors while walking with my friend Simon in the park. Then they’re gone forever, never to return.

I am watching a blu-ray at his place to see in the New Year, and I masochistically choose This is Spinal Tap, a digitised print that is unbelievably fresh and funny after thirty-odd years. I torture Simon by continually begging him to please turn it off, I’m trying not to laugh. I still feel cheated of this movie: there were so many humorous morsels to savour and I was scared to let them tickle through me for fear of the pain.

Second time at the physio and my back’s back. It’s in good form. He is very paternalistic. ‘Good girl’, he says. I don’t care. I’ll do whatever he says, within reason. I ask for some exercises, he gives me two to do morning and night. ‘I’m very motivated’, I tell him and I mean it. My precious independence is beckoning. At the end of the visit, the physio says he wants to see me one more time.

When he’s giving me treatments I understand why I haven’t been to a physio for 20 years. It’s terrifying. He levers different parts of my spine up and down, up and down, and I am scared I’ll panic. I had contemplated telling him I had an anxiety about being touched in a professional setting and then decided against it. Luckily he seems to think my clear discomfort is about a residual fear of muscle spasm.

Ah, physios. What a worthy profession. I used to have a friend who was a physio and while in training she would occasionally come round and practise on me. At the time I wondered why on earth anyone would do such a long and intensive course in an area that seemed so pedestrian. Now I can’t think of anything more worthwhile than watching someone hobble into a consulting room, and later waving them goodbye as they depart with a spring in their step. Not that this happens every time of course –  clearly in my case I was suffering from nothing but strained muscles, easily assuaged by the treatment  – but improving mobility is a noble pursuit.

After my third and final visit to the physio I’m a new woman for a day or two, but my troubles aren’t over yet. The back strain has been worsened by too many hours spent slaving over a hot computer in the last few weeks. My back is angry and painful, and I can’t seem to get on top of it; I’m doing the exercises the physio has recommended, but am still not back to my old exercise routine. One Friday afternoon after meeting a demanding work deadline my back seizes up to the extent that I can hardly walk.

Determined to get my back back, I start walking laps of the oval at the local park. I buy a cold pack, use a wrapped towel as a lumbar back support when I’m working, consider buying a $200 back rest for watching tele. I religiously leave the computer and curl up on the floor when the strain starts to feel serious.

And then it just ends. It stops. My back is back to normal, in fact probably better than normal because of the physio's intervention. There’s no rhyme or reason, I’m not sitting any better or doing anything different, although I have started my old exercises again, which is probably strengthening it further. Perhaps I had actually strained it quite seriously as a consequence of the original abdominal strain, and it’s only just fully recovered. It’s working so well that I’m happily mildly mistreating it again, twisting and bending and struggling to make the effort to crouch down when I pick something up. The garden’s looking better, the car is clean.

But I will never take my back for granted as I did before, and I’ll continue to build it up with strengthening exercises. I need my back and I’m not going to let it let me down again if I can help it.

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Long Live Pippi Longstocking: Appreciating the Larger-Than-Life Friend

Friendships, like life partnerships, are not always simply about similar goals, values and shared interests. Sometimes they’re about complementarities. There’s a category of friend many of us make in our formative years, and sometimes maintain into adulthood – the larger-than-life, or LATL, friend.

The larger-than-life friend is usually fearless – not always completely, but in areas where we may quail. The larger-than-life friend is louder, sometimes physically broader or taller, and more daring than us. When it comes to her background she is a creature of extremes: her home life is likely to have been either more loving and nurturing than ours, or dramatically more dysfunctional; her parents are either poorer or wealthier than ours. The LATL friend may be simply warm, outgoing and exuberant, but she may also have a brilliant comic streak, a sense of the absurd that we aspire to, and a willingness to challenge authority. She is often a youngest child.

The key to a successful LATL friendship is not to try to emulate her, or put oneself down for being lesser in any way. The LATL friend will be drawn to us for what we are not as much as what we are. She may appreciate our average families, our more settled and boring lives. She may gain a degree of emotional stability from our company. She may draw from us strains of humour and brightness that we did not realise we possessed, and appreciate them more than we realise. We do not have to try to be like her, but simply continue to be ourselves.

LATL friends are not always real. I have no idea whether the average imaginary friend of childhood is a LATL friend, but I wouldn’t be surprised.

