It's a pleasure to introduce our new talk by Rachel Freeth - 'Who are mental health services for? A Psychiatrist’s perspective', which explores the current context of mental health services and some of the implications of this.  We have used Facebook to host the video but don't worry, you don't have to be signed up to Facebook to see it on the platform!

Facebook: https://www.facebook.com/TAPLimited

If this talk has peaked your interest, Rachel's book - 'Psychiatry and mental health, a guide for counsellors and psychotherapists', is currently available at an introductory price on PCCS Books website by clicking here:

Psychiatry and Mental Health: a guide for counsellors and psychotherapists

or join her at her next Online Conference here

It’s October 2020 and the Covid-19 pandemic continues to devastate families across the world. Here in the UK most shops and facilities have reopened but we are witnessing an increase in cases again. However we now see people in conversation on the street, seemingly more relaxed about meeting others but still mainly social distancing.   
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From my own experience one of the first question asked on meeting someone is `How are you?` This might be genuine concern for the other’s well being or a testing of the water as to whether it’s safe to converse with this individual or should we leap five paces back and put on our space helmet.

How are you? Is a question that is used by millions of people every day since King Arthur enquired about Guinevere’s headache?  However it’s often asked in a superficial, shallow way just as a means of breaking the ice in a conversation. In the counselling world it’s a genuine and meaningful question that provides an insight to the client’s world but often the reply is guarded, stilted and vague.  Here are some examples of how we might reply to `How are you?` and what actually might be being said.  

`I’m ok`
If you had just had a meal at a restaurant or pub and someone asked how you enjoyed it and you said it was `ok` what would that say about the meal?  `I’m ok` often shuts down further enquiries.
 
`I’m alright`
You have just had your living room decorated and your friend asks if you are pleased with the result, to which you say `it’s alright`.  `I’m alright can also shut down further dialog on the subject of `you`.
 
`I’m fine`
Short sharp response to a question about your wellbeing. Discourages any further discussion about how you are. Can be used to cover up one’s real feelings.  FINE is a well known light hearted acronym in the counselling world, often seen as - Feeling Insecure, Neurotic and Excitable or similar. 
 
`Not bad`
Apples sometimes go` bad` so you’re saying that you’re not mouldering like overripe fruit.  Some honesty here.
 
`Pretty good` 
Crossing the Irish Sea can cause seasickness when it’s rough.  Other times it can be `pretty good` but still a little choppy.  `Pretty Good` is better than it could be but not as good as one may like it to be.
 
`I’ve been better`
There’s honesty here and invites the listener to enquire further as to what might be wrong.
 
`Rubbing along` or `I’m hanging in there`
This answer once again reveals that the speaker is having a rough time and invites the listener to ask for clarification.   
 
`I’m not good`. `I feel awful.` `Things are terrible`. `I’m so miserable`. `I’m really sad`.
Real honesty and openness. Saying how it really is.  Encourages the listener to enquire more.
 
Fishermen are hardy souls, sitting by lakes and canals for hours on end, seemingly impervious to our sometimes inclement weather. However, have you noticed how often you see fishermen wearing sunglasses even on dull and overcast days?  No? Well they do. And this is not some vain attempt to look like Tom Cruise in Topgun but a calculated use of technology to outwit those shrewd and cunning fish. For those sunglasses are polarised which allows the wearer to see below the surface of the water to those crafty creatures below. 
 
As therapists we do this all the time, deciphering what lies below the surface of our clients, only we don’t need to wear sunglasses or have polarised ears to do it, we just do it.  So next time we hear someone on the street asking another how they are, loiter slightly and hear what they say. Are they ok, alright, fine or something else? Are they guarded or open? Vague or specific? It’s an interesting exercise.

© 2020 David Trott – TAP Council Member