Noel McDermott

Managing Grief and Loss and Emotional Recovery
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Managing Grief and Loss and Emotional Recovery

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

Humans are attachment making animals, we form loving bonds with each other that have deep consequences for us. They shape us literally at the biological level. The hormones involved in feelings of love and happiness with each other encourage myelination in the brains, whereby physical structures are formed in the brain. We use the term ‘personality’ as a shorthand for the sum total of these interactions. When a baby is born these loving interactions form the basis of brain health and personality health. Neglected babies have literal holes in the frontal lobes where brain matter is lost. Without this frontal lobe development, the capacity to think, regulate etc are severely compromised. This process is lifelong and crucially our attachments form the basis of our ability to regulate, think, operate in the complex social web of life. The longer we have had a relationship the deeper the impact is on personality and functioning. Although this is about loving relationships myelination also happens with stress-fear based relationships and what follows about loss is equally true.

Loss in this view then, is loss of self as represented in the real, social world. It is the loss of the ongoing capacity to regulate, make sense and meaning of reality, to frame experience in a way that makes it safe (predictable, as in better the devil you know in stress based intimate relationships.) This loss of meaning is frightening and we can’t turn to the person we have lost to help us regulate that fear. For these reasons we can feel the loss of a partner in divorce for example in a complex and confusing manner, particularly if we wanted the divorce, because why would we grieve ending a relationship we didn’t want anymore?

Understanding that loss and grief is our brain and personality trying to heal from a type of injury can help us make sense of this. The brain, our personality or self is primarily a social or environmental phenomena from this view. Loss is an injury to its wellbeing, to its health. So, we need to focus on that in healing that injury.

Loss of a partner to divorce is no different to any other loss and the social framing of it shouldn’t get in the way of the deeper level of understanding. So what helps?

  • Develop meaning in the world again. Much spiritual and or religious practice is based on meaning making so you may find comfort in that. If you are secular, think of helping others. As social animals any activity we engage with that helps the ‘herd’ helps us. There is always someone worse of then oneself and helping them will A) help them and make the world a better place and B) help us to get a sense of perspective and feel connected to something other than our own suffering

  • Increase contact with loving network and fill that hole in the brain with others to help us regulate

  • Stay away from alcohol and drugs. Temporary relief from these chemicals which can and do hijack neurological pathways is too dangerous at times of distress. Emotional distress is a sign you need a hug not a glass of wine

  • You have had a major injury, what would you do with any recovery from a major injury? Correct: rest, slow down, seek help, eat well, hydrate, sleep, show compassion to yourself

  • Normalise your reactions. There is nothing wrong because you are healing from a psychological injury. It is to be expected. Not being able to feel loss and grief (the signs you are healing) would be more worrying. It’s okay to not be okay

It’s worth reflecting upon the healing impact of nature during times of loss. Its impact is so strong that it’s worth developing it as a unique strand of your recovery. Nature has an impact on our brains similar to mindful meditation, which is well researched to help our bodies and brains heal. Nature increases our sense of connection to each other and our feeling of wellbeing. Nature in this context does not mean out in the wilds, it can be that, but equally can be your local park or indeed a bit of gardening. It is well researched for example that putting a park in an urban area reduces violent crime in that area by up to 20%. This is due to the sense of connection and wellbeing fostered. Therapeutic horticulture (gardening) is also well researched in psychological recovery. The impact of nature is so strong that simply taking time to pass attention to a tree at your bus stop on the way to work will produce a noticeable effect. So go hug a tree and say thanks!

Finally, it’s always a good idea to check in with a mental health professional or your GP if you are worried about how you are coping. If you have a history of psychological distress, you may well need extra help such as anti-depressants. Mostly you will be met with empathy and emotional support from the professionals who can reassure you nothing is wrong, but you never know, so it’s always good to check.

Read more articles by Noel McDermott.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/

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Supporting Children Emotionally During Divorce

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

The type of support your children might need will depend on their personalities and the reasons for and the nature of the divorce, is it amicable or a war? Let’s assume significant amounts of child centred insight on both parents’ parts and the desire and capacity to think of their kids first. In that case it’s a question of central life circumstances and the types of transitional phenomena we might see.

Transitional phenomena was a concept linked to a British child psychoanalyst in the 50’s and 60’s called Donald Winnicott. He developed ideas such as ‘good enough parenting’. He used to have a radio show supporting parents and is credited with changing how hospitals supported children as in patients as he advocated for family rooms and allowing parents to stay with their sick kids. He also developed the idea of transitional objects that children psychologically individuate for their primary carer and would use as stand-ins for the carer. All parents know the phase their kids go through of having a special toy, or blanket that can’t be washed or, god forbid, lost! Winnicott called these ‘transitional objects’ that reassured the infant the primary carer was ‘alive’ even when not around. They provide security, a sense of emotional continuity during change.

We would now broaden that understanding out to larger important relational constellations and into an all of life experience or need. The core constellations of experience that matter for security are:

1. Emotionally intimate and dependent relationships to others. That could be a romantic partner, family member and also very close friends.

2. Work, which represents survival and also broader meaning and purpose. Work in this context includes school .

3. Home, representing survival and containing inner world (intra-psychic) needs projected out onto a place.

Once we are through infancy successfully we learn to attach emotionally onto these 3 constellations of meaning and experience in important  ways for our psychological stability. They facilitate a sense of continuity of being. Our identity is in the relationship to these 3 areas. Have them upset, challenged or removed and we begin to break down psychologically.

