A Prescription For Murder

Wow! What a title! Sounds like an Agatha Christie novel or a cheap horror movie. It’s actually the title of a BBC Panorama documentary which hypothesises a link between SSRI antidepressant medication and an increased propensity to commit violent acts. 

Is there a link? Statistically yes maybe. A very tiny percentage of people taking SSRIs experience psychosis as a side effect, but statistically more people are killed as a result of trying to put on a pair of trousers. So why is there not a documentary about trouser deaths called Leg Ends Of The Fall? I believe it is because of the manner of the respective causes of death. 

Accidental deaths caused by embarrassing wardrobe malfunctions would be uncomfortable, voyeuristic subject matter. You don’t kick a man when he’s down through no fault of his own. So what’s the difference between that and someone who’s mentally ill through no fault of their own?

It’s because violent mentally ill people are juicy subject matter. A ratings winner. The subject retains a ghoulish car crash fascination. The notion that mental illness equates to violent, dangerous derangement is deeply embedded in the public’s psyche. Why else were lunatics locked in mental asylums, strapped in straitjackets, if not to prevent them from being a danger to others?

There are many variations of the escaped mental patient urban myth, with invariably innocents being slaughtered by the rampaging, almost supernatural human monster. The thing cannot be reasoned with; it is beyond reason. It is animalistic, bloodthirsty, evil. Something to be hunted and killed on sight. 

The factual reality is that mentally ill people are more likely to be a victim of violence than the general population. Only 3% of mentally ill people ever commit a criminal act of aggression. That means that 97% never commit an act of aggression. The person a mentally ill person is most likely to harm or kill is themselves. Suicide is the biggest cause of death in men aged 20-49 in the U.K. and the biggest cause of death of teenage girls worldwide. 

What then is the basis for a 21st century documentary about mentally ill killers, that lingers over gory details? According to Shelley Jofre, the BBC reporter who made the documentary, it is a public interest story. I see that it’s a story the public will be interested in, but is it in the public interest?

The Panorama programme claims that the incredibly rare side effect of SSRI medication causing psychosis, potentially leading to aggression and violence, needs to be more widely known to both the general public and to people taking SSRIs. The problem with this argument is that family doctors and prescribing psychiatrists already weigh up potential side effect risks and discuss them with patients before prescribing. And there are many possible side effects from taking SSRI medications, the most common of which include weight gain, sedation, fatigue and loss of sex drive. The average person taking an SSRI has been informed by their doctor of likely side effects, thoroughly read the leaflet that comes with the medication, probably read up some more about the risks on Wikipedia and discussed the risks with other people taking the same medication. The vast majority of mentally ill people are already very well aware of the potential and actual side effects of taking SSRI medications. 

What about the wider population? Don’t they deserve to know the danger too? If the 40,000,000 prescriptions for SSRI medications in the U.K. every year are going to trigger a nationwide bloodbath, don’t the public have a right to be warned? Therein lies the central weakness in the programme’s premise. 40,000,000 SSRI prescriptions per year already in the U.K., no mental patient slasher movie apocalypse as a result. 

I don’t deny that there are records of isolated cases where an SSRI may have contributed to a tragic incident. But is the potential danger both proven and statistically significant enough to warrant making an hour long documentary about it? What about the much more prevalent side effect of an increased risk of death by suicide among teenagers when they first start taking some, but not all, SSRI medications? That kills more people. Surely that’s more newsworthy?

The unpalatable reality is that few care about mentally ill teenagers killing themselves. It’s dull TV, compared to bloodsoaked rampaging mental patients. Real Hannibal Lecters lurking in our midst. 

This perpetuates the myth that mentally ill people are inherently violent and a well behaved one is just one waiting to explode in a killing frenzy at any moment. Drugs are supposed to suppress this huge danger, not enhance it. A dribbling, sedated, locked up mental patient is the only safe one. 

This is of course total nonsense. One in four of us will suffer a mental illness in our lifetime. The vast majority of people will be treated with a combination of medication and therapy. Out in society. Not locked up. Normal, but unwell people, not dangerous in any way. 

What are the likely outcomes of the documentary being aired?

