I recently listened to Rebecca Brown give an account of her experience living with Trichotillomania. Trichotillomania is the name given to describe an overwhelming urge in a person to pull their own hair out. This can range from a desire to pull the hair on their head, to eyelashes, eyebrows and other types of body hair.

During the interview Rebecca speaks of feeling the urge to pull her hair out whenever she felt stressed or upset. This behaviour began at a young age and escalated to her pulling large clumps of hair out in her teenage years, resulting in patches of baldness on her head. Chartered Psychologist Jane McCartney explained how pulling strands of hair out releases endorphins into the body, the sensation of which can feel very satisfying for the person with this condition.
So what triggers Trichotillomania? Trichotillomania is largely recognised as an anxiety related condition. The release of endorphins brought about by pulling strands of hair out can momentarily relieve a person from feelings of stress and anxiety. At the same time however, developing a condition such as Trichotillomania can often fuel and increase feelings of anxiety and associated feelings of shame and guilt as the person recognises the effects of hair pulling on their appearance but still finds it difficult to stop. The person can feel trapped and isolated in a vicious circle.

Anxiety is a feeling that is likely to have been experienced by all of us at one time or another. Most of us can identify with feeling nervous and anxious before an exam or driving test, or even before a rollercoaster ride at a theme park. The degree and severity of anxiety experienced by a person is the difference between what can feel reasonable for the situation compared to an overwhelming sense of anxiety which can feel all consuming and debilitating; a barrier to getting on with our everyday lives. It is this type of anxiety that can lead a person to seek professional help and support in the form of psychotherapy and counselling, and therapies such as Cognitive Behavioural Therapy.

Dealing with anxiety is often not about trying to get rid of the feelings of anxiety all together but learning how to manage anxiety so that is doesn’t become life altering and debilitating. Of course with any form of counselling or therapeutic support there will be some exploration of what is triggering the anxiety. In my experience, through discussing the thinking behind the anxiety and challenging problematic thought patterns, many people comment on feeling less anxious as they develop alternative ways of thinking.

Managing anxiety can incorporate finding alternative ways of behaving; replacing unhelpful activities one might do when they feel anxious as an attempt to relieve the feeling, with something that will prove helpful in relieving the anxiety but that won’t be harmful to the person. An example would be helping a person to find an alternative activity to cutting themselves when they feel anxious.

For Rebecca Brown, she finds that having a ‘tangle toy’ provides her with a distraction to pulling her hair.  Jane McCartney comments on the benefits of having something like a tangle toy as being that it occupies the hands meaning that the hands aren’t needing to be occupied by pulling hair.  As an adult, Rebecca also has items of jewellery with similar properties to that of a tangle toy.  One of the benefits is that such items look discreet and age appropriate.

Finding alternative activities that will help to release endorphins into the body is a helpful alternative to an activity that involves harming oneself. Activities such as exercise, particularly more vigorous forms of exercise such as punching a punch bag or kickboxing, all release endorphins into the body and can help to relieve symptoms of anxiety such as stress and muscle tension.

To listen to Rebecca’s interview go to:
http://www.youtube.com/watch?v=ciEo8zC6B6A

To follow Rebecca’s in-depth journey with Trichotillomania then take a look at her TrichJournal at:
http://trichjournal.tumblr.com/

Further information about Trichotillomania can be found at:

http://cognitive-behavior-therapy.com/trichotillomania/

http://www.nhs.uk/conditions/trichotillomania/Pages/Introduction.aspx

http://www.trich.org/treatment/resources-articles.html#success

Mind and Soul provides further information about mental health including details about self harming behaviour. For details go to:

http://www.mindandsoul.info/Articles/279837/Mind_and_Soul/Resources/Articles/Self_Harm_Roots.aspx

Jayne Life

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Didsbury and Chorlton counselling and therapy rooms have expanded. In Chorlton, Counselling Rooms have created an additional room to enable a greater number of counsellors and psychotherapists to see clients. This means that more people in the community have a greater chance of receiving support through counselling and psychotherapy when they need it most as opposed to waiting for support from a counsellor
or psychotherapist when space becomes available.

In Didsbury, the Didsbury Counselling and Therapy Centre has expanded to create a second centre on Burton Road in West Didsbury. The centre not only provides comfortable facilities for people wanting psychotherapy and counselling but also boasts a spacious room for various events including training and workshops for psychotherapists and counsellors as well as training for people wishing to expand their knowledge of areas of interest such as different types of therapies and their effectiveness. One of the forthcoming events at the centre is the Psychology Book Club beginning in January 2014.