Sometimes imaginary friends are created by skilled storybook authors. For me Pippi Longstocking, created by Swedish author Astrid Lindgren in the late 1930s – early 1940s, was the quintessential LATL friend who set the standard for the flesh-and-blood ones that came after her.

The beauty of Pippi is that she is entirely free of authority figures. In contrast to her next door neighbours, Tommy and Annika Settergren, whom she befriends and shares adventures with, she does what she pleases. She doesn’t go to school, cares nothing for social graces and is always breaking taboos.

Pippi (full name Pippilotta Delicatessa Windowshade Mackrelmint Efraim’s Daughter Longstocking) is a virtual orphan, living happily alone in a home she calls Villa Villekulla in a small Swedish village. Her sea captain father disappeared in a storm but according to Pippi is living as a cannibal king on a South Sea island. She has two pets, a monkey called Mr Nilsson and a horse called Little Old Man. She is said to have the physical strength of ‘ten policemen’ and often picks up Little Old Man and carries him from one place to another. Happy and exuberant, she is a shameless liar and truth-stretcher and is always manipulating adults into doing her bidding.

Pippi’s bizarre appearance declares her eccentricity: her tight orange plaits stick out from the sides of her head, her stockings don’t match and she towers above Tommy and Annika. Although she protects the weak and encourages rebellion she is never violent. She owns a suitcase of gold pieces so is financially independent. I’m sure reading about Pippi’s many adventures (there were three books in all) helped me handle my early LATL friendships.

Real-life LATLs, while lacking the freedom and physical prowess of Pippi, often have so much life-force that they bestow a degree of friendship on the siblings of their primary friend. I was friendly with more than one of my elder sister’s LATL friends, but it is Philippa who stands out the most. Philippa and my sister went to school together then shared an Edwardian house in groovy, inner-city Prahran in the early 1980s, playing host to a regular stream of artistic friends and boyfriends.

I idolised Philippa. Of solid build, with huge blue eyes and golden blonde hair, she had a country exuberance and friendliness that were increasingly tempered by arty sophistication, a vibrant, anarchic laugh that could be heard above the loudest party music, and a private-school accent that was inexplicable yet charming. She had a romantic history that would have filled volumes and a nurturing, motherly side that I flew towards. Philippa’s drawcard was not that she was the funniest or even the most intelligent young woman. It was her ability to extract the maximum from those around her, delighting in the humour of others and the quirks of human existence. She was studying psychology and as her social and love lives became busier she tilted dangerously between chaos and order, seeming to know instinctively where to stop the seesaw so that chaos never managed to gain the ascendant.

Once, home alone at my parents’ place, I thought I heard a burglar and got spooked. Philippa answered the phone when I rang Eleanor in a panic. She immediately ordered me over to Prahran despite the fact that Eleanor was out. Dressed in her white bathrobe she made camomile tea for us both. ‘Things can feel really scary when you’re on your own,’ she offered as she tucked her feet under her, sat down on the other end of the couch and gazed at me in sympathy. Her large eyes shone as she clutched the steaming cup and I read in them two motivations, and was perfectly happy with both: the desire to be supportive and a hunger for drama, for a heightening of life’s ordinariness.

At the time I had my own LATL friend, who could not have been more different than Philippa. Geraldine was physically taller and broader than me but it wasn’t just her size that enabled her to dominate the space around her. She was thirsty for attention, would court it and suck it up from wherever it came. She was the youngest child in a dysfunctional Irish Catholic family dogged by the twin curses of mental illness and alcoholism. Like her siblings she was brilliantly comic; for many years I kept a tape we made on one nothing-to-do summer afternoon at my place when we were about fifteen.

In the background, a telephone starts to ring. ‘The phone rings’, Geraldine pronounces in an ominous male narrator tone as she lolls on the bed. ‘Who will answer it?’ She then begins riffing on a hysterical middle-aged reaction to a dodgy television program playing in front of an imaginary child: ‘Turn—the—television off! Turn it off!’

Geraldine is long gone, taken by the evil, self-hating sprite who dwelt within her and waited to claim her at a weak moment. Like me she grew up with undiagnosed mental illness but unlike me she forged a path to adulthood for herself, having a baby in an early relationship and then meeting the love of her life with whom she was living when she died, it’ll be fourteen years ago this year.