To understand what your kids need you have to ask how many and how much of these three constellations are changing? The greater the number of them changing; is it only one of them, or two of them or all three?, then the greater the support needed. Also ask yourself how secure or developed are your kids? Their age will create different challenges and needs.

The types of support and interventions will vary but fall into these broad categories

  • Reassurance of love. The ‘transitional object’ above reassures the infant their ‘love object’ is still with them and therefore they are loved. With younger kids who have outgrown these objects they may well want them again or gain new ones. Older kids might be offended by you offering a teddy bear but ask yourself what are the metaphoric teddy bears you can offer? Often it’s re-instituting ‘rituals’ they have grown out of, movie nights for example.

  • Normalise. Anxiety, depression, irritability, drop off in performance at school, lack of sleep, poor diet and so on are all signs we are going through things we would rather not. They are normal and we shouldn’t diagnose ourselves as wrong if we struggle with change.

  • Increase fun stuff. Make a list of all the things you know everyone enjoys and do it more, sounds simple but we forget one of the best therapies is simply having fun!

  • Expect old behaviours to emerge and accept them. Things you or your kids have grown out of will pop up to say hello. It’s OK, it’s the mind saying, this helped in the past. Is it helpful now?

  • Increase healthy behaviours. Socialise, exercise, eat well, regular rest and sleep, practice your stress management tools more. Be very conscious of being healthy in your habits.

  • Talk, talk, talk…you get the idea.

  • Do transitional work. Having to move home? Visit that home before you go, look around the area, visit it lots and get a feel for the place, find cafes, parks, groups you like and use them before you move. The same applies with moving school. The more you plan the transitional changes the less of a shock.

Change is inevitable and we know lots about it. So do your research, chat to people who’ve been through it. Most important of all, stay loving and forgiving.

Read more articles by Noel McDermott.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/

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Supporting Children Emotionally and Mentally During Family Transitions
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Supporting Children Emotionally and Mentally During Family Transitions

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

Mental health expert Noel McDermott examines what our children need through periods of transition; it’s first important to understand what we mean psychologically by a transition. A transition isn’t just a change of something, it is a change that requires an emotional adjustment. To some extent this type of change, a transition, is mediated by age and experience, but there are also some types of change that require an insight into transition, or adjustment needs, for all of us and especially kids. Transition needs affect humans in general and are linked to deep needs we have connected to survival mechanisms. These transition issues generally fall into 3 categories often called central life circumstances:

  1. Home – place of safety and survival
  2. Love relations – family, close friends, romantic partner
  3. Work – meaningful productive activity that is social and has survival outcomes (school, workplace, university)

Changes to these areas will likely produce transitional phenomena which are behavioural and emotional disturbances that might see A) a reversion to previous coping mechanisms (regression) or B) the development of new coping mechanisms (adaptations.) Typically coping mechanisms are designed to manage distress and some will be fine and some might be upsetting or even destructive. Types of coping mechanisms or soothing mechanisms in younger kids that we accept as normal might be:

  • Being clinging
  • Being grizzly emotionally
  • Thumb sucking, return to pacifier
  • Holding on to ‘blankie’

If age appropriate we don’t notice these and assume correctly they will grow out of it, but when they are a little older and we see these behaviours suddenly emerge again, which they can and do through transitions, we might get worried. But, regression is normal when the three central life circumstances are affected as are adaptions. The key question is are they doing something to help? Adaptations in particular may be unhelpful or what we call ‘maladaptive’. Examples might be aggression, self harming, substance misuse, excessive drinking. These might seem extreme but often they might emerge over time. More subtle forms of expressing distress in children in particular would be sleep disturbances, changes on mood, appetite, withdrawal etc.

The question is how do we reduce the risk of disturbance during transition and when it does emerge help our kids and ourselves manage it? These are some key ideas to utilise:

Normalisation – knowing and accepting that transitions can be upsetting allows us to normalise and explain to ourselves and our children what is happening. Often it’s the magnification or catastrophising of the behaviours that is the problem. When we can say, ‘oh this is normal’ during times of change we can manage things better

PPP – plan, prepare and practice. Plan: If you know the change is coming discuss it before it happens, if it’s a big change start the discussions early, some months before. Prepare: Get folk on board with organising the practicalities which facilitates normalisation, discussion and empowerment. Practice: If say moving home, go visit the new place or area. Stay there if possible for a night or two before moving etc. Build an emotional ‘on ramp’ that allows the reality of the change to be grown into, as opposed to an emotional cliff edge where you all fall off and smash into the rocks of the new reality below

Increase soothing and support for all before during and after the change. More movie nights on the sofa, more self care, more massages, more spa days, more friends and fun, more family meets and openness about feelings, tell the school, work and all support networks about the transition and ask for understanding

Refocus on the four corners of health and wellbeing:

  1. Nutrition (hydration) – eat well and regularly (in between the movie night binges of course!)
  2. Sleep and rest regularly
  3. Get moving and exercise
  4. Manage stress with relaxation, massage, meditation

Often adapting these approaches will not only take the sting out, but it will also mean you have no discernible negative transition issues. Or if you do have them, they are less intense and of shorter duration. If there is a history in your children or yourself of mental health issues, eating disorders, addiction etc then it is super important to focus on support and also developing individual plans for those involved around relapse prevention; for example should a mental health professional be brought in to help, should medication be used prophylactically to reduce the risk of relapse?

