Caroline’s death gives us a glimpse into the messy reality of mental health

A theme emerged during sessions with several of my patients this week: the extent to which they had been impacted by the loss of Caroline Flack, who took her own life a week ago today. Most found it hard to articulate why, but mostly they understood what it’s like to lose all hope that things can get better and to see suicide as the only way out. They saw Caroline in themselves – her fate could have been theirs had they not been able to step back from the abyss. They saw the impact of suicide on those left behind and lamented the waste of life of such a young, beautiful and likeable woman. I could only nod along in sad agreement – I felt this loss too.

In December, a few days after the news that Caroline has been arrested for assaulting her boyfriend Lewis Burton, I sent her a private message on Twitter offering a space to talk to a local professional. I hoped that she might spot my message in amongst the hundreds of messages I imagined she was receiving, but I assumed she would be avoiding social media. According to the blue tick it had been read, but I never received a response.

Like other fans of Love Island I found the reality show entertaining – a silly, often funny and occasionally moving piece of theatre. But I also found it psychologically fascinating in its exploration of interpersonal relationships and group dynamics. Clearly a fan of the show herself, Caroline was at its heart and seemed personally invested in helping others to find love in the way she hoped to find love herself, however unlikely in this artificial setting. She fought for the underdogs, commiserated with the spurned and icily grilled lotharios in post eviction interviews – everything we, as viewers, would do. 

In anticipation of the inaugural winter version of the show, I imagined how excited Caroline must be to see the show expand to twice a year – and to Cape Town no less. When news of the alleged assault and arrest broke I was shocked and confused. This wasn’t the Caroline we knew from social media and on TV – if we were to believe tabloid reports Caroline was usually the one treated badly by the men in her life. The tabloid press had found a new victim and article after article speculated about the incident in lurid detail, led with hateful headlines and published photographs from the scene.

I felt for Burton: if he were a victim of domestic violence (which he denies) it must have been a horrific and lonely experience, especially as Caroline was so beloved. I work with men who suffer at the hands of women (and vice versa) and the shame and anxiety they live with is unimaginable. But I simultaneously felt Caroline’s loss. Whether she was guilty of the violence and had to live with this mistake or it was an accident, as she claimed, she must have seen the life she had built for herself slipping away in an instant. My instinct to reach out to her was borne out of a fear that she might want to harm herself given the guilt, humiliation or injustice she may have felt. I wanted to offer a safe space, free from judgement, for her to process these events and their repercussions.

But then I kind of forgot about Caroline, assuming that she was receiving support elsewhere and that she would be back hosting the next series of Love Island after a period of contrition or indeed vindication. I tuned into the brand new series and watched Laura Whitmore in Cape Town where Caroline should have been but nonetheless settled into the familiar format where everything was kind of different but the same. Until an alert on my phone last Saturday informed me that Caroline had died. My heart sank – I knew instinctively that she had taken her own life.

Caroline was a young woman who wore her heart on her sleeve, but this seemed like the regular, relatable ups and downs of being a young woman in the public eye. She hid her more acute mental health difficulties behind a sheen of social media as many celebrities must do. But the signs were there – a tumultuous love life was a gift to ravenous tabloids who would capture every moment. As Whitmore said, Caroline: ‘lived every mistake publicly under the scrutiny of the media.’ In an Instagram post in October, Caroline posted about her mental health, admitting that ‘when I actually reached out to someone they said I was draining’. This is a sad yet familiar refrain from my patients – despite being encouraged to reach out more and talk they often get similar responses from friends or family. In the age of positive psychology and self-help, we are encouraged to delete ‘negative’ people from our lives and surround ourselves with people who make us feel good. But what about those who are suffering and can’t always muster that reality TV smile?

Far too often only the palatable side of mental health is portrayed in the media – Prince Harry’s dignified grief and anxiety, stories of addictions once sobriety has been achieved or reality TV shows offering celebrities therapy for self esteem or relationship difficulties – all valid and helpful, but they don’t nearly capture the full range of symptoms that severe mental health difficulties can engender. Violence, drug use, promiscuity, chaotic and abusive relationships, jealousy and possessiveness, feelings of emptiness, self harm and suicidality are a daily reality for many people. The darker, less acceptable side of mental heath is messy, ugly, chaotic and raw and usually hidden behind closed doors. 