You can find me at both venues for the Didsbury Counselling and Therapy Centre at various times during the week and at my therapy room at Counselling Rooms in Chorlton on a Wednesday.

Jayne Life

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This week saw the launch of another Didsbury Arts Festival. The event boasts a range of artists and talent from across the arts and always proves a success with local residents and visitors. This is the events fifth year, bringing together local, national and international artists. From poetry at Didsbury Library, a historical walk around Didsbury hosted by New Manchester Walks to live music at Didsbury Perk, the event has something for everyone whatever age. One of the things I love about Didsbury is the sense of community. Events such as the Didsbury Arts Festival really help to bring people together to take advantage and enjoy what the area has to offer.

Didsbury has a vibrant mix of independent shops, bars, eateries, tea rooms, boutiques, furniture and gift shops to name a few of its attractions, as well as plentiful green spaces such as Fletcher Moss Park and Marie Louise Gardens. I have to agree with people who say there is something for everyone. I recently took part in a discussion about what it means to have a sense of self and social identity. Something I have picked up since becoming part of Didsbury’s community is people’s allegiance to the area and how many people speak proudly of Didsbury being part of their identity.

Equally, in regards to Chorlton, I’ve enjoyed the eclectic mix of talent that an area such as Beech Road attracts. From galleries such as The House of Bystander which hosts Jack Lloyd’s photography to On the Corner’s super power juices and selection of vinyls, I love visiting Chorlton’s Beech Road and immersing myself in the vibrancy. Despite Chorlton not being a million miles away from Didsbury, I didn’t visit as frequently as I would have liked outside of my time spent at my Chorlton therapy room. Aside from driving, public transport links between Didsbury and Chorlton were not regarded by many residents as being the best. With the arrival of the Metrolink to Didsbury, there is ample opportunity to travel from any one of the Didsbury Metrolink Stations in East Didsbury, Didsbury Village, West Didsbury and Burton Road, to Chorlton. Having viewed some of the upcoming events in Chorlton, they strike me as having a holistic feel. From Zumba to meditation workshops and comedy, Chorlton strikes me as being conscious of offering attractions that also aim to take care of a person’s physical and emotional wellbeing as well as their mental health. I’m thankful that I can be a part of that by providing support through counselling and psychotherapy. Being affiliated to Counselling Rooms on High Lane, enables me to be part of a Community Interest Company, providing private counselling and psychotherapy at reduced rates to members of the community who might be struggling during difficult financial times.

Both Didsbury and Chorlton pride themselves on fostering the success of independent local businesses. Certainly in my experience of Didsbury residents, they have held strong views against allowing chain stores to open on Burton Road in West Didsbury, preferring to retain its identity and reputation of consisting primarily of independent businesses. Thinking back to the discussion I took part in recently on personal and social identity, we could argue that Didsbury and Chorlton encourage both. They promote the success of independence amongst residents; supporting and nurturing individuals to grow their business and feel successful, where independence and uniqueness is encouraged and celebrated. This in turn appears to evoke in individual residents a sense of belonging to a larger group; a community which has an identity of its own.

Jayne Life

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Having recently taken part in a discussion about bullying and its effects, hosted by ‘Mental Health Chat’ I was keen to share and elaborate on some of the main points from the discussion.

There appeared to be a shared understanding that bullying can take many forms, and can exist for both adults and children.  A common theme of what bullying actually is, centred on a feeling of exclusion.  This idea of exclusion is one that interests me and when asked to elaborate on how one might experience exclusion, there were a number of examples I could give.  The various examples perhaps highlight for us how bullying is not limited to childhood experiences.

What sprang to mind were some of the experiences people have shared with me over time and some personal memories as well.  I recalled when someone recounted to me being new to a workplace and working in a small, open plan office.  Emma had diligently got on with her work throughout her first week, hoping to impress.  On the first Friday after her first week of working there, everyone gathered their belongings and headed out for drinks at a local bar; everyone except Emma who no one thought to invite.  The very fact established members of the work team made arrangements for their evening out in the presence of Emma, without inviting her along, heightened her feeling of isolation and exclusion from the group.  Emma described feeling not wanted as no one appeared to want to invite her to join them for drinks.  Leaving work on her own as everyone else headed for drinks together, she felt depressed and alone.

