Taking stock as the year ends: including the despair I feel about NHS mental health services, eating disorder support and the scourge of anti-semitism.
As the song goes, it’s the most wonderful time of the year. But it’s also the time of the year when many of us look back and reflect on the ups and down; trials and tribulations; positives and negatives; the year in review. I am no exception.
In my supervision this week, we took some time to take stock on what the last tweleve months have brought and began to cast our eye forward to the twelve months ahead.
I am proud of what I have done and achieved in 2023:
continuing to develop my practice and my knowledge and experience of a range of topics, including my continued passion for working with clients with eating disorder(s);
getting to know so many new clients and deepening my relationships with existing clients to try to play a small, positive role in their lives;
building and sustaining my business (AMJ Counselling) so that it generates the right level of income and provides me with intellectual and emotional stimulation but the right balance to lead a contented professional life;
enhancing my relationship with four schools so that I work with students from 11-18 and the teachers and other staff who work so hard, often under extreme pressure and expectation;
completing my Masters study, including my dissertation on eating disorders and therapy;
Continuing the lecturing and speaking work I do with universities, schools, and other organisations who want to engage in a meaningful conversation(s) about mental health, wellbeing at work, work-life balance and resilience;
Trying to do all of that work and professional development, whilst prioritising my own mental health and wellbeing - and succeeding most of the time.
As I look ahead to 2024, I want to continue with all of those things and complete the book I have been writing on and off for several years - charting the story of my own breakdown and recovery, drawing on the many talks I have given and blog posts I have published since falling into a dark hole at the end of 2014.
I am taking time over the next few days to relax, reflect and recharge, getting ready to walk purposefully into the new year feeling refreshed and ready for the future. But I am also keen to mark this moment by sharing one or two difficult feelings and experiences I’ve had this year - and expect to have again in 2024.
Despite my understanding of my own mental health and triggers, I continue to see my wellbeing as a work in progress, which doesn’t always go to plan. The last eight weeks have been especially tricky with a fair bit of illness at home (nothing serious but unsettling and disruptive) and my selfcare taking a hit as a result: not enough walking, golfing; running and down-timing (a new word!).
I have spent 2023 - and no doubt will spend 2024 - despairing at the position so many of my clients and others find themselves in when trying to access NHS mental health services. It upsets and angers me in equal measure when I hear story after story of long waits to receive essential support only to be followed by limited or non-existent help being provided, leaving people often feeling worse; abandoned; unheard; unseen; and under-valued.
Week after week and report after report, highlights the total, utter, shameful mess that NHS mental health provision is in; client after client; family after family share these experiences with me and no doubt with therapists up and down the UK, and still we are stuck. The sixth biggest economy in the world (according to the IMF) and yet the UK cannot, apparently, afford to properly fund mental health services which would save and enhance millions of lives. I despair. I hope 2024 brings meaningful change with meaningful investment. I hope, but I’m not holding my breath.
My despair at NHS provision takes a deeper downturn when I hear about the experience of clients dealing with eating disorder(s). As I have written before - https://www.amjcounselling.com/amj-blog/eating-disorders-wood-for-trees - there are vital NHS services offered to people in life-threatening danger, which often get them out of the medical crisis they are in and give them the opportunity to move forward. It can literally keep them alive but, sadly, this is often where the meaningful help ends.
Too often - as my Masters research showed - food and the eating disorder becomes the preoccupation of the “treatment” being provided, forgetting that eating disorders are about the person not the food or the scales. My experience tells me that eating disorders are never about food - they are about something much deeper and therefore need deeper exploration. These feelings need space to be explored without judgment and pressure. They need the space that can only be offered in therapy and yet the therapy is so often limited or not offered at all. Too many people are told that their cognition is insufficient (due to their lack of food/nourishment etc) to have therapy and so they are left to focus on the food, three meals and three snacks approach, which has its place but only one place in a complex picture that must include therapy.
One last area of despair for me this year has been the hate and division which we see every day on the news, on social media and in our daily interactions. I don’t want to talk too much about politics but I do want to share one recurring feeling I’ve had this year which is rooted in what is happening now in the Middle East.
Like millions of people in the UK and around the world, I am able to hold two positions: I want there to be a safe, autonomous state of Palestine, in which people can live and worship freely, and I want the state of Israel to exist in a world in which it’s very presence is not constantly threatened. I remember Oslo and the agony of Prime Minister Rabin’s murder, at a time when I really thought there was hope of a two-state solution. I think all most daily about this missed opportunity and hope it can be rekindled again.
But the despair I have been experiencing a lot in 2023 is that of seeing the continued (and increased) presence of anti-semitism in the UK and around the world. I am not Jewish. I do not have any Jewish relatives (to my knowledge). I have never been inside a synagogue (but to plan to change that very shortly). I do not have much interaction with Jewish people or Judaism. But I feel sickened every day by the hate experienced by Jews for just existing. For being Jewish. For simply being in the world.
Over the last few months, I have come to realise that I haven’t got over learning about the holocaust in school. I have read so many books, watched so many films, documentaries, YouTube clips and much more over the last 30 years or so. I cannot forget what I learnt and have become deeply affected by it all over again since 7 October as I see the hate which underpinned the holocaust surviving today. It may take different forms but it means that Jews - as David Baddiel heartbreakingly put it - so often ‘don’t count’.
Incidentally, I can talk about this and feel this pain, wanting desperately for this hate to end, and still despair at what is done by the state of Israel in Gaza and the West Bank. This comment and many other related comments and beliefs are compellingly covered in David Baddiel’s book - a book I suggest anyone who cares about injustice, equality and politics should read.
The end of 2023 provided me with an opportunity to reflect - the good and the bad. I’ve had a really good year. I am grateful for it but I also know that my year and the year for many others isn’t black and white - it has much grey about it.
It may be the most wonderful time of the year for many, but not for all those needing NHS mental health services; to have their eating disorder and themselves understood properly; and, for those who want to live without discrimination, hate, threat and worse, simply for being Jewish.