There is a small possibility that a handful of people who are taking SSRIs and experiencing psychosis as a side effect will realise what has been wrong and seek help and advice from their doctor. This is a good thing. 

Something which is much more likely is that some mentally ill people currently benefitting from taking SSRI medications will stop taking them, to avoid the remote possibility of becoming violent. The benefits of that medication will then stop. Clinically depressed people will slide back into the abyss. People with anxiety disorders will retreat back into tormented Hell. Some of these people may well take their own lives as a result. The documentary could possibly cause more deaths, not fewer. 

Then there is the stigma issue. Some think that the term “mental health stigma” is overused. In the face of the ongoing tide of derision, fear, mistrust and demonisation of mentally ill people, I can assure you that the term could be used much more indeed. Just like black people and gay people have had to stand up and say enough is enough, mentally ill people are now standing up to be counted. 

My name is Patrick. I suffer from clinical depression, severe OCD and PTSD. I am a mentally ill person, a loving husband, a good father. I take a high dose of Prozac, an SSRI medication. It helps me to function normally. I’m not an unquestioning fanboy of Prozac. I have side effects from taking it, but I’m zero danger to anyone. Enough is enough. The unwarranted stigma against all the ordinary people just like me has to stop. This documentary will perpetuate stigma and prejudice. That is harmful and dangerous. Much more dangerous than a rare medication side effect. 

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The voice of mental illness

This isn’t a blog post about “hearing voices”, in the sense of auditory hallucinations. It is about the tone of voice and phraseology of the thoughts that accompany mental illnesses. For me, each of my mental health conditions has a consistent and recognisable voice. When I have a thought, I can now recognise which condition is doing the talking, or if the thought is of my own creation. Being able to do this is a fundamental part of the toolkit of recovery. 

So how do the conditions sound to me?

OCD: The voice of OCD is insidious, like a snake’s hiss. That should be a massive warning klaxon to the mind, but the mind doesn’t hear the hiss, just the words. 

The OCD whispers that it’s our friend and protector. It puts a reassuring arm round our shoulder, steering us where it wants us to go. And we go. Like someone vulnerable, groomed and coherced by a creepy family friend. 

The voice of OCD is persuasive. Plausible. Believable. No matter how ridiculous the idea is that it whispers to the mind. We know that it’s whispering nonsense. We’re sure that it’s whispering nonsense. But… there’s a sliver of doubt. I’d best do what OCD wants me to do, just in case…

Aaaaaand it’s got us. Hook, line and sinker. Again. No matter how many times we’ve been caught before. 

Then there’s the OCD trigger voice. Like an opera soprano with her hand caught in a car door. Strident. Loud above all else. Screaming the panic into you to take action now. Immediately! If you don’t, the very worst is definitely going to happen. ACT NOW! Carry out the compulsion to avoid certain disaster! Do it before it’s too late! She keeps wailing, drowning everything else out. 

So eventually you do the compulsion. The trapped-handed soprano stops screaming. The panic drops. A tiny moment of calm, maybe even relief. But then the whispering voice starts again. What if you didn’t do the compulsion correctly? What if disaster hasn’t been averted, merely delayed? What if? What if? What if? And before you know it, the careless soprano has her hand trapped in the car door again. 

Doubt is OCD’s weapon. It doesn’t even have to be reasonable doubt, in the legal sense. A single, tiny, poisonous sliver of doubt is enough to pierce the mind and embed the toxin once again. 

OCD is a one trick pony. Sure, it has infinite variations on a theme, but it always plays the same tune. Recognising the lyrics and disbelieving them is the start of putting the hissing serpent back into its basket, with the lid shut tight.

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OCPD: If Obsessive Compulsive Personality Disorder was a person, it would be a US marines drill sergeant. An uncompromising bully for which nothing is ever good enough. Ever. A harrying voice which pushes ever forward. 

The voice goads you to do better, always better. The last success was a fleeting thing, to be improved upon. Never worthy of congratulation, only introspection and analysis of how it could have been done better, how the next thing must be done better. 