Read more articles by Noel McDermott.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/

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Navigating Family Changes in a Positive Way
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Navigating Family Changes in a Positive Way

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

Getting a hug during times of change 

One of the most important things to learn about having healthy ways of navigating change is to fully accept that a different set of rules apply to transitions for all humans. Change is perceived by our primitive functioning brain as a threat. Predictability and routine are standard elements in the prescription bundle in modern psychological therapies for treating all forms of psychological distress.
Various words are used for this, containment being a useful one in this context. When distressed we find it difficult to contain our feelings and they can spill over. Imagine your child crying due to something beyond theirs or your control, and you scoop them up and hug them into your arms and gradually the tears subside. You help them contain the distressing feelings. In some ways predictability and routine are like that for us in the background of our lives helping us navigate challenges. Imagine now during the middle of the distress you drop your child and tell them to stop being silly?
Change to our personal circumstances can feel very much like being dropped when we are distressed. So, what can we do to create a new pair of arms to help hug us when we have been dropped? Again, think about your child, somehow, they are ok simply with the hug, it’s not the circumstances that you change, but the feeling in your kid of the capacity to survive and manage. Similarly, it’s not possible to stop the change, it’s happening, but it is possible to manage the emotional distress allowing yourself and others to function better.

What are these new arms holding us?

Normalisation or forgiveness of self and others – it’s normal to be distressed during times of personal change and understanding that allows us to accept that our own behaviour and that of others is based on the distress about the situation and not a moral, personal or psychological failing. It may be that one of the reasons the change is happening is because of another’s unacceptable behaviour in the relationship for example, and it is likely to get worse during the transition. Knowing this and not being unrealistic about how well you or others will cope is crucial in lowering the distress. In the same way that you know your child will be ok in your arms, you too will be ok if held and comforted and being able to link the behaviours to the situation tells us that it will pass.

Transitional phenomena – teddy bears and comfort blankets

When our kids are growing especially during the time they begin to psychologically individuate from the primary carer they develop attachments to special toys or pieces of cloth. These special objects represent emotionally the special relationship to the primary carer and have the advantage of being portable when the carer isn’t. They can to some extent stand in for the actual comforting presence of the carer. These transitional phenomena allow our children to manage this change in reality as the carer is no longer magically available to them. So, allow yourself that or allow that in others. Try to avoid using alcohol, anger or drugs to facilitate the transition and instead stick to warm humans or the equivalent stand by. If you haven’t got an emergency teddy bear in your life, time to get one!

Empowering the embrace of change

There is a large body of evidence to show that people who feel empowered in life manage better, even when they have exactly the same circumstances as others, the outcomes are better. Whilst it is important to risk assess in intimate relationships if we can feel like we have some power over change, and circumstances we manage much better. The key task is something along the lines of accept what you can’t change and change what you can. You can’t for example, change the fact of a divorce, or the fact that the person you are divorcing is behaving in an exaggerated form of the person you wish to divorce but you can say, what is in my power to change here? Maybe you can change your health and wellbeing activities and increase your exercise? Maybe you can reduce your unhealthy coping through drink? Maybe you can engage in random acts of kindness to strangers without possibility of reward rather than spreading your gloom? Finding all these things that you can influence and do will be comforting and help you manage better

Create ritual and structure

Ritual during change is a key strategy that humans have developed through time to help manage the distress of change and unpredictability. Rituals allow us to ascribe bigger meaning to suffering and develop and maintain purpose. This has the impact of reducing both anxiety and crucially depression through loss of meaning. We are meaning making machines and we invest meaning into our relationships with others and if they change, we can lose that invested meaning… but by transferring that to something bigger we can reduce the depression relapse in our functioning. It’s unlikely that your situation has never been experienced by any other human ever before, in fact, millions will have experienced it. Doing even a cursory search you will be able to find how others through common cultural expression have developed meaning in change. You can adapt these to meet your needs.

Compassion and kindness to self

Listen to John Lennon, “whatever gets you through the night is alright” – projecting compassion reduces stress in yourself and improves everything around you—but that compassion has to start with yourself.

Read more articles by Noel McDermott.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/

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Resilience After A Relationship Breakdown
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Resilience After A Relationship Breakdown

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

Resilience isn’t a skill, or a thing that we achieve, it’s how we organise our lives on a daily, weekly, monthly and yearly basis. We can pretty much guarantee that life will throw curve balls at us. It’s not possible to insulate oneself against that, but only possible to be living in a way that means we are more likely than not to walk away from those experiences rather than be ended by them. If life is a care journey, then resilience is the safety belt. If you have never had a crash in your car doesn’t mean you get rid of the seat belt.

So what are the seat belts and the crumple zones of life?

  • Loving, diverse and honest relationships

  • General health and wellbeing lifestyle

  • Self knowledge

  • Broad range of interests

  • Growth mindset

  • Capacity to see the bigger picture

  • Basic needs met – Safety, food, accommodation

When we divorce it’s pretty obvious that some of these resilience factors will be affected. Our basic needs might be at threat and our range of relationships for instance. It may take some time to make those factors more secure, but as we can see other things factor in our capacity to survive the emotional crash. We can turn to our self care and ensure we meet that, we can ensure we keep our hobbies and interests going and not let them slide, we can focus on healthy living by ensuring we exercise and eat properly. 

The fundamental lesson of resilience is that it is achieved via a network of intersecting behaviours and attitudes that don’t work alone. Again thinking about a car crash, the force of the impact is spread through the whole of the car’s system. The crash is spread around the car and therefore is more survivable. The car might end up a right off, but we can walk away. 

Why does having a growth mindset and seeing the bigger picture help?

