Tag: mental-health

Who Are You? – I really wanna know

Me, My Self, and I

Who are you? That’s easy! I am me. I am myself. Ok. And who is yourself? Myself is what I think and how I feel.

What do you think? That depends. Sometimes I think this and sometimes I think that. And sometimes I reflect and change what I think. So, what you think isn’t fixed. It is changing all the time.

And how do you feel? Well, sometimes I’m happy, sometimes I’m sad and most of the time I just am. Ok, so at different times you think and feel differently? Yes. And at different times you think and feel more like yourself than at others. Yes, ok. Now and again, I do something I didn’t expect. This can be really good or, unfortunately, it can be really bad. But usually it is ok. What about when you feel tired? Yes, I don’t feel like my usual self. And sometimes you may feel unwell or be suffering from an illness. Yes, then I don’t feel like my usual self. But what is ‘my usual self’? And aren’t you changing all the time? In some good ways I would very much hope that I am.

From this you could say that there isn’t one fixed thing that is myself or indeed any one thing that is The Self. In other words, there isn’t one set of thoughts and feelings that defines who I am. Yes, there are the thoughts and feelings that I have and those that I don’t have. Some are desirable, some are distressing. Some are fleeting and some can last pretty much a lifetime.

These are the sort of responses we come up with when we consider who we are. Theorists go further talking of a Self that explains who we are and how we come to think and to feel as we do. This Self varies from theory to theory. There can, for example, be A True Self and A False Self (Winnicott, 1960), or an Authentic Self (Joseph, 2016) and a Shadow Self (Jung, 1951).

Further terms are introduced to describe how our Self exists in the world around us. Acting Out (Freud,1920), for example, may be used as a way to achieve something we desire while clearly not fitting with our actual thoughts and feelings. And Masking (Goffman, 1956) may enable the person to fit in with who they are with and the circumstances they are in without showing how they actually are in that situation.

Let’s follow this lead and say, at least for now, that the True Self is the desirable state: the way we want to be, doing the things we want to do, being with the people we want to be with. Would anything that deviates from this state be evidence of falsity and, perhaps, the presence of a False Self? At least from the theory this would seem so. And this covers a pretty big range of behaviours that on this reading would need to line up if we are to truly be ourselves.

From this you can begin to see why both in theory and in practice the emphasis has been on the false, the inauthentic, the mask and on whatever it is that lurks in the shadows.

Now surely the purpose of therapeutic enquiry is to bring about healing through understanding what has gone wrong.  So, it’s hardly a surprise to find that therapy often begins with questions as to how and why things have gone wrong for the person. And the usual, the commonplace and the satisfactory are marginalised or, worse, left unconsidered.

This would suggest that the literature and the subsequent practice focusses on the exceptional and perhaps takes the usual as a given. And I’m not sure that such theorists and practitioners would be entirely happy with such an assessment of their work.

For example, The False Self is often presented as a defence to keep out the undesirable or what is harmful. This results in you having to put up with the current situation in order to fit in or to comply. In other words, to meet our needs in difficult circumstances and to take care of ourselves where others are absent or are not fulfilling their relational role. It’s not great but it’s the least bad option.

Often such adaptation works. It keeps you functioning. The people around you may even think you’ve got it all together. This however can lead to you feeling as if you are wearing a mask that dampens spontaneity, reduces your enthusiasm and can result in feelings of emptiness and thoughts of pointlessness. All while giving an appearance of you being your True Self. And over time, maintaining such a false position can lead to feelings of emptiness, low self-worth, disconnection, burnout, and the sense that life is passing you by without you being able to live it fully.

So, if you don’t know already, what are the signs that you may be living your life from a position that may be described as false? Well, maybe you don’t say what you truly think or feel. Sometimes, you aren’t even sure what that is. Perhaps you constantly try to get everything right in your life, in relationships, and in your work and never stop. To do this you tune in to what others expect from you and adjust your behaviours accordingly. While everything looks fine on the outside, you feel flat or numb, or even, invisible.

Yet still you cannot get rid of the feeling that something is missing. If only you knew what it was then you could get it and then life would be all right. And you are constantly people-pleasing and feeling anxious about getting things right for them and hence, you believe, you.

