Raj Persaud in conversation - the podcasts
Unparalleled Trauma. One of the most traumatic events of all?

A young woman who suffered one of the most traumatic experiences of all for anybody talks to Dr Raj Persaud.

 

Raj Persaud in conversation with Victoria, who suffered bipolar illness, sexual assault, self-harm and suicide attempts.

Victoria (not her real name) was a victim of a serious sexual assault who developed mental health problems, yet has made a good recovery. She has been successfully treated for bipolar illness, but her problems may be linked to a difficult childhood and strained relationship with her father.​

 

 

Do Offenders, as in the Rolf Harris Case, Sentence Their Own Families, and Their Victims, for Life?

 

RAJ PERSAUD AND PETER BRUGGEN

Recent high-profile cases of sex crime convictions, as in Rolf Harris and Max Clifford, reveal outwardly puzzling and strange reactions from their own families. Some relatives show solidarity, appearing each day in court, loyally at the side of the accused. 

What goes on inside a household when someone at their centre is guilty of child, and other, sex crimes, could explain how these particular criminals lead such an incredible double-life. This might account for these astoundingly long criminal careers, in what is widely regarded as one of the worse crimes of all, because children are the most innocent of victims.

Laurence Miller, a Florida psychologist, has published an investigation in 2013 into the different types of paedophile; 'Sexual Offenses against children: Patterns and Motives'. His categorisation could suggest families or relatives are sometimes even colluding in some way, or possibly are victims themselves. At the very least, they can appear in severe denial over the perpetrator in their midst.

He points out, in his study published in the academic journal, 'Aggression and Violent Behaviour', that the 'situational' child molester abuses children as targets of opportunity, particularly if other sexual prospects are unavailable. They therefore tend to also target the elderly, disabled and any other kind of available victim, provided by circumstance.

This is in contrast to the 'preferential' child molester, who in the seductive sub-type, grooms young victims with gifts and attention. He rationalises a 'special relationship'. The 'fixated' sub-type, within the 'preferential' category, is a bit of a child himself - emotionally immature and socially inept.

The most violent and dangerous type is the 'sadistic' paedophile, who enjoys inflicting pain, fear and horror. To heighten the torment, they may even tell the child victim that their parents hate them, and ordered this retribution.

Laurence Miller contends that many child molesters seem to deploy primitive child-like 'defence mechanisms' such as dissociation - 'I didn't know what I was doing' - or denial - 'they're not really hurt, they seemed fine at the time'. Another classic psychological inner defence is 'projective identification', in which one's own unacceptable feelings are projected onto the victim; so it's the child who was viewed as acting seductively.

It's possible that some families also deploy such defence mechanisms in order to reconcile themselves to the paedophile in their midst. Some paedophiles either manipulatively encourage this process, or it spreads naturally through a close-knit group, as people under stress often need such defences in order to cope.

These powerful psychological mechanisms may explain why some paedophiles don't get caught for so long.

Laurence Miller comments that few family members will actively collude with blatant criminal sexual behavior on the part of their husband, brother, father, or son who may now be facing prosecution. However families will rationalize the perpetrator's behavior partly because they have a lot to lose if the perpetrator is convicted (home, finances, family reputation, etc.).

Sometimes, Laurence Miller observes, an interesting "flip" occurs when families, who have been rallying on the side of their loved one for some time, are now faced with mounting evidence against him, and abruptly switch to loathing and rejection, partly against the perpetrator, but also partly out of self-denigration for "letting myself be fooled for all these years."

Nevertheless, Laurence Miller points out, many family members continue to support long after the nature and scope of the offenses has been made clear. Parents are more likely to remain supportive than spouses or children.

Laurence Miller quotes an example of a news story in 2009 of New York's then oldest registered sex offender, who had his 100th birthday in a correctional facility, while serving a ten year sentence for sexually assaulting two sisters aged 4 and 7. This perpetrator appeared to have used his grandfatherly charm to entrap young victims for over 60 years.

Garry Walter and Saby Pridmore, psychiatrists from the University of Sydney and University of Tasmania, have published in 2012 a study of suicides across the world in publicly exposed paedophiles, entitled 'Suicide and the Publicly Exposed Pedophile'. 

Their examples, published in 'The Malaysian Journal of Medical Science', include former Liberal MP and Secretary of State to the Colonies, a 1st Viscount, who killed himself aged 59 in 1922, following publicity over the raping of a 12 year-old boy. But he had been a sexual predator for years previously.

Another example they report is of a famous US paediatrician who shot himself in 2011 aged 71, one day after a class action sexual abuse and malpractice law suit was filed against him, charging that he had performed unnecessary genital examinations on 40 boys. He was also a number one New York Times Bestselling Book author. 

Other illustrations they quote include a 56 year old man who had been Texas District Attorney for more than 20 years, who shot himself as a SWAT team entered his home following an investigation by an anti-paedophile group, which had arranged for actors to pretend to be under-aged children making contact with him.