Studies have shown that one of the useful effects of spiritual beliefs in life is a lesson that it inspires us to go through and experience rather than succumb to it. Believing in the big picture that struggle is an important teacher of growth reduces the risk of depressive collapse or anxious avoidance. It’s not necessary to have a specific belief system but simply to believe that life is not out to get you! As Churchill is ascribed to have said, ‘if you find yourself in hell, keep going’. This ability to keep going and take action is crucial in resilient living. Resilience isn’t a feeling state, it is keeping going. 

What about self knowledge?

It’s not about what you know about yourself, your own personal diagnosis of yourself that is important, but the skills around thinking and behaviour modification that you used to develop the knowledge. Ford used to cream off the top history graduates every year to join their corporate management structure, not because of the knowledge base of for example Tudor Kings and Queens, but because of the skills in dealing with complex information sources and making some sense of that. Similarly in terms of self knowledge it’s not what you know about yourself but the skills you have in continuing to know yourself as you go through change; a personal form of self reflective practice. 

Maintaining your health and looking after yourself should be self evident as a useful thing to do during stressful times of change, but let’s make it easy:

  • Maintain healthy eating habits as much as possible but also be compassionate if you comfort eat. Eat to a timetable not to feelings of hunger or not. Stress messes up your appetite, so use your diary not your feelings.

  • Stay hydrated with water, not wine!

  • Rest and sleep, if you can’t sleep then rest. Maintain good ‘sleep hygiene’ (search that term).

  • Exercise, preferably outdoors if you can manage it.

Above all, be compassionate to yourself and try to say nice things to yourself in your head as much as possible. If you can’t think of any then search for positive affirmations and use some of those lists.

Read more articles by Noel McDermott.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/

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Managing Relationship Problems During the Festive Period
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Managing Relationship Problems During the Festive Period

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

Christmas is a stressful time of year and if there are any underlying vulnerabilities which are not managed then they are likely to surface and this is true right across the board. During this time we see many relationships under pressure and tensions increased. Divorce Monday is a term coined by the news media and oddly enough by divorce lawyers on their websites and it refers to the rise in enquiries to divorce solicitors on the first working Monday after the festive season. The key take out is that external factors play a huge role in our intimate family relationships and the festive season can be full of these challenges.

Some people hold onto a fantasy that everyone will somehow do their bit and pitch in to make it a special time of year. In fact our capacity to do that is often paradoxically severely reduced at this time of year and we need to be realistic about that and plan accordingly.

There are many factors that can lead to this overload of one’s capacity to cope and may include:

  • Expectation versus reality, if expectation is too far away from reality then there will always be problems
  • Financial pressures
  • Problems with extended family members that can’t be managed by not seeing them
  • Alcohol over-consumption
  • Pre-existing vulnerabilities reactivated or triggered by the festivities
  • Winter blues

It’s not surprising then that relationships can crack at this time of year as often it may be the case that couples struggling in their relationship have developed coping strategies for stress that activate defensiveness in their partner and vice versa. A vicious cycle that can’t operate the first rule of a relationship surviving challenging times. That rule is it’s not the relationship which is the problem it’s the situation. For example, if you don’t have money to cover bills it is a problem that will make you feel bad. Often we can end up blaming ourselves and our partner for the bad feelings rather than accepting that the bad feelings about the financial problems are to be expected. Getting help to manage those feelings is the key. This is the rule for all real world stresses and understanding that Xmas is a real world stress goes a long way towards accepting and forgiving ourselves and our partners for finding it challenge. This is called normalisation. It’s normal to feel loss at the death of a loved one, it’s not an illness or a personal failure. It’s equally normal to find Christmas stressful.

Accepting this idea leads to the next very important skill which is to not take this stress and the reactions of others to it so personally. It’s a big ask but accepting that your partner has coping strategies you find difficult but are not actually aimed at you personally to wind you up is a very useful skill. There is a caveat here which is true for all relationships. that those strategies are non abusive. If they are abusive then seek professional help and get advice on leaving your partner safely. The more you can depersonalise these issues the better, it’s akin to the mindful observer position. Have interest in what you see but don’t attach to it.

The next major task is to ditch expectations of what Christmas should be like in your situation and work with what it is like. For example there is no possibility that the member of your family/in law’s family that has always gotten drunk and started an argument and will not do it this year. Not unless they became sober since last year, attend AA and have had loads of therapy. The task is not to hope for a miracle but to plan for the risk they present and manage that risk. Think of it in this way, crossing a road requires you to assess risk of being run down and manage that risk by crossing in a manner that is safe. So let’s say you live on a quiet cul de sac, it’s unlikely the risk of getting run down is high and so when you go out the door to visit a neighbour you might do a quick visual check for a bike, but if outside your front door is a busy trunk road you are probably going to find a crossing and use that to go visit your neighbour on the other side of the road. So with that drunk angry person, ask yourself what level of risk are they? Can they be passed around and the emotional load shared, can they be packed off in a cab at the point they become unpleasant or indeed do you need to say they can’t come?

So what can we do during this time of stress as individuals?

  • Get outside as much as possible, both as an individual as a couple and as a family. Nature heals, your park as much as a local coastline walk. It’s called the biophilic effect and is evidenced to reduce stress and promote a sense of connectedness
  • Exercise is the single biggest effect on wellbeing we have. Keep regular activity in your life
  • Step back emotionally and practice managing reactivity. Try not to amplify any highly expressed emotion
  • Keep perspective. It’s normal to feel stress at this time and this is time limited
  • Program in time with friends who don’t cause you stress

Another useful skill is learning how to forgive yourself and learning to meet your emotional needs for support. You are reading this because you care enough to feel responsible for making things better. There are things you can make better but also things you can’t. You are a good person trying their best to improve themself and the situation of others. You work hard to love your family and make them feel special. You are their Christmas, your love and desire to be there for them is the best present you are ever going to give them. You can’t and shouldn’t try to make things perfect just try achieving something that is good enough. Good enough is good enough”.