There’s just one other LATL friend I want to pay tribute to in this blog entry; she died young too, of breast cancer. In the last year of secondary school, most weeknights I walked home from the tram terminus with my younger sister Simone and our mutual friend Kathy; boy that girl was wild. Or so it seemed at the time: in hindsight, not all the wild girls were acting out; some of them just grew up more quickly.

Kathy was fearless and from an early age she drank and smoked dope and partied and had lots of illicit boyfriends. It would have been futile to even try to emulate her but she was a few years below me at the Catholic convent we all attended, so I never felt that I had to. Neither Simone nor I would have mucked around with her at school if we had been in the same year, yet the three of us got on like a house on fire on those walks home.

I picture her walking between Simone and me, skipping slightly ahead as she relates something outrageous she’s done or cackles about some dippy teacher. I see now that her main function was to keep Simone and me from tearing into each other; she held each of us at bay, neutralising our mutual animosity, our unceasing grappling for space and attention. She never would have played this role consciously but her optimism, warmth and fearlessness did the job.

She couldn’t have cared less how she looked; she had uncombed straggly black-brown hair, a sweet creamy lightly freckled face, wild, gesturing hands, very light-coloured eyes and a body that was always curving into a dance of exuberance at whatever brazen act she had done or was about to do. Like many young women who grow up quickly she ended up marrying young, having kids, and working in unskilled jobs; and then the breast cancer claimed her. But she crammed lots of life and laughter into those years.

The LATL friend can lead our adolescent selves into frightening new territory if we let her; if not she may leave us behind. Sometimes, if the LATL friend is too reckless or self-destructive, this is inevitable. It didn’t happen with Kathy, because she was secure enough to accept Simone and me as we were: a tiny bit prissy but witty enough to keep up, and always willing to offer our admiration and sympathy.

If you have LATL friends in adulthood, treasure them but never feel that you are inferior for being less attention-getting or having more mundane problems. You and your friend may be mirroring in each other the qualities that are undeveloped in yourselves. As long as you appreciate and enjoy these complementarities, your friendship will continue to flourish and nurture you both. We can’t all be Pippi Longstocking, but that’s all the more reason to relish her company.

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A Pill Popper's Progress

Please note: the following is my experience only and is not advice about whether or not to take antidepressants. If you are experiencing any serious side effects from pharmaceutical drugs, including suicidal thoughts, contact your doctor or a close family member immediately.

Now that Christmas is over and I have time to breathe I can finally catch up on this neglected blog. It's more than three months since I started taking an antidepressant for the first time in ten years – and probably the first time that I was capable of handling the side effects and waiting for the worst ones to stop. It's high time for a progress report!

I'm taking only 25 mg of Luvox a day, a miserly dose compared with the allowed daily maximum of 300 mg. Being incredibly sensitive to anything I put into my system, I can't imagine what I'd be like on the full dose, apart from comatose – I'd probably make a zombie look like an ADHD sufferer. So even on my tiny 25 mg I'm declaring the experiment a success. This amount is enough to take the edge off my fears and obsessions, to the extent that I can perform certain social feats, and I've totted up a few triumphs that are improving my quality of life. Then there's the relative freedom from obsessional thinking that was becoming more and more debilitating.

On the minus side, there are continuing side effects that won't go away. I consider the trade-off worthwhile but they are significant enough to warn me off a higher dose. As well, despite my progress, the basic structure of my social anxiety is still intact.

The graces

When I started taking Luvox, I was amazed at how quickly I noticed positive change (I know what you're thinking – the placebo effect!) and how quickly life itself seemed to respond to my improved resilience.

Reduction in OCD

The most quick-acting and lasting effect of the Luvox has been a reduction in obsessional thinking – a low-level form of OCD, I'm now convinced. My obsessional fears about people and groups have been par for the course for decades, and in recent years I'd developed a mild body dysmorphia that had me examining various body parts in the mirror in an attempt at reassurance that instead led to horror whenever I discovered some shocking new flaw. But I hadn't realised just how debilitating my OCD had become until my latest periodic fixation reared its head yet again – stains on clothes.