Twenty incidents of suicide in publicly exposed paedophiles were identified from eight countries, with the average age of offenders being Fifty-Three years. These also include a United States Prosecutor, as well as a UK author and academic emigrant to Canada with a PhD in neuroscience.

Of course we never really know why a person who commits suicide does it. But these cases illustrate how really serious family wrecking criminals, often have built socially very respectable careers, just as the 'successful' Rolf Harris.

In four of these cases, Garry Walter and Saby Pridmore explain, the evidence suggests they had been perpetrating sex abuse on children in the order of 30 years, and in another four cases for at least 15 years; some were married with families.

Donald Campbell, a psychoanalyst based in London, recently published a paper entitled 'Doubt in the psychoanalysis of a paedophile', where he argues that issues of disbelief, particularly the ability of such perpetrators to create doubt in the minds of those around them, might be a fundamental modus operandi.

Donald Campbell, Past President of the British Psychoanalytical Society, refers to a kind of 'sadistic' doubt, in his paper published in the June 2014 issue of 'The International Journal of Psychoanalysis', where the sex abuser appears to derive sexual gratification from the sewing of seeds of incredulity all around him.

Perhaps uniquely more than in any other crime, at the heart of sex offences, is doubt. This renders the crime particularly psychologically damaging. Uncertainty is planted in the minds of the victim, and of those close to the victim, and the perpetrator, over exactly what happened.

It may be the ability to make people distrust even themselves, is a uniquely manipulative skill of abusers. Grasping this strategy could halt these immoral careers much earlier, as they seem to be some of the longest in criminal history.

A court conviction, followed by sentencing, normally ends the ambiguity for the public, over what happened, in a sex crime.

But for the families of perpetrators, as well as the victims, the hesitation and uncertainty over who someone like Rolf Harris really is, can be a life sentence.

 

 

This podcast has been made on behalf of the Royal College of Psychiatrists (UK) by Raj Persaud and Peter Bruggen

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

For more general podcasts visit: www.rcpsych.ac.uk/discoverpsychiatry/podcasts.aspx

Direct download: DR-100_0055_1.mp3
Category:(3) EXTRAORDINARY EXPERIENCES of severe emotional turmoil -- posted at: 4:46am UTC

Sleep problems explained. The psychiatry of sleep problems

How to get a good nights sleep without pills?

Dr Raj Persaud in conversation with Dr Jeremy Beider. Problems sleeping are one of the commonest difficulties that doctors in the UK deal with - possibly leading to massive over-prescribing of hypnotic drugs which can be highly addictive. What are the non-pharmacological ways of achieving a good nights sleep? Raj Persaud in conversation with Jeremy Beider who was presenting on this topic at the Annual International Congress of the Royal College of Psychiatrists at the Barbican.

Jeremy Beider is a consultant in adult psychiatry in West London Mental Health Trust and holds a MSc in Behavioural Sleep Medicine from Glasgow University.

He has Clinical experience at Guy’s and St Thomas’ Sleep Disorders unit and the National Neuropsychopharmacology Clinic UK

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

As a Dream Predicts Lottery Win, and Malaysian Airlines Passenger Posts Eerily Prophetic Picture - Can Dream and Visions Foretell the Future?

 

RAJ PERSAUD AND PETER BRUGGEN

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/lottery-dream_b_5605068.html

 

The UK press has reported that a judge recently ordered a restaurant owner to split half of a million pound lottery prize with his waiter, because of a dream foretelling the future.

The boss of a Turkish restaurant in York, England, bought the winning lottery ticket following a vivid dream experienced by his superstitious employee, predicting the win.

Judge Mark Gosnell's ruling followed a protracted legal dispute between the two men as to whom the prize money belonged to. The Judge's final decision, that the jackpot had to be split by the boss with his waiter, partly turned on a premonition.

It is reported that the waiter dreamt that he was holding a large bundle of cash and standing in front of him was his boss. Being a strong believer in the power of such visions, the dreamer interpreted this to mean that he and his boss would scoop the lottery.

The following day the waiter apparently "pestered" his boss for hours, before the restaurant owner finally agreed to enter the EuroMllions draw.

The judge examined CCTV footage from the restaurant which showed the two men filling in the winning ticket, and ruled in the waiter's favour, accepting the dream explanation was "plausible".

While anecdotal reports of dreams predicting the future abound, Parapsychologists are interested in scientifically testing whether foretelling the future might be possible.

For example, a paper entitled, 'An ostensible precognition of the Arab surprise attack on the Day of Atonement, 1973', published in 1986 by Gilad Livneh, in the 'Journal of the Society for Psychical Research', presented just such a compelling case. A letter to Israeli Prime Minister, Golda Meir, was discussed in which a woman reports her vision about an Arab attack, two weeks before the actual event took place.