Read more articles by Noel McDermott.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/

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Mental health first aid after a break up
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Mental Health First Aid After A Breakup

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

‘Mental health first aid’ is a term that is most often used in workplaces and it’s also a form of training you can take: like all first aid it is about recognising signs that someone needs help, stabilising if any immediate risk involved and getting professional support to the person as soon as possible. In the context of a breakup, it’s likely that a friend or indeed a colleague at work of the identified patient (you if you are going through the breakup) will be the first aider. It’s often difficult for the person affected to recognise they need help as a part of mental illness is lack of insight into being ill. So, the first step for anyone is to alert their network to the fact they are going through this. This can be difficult as you may be experiencing shame or embarrassment about the ending of the relationship and not want to talk about it, but it’s crucial to alert folk to your situation.

Thinking of the first aid analogy, going through a break can be seen as analogous to organising a major event where one of the first things you would do is ensure you have first aid, ambulances etc on standby as you know it’s much more likely for people to hurt themselves in these situations. A breakup is of the three major life transitions that can lead to what is known as transition shock. The others are:

  • Moving home
  • Changing job/change in economics
  • Changing intimate relationships

Depending on what the circumstances you are in, it maybe that a breakup involves a number of these transitions simultaneously. All of which is to say that just like medical attention, first aid is more likely to be at a public event, it is part of the risk planning, so you should be realistic that your psychological distress may move into mental health needs. So, the first tip is risk assessment and risk management just in case you need help alert others to what is happening.

If you have a previous history of mental health problems, you need to realistic about the higher risk of a relapse in the condition during the transition, whatever that condition such as anxiety, depression, addiction, eating disorder etc, especially in this context as major life transitions produce significant stress reactions which are triggers of mental health problems. As part of your risk management, you may want to think about prophylactic interventions such as medication before you become symptomatic, or increasing your attendance at support groups if you are in recovery or restarting some evidence base therapy.

As a possible patient ensuring you engage in general good health and wellbeing practice is crucial. Start with the insights from Lifestyle Medicine ensuring you have the 4 corners of health and wellbeing in place:

  1. Exercise/active life.The single biggest health improvement you can make is to have regular exercise, ideally 3 times a week for 20 minutes, raising your heartbeat is what you want to aim for, anymore and that’s a bonus!
  2. Stress management.Relaxation and stress management are crucial to physical and psychological health. Stress is implicated in all major lifestyle illnesses and every manifestation of psychological distress. Learning to spot and reduce stress reactions is central to living a healthy life.
  3. Diet.Having a heathy balanced diet contributes massively to a healthy mind and body. Try to reduce processed foods, eat a mix of 80-20 vegetable and fruit to meat, control portion size and reduce sugar.
  4. Sleep.Good sleep hygiene is essential to healthy living. Sleep deprivation is a form of torture due to the psychological consequences of missing REM sleep cycles. So, practice good hygiene in your sleep habits; don’t drink alcohol or other stimulants at night, exercise, have a simple and regular bedtime routine, reduce blue screen activity at night and don’t use your phone in bed!

If you are the possible ‘first aider’ it’s important to feel confident in being a little nosier than you normally would. Don’t be afraid to ask your ‘patient’ about their symptoms, at worst you will get a grumpy response to leave them alone, but mostly you will get thanks for being solicitous. What are the types of symptoms that might indicate the need for signposting or referral to professional help?

  • major sleep disturbances
  • significant changes in outlook
  • significant changes in appetite or eating patterns
  • increase in alcohol use
  • dysregulation (anger aggression etc)
  • low mood
  • thoughts of being a failure and a burden on others
  • lack of concentration, stopping and forgetting tasks
  • emotional lability

Any one of them at low levels is to be expected, but it’s about poly symptom, intensity, and duration. If there are several at the same time and they hang around for more than a few days or if they are very intense it’s time to ring the alarm bell. So, what can you do?

  • Give your patient a good listening to. Learning to actively listen to someone without judgement is more often than not the most helpful thing you can do. Unburdening ourselves reduces our isolation and improves our mood, allowing us to make better real-world decisions to improve our circumstances.
  • Signpost and follow up. Know what the services are available in your setting. If you are work colleagues have a chat with your line manager and ask what EAP exists and how that can be accessed for example. If you are a friend, maybe scope out support groups and offer to chaperone? Maybe ask if you friend has talked to their GP?
  • Why don’t you get mental health first aid training?
  • If you have very serious immediate concerns for the safety of your friend/colleague or someone they care for, then contact emergency services who can intervene to take them to a place of safety for assessment and treatment if needed (for example of you ask them how they feel and they say they want to kill themselves and they have it planned out/methodology/timescale dial 999)

Mostly what we all need is to know someone has got our back and is willing to be a buddy in times of stress, and that doesn’t need loads of training, it just needs a big heart, open ears, and mostly closed mouths that murmur support.