It was reported that the police footage of Caroline’s arrest in December, probably offering a candid glimpse into a the scene of a mental health crisis, is what Caroline was most ashamed of being seen at a trial. We will perhaps never know what happened between Caroline and Lewis that night, but I’m sure that whatever it was came from a place of pain and desperation. Reading between the lines from an unpublished Instagram post reported by Caroline’s parents after her death (‘the blood that someone SOLD to a newspaper was MY blood and that was something very sad and very personal’) leads me to believe that Caroline was self-harming and perhaps lashed out when Burton tried to intervene, either accidentally or otherwise. I say this, not to further add to the speculation, but to highlight the reality of mental health.

Caroline was any of us who have suffered with our mental health, but she had to do it in public, hounded by the press and made an example of by the Crown Prosecution Service (keen to be seen to be tackling the real issue of domestic violence) despite her clear vulnerability. Celebrities may have the means to afford help, but with such high stakes, the threat of ‘cancel’ culture and a press without morality, how can they trust anyone beyond their immediate circle? Even a therapist may be too much of a risk. I see several high profile people in my consulting room – many have found it very difficult to open up and wait years before seeking help because of how dangerous a confidentiality leak could prove. Caroline’s haunting instagram post from October foreshadows events of this week: ‘I certainly hate talking about my feelings. And being a burden is my biggest fear…. I’m lucky to be able to pick myself up when things feel shit. But what happens if someone can’t. Be nice to people. You never know what’s going on. Ever’.

I can’t help feeling that I should have tried harder to reach Caroline. Poignantly, I recognised her home from news reports  – not only did we live in the same borough, we were neighbours. If only she would have responded maybe I could have helped when she felt so alone with no way forward. But this is the therapist’s curse – we can’t help everyone. Therapy is not a panacea but it can and does save people from taking such a permanent, devastating step by giving room to voice to those dark thoughts and feelings, without fear of repercussion or of being a burden. 

I think of Sophie Gradon and Mike Thalassitis, former contestants of Love Island who also took their own lives. Three suicides linked to the programme is a shocking record and serious questions need to be answered. But as Whitmore said this week: ‘The problem wasn’t the show, the show to work on is loving, and caring and safe, and protective. The problem is the outside world is not’. Love Island merely reflects the world out there in all its cruelty and pain as I see every day in the NHS, where extremely vulnerable people are tirelessly cared for behind closed doors. Mental health awareness can’t just be this year’s trendy cause or millennial hashtag  – we need to understand it in all its guises so that we can help those it afflicts.

Caroline is another victim of the deadly consequences of a tabloid media driven by clickbait tallies, the human weakness for schadenfreude and lack of understanding of the reality of mental health beyond a basic awareness. Please be kind to each other, talk about your feelings, find a therapist that you can trust and surround yourself with people who can take you at your worst as well as your best.

Love Island episodes have stacked up on my Sky box – life goes on, apparently. But for now I can’t watch it; it makes me too sad.

In the UK and Ireland, Samaritans can be contacted on 116 123 or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at www.befrienders.org.


We Need To Talk About Love Island

I was about to draw the blinds last week in case my posh neighbours saw me watching ITV’s annual summer ratings hit, when I saw that they too were watching it. I left the blinds open and settled down to watch my guilty pleasure, vindicated.

As a therapist specialising in groups, I’ve always had a fascination with certain reality shows – Big Brother, Shipwrecked etc. Beyond the voyeurism and vacuity these shows are the compelling human equivalent of nature documentaries, albeit offering up a very narrow subset of society: the young and the beautiful. Sure, these shows have become more scripted, more cynical and way more fixated on looks, but it’s the authentic moments that keep us hooked: the persistent good-guy thawing the heart of the formerly broken-hearted ice-queen or the previously unchallenged, arrogant player getting his comeuppance. Yes it’s a game, confected and manipulative, but some things can’t be faked and the result is as addictive as sugar.

For a show ostensibly about sex, there is remarkable little of it. Instead it focuses on group dynamics, friendships, competition and vulnerability. People tune in for the nubile bodies and sexual banter, but they stay for the soap opera of attachments forged and broken.