While accurate prophecy was a plausible explanation, however, the author also conceded that chance coincidence could not be ruled out, due to the inconsistency of certain details between the dream, and the actual event itself.

Caroline Watt, Natalie Ashley, Jack Gillett, Megan Halewood and Rebecca Hanson from the Department of Psychology, University of Edinburgh, have just published one of the most recent systematic studies on prophetic dreams.

These authors report surveys showing that around one quarter of the population believes in the ability to foretell the future, while about one third report 'precognitive' experiences (precognitive means literally fore-knowing).

The authors also point out the scientific and public importance should some dreams indeed turn out to be reliably prophetic. For example, if such precognitive dreams contain trustworthy information, it might be possible to warn of forthcoming disasters, or even to prevent them from occurring.

This has particular resonance right now given a Dutch passenger feared dead, is recently reported to have posted a photo of the Malaysian Airlines Jet he was boarding, destined to crash in the Ukraine, with the message: "if we disappear, this is what the plane looks like".

Caroline Watt, Rebecca Hanson and colleagues point out that following the Aberfan disaster the British Premonitions Bureau was set up in London, and in the USA the Central Premonitions Registry was established. Both appear to have faltered partly due to an insufficient number of predictions that could be related to specific incidents.

Linking an incident which has now happened with a prior dream could merely be a tendency to see patterns facilitated by the benefit of hindsight.

In another past study reported by the authors of the latest research, participants were asked to document their dreams upon awakening, and then to mail a copy to the researcher. The dreamers were asked to notify the investigator if they noticed any events occurring that corresponded to their dreams. In one series, it was judged that only two out of 265 dreams (over an 8-week period) appeared 'moderately' prophetic.

Caroline Watt, Rebecca Hanson and colleagues' current paper, entitled 'Psychological factors in precognitive dream experiences: The role of paranormal belief, selective recall and propensity to find correspondences', investigated the part of selective recall in prophetic dream experiences. Participants read two diaries, one purporting to be a dream diary, and one claiming to be a diary of incidents in the dreamer's life. The events either confirmed or disconfirmed the reported visions.

A significantly greater number of confirmed than disconfirmed dream-event pairs were recalled by participants taking part in the experiment, possibly indicating a human tendency to see connections over unconnected happenings.

The authors argue that their research, published in the 'International Journal of Dream Research' in April 2014, explain the seeming coincidence between dreams and events that can be interpreted as prophetic.

Two possible psychological mechanisms - selective recall and propensity to find correspondences seem to lead us to experience many more dreams apparently foretelling the future, than may genuinely exist.

These explain the discrepancy between the dearth of scientific support for prophetic dreams, compared with the rather frequently reported experience in the general population, of having dreamed about a seemingly unpredictable future event.

Psychologists Gergo Hadlaczky and Joakim Westerlund from Stockholm University have published a study in 2011 which argues that how surprised you are by coincidences could predict how likely you are to end up believing in phenomena such as parapsychology and the supernatural.

The study entitled 'Sensitivity to coincidences and paranormal belief' and published in the journal, 'Perceptual and Motor Skills' exposed participants to artificial coincidences, who were asked to provide remarkability ratings. Those who were more surprised, when experiencing coincidences, tend towards higher paranormal belief (beliefs such as in telepathy etc).

The most obvious explanation for many coincidences is 'just chance'. Tending to be more surprised by coincidence suggests a tendency to reject the 'it's just chance' account. For example, there will be some who put it down to just chance that two Malaysian Airlines Jets should suffer catastrophe in a short space of time. Others will be much more surprised.

It's possible that a tendency to be more shocked by coincidence simply betrays poor probability reasoning. But it could also have positive survival value in an evolutionary sense. Being more paranoid may mean seeing patterns in what others assume are random events.

Being more astonished by coincidence, could have made you more vigilant for threat in our ancestral environment, more paranoid, and therefore more able to detect and defend against predators in our ancestral past. We could be genetically wired up to be surprised by coincidence.

But paranoia and surprise by chance is only helpful if it leads to an actual action that then produces a positive outcome. The passenger reported to have posted the prophetic internet message about the Malaysian Airlines Jet due to be flying over Ukraine, apparently still did board the plane.

The recent lottery-winner case appears an excellent example of a kind of quasi-scientific proof that dreams can foretell the future, because the person who had the dream then engaged in an action the next day as a direct result - persuading his boss to buy a lottery ticket.

Yet if the waiter in the most recent legal judgement ruling was so convinced by his prophetic dream - why did he not take more precautions to safeguard his claim to the win?

Why did he not foresee that sharing the ticket purchase with his boss was going to lead to a protracted legal battle?

Depending on how you interpret it, this could become an example of how dreams or visions don't really predict the future.

