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Fear and Self-Loathing in the City

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Fear and Self-Loathing in the City is a practical guide to both managing the pressures of the workplace and coping with the struggles we may have in our personal lives. It incorporates simple techniques and quick solutions to many stressful work-related issues that exist in most working cultures.This book is crucial for today's workplace. The current state of the economy, financial disasters and general instability is having a massive affect on employees. Workers have to deal with redundancies and the pressures of finding new jobs; the number of sick days is on the rise; drug use and alcoholism is increasing; and depression and anxiety are becoming more and more common.Although more people are seeking help, there is still a stigma in the workplace about depression, anxiety, and other very real mental illnesses. As a result, many employees suffer in silence for fear their contemporaries will find out they are not coping, see it as a sign of weakness and think badly of them. In this book, Michael Sinclair has taken a lighter approach and used language common to the workplace with which the reader can identify. In short, this book aims to remove this stigma about mental health, and promote a sense of acceptability about seeking help and resolving problems in a healthy way.The book deals with very current topics, including: depression, anxiety, alcoholism, sleep deprivation, and unhealthy lifestyles (e.g. eating habits) amongst many others.

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11 Chapters

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CHAPTER ONE: Rocking the foundations


Rocking the foundations

“Criticism, like rain, should be gentle enough to nourish a man’s growth without destroying his roots.”

—Frank A. Clark

Do any of the following statements sound familiar?

‘I’m not good enough’
‘He must think I’m really boring’
‘I can’t believe I made that mistake; I’m such an idiot’
‘I always say the wrong thing’
‘I totally screwed up that meeting’
‘That presentation I did was awful’
‘I never make my deadlines’
‘Everyone else is doing better than I am; I should be better
than this’
‘I just got made redundant: they must have thought I was
‘I didn’t get promoted this year; I’m incompetent’
‘Everyone got a bigger bonus than me: I’m treated so

Yes, we have a tendency to beat ourselves up. Our negative critical inner voice is always there in the background, telling us how stupid, incompetent, inadequate, and disliked we are. By setting impossibly high standards, we will attack ourselves if we don’t live up to our own expectations. We also have a tendency to focus on mistakes rather than achievements and often compare ourselves with others: everyone else is more intelligent, happier, and wealthier than we are.


CHAPTER TWO: Under the spotlight


Under the spotlight

“According to most studies, people’s number one fear is public speaking. Number two is death. Death is number two. Does that sound right? This means to the average person, if you go to a funeral, you’re better off in the casket than doing the eulogy.”

—Jerry Seinfeld

The first time I met Richard, he was shaking uncontrollably. Later, I found out that he had just had a major panic attack before coming to see me. After some time (and several gulps of water) he managed to calm himself and was able to explain the reason why he needed some help.

Richard was a top City banker who had developed a fear of going into meetings, presenting in front of others and partaking in conference calls. It had reached the point where he couldn’t even speak in public anymore, irrespective of whether the event was social or formal.

He was a senior executive and he had never had any problems speaking in public before. Whenever he was put on the spot, hewould start to blush. On these occasions, he would pass the buck to one of his colleagues and, as time went on, he would just avoid meetings altogether. Each evening and particularly on a Sunday evening, he would dread the prospect of attending meetings. He worried that he might be asked a question that he did not know the answer to and feared that he would look ‘stupid’ in front of his colleagues.




Power cut

“When you stop drinking, you have to deal with this marvellous personality that started you drinking in the first place.”

—Jimmy Breslin

Work is such a fundamental part of our lives. Given that most of us spend more time at work than anywhere else, it is not surprising that it plays such an important role. Work gives us a sense of forward movement and productivity which is essential to our sense of self-worth and therefore, survival. It can give us a boost to our self-esteem and helps us relate to different types of people. However, a poor working environment can trigger more negative feelings and responses which not only affect work but our personal lives too. Sometimes we bury ourselves in work to avoid these unpleasant feelings. When we do that, it’s only a matter of time until we ‘blow up’ or burn out.

When John first came to me, he was drunk. It doesn’t take a psychologist to know when someone has had a few drinks, but John’s stateof inebriation was particularly memorable. He practically fell into my office and then, red-faced, began to crack jokes for a good few minutes. I knew he was just trying to distract me from beginning the session, but he was truly hilarious. It took a bit of time for both of us to gather our composure, but once we had calmed ourselves, we began to talk.