However, such feelings don’t reflect what actually exists, and what in fact happens, does it? Maybe we do what we choose to do most of the time and maybe that’s as true and authentic as we are going to get. Maybe our Real Self is what it is and maybe it just gets on with living. And maybe our Real Self sometimes gets it wrong. We have all made poor choices. We have all felt differently about certain people and about particular places over time.

Professionals may say ok but why should we waste our time talking to people about how their life is ok for them? We want to know what’s wrong so we can use our professional skills to help them fix it. This may seem very reasonable. Thing is, how do I come to find out what a good or satisfactory life would be for me if I am spending all my time fixated on what’s wrong with it. An exaggeration perhaps but where is the balance between analysing and supporting what is both good and true while examining what is bad or false or inauthentic or hidden?

Maybe the balance is there. Maybe it’s just not expressed explicitly, at least not as much as it could be. Well, I’m not sure I’ve ever come across a consultation where the client simply says how normal things are or one where the therapist asks them to say more about their normality. It’s far more usual for professionals to focus on the problems their clients or patients may be having and to work on understanding the issues they are having and the problems that are arising from these issues.

And maybe the idea of a True Self and a False Self just gets in the way of what is actually there; you, me, us, alive in the world together. Maybe the task we all have is to create ourselves as we wish to be, not as we happen to be and not as others tell us be. If so then we would be able to appreciate what is good about ourselves and seek the company of people who can nurture us and situations that will allow us to grow. And maybe that’s what every single one of us should know and should do.

References

Michel Foucault – The History of Sexuality 3: The Care of the Self (1984)

Sigmund Freud – Beyond the Pleasure Principle (1920)

Erving Goffman – The Presentation of Self in Everyday Life (1956)

Stephen Joseph – Authentic: How to be yourself and why it matters (2016)

Carl Jung – Aion: Researches into the phenomenology of the self (1951)

The Who – Who Are You? (1978)

Donald Winnicott – Ego Distortion in Terms of True and False Self (1960)

Leaving on a jet plane (Don’t know when I’ll be back again)

ADHD and other stories

Attention Deficit Hyperactivity Disorder (ADHD) is very popular. It is a condition that seems to explain a lot of difficulties that people have had and may have had for a long time. It seems to provide both an explanation of what they are suffering and a treatment route for their relief. Furthermore, the scientific validity of ADHD is now widely accepted. Taken together these factors have led to a high demand for ADHD diagnosis and treatment (NHS Taskforce, 2025).


So, what is ADHD and how does it relate to other approaches?
ADHD, is sometimes presented as a neurodevelopmental condition:
‘Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition characterized by a persistent pattern of inattention, hyperactivity, and/or impulsivity that interferes with daily functioning or development.’ Psychiatry.org (Accessed 12 May 2026)


At the same time, ADHD is also presented as an analysis of behaviour:
‘ADHD is a disorder that is defined through analysis of behaviour. People with ADHD show a persistent pattern of inattention and/or hyperactivity–impulsivity that interferes with day-to-day functioning and/or development.’ adhd.co.uk (Accessed 12 May 2026)


Now, you may find it interesting, if not puzzling, that ADHD is open to such different explanations and is available to such different approaches. How can this be?


Well, who are the people who are given ADHD diagnoses based on these (and related) definitions? Are they people suffering from ADHD as from a chemical imbalance, say, or from a type of psychological disorder? Are they people looking for relief from the distressing situation they find themselves in? If so, are they offered an ADHD diagnosis as a way out of their situation? Or are they people who have been told that they have a condition they were not aware of and who regard their ADHD diagnosis as their way of getting treatment? And what does receiving an ADHD diagnosis in fact do for them? Does it relieve their personal difficulties? Does it change their actual situation? If it does, then how does it do this?


To help us address these questions let us break the concept of ADHD down into its component parts and look at how the condition known as ADHD comes to be put together.


First, ‘Attention Deficit’ – Well, not paying attention is not uncommon, is it? We’ve all been caught looking out of the window when we should have been concentrating on the job. And we’ve all nodded off after a late night and missed what is going on around us.


Next ‘Hyperactivity’ is something we all engage in, be it a deadline at work or college, or getting the packing done before a trip or a holiday. We may simply feel overwhelmed by the pressure of all that we are expected to do. After all we don’t want to get the sack, fail the exam or literally miss the boat.