 

This podcast has been made on behalf of the Royal College of Psychiatrists (UK) by Raj Persaud and Peter Bruggen

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

For more general podcasts visit: www.rcpsych.ac.uk/discoverpsychiatry/podcasts.aspx


The science of hearing voices

Raj Persaud in conversation with Professor Peter Woodruff. Professor Peter Woodruff from Sheffield University and Raj Persaud discuss the latest neuroscience research on hearing voices or auditory hallucinations with Raj Persaud - the conversation was recorded at the Annual Congress of the Royal College of Psychiatrists at the Barbican. The latest neuroscience developments appear to hold out the prospect of innovative new non-drug related therapies.

 

Professor Peter W R Woodruff MBBS PhD MRCP FRCPsych

Professor and Head of Academic Clinical Psychiatry
Director of the Sheffield Cognition and Neuroimaging Laboratory (SCANLab)
Deputy head of the Section of Neuroscience

  • 1 July 1999 – present: Professor and Head of Academic Clinical Psychiatry, University of Sheffield & Honorary Consultant Psychiatrist, Sheffield Care Trust (from 1 July 1999)
  • 1997- 1999: Senior Lecturer in Psychiatric Neuroimaging University of Manchester
    Honorary Consultant Psychiatrist, Mental Health Services of Salford.
  • 1995 – 1997: British Telecom Research Fellow in Functional MRI, Institute of Psychiatry London
    Senior Lecturer in Psychiatric Neuroimaging/Hon Consultant Psychiatrist in Psychiatric Intensive Care, Maudsley Hospital London
  • 1994 – 1995: Fulbright Fellow in Functional MRI, Harvard Medical School & Massachusetts General Hospital USA
  • If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

A related article which may be of interest originally published in The Huffington Post:

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/washington-shooting-naval-yard_b_3960983.html

 

 

Could Psychiatrists Have Prevented the Washington Naval Yard Shootings?

 

Raj Persaud and Peter Bruggen

 

As reports began to appear of the disturbed background of Aaron Alexis, the media seems to have universally decided that mass shootings are readily explained by severe mental illness.

 

The assumption is that as psychiatric disorder is so obviously linked to violence, there should be no surprise that the Washington Naval Yard killings involved someone with a mentally troubled history.

 

New research finds that media reporting of mass murder, such as this most recent tragedy, leads to more negative public attitudes to the mentally ill. This in turn may contribute to a pessimistic stereotyped image for psychiatric problems and services. As a result, people who suffer symptoms, as it appears Aaron Alexis could have, may not access treatment which possibly prevents these atrocities.

 

 

A vicious cycle is thus created, ironically perpetuated by media coverage. Is it possible the reporting is part of the cause of such senseless violence? Not because this encourages one sub-type of mass killers - 'infamy seekers' (which it may do) but also as it may discourage early psychiatric intervention?

 

 

Emma McGinty, Daniel Webster and Colleen Barry, from the Johns Hopkins Center for Gun Policy and Research, and the Johns Hopkins Bloomberg School of Public Health, Baltimore recently found that reading a news story about a mass shooting, heightened negative attitudes toward sufferers from mental illness.

 

 

The study entitled 'Effects of News Media Messages About Mass Shootings on Attitudes Toward Persons With Serious Mental Illness and Public Support for Gun Control Policies', involved a national sample of almost two thousand participants. Their findings suggest public perception is that serious mental illness, more than access to guns, accounts for mass shootings.

 

 

The study, recently published in the 'American Journal of Psychiatry', concludes that in the aftermath of mass shootings, the barrage of news stories describing the shooter with psychiatric symptoms, his history, and his actions during the shooting might raise public support for gun control policies. But such coverage also contributes to negative attitudes toward the mentally ill.

 

 

The authors go on to point out that pessimistic public attitudes are linked to poor treatment rates among persons with serious mental health conditions.

 

 

But if there were better psychiatric services, and if the taboo surrounding mental illness was less, so more people accessed better treatment earlier, would it make a difference to these tragic shootings? Could psychiatric interventions prevent these atrocities in the future?

 

 

'The American Journal of Psychiatry' was partly prompted by the Johns Hopkins media effects study, to wrestle with the question of how psychiatrists could make a difference to the apparently rising incidence of mass killing incidents.

 

 

Psychiatrists Richard Friedman and Robert Michels, were in fact responding to the Newtown Connecticut school shooting, at the time of their editorial. Yet their comments anticipate the likelihood that such tragedies would recur soon.

 

 

They did indeed, when Aaron Alexis recently killed 12 people in the Washington Naval Yard.

 

 

The media reports suggested the navy contractor was wrestling with mental illness. He appears to have been hearing voices and complained he was being followed by people using a microwave machine to send vibrations through his body.

 

 

Doctors Friedman and Michels agree that mass killings attract the kind of blanket media coverage which can create misleading impressions. For example, the attention they attract distracts from the fact mass killings are very rare. Friedman and Michels point out that in 2011, mass killings accounted for only 0.13% of all homicides in the United States.