Every now and then, an incident in which a piece of clothing was ruined by an irremovable stain – oil is a common culprit – would spark an obsessional fear that all my clothes, as well as sheets, doona covers and so on, were or would become irrevocably stained. Everything else shrank in the face of that possibility and I would wonder how civilisation was at all possible with this ever-present threat, and how people with children managed to afford to clothe them, when surely the little blighters would be routinely ruining everything they wore (I'm still amazed at the temerity of anyone who wears white, including brides!). I'd had a couple of these attacks when I started to realise they might actually signal the OCD that I'd been wondering if I had.

The strength of this fear in me is a good measure of my obsessional thinking in general, and Luvox has quietened these fears. When a loved piece of clothing stains, I still get upset but it no longer signals the arrival of the four horsemen of the apocalypse. I still obsess about people and social situations, too, but less so.

Reduction in social anxiety

Work has been an area of giant strides. Two days in a row – try to imagine the angst – I had to drive out to different locations to meet clients I'd never met before (well, I didn't have to – but with the drug in my system I was willing to give it a burl). Both of these involved long drives to locations of varying familiarity with all sorts of fears of doom and dark forebodings going on beforehand.

Having the two meetings in the same week created an accidental curve of therapeutic exposure. Upping the ante even further, both happened to be male clients, which I find far more anxiety-provoking than female. The second one was far harder than the first, connected as it was to my main copywriting client.

To top it off, I actually went into the workplace of a long-standing publisher client and worked in-house for three days – three whole days! While this was a triumph, there's no way I could have sustained it – or would even have wanted to. But to be able to actually achieve some work while in the company of others, and to say hello and interact with people I hadn't seen for a couple of years and had communicated with mostly by email was a huge boost to my confidence.

In all these scenarios the drug didn't take away the fear but it took away the worst of the physical symptoms. Having fear is strange on an SSRI like Luvox. To an extent your body and mind still perform their usual, rusted-on routine (mind conjuring up social catastrophes while stomach churns and somersaults) but there's a numbness there too, a sense of detachment, as if you know you're bluffing and there's a fair chance you might actually be alright. The first time around on Luvox in 2001, I remember telling a friend it was like having a platform underneath me for the first time, whereas before in social situations I was always falling into the cellar of my unconscious terrors. This time around it sometimes feels as if the drug is holding me, keeping me steady. It's like a good fairy or a guardian angel.

The other triumph is that I'm now attending a mental health group that meets on a weekly basis. We sit in a circle in the front room of a forties Tudor-style house converted to the group's office in a middlebrow suburb about fifteen minutes' drive from my place. I can't say I go every week – sometimes work forbids it – but the exposure has been incredible. The meetings go for two hours, way too long for someone like me, and my usual habit of homing in on 'scary' people is still there, but the Luvox allows me to stay put and work through this (touch wood – as I become more familiar with the group members, it actually becomes harder for me).

Better sleep

I'm also sleeping better. Nothing seems that pressing any more that I can't eventually get to sleep. My dreams are clearer too, vivid and fun to interpret in the morning, although they fade quickly after I wake.

The curses

Here are the side effects of Luvox that have continued into my third month on the drug. I can't speak for others – I suspect some of my symptoms are to do with have a dodgy immune system and a sensitivity to common food chemicals rather than being typical side effects of the drug, but I could be wrong.

Memory

My memory isn't as good on Luvox. For example, I struggle to remember what is on telly that evening after checking the guide online (the litmus test for me of good working memory). The other thing is reading. Depending on the level of detail, I struggle to recall much of what I've read even after a few paragraphs. Non-fiction, with its endless new names of players and organisations, is much worse than fiction. Part of this, I tell myself, is low blood sugar. There's no doubt the drug makes me even more susceptible to blood sugar fluctuations than I was previously.

Being more careful with my diet would definitely help. My weekend treats, mild as they are (rice cakes, tomato and hummus; cashews) result in greater tiredness, even exhaustion. So I need to indulge less, and this is difficult.

However, it not's all bad where memory's concerned. Having a quieter mind in some ways increases my ability to focus (although I can be a bit slow on the uptake), so I suspect in some ways I might be retaining some information better, especially the kind that occurs in conversation.

Digestion

There is evidence that SSRIs can disrupt the workings of the digestive system. I don't know whether this is related, but I have a permanently bloated stomach. (I've heard people complain of putting on weight while on anti-depressants, although I haven't put on a pound, probably because I'm on such a strict anti-allergy diet.) On the other hand my body image issues are reduced on Luvox, so the slightly distended tummy isn't such a terrible thing now I've got used to it.