About Noel McDermott

Mental health expert Noel McDermott is a psychotherapist and dramatherapist with over 30 years’ work within the health, social care, education, and criminal justice fields. His company Mental Health Works provides unique mental health services for the public and other organisations. Mental Health Works offers in situ health care and will source, identify and co-ordinate personalised teams to meet your needs – https://www.mentalhealthworks.net/

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Infidelity - Everything you Need to Know
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Infidelity: Everything you Need to Know

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

The first thing to understand is that infidelity is a lot more common than is thought, it is believed that about 25% of men are thought to have extra relational affairs, and about 15% of women. There are biosocial reasons for this behaviour in humans, common with our nearest social animals such as chimps etc in terms of seeking a healthy gene pool.

We are all familiar with the apocryphal stories of the kings and queens of yore having sickly babies due to inbreeding, which doesn’t help if you are the victim of a cheating spouse, but it does help to make a distinction between normal cheating and abnormal cheating and it should be pointed out that the 25% and 15% are not the same group of people but it’s at any one time.

We may all at some point be the perpetrator or victim of this scenario and really should head the adage around stones and glass houses. The decision about whether you stay with the partner who cheated will largely depend on the circumstances of your relationship.

If you decide to end the relationship it’s unlikely it will be due to solely the infidelity, but that will be one of the factors and maybe the most important of the factors that mean the relationship is unsustainable. Why this is important is for several factors that will mean you can move on cleanly and not bring this dynamic into you next relationship. Crucial to this is to normalise the experience and to take some power of decision making and authorship.

Allowing oneself to experience the infidelity as an event which turns us into a victim disempowers and possibly sets up a situation in which you will blame yourself inadvertently for the cheating of your partner.

You will ask yourself what is wrong with me, rather than what went wrong with the relationship or with the situation and in thinking about what was wrong with the relationship it’s not, ‘what was wrong with the relationship that led to the cheating’ as this is another trap, but what was wrong with the relationship that I didn’t want to or couldn’t forgive the infidelity?

In relationships we forgive because we want that person in our lives, and we refuse to forgive because we want them to go.

As much as possible we want in this situation to move to a place where we can accept it’s an event that happened, that happens to many people, and it was the last straw. The effort involved in repeating the rupture wouldn’t yield enough return as there were problems anyway. We move from being potentially the victim of a soap drama to someone who has had a challenging life experience who wants to move on and heal.

Being able to reframe in this way does mean we are very much less likely to be processing the experience in our next relationship, and by processing, I mean carrying dumping the baggage from the infidelity into the next relationship.

During this process of ending and moving on it’s going to be important to avoid those folk in your network who feed on drama. Even though this may feel tough at first, it’s important to have voices in your life that ask you to be reflective, avoid dramatising the situation, try to normalise it, look at the bigger picture, look at your part without self-blame and at what you gain from moving on, above all avoid angels and demons.

Angels and demons are simplistic, black and white, infantile ways of thinking about people and life. Life and people are complex and muddy and there is good and bad in all of us.

It’s important to look at abnormal cheating and by that, I mean cheating that should not be normalised. This will tend to be of the serial nature and often the person doing it will have other issues, such as drinking, substance problems and for sure intimacy issues.

Generally, the partners of the type of hyper-sexual person will experience significant harm over time due to the range of manipulations, the love bombing, the lying, the intimacy problems that lead to attachment issues and self-doubt in the person being cheated on. You will be very likely to need professional help to deal with the damage done in this type of situation as you will have been living with someone with a chronic relationship problem.

Often the partners of the philanderer in that type of situation will experience significant trauma and need help to overcome it. As the partner there is little you can do to change them, in the same way you can’t change an alcoholic, unless they do the work to get help and stop.

You are better off getting out of an unhealthy situation and seeking help to ensure you don’t carry the damage with you.

Read more articles by Noel McDermott.

About Noel McDermott

Noel McDermott is the Founder of Mental Health Works Ltd. He has created unique, mental health services in the independent sector. Noel’s company offer at-home mental health care and will source, identify and co-ordinate personalised care teams for the individual. They have recently launched a range of online therapy resources to help clients access help without leaving home.

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Mutual Parenting After Divorce: Putting Children First
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Mutual Parenting After Divorce: Putting Children First

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

It’s clear that staying together for the sake of the kids is no longer something we believe in.

In the UK, divorce rates are high (42% of marriages end up in divorce), and this is not likely to drop.

The question is then, what is best for our kids?

As a general rule what we do is more important than what we say and indeed much therapy in relationships is about getting people to look at actions not words; in our actions are our truths. This is never more so than in our parenting practice.

Modelling healthy behaviours around relationships and relationship breakups is of vital importance for our kids.

Children see a lot more than you think and see much less of what you imagine.

They are egocentric and look for their needs to be met. Around their family the core needs are, love, consistency and them being central to family life. The advice that follows relates to situations in which there is no danger to yourself or your children from the behaviour of your ex, such as situations of domestic abuse.

Safety of yourself and your kids are the most important issues there and the best thing you can do is get police and legal help to get away safely.

Putting Children First

If you are going through a breakup with your partner and have children, the key rule is to organise the breakup in a child centric way, to ensure you put them first during the process, that their needs for love and safety are met. Not by saying that it is important, but by showing it is important.

Some golden rules in navigating a child centred breakup:

  • Never trash talk your ex or soon to be ex around your kids.
  • Don’t put your children in a position to have to make choices about who they can be loyal to.
  • If possible, show affection and kindness to each other in front of your kids, even if this is painful. Maybe agree a script and touch boundaries.
  • Be honest with your kids about being sad about the breakup if that is true for you but explain that this happens between adults.
  • Try, if possible, to have ‘family’ events.
  • Think about blended family events if one person has another relationship.

