In my view, those who try to come up with totalising explanations of mental health are misguided (Letters, 20 April). It’s neither purely social nor purely individualistic, though effective help should start from actually listening to and honouring the individual case. Often in practice it does not, and I would agree with Professor Read that a biogenetic medical model is generally inappropriate and can actually be damaging. It also goes radically unacknowledged that there are various different types of bereavement, some of which are far more traumatic than others, and are not directly comparable. The effects of traumatic sudden bereavement experienced in childhood or adolescence can last for years and ultimately for a lifetime, as the princes have now highlighted. It is known that this type of bereavement can sometimes result in lasting shock followed by delayed grief years later, yet there is often little or no acknowledgment readily available, never mind any effective support.
On top of this, and especially in a culture of competition, the bereaved are often subjected to cutting comments, judgments and dismissals. Sometimes these are from those who claim to know what it’s like because their grandparent or cat has died, while sometimes they are from people in medical or authority positions whose callous judgmental ignorance can be devastating. Why does it require the intervention of princes to highlight the issue? At least they get taken seriously.
• It seems to me that a potential key to improving psychological provision for common human grief and misery (Freud’s term) is not only more better-trained, organised professionals, but also a more compassionate and empathic caring society attuned to the emotional needs of others. Where many families are so economically impoverished, they barely have the inner resources, strength and resilience left to attend to each other’s mental pain and suffering. What chance this election gives us all an opportunity to change our minds about the material hardship and distress we are causing those most in need of help, so they can move on?
Ya’ir Z Klein
• Keith Farman asks whether bereavement is a mental illness. Before answering, note that Harry says he suffered from denying grief when his mother died, not from the grief itself. While grief is a normal reaction to loss that cannot be blamed on others or self, its first stage is usually denial, which may help deal with events following the loss and which I believe is an illness. However, as confidence recovers, fear should subside and a second stage of grief usually occurs when the rage or fear roused by the loss is normally expressed. This is not evidence of mental illness. Alison Sesi says children cannot yet express their feelings effectively. This should not be so. But they may not experience grief but the simpler hate, sadness, anxiety or rage. I suggest that when our species acquired verbal language, most societies came to believe in gods and devils. Though later religions used these to help sustain laws and customs, they do not exist. So mental illness has long been endemic.
• Professor Samuels never misses an opportunity to take a swipe at the evidence-based psychological therapy now available on the NHS. Prince Harry is at liberty to choose whatever sort of therapy he wishes and his comments, which seek to normalise and reduce the stigma attached to mental health problems, are very welcome. We don’t know what sort of therapy Prince Harry had, but scientific evidence suggests that had he attended eight to 12 sessions of cognitive behavioural therapy (CBT) at his local GP surgery for the traumatic bereavement he experienced, the outcome would have been a good one.
(Cognitive behavioural therapist), Bath
• It was with interest that I read Andrew Molodynski’s comments regarding ECT as a useful option for treatment resistant major depressive disorder (Shock treatment on increase again in NHS, 18 April). I have experienced this horrible illness along with anorexia for a number of years. I underwent a significant number of ECT treatments. Apart from some short-term memory loss, it is painless, and one is unconscious for a very short period. For me it was life-saving. I don’t think I would be alive today without it. If the need arose I would willingly have it again. Although medical treatments may help the many symptoms of severe depression, it frequently returns time and time again.
The causes of this life-altering illness need to be untangled if treatments are to succeed. This is where psychologists/psychotherapy may have the answers. In an underfunded and understaffed mental health service, therapy can be difficult to access. I have been one of the fortunate ones. Let no one underestimate the distress of severe depression on the individual and their loved ones, and the challenges it presents to mental health staff. ECT is an important life-saving treatment for people like myself.
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