Numbness

Unlike many on SSRIs, I mostly enjoy the relative emotional numbness I feel on Luvox. It's preferable to the combination of disassociation and depression I used to feel. I still feel just as concerned about the fate of the world, and the suffering of humans and animals, but the concern doesn't make me feel as unhappy and unsettled as it did in the past.

However, the reduced sexual response that is a common effect of SSRIs is also my experience, and this is where numbness (not just sexual but emotional) can become a burden.

Future possibilities

While Luvox alone is helping me, combining it with therapy would enable me to get the maximum benefits.

As I've said, Luvox blunts rather than removes my social anxiety. For me there are two aspects: the performance itself and then the replay at home afterwards. Common to this is an 'oh no!' reaction as I relive one or two incidents where I feel I've made a terrible fool of myself. I torment myself by going over the incidents again and again, and cursing myself for whatever I said or did. (I'm aware that the 'oh no!' is something my brain has built into it, and then finds a memory to attach itself to, but awareness doesn't seem to make much difference to the angst.)

The Luvox doesn't actually stop this process, but it blunts the pain and shortens the length of the remorseful period. Therapy could be a useful adjunct: someone to hold my hand as I expose myself to the horrific social possibilities my mind conjures. In theory I could do much of this exposure work alone, but in practice I need a skilled and knowledgeable psychologist who can parent me through the worst. 'So what if you acted strangely in front of aunty X and cousin Y the other night. What if you're right, and they do think you're weird – so what?' the skilled psychologist might say.

Or as I face my mental health group and try not to blush and look self-conscious, I could be doing something more useful: not simply allowing myself to think disallowed thoughts but actually making myself think them. My imaginary psychologist might encourage me to picture myself in bed with half the meeting as they sit opposite me – so that I'd gradually become more accustomed to, and less fearful of, such 'scary' thoughts.

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Coming your way - the empowered patient

I was reading a forum recently on the topic of 'staring OCD', a very distressing condition. The discussion was headed by a doctor who was either a psychiatrist or psychologist. Some of the sufferers suggested that their condition seemed to be caused by a combination of social anxiety and OCD. The doctor responded that this wasn't the case; instead the staring OCD was causing the social anxiety.

How could he know that this was true for each individual sufferer? To my mind it's arrogant to make a sweeping dismissal of patients' lived experience of comorbidity in this way. Staring OCD has been all but ignored; many therapists seem not to have heard of it. For some patients it could well start off as an obsession with staring and progress to social phobia, but it's not exactly farfetched to suggest that the two are often connected from the beginning; the Diagnostic and Statistical Manual of Mental Disorders (DSM IV) acknowledges that social phobia and OCD in general often occur together.

This is an example of doctors being in love with particular categories that patients then have to squeeze themselves into, even if it's an uncomfortable fit.

It also suggests how important it is for patients to empower themselves and learn to trust their instincts (as opposed to 'listening' to their illness).

An empowered patient might refuse to take this doctor's opinion as gospel truth if it doesn't chime with her lived experience. At the same time she might recognise the doctor's overall expertise and use his knowledge in other areas as a resource.

What does empowerment mean if you have a mental illness?

About two months ago, for the first time in a decade, I started taking Luvox, an SSRI that is often used to treat OCD. Around this time I became fully aware of one of my 'conditions' for the first time, and the many ways it has affected me over the years and continues to do so – pure obsessional OCD, or 'pure O' as it's sometimes called (sounding more like a soap powder than a mental illness).

Being on the drug has made me think a lot about what it means to be mentally ill, to have a condition that affects the way you relate to others, and to be 'medicated'. It's renewed some of my regrets about my earlier failures to make the most of drugs to improve my mental health, and to take responsibility for my life rather than handing over too much power to therapists. Here, then, are some of my thoughts about these issues. Please be aware that the recommendations I make are reflections of my own experiences.

Psychiatric drugs that have an acceptable degree of clinically proven efficacy and safety are neither good nor bad – assuming, of course, that the patient needs the drug and can benefit from it. Along with therapy they are tools, with two people wielding them and responsible for their safe use – the therapist and the patient.