CHAPTER FOUR: Hot under the collar


Hot under the collar

“Speak when you are angry—and you’ll make the best speech you’ll ever regret.”

—Dr. Laurence J Peter

O‘h God, so sorry I’m late. I was stuck behind the slowest driver in the world and he made me late, he was so annoying. The thing is I’m never late; I shouldn’t have been. I should have left earlier.’

I looked at this woman called Joanne, who had burst into my office in such a panic and tried to reassure her that it was no problem that she was a few minutes late. To be honest, it had suited me as it had given me a chance to grab a much-needed cup of coffee!

As soon as she calmed down, she rummaged in her bag and whipped out a notebook. With pen poised, eyes fixed on her pad she waited for me to start the session.

‘I want to take notes on everything you say,’ she told me.

Never before have I seen a patient so proactive and, I must say I was struck by her apparently strong belief that I had all the answers!

When I asked her why she had come to me, she told me that she had been made redundant from her job as marketing manager for a blue-chip company; that she knew it was because her team had hated her and she wanted to find a way to stop it from ever happening again. Not once, during this whole exchange did she maintain eye contact.


CHAPTER FIVE: Uncomfortably numb


Uncomfortably numb

“There are some people who live in a dream world, and there are some who face reality, and then there are those who turn one into the other.”

—Douglas H Everett

Consider what you would think if a friend or family member described the following to you:

‘I feel a bit weird: separate from the world like I am living in a dream or I am an actor watching my life play out on stage; sort of robot-like and my head feels like it is full of cotton-wool.’

Be honest: you would think they were nuts, right? To be fair, you would be forgiven for edging away nervously, and making a run for the nearest exit.

Now, have a look at the next scenario:

You are driving along a country road in your fancy Porsche going a zillion miles per hour and loving it. Suddenly, an unexpected tight corner appears; you slam on the brakes and thecar does a violent skid, spinning you around and then upside down. You find yourself upturned, in a ditch.

During the skid, you might have felt that everything was going around in slow motion, or felt a bit unreal or numb. When you got out of the car, you may feel a bit detached from everything or that your voice is coming from very far away. It is only later when you come back ‘to reality’ that you might notice that you’re bleeding or that your hands are shaking.


CHAPTER SIX: Force of habit


Force of habit

“When eating an elephant take one bite at a time”

—Creighton Abrams

Recently, a very pale, dangerously thin, girl called Lucy walked meekly into my office. She sat down, fiddled with the end of her coat and told me through a wave of long hair that she was having problems with time management (Please see Chapter Nine for more information on Time Management). It was becoming an issue at work as she couldn’t find the time to finish her projects or meet her deadlines; she wasn’t attending meetings and didn’t know how to handle the amount of work she had on. It seemed like the more she tried to fit everything in the less she achieved.

So, I asked her to run through a typical day in her life, and to be as specific as possible, to see if we could sort out a new schedule together to address her time management problem. This is a summary of what she told me:

‘I get up at 5am and weigh myself. Then I jog three miles to the gym and take a spinning class which lasts an hour. Then I walk from the gym to work which takes about half an hour. I arrive atthe office at 7 am and start working. At lunchtime, I go to the office gym for an hour. I am busy all day until 9 pm and then I leave and usually meet a friend or attend a late night showing at the local cinema. I go to bed around midnight and then the day begins again …’


CHAPTER SEVEN: The phantom menace


The phantom menace

“It is far more difficult to murder a phantom than a reality.”

—Virginia Woolf

Managing pain is always tricky, but dealing with pain that, medically, shouldn’t even exist, is even worse. You may hear this sort of pain described as somatic or phantom pain, but before I go any further, I want to make one thing perfectly clear: the pain is real. It may go undiagnosed by the medical field, but this does not mean the pain does not exist. Therefore, somatic complaints are not to be merely dismissed as ‘all in your head’, the physical pain is very real.

There is a common assumption out there that somatic complaints such as Chronic Pain and Chronic Fatigue, are strictly reserved for middle-class housewives who have ironed one shirt too many. However, Chronic Pain can affect anybody irrespective of their social class or profession. Indeed, a large majority of my patients who work in highly pressurized jobs in City suffer from these complaints.

