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mental distress

Khalid Ali: ‘Let’s talk about death: a review of ‘Last cab to Darwin’, Australia 2015’

31 Mar, 16 | by Ayesha Ahmad

Let’s talk about death: a review of ‘Last cab to Darwin’, Australia 2015

5*, Directed by Jeremy Sims based on stage play by Reg Cribb

Dubai International Film Festival (DIFF) December 2015, possible release in UK cinemas 2016/17

The controversial subject of ‘euthanasia and assisted suicide’ has been a rich source for films; ‘Whose life is it anyway? USA, 1981, directed by John Badham’, ‘The sea inside, Spain, 2004, directed by Alejandro Amenabar’, and ‘Million Dollar baby, USA 2004, directed by Clint Eastwood’ have all explored the ethical, legal and moral complexities of ‘the right to die’ from a patient’s perspective.


Ayesha Ahmad: ‘Lahore is an Illusion, Lahore is Everywhere’

27 Mar, 16 | by Ayesha Ahmad

The mango tree faded many shadows ago, its fruit became stones and the branches became a skeleton. Yet, the roots remained, and they embrace the soil in the womb of the earth.


This was the cradle of my family’s birth.

Now, blood is watering Lahore’s gardens.

In sorrow, I remembered these words given to me a few days ago by my father.

 ‘Lahore is an illusion, Lahore is everywhere’

I wondered about them for sometime afterwards and I did not realise the gift that these words were to become.


Franco Ferrarini: The Past: a Friend or Foe? Different Perspectives from ‘Spectre’ and ‘45 years’.

27 Mar, 16 | by Ayesha Ahmad

The Past: a Friend or Foe? Different Perspectives from ‘Spectre’ and ‘45 years’.

Spectre- directed by Sam Mendes, UK, 2015

45 years- directed by Andrew Haigh, UK, 2015

By Franco Ferrarini, Gastroenterologist and film reviewer

In the words of the French philosopher Henri Bergson: ‘The pure present is an ungraspable advance of the past devouring the future. In truth, all sensation is already memory’. In this view the present, as we usually think of it, is virtually non-existent as the past connects directly with the future. Two recent, but very different films, ‘Spectre’ and ‘45 years’ provide thought-provoking insights into this relationship.


Ayesha Ahmad: Introduction to Global Humanities—Through Creation, Violence Will Die

15 Mar, 16 | by Ayesha Ahmad

Against the backdrop of violence, I have been examining through my research the qualities of our human condition that perpetuate both our survival and our spirit.

As an introduction to an ongoing series on Global Humanities, I will be discussing ways we can counter the dominant narrative of violence.

Our globalised world, or rather, the collective ‘Other’, is met through encounters from suffering—the patients that enter our clinical settings, the individuals that sacrifice their lives to reach the shores of safety, and the images that we only ever see from afar of stories that breathe suffering.


Cassandra (Royal Opera House): A Review by Rory Conn and Chloe Bulwer

2 Dec, 14 | by BMJ

Twenty years ago the ‘National Attitudes to Mental Illness Report’ was established. This annual survey, funded by the Department of Health, was devised to monitor changes in public opinion, recognised at the time to be primarily driven by misunderstanding and stigma.

On World Mental Health Day 2014, the latest in a series of encouraging figures from the survey were revealed. They showed that since 2011 an estimated 2 million people – 4.8% of the population – have demonstrated improved attitudes to mental illness. Much of this change is attributable to investment in anti-stigma campaigns, most notably “Time to Change”, a joint initiative of the charities Mind and Rethink. Additionally, or perhaps as a consequence, media portrayals of mental illness have shifted.

Not only are negative or alarmist news reports less frequently produced, there has been a cultural transformation in the depiction of mental illness in the cinema and on television. Producers are aware of a greater level of accountability in their work; their images of mental illness are better researched and tend to invite empathy and reflection rather than the scaremongering and ridicule of the past.

Now, it appears that this fruitful change has reached the theatre, as evidenced by the Royal Ballet’s performance of Cassandra, in Covent Garden. The show’s three co-creators, a choreographer, a singer-songwriter and a filmmaker all describe “deeply personal connections” to the themes of the production and it is surely this motivation which has inspired such a powerful piece, designed to challenge public assumptions of what it means to be ‘mad’.