Love Island is often derided as trash TV and blamed for an increase in the prevalence of poor mental heath among young people (more on that later) but I argue that there are more layers to this show that it firsts appears and, don’t shoot me, that Love Island is in fact educational.

The show has done more for teaching young people about the unwritten rules and pitfalls of dating than any PSHE lesson could. From the cruelty of gas-lighting (last year’s Adam), the impact of low self-esteem (Yewande) and the power of loyalty (er, Georgia?), to spotting authenticity, understanding your impact on other people and asking for help, Love Island is not only (bronzed) skin-deep. After five series’ we all know that winning this show is not about how you look, but your personality: authenticity and likability – not a bad lesson. Parents need to exercise caution, clearly it’s not for the very young, but for adolescents it’s a far better teacher than sex education via pornography on a smart phone.

There is also something reassuring about seeing these super confident young people such as Anton, now small fish in a big pond and likely so used to adulation on a night out in their hometowns, face hot competition or even rejection when an even more impossibly good looking rival enters the villa to stir things up. It humanises them, teaching them a valuable lesson in humility and perhaps instilling some empathy for future interactions.

The romances are full of intrigue and drama (Lucy and Joe anyone?), but it’s the same-sex relationships that offer some of the greatest and uplifting moments of genuine affection on Love Island. Less of a surprise are the friendships that blossom between the women which are often a beautiful thing (to counter some of the bitching and backstabbing). But seeing these masculine, modern men open up to their friends about matters of the heart with endless hugs, reassuring pats and even kisses without self-consciousness (and barely a ‘no homo’ to be heard) is joyous. Without realising, they are teaching a new generation of boys that talking about emotions and treating women well is in – today’s modern man can be sensitive, articulate and respectful.

And what about Maura?! Proving that a woman can be as sexually liberated as the horniest man but woe betide anyone who mistakes this liberation for ‘easy’ – Tom felt the full force of her articulate rage.

Okay, we do need to talk about the dark side of the show: namely the psychological impact that Love Island has on its vulnerable viewers and on the contestants themselves. It sets a dangerous precedent for body image in young people and they must be taught that these people do not represent the norm – they are sculpted, plucked, tanned and trained within an inch of their lives – and it’s a full time job to look so Insta-ready 24/7. But after the first couple of days don’t most of us see past their appearance and see them as just a bunch of young adults trying to navigate the show without too much humiliation, hoping to find love, but mostly to boost their brand once released as this year’s crop of reality stars? The show is, disappointingly, very narrow in its definition of beauty and it definitely needs to up its diversity credentials to include a wider variety of body types and skin tones, to avoid the alienation of some of its viewers.

Then there is also the uncomfortable truth of the suicides of Mike Thalassitis and Sophie Gradon. I don’t think the show is directly to blame for their deaths, but I think by its nature it attracts damaged people, longing for a validation that can never been given. Such people need to be spotted sooner and offered support, not flung into the Horny Hunger Games and then abandoned. These desperately sad deaths have provided a violent jolt for the world of reality TV and gave viewers a peak behind the curtain: even the most attractive, seemingly happy people we see on TV can be suffering beneath that Instagram sheen. I hope that contestants are now given much greater support throughout the whole experience: more thorough assessments, producers who show restraint in goading contestants into emotional situations that they can’t handle, and, perhaps most importantly, solid aftercare. How is a person suddenly thrust into the public domain, becoming a household name for the summer, supposed to deal with being dropped back into obscurity after their brief but brightly-burning star fades and burns out?

These (big) caveats aside, Love Island has plenty to offer many of us through its universality. It’s not the best example for young people, but it’s not the villain that some insist and has a place within popular culture, alongside other, more wholesome, programming. News that there will be an additional winter visit to Love Island based this time in sunny South Africa will no doubt prove wildly popular too. And as long as kids are encouraged to see beyond the superficial and the show pushes its narrow definitions of beauty, injects more diversity and provides better mental health support, I will continue to enjoy my not-so-guilty pleasure with the blinds open.


We’ve come a long way, but it’s still unsafe to be gay

On the bus today I watched as a young straight couple two seats in front of me kissed and laughed so unselfconsciously it was as if there was no-one else in the world but them. The immediate warm, fuzzy feeling I felt at their oblivious mutual affection was quickly replaced by a rush of envy – could I ever feel so free to display affection in public towards someone I love?