Chronic Pain is characterized by recurring and, sometimes, undiagnosed physical complaints that may last for long periods (usually more than six months). These pains may come in the form of headaches, feelings of lethargy, or other bodily aches and pains. Often, the pain is triggered by some sort of trauma to the body such as a viral infection, an operation, or an injury to bones or joints. Even after the infection or injury has healed, the sufferer may still feel the physical symptoms of their illness which can become very debilitating over time.


CHAPTER EIGHT: The weakest link


The weakest link

“The single biggest problem in communication is the illusion that it has taken place.”

—George Bernard Shaw

Productive communication is vital in any relationship, including those in our working environments. Without it, our relationships with others simply do not work or continue to feel unsatisfactory. Over the course of this book, we have looked at a number of mental health conditions such as eating disorders, deper-sonalization, anger management etc. Although these conditions may seem to be very different from each other, one thing they share in common is the potential to be very isolating.

Sometimes, we feel reluctant to communicate our feelings with others, particularly at work, when we are feeling down, depressed, or anxious. We are afraid that if we confide how we are feeling, we will look weak and go down in the estimation of our work colleagues. We may fear that others will see that we are not coping, and may worry about losing their respect, and potentially missing out on that bonus, or being the next one in line for the redundancy chop! This means that we end up hiding our feelings, retreating into ourselves, and isolating ourselves from others which makes things even worse.


CHAPTER NINE: The rise and fall


The rise and fall

“If you can’t sleep, then get up and do something instead of lying there worrying. It’s the worry that gets you, not the lack of sleep.”

—Dale Carnegie

Sleep is something we absolutely cannot do without, yet most of us take it for granted. Given that we can go longer without food than sleep, perhaps it is time to take our sleeping habits a bit more seriously. Our body relies on sleep for growth and repair, and our brain depends on sleep for memory and concentration. Sleeping difficulties have also been found as a symptom of depression and anxiety, and vice versa. Therefore, a good night’s sleep is essential if we want to maintain our mental and physical health.

Many of us worry about sleep, fearing that if we don’t get enough then it will have catastrophic effects on our ability to function normally. However, there are general beliefs out there that aren’t necessarily accurate:

There is no such thing as the ‘right’ amount of sleep; it is very much an individual thing and differs from person to person. The body will take all the sleep it needs. Some people need between seven and nine hours per night, and others may feel refreshed after only four or five hours. It is not about the amount we sleep but the quality of it. Remember that our sleeping patterns also change as we get older. You may have been a ‘sleeping machine’ when you were in your twenties but you will find yourself sleeping less when you are in your sixties.


APPENDIX II: Meditation



“What’s encouraging about meditation is that even if we shut down, we can no longer shut down in ignorance. We see very clearly that we’re closing off. That in itself begins to illuminate the darkness of ignorance.”

—Perma Chodron

Meditation is great for relaxing your mind and putting you into a calmer state. If your mind is settled, your body will follow. Thus, frequent meditation will help to relieve the anxiety of our busy lives. Many people attend meditation classes; however, you can also practise meditation at home. The more you practise, the easier it becomes and you will reach a point where you will know exactly what you need to do to quickly put your mind and body into a relaxed state.

There is no set time for meditation, but even 10 minutes a day can make a difference. So, have a look at the following simple exercise and give it a try!

•  Find a quiet place where you will not be distracted or disturbed. Dim the lights, if possible.

•  Make sure you are sitting or lying comfortably.


APPENDIX III: Relaxation



“Tension is who you think you should be. Relaxation is who you are.”

Chinese Proverb

Relaxation exercises can really help to improve our body and mind by removing the physical/mental tension we feel as a result of our busy lives. Of course, there are many ways to relax: some people take a walk, listen to music, or take a bath. However, others find it difficult to relax at all, even after these activities, and need to learn specific techniques to help them recover from everyday stresses and strains.

Taking Yoga or Meditation classes (see Appendix II for some meditation exercises) is a very useful way to learn more about relaxation. But if you don’t have time to take these classes then have a look at the below simple exercises which will really help to take the tension out of your day.

When we lead such fast-paced lives it seems impossible to think we have the time to relax at all. However, here are some reasons why relaxation is helpful:

•  When we worry our whole body can feel unpleasantly tense, which brings about a range of physical symptoms, including: shoulder pain, back pain, chest pain etc.



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