 

 

Friedman and Michels believe the conundrum the public find most difficult to grasp is that although mass murderers probably suffer more mental illness than other killers, the mentally ill as a group actually pose relatively little risk of violence.

 

 

For example, their editorial entitled 'How Should the Psychiatric Profession Respond to the Recent Mass Killings?' quotes that only 4% of violence generally can be attributed to persons with mental illness. The prevalence of violence amongst those with serious mental illness throughout their lifetime is 16%, as compared with 7% among people without.

 

 

Alcohol and drug abuse are far more likely to produce aggression. Those who abuse alcohol or drugs but have no other mental disorder, are nearly seven times as likely as those without substance abuse, to commit violence.

 

 

One possibility is that improving mental health services might make a difference; Aaron Alexis appears to have fallen through the net of treatment.

 

 

But, remarkably, should a psychiatrist have been able to evaluate this man before the shootings, suffering though he appeared to be from hearing voices and delusions, it's not clear he could have been easily detained involuntarily by current mental health legislation. The law, both in the USA and the UK, supports doctors in seeking involuntary admission to hospital, only if they can convince the authorities that a patient is an immediate danger to himself or others.

 

 

Perhaps in the wake of these recent shootings, involuntary mental health legislation and practice should be loosened from 'imminent danger', to a 'reasonable likelihood of violent behaviour'.

 

 

But Friedman and Michels argue that lowering the threshold for involuntary treatment could discourage consulting doctors. People could become more wary of being candid or seeking help voluntarily.

 

Heightened fears of being committed to an institution against their will, might mean some of most unwell patients would be driven further away from the mental health system.

 

 

Mental illness is very treatable, and sufferers can and do return to productive well-being with the right healing, implemented early enough. Yet the fear of being 'locked away' forever in an asylum continues to stigmatise the system.

 

 

As psychiatrists, when we hear these tragic stories of what mental disturbance lay behind a mass shooting, we have a further concern. It is that sufferers from these severe psychiatric symptoms, over and over again, were not receiving adequate treatment.

 

 

The media clouds the key lesson to be learnt, which is that it's neglected and untreated mental illness, not psychiatric disorder alone, which is involved.

 

 

If the truth was more widely understood, about how effective modern treatment of psychiatric problems can be, particularly if dispensed by properly trained professionals, then it is possible that these incidents could indeed become rarer. Clinics might then attract adequate public funding, and even better clinicians, which would all help services become ever more effective.

 

 

Some may possibly argue that even the best mental health system would likely have little impact on deterring mass killings, as some of these killers largely avoid psychiatric treatment - but for the others - and those who might be influenced by friends and relatives observing something amiss, we still believe there could be a worthwhile impact.

 

 

If the USA is not going to embrace tougher gun control, as it appears reluctant to, then it may well be even more imperative they develop absolutely excellent mental health services.

 

In the aftermath of yet another mass shooting tragedy, this might just be our only hope.

 

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


What is it like to feel suicidal?

Dr Raj Persaud in conversation with Kenny Johnstone about the extraordinary experiences that led to Kenny setting up CLASP

 

FROM THE ROYAL COLLEGE OF PSYCHIATRIST'S WEBSITE

http://www.rcpsych.ac.uk/discoverpsychiatry/podcasts/kennyjohnston-suicideand.aspx

Kenny Johnston, Founder of the Counselling, Life Advice and Suicide Prevention charity, CLASP, talks to Dr Raj Persaud about how he set up the organisation after he twice tried, but failed, to take his own life.

Kenny Johnston is 43 and from west London. Having witness domestic abuse, racism, mental illness and a variety of stress-related experiences in his life, many could assume his suicide attempt in October 2010 was due to a build-up of tragic life experiences.

Kenny studied to become a CBT and Suicide Intervention Counsellor in order to help those living with their life traumas and daily trying to overcome the stigma which surrounds mental and stress related illness as well as suicidal thoughts to seek help and feel able and empowered to discuss their emotions and thoughts openly in order to resolve them, see a positive future and save a life.

 

"I truly believe that, if 50-60 years ago there was a stigma over black and white couples and now there's mixed races children including me; 20-30 years ago we had a stigma about Gay and Lesbians because of HIV and Aids, now there's same sex marriages; then isn’t it time to end the stigma about mental and stress related illness as well as suicide, because the longer it’s there the more lives will be lost"

Kenny Johnston

Founder and CEO, CLASP Charity

 

After the Robin William’s tragedy – will there be copycats?

 

Raj Persaud and Professor Sir Simon Wessely (President of the Royal College of Psychiatrists)

 

 

Robert Enke, a very famous German football goal keeper, killed himself on the railway on 10th November 2009.

 

 

 

The number of railway suicidal acts, in the following two weeks, more than doubled in Germany.

