Addressing Self-Care, Mental Health Conditions And Philosophy With Stoicare’s Paul Wilson

Caregiving is a full-time job. One that impacts the mental health of the care provider as much as the person who is being cared for. Finding ways to develop a self-care practice for yourself is essential, especially in the mental health field as Paul Wilson will tell you.

A mental health practitioner and volunteer at Stoicare, Wilson shares great insight into the state of the mental health system in the UK and how Stoicism can be applied for caregivers. 

What has been your previous background in the mental health sector?

I’ve held a number of different mental health roles in the past. The role I think gives me the greatest insight into the issues we’ll be discussing today is the Head of Community Mental Health Services. So, a wide range of different services but with a dual focus on de-escalation and crisis recovery.

In that role, if people were escalating towards a crisis state, I tried to wrap some support services around them to see if was possible to de-escalate that state and address whatever their needs were. Often, that was possible. That was a fundamental part of the service philosophy. 

Sometimes, crisis was unavoidable. And when that happened, my role was to meet them on the other side of the crisis to support people to move back into community life in a positive and productive way.

I’ve also spent time as a strategic lead for the prevention of mental health issues and the promotion of wellbeing for a large physical and mental health care provider. That was interesting because the focus was on prevention and that’s always the agenda.

I think a lot of work runs contrary to most people’s understanding of mental health. In recent decades, our mental health has been influenced heavily by what is described as the medical model of mental health. This is the belief that mental health issues occur spontaneously in the body and brain. 

The scientific evidence for that perspective is extremely scant. I think mental health professionals are moving away from that limited perspective towards a more psychosocial informed approach. This is recognising that life events are the primary stressors and causes of mental health issues. 

The distinction between the two models can be described in the following terms. The medical model asks what’s wrong with you and the psychosocial model asks what has happened to you. We’re moving slowly towards the latter model and I’m eager to support it. 

How did you become involved with Stoicare? 

I joined Stoicare in a volunteer capacity at the request of Brittany Polat and Eve Riches. I respect Brittany and Eve very much. They are important voices in the modern Stoic community. 

I like the particular focus they have given Stoicare: self-care for caregivers. In my experience, people who care for others – whether professionally or personally – tend to do so at the cost of their own wellbeing. That is not a sustainable situation. 

Therefore, if we can provide caregivers with free self-care materials based on Stoic philosophy, we can interrupt a cycle of self-neglect and put people on a path to better functioning and even flourishing. 

That approach is based on a belief I expressed at the Stoics Care event: without a strong ‘I’ there is no ‘we.’

Listening to you speak at the Stoics Care conference you spoke about challenges around the mental health system in the UK. What do you think needs to change here specifically?

There are several severe challenges that need to be addressed in the system and a lot are linked to the ever-rising mental health demand. There are measures of demand that give us a sense of consistency and severity.

For example, a report came up recently by the Mental Health Foundation, which unusually for a mental health strategy document, focused largely on the potential for preventative practice and moving away from reactive ideas about mental health. 

We need to move in that direction because the costs of our reactive approach are colossal. The Mental Health Foundation has made an attempt to estimate the overall cost of mental health issues in the UK. Not just the health system. It’s the criminal justice, housing, education and employment systems. 

That amounts to £117.9 billion pounds per annum, which doesn’t even include the costs of self-harm and suicide. With huge figures like that, a degree of caution must be taken because there are some assumptions at play e.g. attempting to quantify lost productivity due to poor mental health in the workplace is difficult to do.

Nonetheless, those figures are backed up by a sound research methodology. They give us some indication of how we are going wrong as a society in our beliefs and our response to mental health needs.

If we also look at the number of prescriptions for anti-depressants that were issued by the NHS during the early stage of the pandemic that figure was £ 79.4 million per annum. It’s a figure that goes up every year. 

That’s another reason to move into a preventative direction because the reactive approach we’ve taken clearly isn’t working because demand keeps going up. So something in that cycle must be broken.

What do you see as the mental health benefits of Stoicism? 

There’s a profound difference between being a passive recipient of someone else’s care and expertise and regaining a sense of control in your own life. At the heart of Stoic practice is the locus of control that what we can control extends only to our own thoughts, feelings and actions. Recognising that gives us the opportunity to exercise control in a way that is empowering. 

