I spent the early part of last week doing a Mental Health First Aid course. This was a stretching exercise, largely because we had to delve into areas which I find uncomfortable (such as depression, anxiety and PTSD, all of which I’ve been diagnosed as suffering from) – and to some extent because some of the class exercises demanded that one of our group tell a sad or distressing story, which led to me twice dredging up incidents from my past which were painful at the time, and, it seems, are still distressing now. One of the class members couldn’t cope with the second day and vanished, hotly pursued by one of the instructors, who made sure that she was safe enough to be allowed to make her way home. However, it was also rewarding and informative, and bolstered my confidence in being able to give appropriate support to people suffering from various mental health crises. I probably need to except psychotic breaks from that – I still really feel those are well above my pay grade and need a professional!
I can strongly recommend going on such a course to anyone who has a lot of contact with people. My first draft of this said “people with mental health problems”, but frankly such a high proportion of the population suffers at some point in their lives from a disagnosable mental health condition (at least 25%) that I’m confident that anyone dealing with people regularly will find occasions where mental health first aid training would be useful.
We had a diverse and interesting group, including a bunch of police officers (one or whom specialises in talking people down from bridges or out of hostage situations and who had a wonderful line in rather black humour, which I suspect goes with the territory), some service users, some carers and a few people actually in the mental health establishment, and that contributed a lot to the benefit of the course – we had people who had actually experienced most of the conditions “from the inside” as well as having between us experience of trying to care for people with all of them.
It was therefore slightly surprising to find that it needed to be me who contributed one piece of advice, this being for anyone dealing with someone experiencing a panic attack. That advice is “don’t get between them and the door”. The rationale is this – when suffering a panic attack, it is overwhelmingly likely that the conscious mind will be overwhelmed by the subconscious “3F” reaction, which many psychologists call the “reptile brain”. The three “f’s” are fight, flight and freeze.
Freeze is distinctly the easiest to deal with from a first aid point of view – the person panicking is probably going nowhere, and you can talk to them in a calm and measured way if they aren’t in danger, or guide them gently out of danger if (for instance) they’ve frozen in the middle of crossing a road. If someone is running away, you can follow them. However, the subconscious flips between these rather easily, and particularly if there’s a strong impulse to flee, clearly getting in the way of that can very easily trip the subconscious into the “fight” reaction instead. That may also be the case if the person panicking appears frozen to you – they may be on the edge of flight, and closing off the available exit can be enough to flip them into fight.
The thing is, this is not a “press the f*-it button” reaction much of the time. Sometimes that is the case – the tide of “must do this” is resistable, at least for a time. But other times, the tide overwhelms the conscious mind, and willpower (or, more accurately, won’t-power) is just not a factor any more.
When this happens, the panicking person is, to my mind, not responsible for their actions – and those can potentially be very violent. As Frank Herbert wrote in “Dune”, “fear is the mind-killer”. In the case of someone panicking, I’d be inclined to think that the person who got in the way was primarily responsible for getting injured, at least if they had any understanding of panic.
But how about a whole society which panics? I’m inclined to argue that this does happen; it happened in most of the West, but particularly America, when communism was seen as an existential threat (and there was a particular fear-factor in the nearness of mutually assured destruction through nuclear war, not entirely unreasonably, given that 99 red balloons could conceivably have started war – a flight of seagulls came close on at least one occasion). Western governments did things to combat that perceived threat which were, frankly, unconscionable, such as propping up right wing dictators and formenting rebellion against left wing governments.
Much of the Western world (and again, in particular the States) now lives in constant fear of serious crime, such as home invasions – which, statistically, seem about as likely as lightening strikes. However, the reaction is, both sides of the Atlantic, to hand down swingeing sentences for violent crime, and in the States to cling to guns as if they would solve the problem (there is very little evidence that gun owners successfully foil violent crime, and every evidence that gun owners and their families are in more danger from their guns than they ever would be from criminals). This is not a sane response. Fear is the mind-killer.
We also have on both sides of the Atlantic populations which are increasingly insecure in relation to employment. Gone are the days when most people could be assured a “job for life” – several changes of actual job, and multiple changes of employer are now standard, and although technically employment has increased significantly in the last 30 years, most of the jobs “created” are not good jobs, i.e. jobs which can keep a family in reasonable comfort. The threat of unemployment leading, potentially, to homelessness and destitution, is far far higher now than it was when I first looked for a job in the 1970s. People generally are scared, and perhaps rightly so, as statistics show that most of us are at most three pay checks away from destitution.
And, of course, scared people do stupid things (fear is the mind-killer). They fix on immigrants as the cause of their job-insecurity, for instance, despite evidence that immigration actually contributes to the economy (after all, the immigrants are going to spend significant amounts of their money in our economy, not the one they’ve left). They decide that government regulations are holding us all back, rather than protecting us (mostly, the second is the case); those two factor were big in both our Brexit decision and America’s Trump decision. Those in government are not immune – instead of protecting people against destitution, they fix on austerity as being the solution to all our problems, and thus deepen insecurity for everyone who is not in the top 10% – and they so capably sell the same message to the rest of us that we actually vote them back into office.
We are a scared and anxious people, and the news media seem calculated to keep us that way – or, perhaps, it’s just our own fascination with death and disaster, as good news doesn’t seem to sell papers…
With this background, I am less than ecstatic to find Trump posturing against North Korea – or, at least, I hope it’s just posturing. The trouble is, making excessive threats is the action of a scared person. The USA has at least 7,000 nuclear weapons, and the idea that an unfriendly power might acquire one or two should really not be all that worrying, unless they are totally insane. Or, of course, very scared; fear is the mind-killer, and either Trump or Kim Jong Un might, conceivably, be very scared, and therefore very stupid. If either were to use nukes against the other, there would assuredly be retalliation, and there is really no way of knowing what other players would then do…
In the lowest days of my depression and anxiety, I sometimes found myself repeating over and over again the 23rd Psalm, and in particular the words “Yea, though I walk through the valley of the shadow of death, I will fear no evil”. Readers who are keener on SF and fantasy than on religion might just go with Frank Herbert; “I shall not fear, fear is the mind-killer”.