 

 

 

The study which uncovered this is entitled ‘One followed by many?—Long-term effects of a celebrity suicide on the number of suicidal acts on the German railway net’, and is recently published in the ‘Journal of Affective Disorders’. There was also an increase of railway suicides of 19% in the following two years, as compared to the two years before this tragic event.

 

 

 

The authors of the study,Ulrich Hegerl, Nicole Koburger, Christine Rummel-Kluge, Christian Gravert, Martin Walden and Roland Mergl, found the 25% increase of fatal railway suicides between 2007 and 2010 was significantly greater than the 6% increase in the total number of suicides in Germany over the same period.

 

 

 

The authors based at the University of Leipzig, and Deutsche Bahn AG (the German Railway Company), conclude that Enke’s suicide probably led to copycat suicidal behaviour on the railways.

 

 

 

 

 

The authors point out that the media attention of the footballer’s suicide was exceptional and enduring, and this may have had an impact. For example, television broadcasts of a public mourning ceremony, held in the team’s stadium, were viewed by almost 7 million German viewers.

 

 

 

30 railway suicidal acts occurred in the two-week interval before Encke’s suicide, 71 railway suicidal acts in the two week interval following this event; an increase of 137%.

 

 

 

But what is more ominous is that this research found an elevated long-term ‘attractiveness’ of railway suicidal acts after Enke’s suicide.

 

 

 

The authors conclude that their findings are a strong argument for improving media coverage of suicides, and community suicide preventive programs.

 

 

 

A study entitled ‘To What Extent Does the Reporting Behavior of the Media Regarding a Celebrity Suicide Influence Subsequent Suicides in South Korea?’, just published in the journal ‘Suicide and Life-Threatening Behavior’, investigated the world record copycat effect thus far. This was the suicide of the Asian star actress Choi Jin-shil; starring in 18 films, she has been described as South Korea’s equivalent of Julia Roberts .

 

 

 

The authors, Jesuk Lee, Weon-Young Lee, Jang-Sun Hwang and Steve Stack, found her death on 2 October 2008 was subsequently associated with 429 additional suicides in South Korea, which is a record copycat effect.

 

 

 

Another recent investigation entitled, ‘Changes in suicide rates following media reports on celebrity suicide: a meta-analysis’, examined 10 studies from around the world, probing for similar copycat effects, examining 98 suicides by celebrities.

 

 

 

The team of authors, led by Thomas Niederkrotenthaler,  King-wa Fu, Paul Yip, Daniel Fong, Steven Stack, Qijin Cheng and Jane Pirkis, report a change in suicide rates of on average roughly almost three suicides per 1000 000 population, in the month after a celebrity suicide across the world.

 

 

 

Extrapolating from these figures, the worse case scenario would be an additional almost 200 suicides over the next month, in the UK, with approaching 1000 in the USA. Whether or not that happens remains to be seen, but these non-celebrity suicides are unlikely to make the headlines.

 

 

 

 

 

The study, published in the ‘Journal of Epidemiology and Community Health’, report suicides by an ‘entertainment celebrity’, across the planet, had the greatest impact of all in Europe, in terms of copycat incidents, followed by a slightly smaller impact in the USA.

 

 

 

The authors based at the Universities of Vienna, Hong Kong, Melbourne and Wayne State, found a particular celebrity impact on copycat behaviour by entertainment celebrities, as opposed to other prominent people, such as politicians.

 

 

 

Thomas Niederkrotenthaler and co-authors argue the suicide of an entertainment celebrity is so influential perhaps because of audience identification.

 

 

 

Celebrities are revered and may therefore act as particularly strong role models even when it comes to taking their own lives.

 

 

 

Guidelines for media reporting of suicide include that detailed discussion of the particular method should be avoided, and as images of the death scene are highly influential, these should not be broadcast. For details see http://www.samaritans.org/sites/default/files/kcfinder/files/press/Samaritans%20Media%20Guidelines%202013%20UK.pdf. These and similar links may be of special interest for journalists reporting about suicides

 

 

 

But by writing this article are we ourselves violating the media guidelines? Not so, we contend, because the recommendations do not say there should be no media reporting, but that it should be sober and responsible.

 

 

 

Thomas Niederkrotenthaler points out that not all celebrity suicide reporting is associated with increases in suicides subsequently. This is exemplified by the suicide of Rock Star Kurt Cobain. His suicide was widely reported, but there was no copycat phenomenon afterwards, Dr Thomas Niederkrotenthaler maintains.

 

 

 

This may be due to Cobain’s widow, Courtney Love, expressing both her sadness and anger about her far too early loss, in the media, and contacts to support services were published, along with her statements, immediately after his suicide. Indeed, research showed that these mental health services experienced an increase in clients, but there was no upsurge in suicides.