It also prevents us from wasting time, energy and other resources on things that are not within our direct control. If you’re a citizen in a deprived community where lots of things are done to you, you still possess a degree of control and that is psychologically better than an anti-depressant. 

I’m not anti-medication as it can help people and take the edge off painful feelings. Yet there are better ways for people to learn how to function and Stoicism is one of them. 

Stoicism is already a silent presence in the mental health field. If you experience anxiety or depression and you go to your GP, the GP responds with one of two tools they have in their toolbox: medication or therapy.

The talking therapy that’s recommended will likely be Cognitive Behaviour Therapy (CBT) and Stoicism influenced the early versions of CBT.  Stoicism also has a presence in more preventative schools of therapy or psychology as opposed to clinical. 

Lots of the so-called Science of Happiness has its origins in Stoicism and other wisdom traditions. I’d like to see the philosophy be used in various communities because another contributing factor to mental health conditions are health and wealth inequalities. 

Stoicism can help with both of these factors because it’s simple, everyday practices that are easily absorbed. All it takes is time and effort. 

It’s struck me that Stoicism does attract a lot of men to the philosophy and would be interested to hear why you think that is.

I don’t know if I can adequately describe why it appeals so much to men but it does. All I care about is that it does. When looking at training and events under the wellness banner, attendees are generally 70% female and 30% male. 

One of the things I wanted to do when commissioning or delivering preventative practices and services in my organisation was to offer something that might have more appeal to men. I piloted a few workshops and it was interesting that Stoicism was the only thing that reversed the attendee order.

I put on a mental health event with a celebrity who was an ex-member of the SAS. I thought it would appeal more to men than women. Yet when I analysed the attendance split by gender it was exactly the same: 70% female 30% male. However, when I put on a Stoic self-care session things changed: it was 60% male, 40% female. Stoicism is the only thing I have found that works in that way.

At the same time, I wouldn’t want to discourage women from getting involved because Stoicism has the reverse problem that wellbeing does. It has an underrepresentation of female participants and leaders. 

That is being changed because you have people like Brittany and Eve and their presence in the Stoic community is having an impact. 

You also mentioned that you think Stoicism could be collated with more of a framework. What would you propose for that?

Stoicism is my preferred form of self-care practice though I’m influenced by other wisdom traditions and there are commonalities in different areas.

One thing that’s clear from positive and humanistic psychology is that there are famous frameworks. With positive psychology, there’s the PERMA system of Martin Seligman, the father of the discipline. With humanistic psychology,  there’s Abraham Maslow’s hierarchy of human needs.

Both are powerful, relatable frameworks that give a sense of progression through tiers of consciousness and levels of practice. Stoicism doesn’t have that and it’s not an issue in itself because it has so many wonderful perspectives and practices. 

The dichotomy of control and the four cardinal virtues is enough to give people a starting point and a sound foundation to work from. But I do feel that a model of ascent much like Maslow’s hierarchy is beneficial because it gives us a sense of where our practice is supposed to take us. 

The common thread here with Maslow’s hierarchy is transcendence, where we ascend to a level beyond the self. It’s been described in other ways too such as the flow state or eudaimonia (human flourishing).

The wonderful thing about this state is it’s egalitarian and when I’ve experienced it there’s nothing better in the world. It’s only a temporary thing but you can return it and it doesn’t matter how much money or status you have. Eudaimonia is dependent upon factors that go beyond the modern day measures of individual worth. 

In the arena of philosophy and psychology, what are your thoughts on fluidity? 

I associate fluidity with intellectual flexibility and humility. It’s recognition that however much we think we know there’s an infinite amount more beyond our understanding. While I enjoy frameworks that provide a sense of progress, I’m not in favour of being too rigid in psychology or philosophy.

I’m conscious of my time in the mental health system and how thought has evolved over a comparatively short period of time. In my earliest days, I felt disadvantaged because I wasn’t educated in the psychiatric part of the model and now the psychosocial element is becoming dominant. 

Stoicism promotes flexibility and fluidity and it’s only going to become more important to self-care practices as time goes on. 

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If you’re a caregiver or mental health professional and want to learn how to incorporate Stoicism into your daily life, go to Stoicare and be part of a wonderful mission.

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