Both need to understand that a drug is not a cure but a starting point. Assuming the drug is compatible with the patient's biochemistry, along with therapy it may enable her to reach a level of functioning that makes further change possible. Positive changes in the brain made by the combination of drugs and therapy may lead the way to further brain changes as the patient gets used to ever riskier and more challenging activities.

Whether positive change takes place depends on the commitment and hard work of the patient, and the effectiveness of the therapy, but there are also a host of other factors: the severity of the illness, the patient's support structure, whether she has security in housing and finance, and whether she has other addictions or health issues.

All this suggests an approach that considers the dynamic between patient, drug, doctor and the patient's larger social context. Within this dynamic there is one factor beyond all others that to my mind determines success.

The patient's degree of maturity is a key element in the treatment. She must be ready for the effects of the therapy, including the initial side effects of drugs, and the ups and downs to expect. She must be able to 'hold herself' and to withstand the whirlwind of change without dropping the therapy in a panic if her beliefs are challenged or as soon as something goes wrong.

Maturity enables the patient to be as fully aware as possible of the nature of her illness, and the way it operates in her life, and to separate the illness from her own self-image.

Maturity implies empowerment and self-advocacy. In some instances it may mean a patient who talks back, who appears to be non-compliant, who doesn't always take the therapist's word as gospel.

In some respects the patient may be more knowledgeable than the doctor about the day-to-day, lived aspects of her illness. This should not be surprising; given that less than half a century ago some doctors were still sticking ice picks into people's eye sockets and detaching the prefrontal cortex from the thalamus, it's fair to say we're at an early stage when it comes to understanding the nature and causes of mental illnesses. For example, we now know that the diagnosis of schizophrenia actually refers to a cluster of illnesses rather than just one.

However, the doctor will be more objective and have insights that the patient needs; the patient must find a balance between trusting her own instincts and taking full advantage of the doctor's expertise and objectivity. And doctors need to retain a degree of open-mindedness about the lived experience of patients and to look at qualitative as well as quantitative evidence, while not indulging or kowtowing to their patients.

Benefits of empowerment

It took me years to become empowered because I had to struggle with lack of information from therapists and my own dysfunctional thought processes to get a clearer view of the world. You need to know yourself and the operations of your illness very well before you can be an empowered, assertive patient and not simply non-compliant.

Ironically, the very psychiatrists who disempowered me by refusing to give me a clear diagnosis – something I didn't think to ask for myself – helped me in other ways by encouraging me to shed many of the deluded ideas I had about life, to grow up and to take some responsibility for myself.

It's my belief that if therapists want ultimate success they should try to foster empowerment in their patients. I'd go so far as to say that encouraging the necessary maturity for patients to actually grapple fully with their illness should be one of the major goals of therapy. While a certain degree of empowerment and self-knowledge can only come from experience, therapists can do a great deal to hasten the process.

No therapist should feel threatened by the idea of an empowered patient. Without life skills, self-knowledge and maturity, the patient can't get the full benefit of the therapy. An empowered patient is one who is motivated to change and recover to the extent possible. An empowered patient and their therapist can become a team with a common goal while still having separate roles and responsibilities.

Below are my ideas for the way therapists might do this. Of course some therapists already do some of the things I call for, such as encouraging their patients to join a self-help group.

A better way

These are the steps I believe therapists should take when they're establishing a relationship with a new patient.

• After gaining an overview of the problem, explain herself, her qualifications and methods of treatment, and let the patient 'interview' her.
  
  The patient needs to find out whether she wants to work with the therapist, while the therapist needs to ascertain whether she feels she can help the patient or whether the patient should be referred to someone else. Many therapists simply assume that they are the person for the job.

• Once enough information has been gained, tell the patient exactly what she believes is wrong with her and the implications of this. The therapist should be open-ended about these implications.
• Point the patient towards resources rather than suggesting that she is the only resource.
• Encourage the patient to arm herself with knowledge and join self-help groups.
• Encourage questioning and feedback, while being willing to call the patient out when she exhibits thoughts and fears that may be related to the disorder.
• Set up a treatment plan with goals (to be agreed by the patient) and ways to achieve those goals.

• Encourage the patient to pursue a healthy lifestyle and to get the basics of life right – housing, work or financial support, strong relationships. If there are barriers to any of these, they should be treated as goals and included in the treatment plan.