Staying with work, I can recall a personal experience of joining an organisation which consisted of a great number of long standing members of staff.  All were very familiar with one another having worked as part of small teams for a significant number of years.  As part of my role I was required to manage one of the teams.  Introducing change can often be met with unrest from established members who have been used to a particular way of working.  It is one of the tasks as a manager to contain and manage members’ feelings around this.  However, what is common, somewhat ‘normal’ unrest and a period of ‘storming’ (Tuckman, 1965) soon became bullying; the aim of which was to obstruct and prevent change being made, and challenge my leadership of the group.  It is important to note here that challenge is fine.  It is how it is done and what exactly is challenged which differentiates the behaviour as bullying.  What I considered to be bullying was the ‘linking up’ of group members and a collusive ‘splitting off’ from me as part of the group.  This separate group persisted to criticise and challenge everything that I did with no reason as to why.  They abandoned their individual tasks resulting in an increased workload for me.  When I tried to address this with them they insulted me and accused me of lying claiming they had done the work that they had left.  They created stories about me which were untrue and which they shared with their colleagues in other teams who were also their friends.  As someone new to the organisation with no allies, I began to feel excluded and very much an outsider to the group.

These examples describe what some may regard as ‘mental’ or ‘emotional’ bullying.  There are also cases of more ‘physical’ bullying such as a group or ‘gang’ of school children that physically beat up and attack another young person.  We could argue that regardless of whether bullying exists in the form of what people say to another person or by someone or a group physically attacking another, the aim is to overpower and intimidate.  I would argue that it’s this overpowering and intimidation that can evoke feelings of exclusion and loneliness in a person.  In the above example of my experience of managing a group, I would argue their aim was to overpower me so that I wouldn’t introduce change; that instead I would give up trying to manage them and let them have their own way and allow them to manage me.

The longer the period of time a person is bullied, the longer lasting the effects can be.  Such long term effects can often include feelings of anxiety and depression in an individual.  An interesting point of view from some is that a person bullied is more likely to bully others.  Perhaps this is where help and support for a victim of bullying is so important in order to help an individual process what has happened and recover from the experience without exhibiting negative behaviours towards others.  This could be in the form of mentoring in school or through counselling or psychotherapy.  It is understandable why one might want to let others know what the painful experience of bullying was like by giving them a flavour of the experience themselves.  I have met many people who have said that through being bullied they made a conscious decision to be more assertive so as to try and avoid people thinking they can overpower and intimidate them.  We could argue that an effort to be more assertive is something positive to come out of the experience.  Anything positive that can come from a person’s experience of being bullied is surely a good thing, for the experience whether as a child or as an adult, can feel like a cruel existence; an existence that can feel so painful that at its most extreme has led people to take drastic action to end the suffering.

There is so much more that can be explored in regards to bullying.  Many questions have been looked at and continue to be revisited as bullying continues to exist in a growing number of forms such as cyber bullying.  Questions such as whether there are differences between how males bully and how females bully and whether it is more common among one sex compared to another.  Other questions focus on exploring the effects of bullying both short term and long term and how to tackle bullying, particularly in schools.

One thing we can probably be certain of is that bullying is unlikely to go away.  This in itself is a depressing thought.

*Consent has been used to use specific examples and names have been changed to protect identity.

References and further reading ‘The Four Stages of Group Development’ (Tuckman, 1965)

Find ‘Mental Health Chat’ on twitter at @MHchat

Jayne Life

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Having worked in specialist schools for several years, I have been reflecting on how the needs of students are met within the classroom.  Over the years there has been much debate amongst educationalists as to what kind of class grouping works best for students; whether grouping should be based largely on the students’ ability or age.  However, on thinking about meeting the needs of students on the autistic spectrum, there is perhaps more to consider.  This article aims to discuss some of these considerations and provide food for thought for practitioners working in schools.

For young people at what might be referred to as the severe to moderate end of the autistic spectrum, there are many factors to take into consideration when placing them in a class.  Many students at this end of the spectrum, described as what many refer to as ‘classically autistic’ present with attributes that can be challenging for any class group.

I have worked with many students over the years who have experienced noise sensitivity yet have generated lots of noise themselves as a result of the nature of their autism.  Their noise has appeared to increase around one another in what has appeared an attempt to block out one another’s sounds.  Such noises have included the constant repetition of phrases and sounds which have frequently accompanied ‘flapping’ and what can be described as the re-enacting of footage and clips from favourite DVD’s and computer programmes.  As a practitioner I have at times found it difficult to try and teach a group of students who are generating so much noise as individuals yet are incredibly noise sensitive to the sounds of each other.  Many have struggled to tolerate one another, becoming distressed at one another’s sounds.  As an adult who isn’t autistic I have found the noise at times overwhelming, so for students who are acutely noise sensitive as part of their autism, the experience must feel unbearable.   Indeed, this may well be the case when I think about some of the behaviours that are exhibited; students lashing out at the member of staff working with them, cowering when they see a particular student who is particularly noisy, biting their hand in what looks like frustration and anger.  We could argue that they may be exhibiting such behaviours as a result of other triggers, yet it would appear from observing the behaviour of the students and their constant desire to hold their hands over their ears, that the noise is a major contributor.

