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IN THE WORKPLACE

New Research on Depression in the Workplace.

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JOURNAL

Mental Health Matters Journal for Psychiatrists & GP's

MHM September 207x300

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SPEAKING BOOKS

suicide book

Literacy is a luxury that many of us take for granted.  We depend on written communication for information, guidance, and access to heath care information That is why SADAG created SPEAKING BOOKS and revolutionized the way information is delivered to low literacy communities. It's exactly what it sounds like.a book that talks to the reader in his or her local  language, delivering critical information in an interactive, and educational way.

The customizable 16-page book, accompanied by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood..

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 30 titles, such as TB, Malaria, Polio, Vaccines for over 30 countries.

depression book

As he notes in his remarkable new memoir, “Wish I Could Be There,” the composer Allen Shawn suffers from a veritable rainbow of phobias: “I don’t like heights,” he writes. “I don’t like being on the water. I am upset by walking across parking lots or open parks or fields where there are no buildings. I tend to avoid bridges, unless they are on a small scale. I respond poorly to stretches of vastness but do equally badly when I am closed in, as I am severely claustrophobic. When I go to a theater, I sit on the aisle. I am petrified of tunnels, making most train travel as well as many drives difficult. I don’t take subways. I avoid elevators as much as possible. I experience glassed-in spaces as toxic, and I find it very difficult to adjust to being in buildings in which the windows don’t open.”

In short, he concludes, “I am afraid both of closed and of open spaces, and I am afraid, in a sense, of any form of isolation.”

These phobias, Mr. Shawn goes on, have meant that he ends up “missing things and harming, or losing relationships.” They have circumscribed his life, and turned ordinary undertakings — going on a trip, visiting friends, doing errands — into a daunting obstacle course. The prospect of a trip makes him “almost frozen with anticipatory anxiety for weeks or months in advance,” and even small jaunts, like a walk down a road, require him to equip himself with “safety items,” like a supply of Xanax, a bottle of ginger ale, a cellphone and a paper bag “of the type I breathed into once, many years ago, to calm myself when I suffered a concussion.”

In probing the consequences and possible causes of his phobias, Mr. Shawn has written a brave, eccentric and utterly compelling book that’s as revelatory and candid as anything ever written by Joan Didion, and as humane and scientifically fascinating as any one of Oliver Sacks’s case studies.

Mr. Shawn is unsparing in his dissection of his phobias and the self-preoccupation they entail, and he intercuts his research into the psychology of his affliction with some painfully recalled childhood memories that unfold into a thoughtful, philosophical meditation on Freud and families and identity.

The son of the famed New Yorker editor William Shawn, Allen Shawn has an older brother, Wallace, the playwright and actor; and a twin sister, Mary, who is autistic and lives in an institution in Delaware. The diagnosis of his sister’s condition and her departure, when she was 8, for a special school on Cape Cod seem to have triggered a severe case of separation anxiety in Allen, as well as fears that “one could be turned out of the house for being too difficult to handle,” for “being too inefficient mentally, or for being too wild.”

These fears amplified his own “terror of mental illness” — the fear that, being Mary’s twin, he too was somehow damaged or different.

Mary had been Allen’s closest companion when they were small children, and he says that his parents’ desire that he simply move on with his own life backfired: he had remained Mary’s twin, “finding ways to make my life parallel to hers.”

“I can’t help noticing that she, like me, is subject to ‘attacks,’ ” Mr. Shawn writes, “lives within a fixed routine, resists even minute changes from what she expects, is extremely limited in her ability to travel. She is institutionalized, I am out here, ‘free’ and ‘functioning,’ yet I have managed to build some invisible walls around myself.”

There were other factors that fed Allen’s phobic inclinations as well: a hereditary predisposition toward phobias; a childhood desire to emulate his father (who suffered from an array of phobias, including a distaste for airplanes, bridges and elevators); and a tendency to internalize his overprotective mother’s warnings about the perils of the world. Mr. Shawn recalls that she kept a watchful eye on him as a child, “delaying seemingly forever the moment when I would be allowed to cross the street by myself, and cultivating a sense that I wasn’t ready to ‘handle’ this or that activity, this or that scary scene in a movie.”

In addition, the Shawn household, with its emphasis on discretion and denial, seems to have been an “incubating environment” for future phobias, a petri dish of unspoken emotions. The author’s father carried on a four-decade extramarital affair, and his reticence about his complicated double life (“it wasn’t uncommon for him to eat, or at least, attend four or even five meals a day to accommodate all the important people in his life”) created an atmosphere in which secrecy and repression flourished.

“Beneath my sunniness,” Mr. Shawn writes of his younger self, “there was also rage that my family was somehow a sham, that I was a twin who wasn’t supposed to feel like one, that we were Jews with an Irish name. I felt that huge passions and angers that somehow couldn’t be mentioned were seething within me and within the house and that the world was raw and crude but had to be referred to politely in perfect sentences. There were blinding hatreds in the air that couldn’t be named; there was sex that couldn’t be spoken of; there were deep mysteries that had to be sanitized and secularized; there was deep competitiveness and there were deep character flaws that couldn’t be acknowledged.”

Mr. Shawn says he “held in my feelings and my problems, and they grew without my even knowing it.” Although he wasn’t agoraphobic as a child, he began, after college, to build his “life around the experiences in which I felt calm.” Since then, he now realizes, he has been dragging his childhood along with him like a giant, melancholy shadow.

With phobias, of course, it’s impossible to point to one precipitating cause, one formative event, and in Mr. Shawn’s case, a constellation of events, experiences and environmental influences helped reinforce any existing tendency to bury his difficulties inside. In “Wish I Could Be There,” his inquiry into his affliction becomes an inquiry into his own past, and that inquiry, in turn, becomes an eloquent meditation upon the mysteries of personality and family, and the ingenious, often debilitating ways in which the human mind can try to cope with the exigencies of the world.

“In a way,” Mr. Shawn writes, “I had been raised to feel that the world was a kind of Pandora’s box that was simply too frightening to ever fully open. As an adult I found a way to open it a bit, while sitting on top of it too.”

 

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