Keep communication going

In parenting the key thing is ongoing communication between the parents and this is even more important between co-parents who are not sharing a physical home together.

A very close second to this is parents not undermining each other or allowing themselves to be played off against each other. Kids need consistency in the parenting they receive, and a breakup is no reason to fall down on this. It’s maybe better to rid yourself of the idea that you are breaking up because in many ways you are not. You will have a couple relationship for the life of your kids even into their adult relationships, but the boundaries will shift away from the sexual intimacy and house sharing for example. Although that is important to you, it shouldn’t have much impact on children if you maintain a loving and friendly co-parenting relationship.

There are key messages in all of this for your kids which are crucial for them for the whole of their lives:

  • They remain the most important thing in their parents’ lives.
  • Their parents are able to put their needs first and as divorce and breakup is likely for them, they can use this modelling in their later lives with their own kids.
  • Love relationships can survive change and remain healthy and strong when the boundaries change radically.

Successful co-parenting

The evidence for successful co-parenting is beyond challenge these days and if you manage to navigate it successfully there will be no damage to your children’s’ life outcomes.

Whilst divorce is still listed as an ACE (adverse childhood experience), it is more about how the divorce is navigated and it’s more correct to say a messy and acrimonious divorce is an ACE.

About Noel McDermott

Noel McDermott is the Founder of Mental Health Works Ltd. He has created unique, mental health services in the independent sector. Noel’s company offer at-home mental health care and will source, identify and co-ordinate personalised care teams for the individual. They have recently launched a range of online therapy resources to help clients access help without leaving home.

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How toxic masculinity and femininity can affect a relationship/marriage.
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How Toxic Masculinity and Femininity Can Affect a Relationship / Marriage

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

Toxic masculinity is discussed in mainstream media quite a lot having migrated from a narrow academic interest in gender studies course and come to cover a range of problematic behaviours around rigid gender roles.

In 2018, the American Psychological Association issued the first ever guidance on working with men and boys and issued alongside its guidance on working with harmful masculinity and violence. This is key to understanding the current situation and the focus on toxic masculinity.

In general broad-brush sense (excluding nuance of gender identity), men are socialised into acting out their psychological distress in aggressive and violent ways and women acting in distress in self harming ways. This is still pervasive.

Alongside this is the psychologically and therefore relationally destructive socialisation of unhealthy masculinity beliefs around denial of psychological distress, refusal of emotional intelligence and help seeking viewed as a weakness. Society is still largely structured on the notion that men provide rather than nurture.

In the UK, which has many dual income households, structural inequality still means men’s salaries provide the majority of a household’s income. These structural issues reinforce gender stereotypes.

Toxic femininity doesn’t really exist as a term but in this formulation could be understood as the ‘self-harm’ side of unhelpful female modelling and expectations. So, whilst men face most of society’s violence as victims and perpetrators (including being victims of suicide) women face eating disorders, high levels of anxiety and depression, direct self-harming behaviours, carer and financial struggles and of course male violence to women, especially rape.

It’s easy to see how extreme issues would negatively affect any relationship but it’s important to understand that all these issues exist on a spectrum of severity and in most cases don’t manifest at the early stages of a love relationship in extreme forms. They tend to emerge over time becoming more chronic with the stressors of life.

Intimate partner violence, for example, rarely starts when you are dating.

More often it is controlling behaviours and inflexibility that become more intrusive over time. In fact, it may not develop into violence at all but becomes normalised in the interaction creating high stress levels and fear, the so-called walking on eggshells to avoid triggering your partner. It may manifest in lack of attention, controlling through withholding and withdrawal to punish etc. Over time these destroy intimacy and safety, leading to significant psychological and other health issues.

One of the core needs we have as social animals is safe, predictable, loving relationships to form resilience in the face of life’s challenges. There is a very harmful view of resilience as coming from being exposed to threat and challenge, and in fact the opposite is true. We can demonstrate we are resilient by getting through challenge well, but the resilience predated the challenge and formed because of kind, loving, consistent relationships. Resilience is a consequence of strong attachments to other stable people where we can share our vulnerabilities.

Our social (animal) nature is what gives us the edge in terms of survival, allowing us to live in very complex social structures that mean we can combine skills and abilities for the greater good, what in general is termed prosocial behaviours and activities. As a matter of fact, the more prosocial we are the healthier we will be on all levels; psychologically, physically, financially, and relationally. Unhealthy masculinity in many ways promotes anti-social behaviours and attitudes.

Lacking resilience because of our lack of ability to form or maintain loving relationships will lead to developing unhealthy and unhelpful coping mechanisms, generally increasing our antisocial attitudes and behaviours. For many men this will look like withdrawal, rejection, substance misuse especially alcohol, hyper-sexual behaviours and cheating, or aggression and violence.

Unhealthy masculinity does not allow men to say, “I feel lonely, lost, broken” even though these are perfectly normal things to feel in life at times. The anti-social nature of the coping behaviours leads to a vicious cycle of greater isolation and rejection reducing resilience further.

Again, these things develop over time and one day a straw breaks the camel’s back with the relationship seeming to suddenly implode. The male in this situation is unlikely to learn a lesson from this and will often go on to find another partner to repeat the same mistakes or being unavailable and anti-social.

Children witnessing and experiencing this can find it very challenging and especially male sons.

Since the 1970’s mothers and daughters have been coming to terms with seismic changes in society and in what it is to be women with many daughters of the 70’s / 80’s etc feeling they had to reject their mums to be liberated. The current generation of women maybe not having to go through this pain.