Finally, ‘Disorder’. Now, is everything we do in our lives ordered? Or to put it another way, is order ordinary? It might be nice if it were but we’re all human and while some of us are less ordered than others I don’t think anyone is completely ordered. Indeed, someone who was completely ordered would probably strike us as at least a little strange. So, disorder is both common and to be expected in our lives.


Overall, then by looking at these concepts together we can see that if you are; someone who has attention deficits, engages in periods of hyperactivity and lives a less than ordered life then you are someone who is as normal as the rest of us. You are like me, your friends and indeed everyone else around you. Welcome!


Hang on. Am I saying that people who give and are given ADHD diagnoses are making it up? No, absolutely not. The people who give the diagnoses have identified the symptoms they have identified. The people who are given the diagnoses really do feel the way that they do. They may not be feeling happy at all. So, are they being mistreated? Are they given medication for being the way we all are? Again no, for they are being treated for the symptoms that have been identified and identified through an ADHD assessment process.


So, that’s ok then? Well, it would be if they were being treated for the conditions that they actually have. And this would be based on an assessment of what else is going on with them and what is happening to them in their lives. For example, do they feel anxious or depressed? Do they or their loved once have a serious health condition? Are they going through redundancy or divorce? Are they worried about having enough money? In short, is there something about them that would explain their problems, their issues, and their difficulties in their own terms? And would it be better if they themselves could do something about this such as talking about how they are feeling to loved ones, or with a counsellor or psychotherapist?


Ah, you may say, surely what is better is for people to find relief from their suffering no matter how such relief is presented or whatever the motivations behind whatever diagnosis they have received? Well, is it? If you go into a bakery you don’t expect to be asked to buy a sofa. And, more seriously, what if your underlying condition is missed? Who will then listen to you? After all, you have had your ADHD diagnosis – job done! However, what matters to you is not whether you have ticked the diagnostic boxes for ADHD. Rather what is truly important is what truly matters to you and how you truly feel about your life. If this is shown through the process of ADHD diagnosis and treatment then so be it, though this should not be the end of the matter. This should only be the beginning of your journey; your journey to a healthier and a better life.

References
adhd.co.uk – About ADHD, Accessed 12 May 2026.
NHS England – Report of the independent ADHD Taskforce, Parts 1 & 2, 2025.
Peter, Paul & Mary – Leaving on a jet plane, 1970.
Psychiatry.org – What is ADHD? Accessed 12 May 2026.

Mustn’t Grumble

Do I suffer from Health Anxiety?

Am I healthy enough to do all the things I need to do? Would I feel better and achieve more if my health was better? And am I spending more time worrying about my health than doing something about it? If these are questions you find yourself asking then perhaps you suffer from health anxiety. And perhaps you spend so much time worrying about your life that the anxiety itself gets in the way of what you want and need to do.

Well, like many people you may feel anxious about the challenges confronting you each day. You may feel as if you’ll never be able to change your circumstances or to achieve your personal goals. And such anxieties apply to healthy people and unhealthy people alike.

Maybe you just don’t feel healthy enough to do what you want to do and to live a good life. Ok, so health itself, whether you are in fact healthy or unhealthy, can always be a source of stress. Nonetheless, many people in poor health make honest efforts to keep their mood up and to fill their day with good things to do. People in poor health can appreciate the value of having nice people to meet and good friends to socialise with just as much and maybe even more than healthy people.

So what can we do about this? How can we live our lives free from unnecessary worrying about our health? In other words, how can we live free from health anxiety? Some people are able to resolve anxiety about their health through engaging in deep and challenging self-examination. Such people would say that we should all do this albeit in our own individual way. At the same time other people may feel that they are simply unable to do this while others may be unwilling to take the time and effort needed to do this. Well, whatever your feelings, surely we can all take steps that will allow us to gain some satisfaction from life and to live free from unnecessary anxiety.

And isn’t it true that even very healthy people feel stressed? Relationships, work, finances can all be stressful for anyone. We may, for example, may be unable to see our way forward. We may find it hard to trust the people we rely on and need to trust. We may not always pay enough attention to our partner, to our relatives or to our friends. And this may extract a high emotional cost from us. It may damage our established relationships of every kind, and it may spoil our new and growing ones.