A haunting and ethereal theatrical experience depicts with beautiful sensitivity the onset of a de novo psychotic illness in a young woman. A happy life, successful career and close family relations disintegrate before our eyes. Few words are needed; perceptual disturbances are described through disorientating and intrusive visual projections, then second and third person auditory hallucinations emerge, delivered via a discordant voiceover.

The medium of dance lends itself perfectly to the onset of psychomotor symptoms as the protagonist’s graceful movements become increasingly unpredictable and chaotic. Her mental state fluctuations are analogous to the erratic stockmarket variations of her high pressured trading job.

This is a thoughtful production, without hyperbole or gimmick. The degree of impact on family members, not often a feature of cultural depictions of mental illness, is profoundly delivered. Cassandra’s mother and brother oscillate between experiencing happy memories of her earlier times and acute distress at her clinical deterioration. Projections of an idyllic childhood interchange with fleeting abstract visions, including images of synaptic junctions and Rorschach plates. Such complexity of emotion is rarely achieved through dance. The depiction of carer burden is all the more poignant when one learns of the music producers’ brother, diagnosed with schizophrenia in his teenage years: the programme notes document her cathartic need “to keep his voice alive” by translating her own experiences to stage.

There is a critique of the process of medicalization, but this does not stray into the realms of anti-psychiatry. Cassandra is admitted to a stark hospital environment, where she remains under a spotlight, observed and exposed, at one point more than metaphorically. This sat uncomfortably for the professional viewer, but with good reason, speaking powerfully towards all patients’ potentially isolative and bewildering experience of an admission.


Gary Avis and Mara Galeazzi ©ROH, 2014. Photographed by Andrej Uspenski

(Gary Avis and Mara Galeazzi ©ROH, 2014)

Psychiatric professionals come and go metronomically, somewhat anonymously, the noise of a ticking clock accompanying their routine, but are ultimately seen to provide compassion and comfort in Cassandra’s greatest time of need. Importantly, the production’s balanced conclusion contains evidence of an improvement in Cassandra’s mental state but also a realistic sense that her life will never quite return to normality.

To their great credit, the producers have enlisted the advice of Dr Mark Salter, a consultant adult psychiatrist. His influence proves vital to the authenticity of the psychosis. After the production we met with Mark, who rightly appeared proud of the work. His main disappointment was that the psychiatrists had been dressed in white coats, an element he had wanted removed.

In Greek mythology Cassandra, daughter of the King of Troy, is blessed with the power of prophecy but cursed never to be believed. She predicts the fall of Troy but is dismissed as being insane. In some versions of the story, this very process drives her to madness. One of the many modern day descriptions of the ‘Cassandra Syndrome’ characterise an individual able to see or understand things long before others are able to reach the same conclusion. It can only be hoped that visionary productions such as this will provoke further attitudinal change so that one day we will wonder how we ever got it so wrong.


Dr Rory Conn is an ST5 in Child and Adolescent Psychiatry at The Tavistock and Portman NHS Foundation Trust

Dr Chloe Bulwer is an Academic Paediatric Trainee at the Institute of Child Health

Correspondence to:

Twitter: @roryconn

Psychosis and the Arts: Conference

12 Feb, 14 | by Deborah Bowman

Psychosis and the Arts – Thursday 27th March, 2014
Amnesty International Human Rights Action Centre
17-25 New Inn Yard, London, EC2A 3EA
Speakers include:
Bobby Baker, Martin Gayford, David Bell, Wiebke Trunk, Nanna Luth & Meg Harris-Williams.
About the Conference:
The use of the arts in personalised recovery journeys, as well as in psychological treatment approaches to working with psychosis, is well known in contemporary mental health practice.
In this one-day conference supported by Tate Modern, clinical and non-clinical speakers will come together in encouraging dialogue and dispelling some of the myths that persist in the field of psychosis and the arts, including Van Gogh’s ear.
Confirmed speakers include the acclaimed visual and performance artist Bobby Baker, the award-winning writer Martin Gayford, the psychoanalyst David Bell and the psychoanalytically-informed arts scholar Meg Harris-Williams, together with arts therapists, service users, their family and friends and other specialists working with psychosis. International gallery curators Wiebke Trunk and Nanna Luth and educators in the medical humanities will provide a new lens through which ways of approaching the urgent UK agenda of compassionate care can be looked at in the context of the wider contribution of the arts for enhancing empathic mental health care.
To find out more, please visit or email:

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