Younger male adults and young men are having to face a world which is very different to the one their fathers grew up in requiring a new set of tools. Many fathers are ill-equipped to deal with these changes, unable to offer insights into their sons’ challenges in life and relationships. Many of course have adapted but sadly attacks on these adaptations are rife, with men being called ‘snowflakes’, or being attacked in the media for carrying their babies in carriers on their bodies for example. But many young men feel they have to reject their dads so they can have relationships that last or to thrive in a work world that is increasingly demanding of prosocial group work. There are very public relationships in which sons have clearly made these decisions leading to camps forming in support or in attack.

The social changes we seem to be witnessing in terms of the reformulation of many masculinities is unlikely to be smooth, but it is certainly needed.

About Noel McDermott

Noel McDermott has over 25 years’ experience creating unique mental health services in the independent sector and is considered an expert on mental health in the workplace, he is also the Founder of Mental Health Works Ltd.

Passionate about bringing high quality care and support to the vulnerable, he is an advocate of community care and the power of an at-home mental health care model that includes the affected individual, their family, and their workplace.

Well-known to the UK media, and regularly featured on channels including BBC Local Radio, 5News, LBC and SKY News, Noel also produces and presents The Well-Being Show, a weekly live podcast where he is joined by guests sharing stories on mental health issues.

Noel’s areas of expertise include mental health, addiction and recovery, trauma, social care, distance therapy, childcare, refugees, personal development and emotional health and wellbeing.

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pursuit of healthy love
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The Pursuit of (Healthy) Love Post Divorce

Published on
Noel McDermott
Noel McDermott
Founder
Mental Health Works Ltd

The first thing to do is to give up thinking that there is a simple rule book for life or relationships as there isn’t and the desire to have one might suggest anxiety about taking risks.

Life involves taking risks and if you are not taking risks then you are not living, this is especially true in terms of love relationships.

Miss Haversham from Dicken’s Great Expectations serves as a lesson in what in grief therapy we call mummification, this is the process where we try to avoid the process of loss and moving on.

Mummification being what happened to the bodies of the ancient Egyptian Pharos so they would live forever; what it does is stop the natural process of decay, change and growth, this natural process is needed when a relationship ends.

Learning to move on

Another thing to look at is if when people move into a new relationship, they still try to work through the problems of the previous relationship, it’s another way of refusing to accept the loss and move on and this can be a crucial issue.

It’s more than possible to grieve the loss of a relationship that you are already in.

In fact, for many people this is the case and the formal ending through divorce is akin to the funeral rites. Obviously when burying someone they are already dead, and the funeral is there for the living.

Extending the metaphor, the way we respond to that loss, an actual death will depend on what our relationship to the deceased was and how we experienced their death and to some extent how they died.

The level of shock at the loss complicates the grieving process and we may well stay in the denial phase for a long time as we numb to avoid the pain.

Learning to let go

There are similarities to this in intimate relationships that don’t end in death but end in divorce.

So, the answer to the question of when one should start a new relationship is often linked to how the previous relationship ended and the nature of that relationship.

Let’s look at a divorce that happens after a couple have gradually grown apart and ends with mutual understanding and rational split of resources and responsibilities if there are children to co-parent. Clearly both parties will have come to terms will the situation already and can start and in many cases, will have started another relationship.

In a situation where a divorce occurs after one partner was abusive, or carried out secret affairs, there will be a significant amount of emotional baggage to process. This is probably best done in singleton, which is not to suggest you shouldn’t have intimacy, but is to suggest the capacity to have long term stable intimacy with another will follow on from doing the repair work on oneself.

Do engage in dating and having liaisons if you wish, this may be very helpful in retrieving aspects of self-esteem but be very thoughtful about what is known as rebound.

Where there is a lot of stress, fear and anger involved, letting go and moving on is always more difficult.

The odd thing about love is that it confers freedom on all the parties involved psychologically. Stable attachment, which is what therapists rather boringly call love, is designed by nature to allow us the courage to explore.

The less stable the attachment the more we cling on.

Stable attachment in relationships

Stable attachment in adult-adult relationships is a two-way process and both parties need to be in a relatively stable place emotionally to give and receive in this way. This might be a useful rule in thinking about when to start a new relationship aimed at longevity and mutual growth.

As with any loss grieving a marriage takes time but the intensity of the early experience fades and as it fades it’s perfectly reasonable to get involved again. It’s probably though not sensible if the experience is still very intense or still too painful or damaging to even experience.

If that’s the case, you are likely simply to be trying to heal damage rather than love and be loved. My advice would be that healing damage is better done with a therapist rather than a love partner.

It’s best then not to think about timescales for starting new relationships but milestones or markers.

While there is not a direct correlation between loss through death and loss through divorce and whilst every experience of loss is unique, it’s useful to look at the six stages of grief to provide you with a guide to getting back to dating for the longer term:

  • Numbness and Denial
  • Anxiety and Panic
  • Bargaining and Control
  • Frustration and Anger
  • Depression and Despair
  • Acceptance and Peace

This list is a little simplistic and, in some ways, idealised, we never develop in a linear fashion as humans, but it might make a handy checklist. Clearly starting a new relationship once you have achieved acceptance and peace over the ending of the old one is the preference.

Click here for more articles by Noel McDermott

About Noel McDermott

Noel McDermott is the Founder of Mental Health Works Ltd.

Noel’s company offers at-home mental health care and will source, identify and co-ordinate personalised care teams for the individual. They have recently launched a range of online therapy resources to help clients access help without leaving home www.noelmcdermott.net

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