• Work out if the illness has created distorted thinking and ideas about life, society, and important life goals, and personality factors such as dependency and narcissism. If these kinds of things aren't identified they could stymie the treatment. Personality problems don't need to be fully blown personality disorders to sabotage progress.
• Share these findings with the patient and incorporate them into the treatment plan. 

• If the patient has concerns about medication (common for OCD sufferers, for example) rather than taking offence or trying to fob the patient off she should talk about risks versus benefits, ways to minimise side effects, and assume the patient has a 'What's in it for me?' approach.

Empowering young people

I was pleased to hear that some aspects of this approach are being used in the treatment of schizophrenia in young people. In a recent discussion on Radio National about the latest treatments, the practitioner spoke about the importance of early intervention, and the need to tell young patients that it was important to focus on two things that are basic to happiness: work and love.

I couldn't agree more. Young people with mental illness need to be encouraged to grow up faster than their peers. Work and love are, after all, the goals of most people's lives (which is not to say that a recovery plan should always aim for, say, a full-time nine-to-five job and a long-term relationship – recovery for some people could mean volunteering and establishing new friendships).

Following a thorough diagnosis (including personality factors) and treatment plan, this is what I wish I'd been told when I first presented to a psychiatrist at the age of 21 with an unspecified nervous problem. I would like to see all young people receive a similar introduction when they first enter therapy.

•  How you manage this condition will affect the quality of your life.  The most important thing you can do now is grow up and learn to look after yourself, and work on your treatment plan. While a certain degree of rebellion and acting out is normal for your age group, it may just hold you back and threaten your recovery.
• Get the basics right.  A secure roof over your head, good diet and exercise, strong and healthy relationships are essential to your recovery.
•  Alcohol and caffeine are not your friends.  If you have any serious addictions, go into treatment for them.
•  Use your time wisely to develop as a person.  Focus on strong friendships, and work towards being partner-ready without being obsessed about finding a partner. A strong relationship can greatly assist your success, so work on yourself.
• Don't try to do all this perfectly.  There will be plenty of times when life gets temporarily busy, and there will be setbacks as well as strides forward.
• Be sensible about sex. Sexual experimentation can be good and healthy but only if it is fully consensual and you feel happy and comfortable about it. But sex as an escape, or sex that is exploitative and not enjoyable for you, is simply a waste of your time.
• Learn to separate your thoughts and intuitions from your feelings.  Trust yourself, but don't necessarily trust all your feelings all the time – they will chop and change. Learn about your intuition and separate it from your emotions. Learn to follow your gut but remember your emotions aren't always telling you the truth.
• Don't give away responsibility for yourself.  Respect professionals and their advice but view them as resources.You are not there for their benefit; if they're not helping you, you are under no obligation to keep seeing them. On the other hand, try to tolerate a state of openness and unknowing; it may take time to form an opinion on whether a treatment is working. Leaving simply because a therapist challenges your boundaries, prejudices or distortions would be self-defeating.
• Understand that there is nothing wrong with the essential you.  Your disorder is stopping your true self and personality from expressing itself. Your goal should be to come home to, and learn to love, the body and mind you have, and to live your own life, not someone else's.
• Work towards a sustainable career.  Where work's concerned, it's a fine balance between taking your illness into account and stretching the boundaries. Accepting and managing the illness is vital to your success. Choose your vocation carefully – whether you have to give up on a particular dream or pursue it will depend on individual circumstances but management of your illness must come first if you want long-term success and health. At the same time, sometimes only experience can tell you if a career path is right or not; cultivate flexibility and be willing to change to a related career or different way of working if a job or vocation is too stressful.

I was a very rigid thinker, and had strange ideas about the world, when I was 21 and first spoke to a psychiatrist about my nervous condition. Would I have been able to take advice like this on board at the time? Probably not if it was verbal, but if something similar had been given to me as a leaflet, and presented as advice from other sufferers, it might have helped.

Most of all, if I'd been told that I had a serious condition, a chronic illness if you like, that I would have it all my life, that no magic Freudian catharsis was going to get rid of it and that it was up to me to accept this and learn to manage it, I might have cultivated more sticking power, patience and resilience. I hope people going into therapy for the first time can get the full benefit of the many resources now available to them, and understand that they are their own greatest resource!

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