 

 

 

Perhaps the celebrity obsession of the media is in fact a reflection of a deeper problem with journalism, of which suicide reporting is merely a symptom. Reporting of celebrities lives in general tends to remain somewhat naïve. Being rich and famous, according to the classic simplistic media analysis, inoculates against any serious psychological problems.

 

 

 

In a study entitled ‘Psychological strains found in the suicides of 72 celebrities’, the tensions experienced throughout the lives of 72 celebrities were systematically investigated.

 

 

 

The authors, Jie Zhang, Jiandan Tan and David Lester found of 72 ‘celebrity’ suicides, only one had no ‘strains’ at all.

 

 

 

 

 

The authors, from Shandong University School of Public Health and Central University of Finance and Economics, China, and The Richard Stockton College of New Jersey, USA, found the most common pressure was ‘aspiration strain’ – found in 97% of the lives of celebrities who kill themselves.

 

 

 

‘Aspiration strain’ was defined in this study, published in the ‘Journal  of Affective Disorders’, as a gap between an individual’s aspiration and the reality of their life. For example, wishing to be much richer than you actually are.

 

 

 

The study found 30 celebrities who killed themselves suffered at least two contrasting life strains, while 36 had endured three different ‘strains’.

 

 

 

Perhaps the take home message should be that despairing sadness may happen to anyone, irrespective of fame or wealth.

 

 

 

But what many people still do not know is that depression, and also other mental health problems, including personal crises, can be treated, and that there is help available.

 

 

 

That should be the headline story.

 

 

 

If you have been affected by any of the issues raised in this article you may find the following of help: Samaritans Helpline: 08457 90 90 90 http://www.samaritans.org

 

 

http://rajpersaud.wordpress.com/2014/08/22/after-the-robin-williams-tragedy-will-there-by-copycats-raj-persaud-and-professor-sir-simon-wessely-president-of-the-royal-college-of-psychiatrists/

 

http://www.amazon.co.uk/Dr-Raj-Persaud-Latest-Users/dp/B0082XNF40


Manic-Depression or Bipolar Illness. What is it like to experience a bipolar illness?

Raj Persaud in conversation with a lady who experienced a bipolar illness

What is it like to suffer from a Bipolar Illness? This lady talks frankly to Dr Raj Persaud about the reality as opposed to what is widely believed.

 

 

A related article which may be of interest first published in The Huffington Post: 

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/stephen-fry-attempted-suicide_b_3395012.html

 

Does Fame Make You More Suicidal?

Raj Persaud and Peter Bruggen

 

 

Stephen Fry has revealed that he recently made a serious suicide attempt. He has gone public with the shocking disclosure, apparently in an attempt to de-stigmatise mental illness. 

 

Fry is a patron and supporter of mental health charities and has previously disclosed suffering from manic-depression, or mood swings, now termed bipolar disorder. 

 

He is extremely successful in many different areas of life; a 'national treasure'. How can someone popular, wealthy, busy and successful, end up feeling hopeless and despairing?

 

Yet it's well established from psychological research that there is a link between fame and suicide. 

 

David Lester, a professor of psychology at the Richard Stockton College of New Jersey, has conducted much research establishing this link. In the journal 'Perceptual and Motor Skills' he published a review of research entitled 'Suicide in Eminent Persons'. He cited various surveys establishing an average suicide rate in the well-known of around 3%, considerably higher than in the general population. One study focusing on eminent people from the 20th Century found a suicide rate of 5%, hundreds of times higher than the suicide rate in the UK's general population.

 

Why are the famous so prone to suicide?

 

 

Perhaps being famous, or becoming well-known, might be stressful.

 

 

However, psychological thinking is swinging towards a new idea - there could be an aspect of personality which drives particular people to become eminent, which is the very same factor that also elevates chances of suicide.

 

 

For example, psychologists Sheri Johnson, Charles Carver and Ian Gotlib have just published a study which has found that people with bipolar disorder (the same diagnosis as reportedly given to Stephen Fry) had higher ambitions for popular fame. Bipolar disorder has been found to be over-represented amongst the creative and the famous, especially those from artistic fields.

 

 

These researchers, based at Stanford University, University of California and the University of Miami, used a scale termed 'Willingly Approached Set of Statistically Unlikely Pursuits', which measures desire for extremely ambitious (difficult to achieve) life goals, such as becoming the focus of books and TV shows. Goals of great recognition, such as achieving fame, multi-millionaire rank, or political influence, were much more likely to be found in those with Bipolar Disorder.

 

 

This study, 'Elevated Ambitions for Fame Among Persons Diagnosed With Bipolar I Disorder', published in the 'Journal of Abnormal Psychology', suggests the drive to achieve difficult ambitions arises partly from this diagnosis.

 

 

But does this also explain propensity to suicide?

 

 

Of all the various talents Stephen Fry displays, perhaps the most pertinent to the recent suicide attempt may come as a surprise.