Ok, so given the choice we all want to be healthy. And good health surely makes it easier to carry out the basic needs of living, which in turn leads us to a secure sense of subjective well-being.

So, what can we actively do to address our anxieties about our health? Well one approach is to get some help at some level be it from relatives or friends, or professionally through issues-based counselling or in-depth psychotherapy.

If we choose the professional path, we should expect to receive fair, compassionate help with our anxieties of whatever kind. And this goes back a long way. Freud and Breuer themselves saw their task as follows:

“I do not doubt that it would be easier for fate to take away your suffering than it would for me. But you will see for yourself that much has been gained if we succeed in turning your hysterical misery into common unhappiness. With a mental life that has been restored to health, you will be better armed against that unhappiness.” – Sigmund Freud and Josef Breuer, Studies on Hysteria, 1895.

While these words would clearly apply to someone suffering mental anguish they may also apply to those who consider themselves relatively healthy. For the healthy person may be less insulated against such mental difficulties than those who have experienced difficulties while growing up, been able to gain self-awareness and who has hence built up some resistance to their adversities. And sometimes, healthy people feel less comfortable seeking help, fearing for example that their therapist might be privately thinking “What have they got to worry about?” So, the healthy person may be more reluctant to ask for help when they need it than those people with identified health issues. 

Here it is worth remembering that therapists owe all of their clients sincere empathy in coming to understand and to support them as unique and valued individuals. In this way empathy may even be seen as the most important active ingredient in counselling and psychotherapy. Every client, healthy or unhealthy, needs and deserves to be regarded as a whole person, with their own individual wants and needs.

No matter who you are, no matter how you feel, talking can help you feel better. No matter how you do this, to a friend or to a therapist, whether individually or in a group, opening up and sharing can help you feel better.

Oh Man, Oh Man, Oh Man!

Masculinity: Toxic and Non-Toxic

There are men, there is the masculine and there is toxic masculinity. If look at the news you will see some fine examples of toxic masculinity. Given this you might think that all men are toxic, one way or another. But is this really true? Men may all be similar but are they all the same?

Well, just because some men are billionaires doesn’t mean there aren’t a lot of poor men. Men get the dirty jobs. Men die younger. So, you may think it’s not easy being a bloke, poor thing. If this sounds whingy then, all things considered, it’s because it is. So how easy is it to be a bloke? Depends which bloke you mean. I’m a bloke and we’re all different. So that’s that then. Cheers!

Except it’s not. Something has been changing in the way we view and yes judge men. Men were the bread winners, the brave and fearless hunters, bringing home the goodies for the family to enjoy. Now they are more likely to be regarded as tolerable at best and otherwise as leeches, takers and certainly not givers. All because they are entitled to. After all they are men.

And interestingly the context of such judgements has shifted from biological men to the attribute of masculinity itself. Today men are often talked about in terms of their masculinity and often with disapproval or worse. You may feel good about him but oh his masculinity! Leave that at the door. Ok you say, men will just do what they like if you let them. Perhaps but now with feminism we can at least call them out for doing just what they like. Quite right!

But hang on. If I said the same about women and femininity I’d meet with your disapproval if not outrage. Best I’d get is ‘trust a bloke to come out with rubbish like that’. And I’d be accused of treating men and women as the same and not as equals. Square pegs go in square holes, and round ones go in round ones, matey!

So do men get a fair deal here or has the pendulum swung the other way? Well, you may say, men get the lion’s share in so many ways why shouldn’t they put up with a bit of justifiable criticism? And isn’t the point here that after all her hard work, the lioness’s share isn’t equal to the lion’s. Not looking good for masculine men so far.

Ok, given our new awareness of masculinity what positives can we genuinely focus on? What about the New Man? Well, men are becoming more aware of their feelings. Men are more likely to share childcare and other caring responsibilities than their previous generation. Men are increasingly responding to the inequalities women face. No one thinks that the job is done, apart from some toxic men who think that we have gone too far already, but progress is progress.

Really? may well be your reply. Thanks very much for these crumbs. If this is the best you can do then don’t bother. This is certainly a useful reminder, to say the least. Nevertheless, it raises the question: if he’s a bloke, does he have to do it?