A recent spike in attacks on gay couples has confirmed that ancient gay-person fear of reprisal from displaying any overt sign of your sexuality in public. Why tempt fate? Better to hide it, keep it behind closed doors.

As a demographic we are tolerated at best, hated at worst.  Whether it’s the straight man’s fear of his own homosexual side or an incel-inspired rage projected onto the women who prefers women, gay people bring out some strange reactions in people. Thankfully it’s the tolerance that usually prevails, the hatred dampened down, casually expressed in banter between friends: ‘that’s so gay‘ or the arch, promiscuous gay best friend fetishized in movies. Whilst the day to day lives and rights of gay people have improved over past decades, homophobia is sadly alive and well, perhaps less raucous, but driven underground where it festers.

Until it comes out in an ugly, inexplicable rush of homophobia and misogyny as with the lesbian couple on the bus in West Hampstead this month, goaded into kissing for the titillation of teenagers, left with blood-stained blouses when they declined. Or what about the mostly Muslim parents in Birmingham furious at their children being taught that we exist, insisting on passing the torches of ignorance and intolerance to the next generation? That’s not to mention those Muslim/Jewish/Catholic children who will turn out to be gay – what chance do they have? I’ve seen those children as adults – it destroys them.

We are not all hiding in the shadows: there are many men and women in gay partnerships who feel able to display their sexuality and relationship in public, particularly millennials and generation Z who seem to possess more confidence and carefree defiance than those before them. Whenever I see it though, I cynically see it as a show for others, taking a brave stand rather than enjoying a spontaneous interaction like the couple on the bus. Most gay people I know, through life or work, are far more self-conscious, refraining from affection in public, or only after a quick glance left and right as if crossing a dangerous road before kissing the person they love.

For me (and most), this can be traced back to school, where, in the vulnerability of my burgeoning sexuality, affinity with the female sex and quiet, sensitive nature, I was pushed around and teased, not as badly as some, but enough to dampen down certain instincts, creating an ambiguous, masked persona in which my sexuality might not be immediately apparent (which I would take as the highest compliment, before realising what self-sabotage this is). At the gym, which I assume I took up, like many gay man, in an effort to distance myself from the stereotype of the weak gay man in mastering my muscularity (if not emotionality), I would never reveal my sexuality with the other guys there, some I’d known for years, preferring to blend in, avoid any rejection or even danger that being myself could bring.

You would think that we gay people would band together, like Attenborough’s penguins for warmth in the storm, but you only have to spend an hour on a gay dating app to see a snapshot of the internalised homophobia on the inside: rampant racism, fat-shaming and fem-bashing: a case of the bullied becoming the bully. Not only do gay people not feel safe, merely outliers in society and often excluded from their own gay community, but after a lifetime of rejection they turn this hatred inwards where it manifests as depression, anxiety, self harm or worse. The hatred therefore comes from all sides, within and without; a pink prison.

It’s not all gloom: London is one of the safest places on earth to be a gay person for the most part (the stories I hear from other places where we are brutalised make me weep and rage). But you find ways to covertly express affection with your partner in public – a glance; a brush of the hand; a squeeze of his bum when no-one is looking, which can be exhilarating – but seeing that couple on the bus today and their easy affection opened up a deep sadness in me. Straight couples don’t even need to think about their day to day interactions, but gay people come with a built-in hypervigilance.

So how do we change this and protect a new generation of vulnerable gay people? We can start by introducing young people to the fact that we actually exist.


Intro: Musings of a therapist

As a psychotherapist and counsellor I am pulled daily into the weird and wonderful lives of others which leaves me with quite a unique view of the world. Add this to my own curiosities, daydreams and musings on my place in this crazy world, by the end of any given day my head is so crammed full of thoughts, ideas, rages and inspirations that I figured I should write some of it down.

This may just be me talking into a void, but I also think that some of the things I have to say could inspire or motivate others, make them angry, make them think, or just feel less alone. It’s my way of reaching out into the world in an attempt to find resonance with others, rather than just staying in my head. A blog as a therapist’s therapist.

I’ll opine on all sorts of subjects – themes from my patients, current events from politics to tv shows and beyond. Join me on this journey of the weird and wonderful.