 

 

See his recently published The Ode Less Travelled - Unlocking the Poet Within. The attached publicity for the book confirms that he has 'written long poems, for his own private pleasure'. The book 'invites you to discover the incomparable delights of metre, rhyme and verse forms'.

 

 

Particularly high rates of suicide and bipolar illness have been found in poets. Some psychologists even contend that writing poetry may not be good for your mental health, particularly if you suffer certain predisposing mental vulnerabilities.

 

 

In a study entitled 'Word Use in the Poetry of Suicidal and Non-suicidal Poets', psychologists Shannon Stirman and James Pennebaker, from the University of Pennsylvania and University of Texas, point out some psychologists believe Sylvia Plath's poetry may have undermined her coping skills, which in the face of highly stressful life events, possibly contributed to her death through suicide.

 

 

Yet writing, particularly poetry, is seen in some circles as a 'release' and therefore therapeutic.

 

Stirman and Pennebaker probed further. They analysed the words in the poems of suicidal poets, investigating a theory that it might be possible to predict which poet is going to kill themselves, from the word choice in their poetry.

 

 

These psychologists analysed a total of 156 poems by eminent poets who committed suicide, and compared them with equally famous poets who did not.

 

 

Overall, the suicidal group of poets used more first-person singular (I, me, my) words in their poetry than did the control group. Suicidal poets also used the words 'we', 'us', and 'our' more in the early and middle phases of their career, than did the non-suicidal group. The percentage of use dropped sharply below that of the non-suicide group, during the late periods of their career (ie just before the suicide).

 

 

The authors of this study, published in the journal 'Psychosomatic Medicine', suggest that the finding of more first-person singular self-references ('I', 'me', 'my') in their poetry throughout their careers, means that self-references do not increase over time in the suicidal poets. Stirman and Pennebaker contend this means that the suicidal poets' level of preoccupation with self is not due to increasing levels of fame or recognition of their work over time.

 

 

Self-reference could be a measure of self-obsession. Maybe getting a lot of attention makes you self-obsessed - or could it be that being self-preoccupied leads you to consider becoming famous? Certainly this self-centredness doesn't appear good for you, if it's linked with suicide propensity.

 

 

Stirman and Pennebaker further wonder if their pattern of findings suggest there could even be a kind of 'suicide fingerprint', in patterns of word usage by those who are predisposed to suicide, or becoming more suicidal.

 

 

It's perhaps even possible such a 'write fingerprint' might show up in non-poets writings, as in text messages and emails.

 

 

However, their main finding is that this 'suicide fingerprint', appears present from the beginning of a poet's career. In other words, suicide and fame might be connected through psychological characteristics present in the personality from the beginning.

 

 

The latest evidence is psychological disturbance might drive desire for fame, and this could lie behind the high rates of suicide in the illustrious.

 

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Young Shrinks Speak Out. Headstarters Part 4 - young psychiatrists speak

Headstarters Part 4 - Raj Persaud in conversation with young psychiatrists

The research indicates that there are two kinds of medical student - those who know what they are going to specialise in before they start medical school and those who choose afterwards - is psychiatry as a medical speciality different in this regard? Raj Persaud chats to young psychiatrists in training about this issue and others.


Young Shrinks Speak Out. Headstarters Part 3 - Young Psychiatrists Speak

Headstarters Part 3 - Raj Persaud in conversation with young psychiatrists

Many medical students have chosen medicine because they were inspired by drama series on TV such as ER where the excitement and intensity of high stakes medicine is absorbing - is one of the reasons that psychiatry appears less popular, is because it seems less intense? Is this a correct appraisal of the discipline? Raj Persaud discusses these issues and others with some young psychiatrists starting out in their psychiatric career.


Young Shrinks Speak Out. Headstarters Part 2 Young Psychiatrists Speak Out

Despite playing the role of grumpy old man and attempting to discourage them from entering the field - do these young enthusiastic psychiatrists take the bait and run? Or do they argue with Raj that psychiatry has a lot going for it as a career choice for a young doctor?


If your son goes psychotic? What do you do if your son develops psychosis?

Raj Persaud talks to a man whose son developed a severe psychotic illness.

Nick describes an all too familiar battle that carers have of getting NHS psychiatry services to take the concerns of carers and relatives seriously. As a result of being ignored when they tried to inform services, the son became seriously unwell and a series of tragic events unfolded. Nick talks frankly and openly about his experiences and speaks for many carers and relatives in his account of what they have to endure.


Post-Natal Depression. Annalin developed severe Post-Natal Depression

Raj Persaud talks to Annalin who developed severe Post-Natal Depression

Annalin describes how it feels to get severe depression despite what is supposed to be one of highlights of any woman's life - the birth of her first child. She discusses with psychiatrist Raj Persaud possible causes of post natal depression and how recovery is possible.