So what is the solution?  Perhaps a more mixed class grouping is appropriate.  In mainstream schools it is uncommon for students to be grouped in mixed year groups.  Some primary and early years settings offer mixed groupings however once students reach secondary age it is unlikely one would find a group of year eleven students being taught in a group with year nine’s.  However, in special schools there is often scope to group students in a way which reflects a range of factors that are taken into consideration as opposed to simply age.

Autism represents a diverse spectrum of need.  It is this spectrum of behaviours and traits that I believe needs to be thought about with closer inspection.  Some questions to ask might include which students can tolerate being near to one another regardless of their academic ability?  Which students create a lot of noise and which don’t?  Which students are verbal?  If so, what is the extent of their functional language?  Which students enjoy interaction and contact with others?  It is important to note here that although there might be a stereotypical view of people with autism not wanting to engage with others, this is not true in my experience.  I have worked with plenty of young people with autism who have actively sought out contact with others, have been affectionate and have enjoyed interacting with another person.

On first thinking about how students should be grouped, it may seem an obvious choice to group several students together who are of a similar age and who present with a similar level of need and academic ability.  However, it would appear that this model results in some class groupings which offer a climate we might argue is conducive to learning, and groupings which offer the opposite.  Having worked in schools that have catered for students with a range of special needs and those which are designed specifically for students with autism, I have taught and seen a range of groupings; some have been very diverse and reflected a variety of needs and ages, others less so.  This has led me to draw my own conclusions as to what does and doesn’t work in creating an environment conducive to students learning and in particular students with autism.

Think of a large organisation or business.  There are many different roles that need to be filled, each with a different job description.  There may be similarities between roles and multiple positions however generally workplaces reflect a variety of personality types and talents.  There are extroverts, introverts, leaders and followers to name a few.  A team wouldn’t be conducive to succeeding at the task in hand if all the members had the same skills and personality type.  It’s a similar result when thinking of students learning in a classroom.  A group of noisy, noise sensitive students, who each need lots of individual support and attention, are not going to work well together in succeeding at achieving their individual targets and goals, particularly if there is a limited number of staff available to support them.  A group which contains quiet, and what some may regard as ‘high functioning’ autistic students, where sensory difficulties are less of an issue, are more likely to succeed.

So why not mix?  I have experienced teaching large groups of students with autism with a range of needs and abilities and with a limited number of staff.  The significant factors that contributed to the group working were as follows;

The majority of students were quiet and did not generate a lot of noise or flapping.

The majority of students were not noise sensitive and could tolerate the sounds and noises of some of the other students who were.

Students who made a lot of noise and flapped were in a minority.  Being in a group where the majority of students were quieter appeared to decrease the tendency to be noisy and flap in the students who did at times exhibit this type of behaviour.

Staff were more easily deployed as not every student required one to one support.  Students who did require support to help refocus them could have a member of staff working closely with them.  Students who were able to work alongside one another could be comfortably supported by one member of staff.

There was much differentiation required in the planning of lessons in order to engage each student and enable them to reach their individual learning goals.   However, students were able to sit close to one another whilst working on individual pieces of work.  The range of abilities also lent itself to small group activities and peer work.  Having a limited number of staff didn’t matter as students weren’t trying to drown out one another’s sounds through their own sounds nor were they attempting to silence one another through aggression.  Such behaviours have been apparent with smaller groups of students where the needs have been less diverse.

As mentioned earlier, this article is not intended to outline a set of criteria for what makes for a successful class grouping nor has it been written with the intent to criticise and blame in any way, schools and practitioners.  It is intended as food for thought based on my experience in the classroom.  That said, a group of students who are each noise sensitive yet very noisy themselves, struggle to tolerate one another and become aggressive, who have a limited number of staff working with them, is what we might call a recipe for disaster.

Jayne Life

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Hi, I’m Jayne Life and welcome to my blog.  I’ll be posting various articles and commenting on matters in relation to special educational needs and psychotherapy.  For starters, check out my article on discussing noise sensitivity in children with autism titled ‘Volume Control’.  Also, earlier today I was interviewed about Pica – a condition that affects many children with autism.  You can watch the full interview on Granada Reports tonight at 6Pm on ITV.

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