Each task is a competition with your previous self. The OCPD says that Old Self was weak. Imperfect. Flawed. Unacceptable. Not good enough. New Self must be better. No excuses. No mercy. Everything is a task. Perfection is the goal. Anything less than perfection is failure, no matter how close it came. Do the task, meet the deadline, be perfect, don’t show weakness, don’t hesitate, don’t slow down, don’t draw breath. Keep the juggernaut rolling forwards, ever forwards. Failure is not an option. 

The voice of OCPD is an absolute bastard. Absolute in its true sense. All or nothing, black or white, win or lose. No room for grey. No room for error. No room for weakness. OCPD is an utter asshole. A shouty, demanding asshole. And sadly, that’s what the sufferer can become in turn. A task driven, order obsessed, singleminded, inflexible, perfectionist asshole. The inner bully begets the outer asshole. 

It’s stressful being that protégé asshole. Exhausting. Lonely. It gets results. Success. But what is all the success in the world worth, if it requires being whipped through life by an asshole in your mind?

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Depression: Of all the mental health conditions I have experienced, depression is by far the most deliberately harmful and destructive. It is just as much a parasite as the other conditions, but seems Hell bent on destroying both its host and itself in turn. 

The voice of depression is mean, evil, remorseless. There is no pretence. It wants to do you down. Its vocabulary is scathing: “Pathetic. Failure. Carcass. Dead man walking. Waste of breath. Waste of a soul. Sad little fat failure. You’re better off dead. You are a liability to this world”. The tone is harsh and sadistic , like a Dickensian villain. 

The voice of depression is internalised death-by-a-thousand-cuts. It eats away at you, like a wasp larva, hollowing its way out of its living host victim. 

I get angry at the voice of depression now. When it spits its bile through its gritted teeth, I shout “FUCK OFF!” back at it, sometimes out loud, if nobody can hear me. Depression is an evil thing, intent on killing. It is my enemy. I will show my enemy no mercy. My family motto is “Cut and burn to victory”. I like to summon a little of that family bloodlust when fighting the voice of depression, cutting it down mid sentence. 
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PTSD: For me, PTSD is voiceless. That is to say, it has no voice of its own, only echoes of my voice in memories and flashbacks. 

I can hear the voice of my thoughts as I relive or recall events. “You’re trapped. Cornered. There is no escape. You must hide, fight or die. Don’t show weakness. Don’t fall. If you fall, you’re dead. Stay on your feet. No, stop drop and roll! Roll to cover. Head down. Cover vital organs with limbs. Make yourself small. Invisible. Take the pain. Stay quiet. Take it. The pain will stop eventually. Please let me die a clean death God. A bullet to the head. Instantaneous. Don’t let me be blown up. Half dead. Dying. Gargling. Moaning. Screaming. Run! RUNUNRUNRUNRUNRUNRUN! Keep running. Don’t look back. Don’t slow down. Don’t stop. Knife out. Ready to be caught. Ready to defend. Be ready. Be ready. Get home.  Get home. Quietly. Calm your breathing. In shadow. Survive.  Hide. Hide. Hide. In darkness. Silent. Curled. Hide”. 

That is all so fresh in my mind. I can hear myself think it all, because those phrases never went away. The phrases from so many different situations. Some I escaped from, some I couldn’t. 

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The worst thing about these voices is that, as for many people who suffer mental illness, there isn’t just the one voice. There is a cacophony of voices from all sides, all the time. Like being trapped in a crammed full lift (elevator), surrounded by people shouting. Some of them constant, never even drawing breath. Others watching for signs of fatigue, weakness, the guard dropping, before joining in the discordant haranguing chorus. All of them heard. Every single word. 

A few moments on the beach or in the woods, with the mind briefly quiet, are blessed respite. 

Alternative therapies

I had an interesting discussion on Twitter recently with a “Cognitive hypnotherapist” who was very keen to treat people who have OCD. If they had also been a BABCP accredited Cognitive Behavioural Therapist with good experience of treating people with OCD, I would have said, “fair enough. Please work on unhindered by me”. 

But they weren’t. There wasn’t a single mention on their entire website about OCD treatment and only one mention of treating anxiety, not anxiety disorders. Mostly it was the usual hypnotherapy stuff about weightloss, stopping smoking, business success and confidence boosting. But disturbingly, there was also mention of curing the infertility caused by polycystic ovary syndrome with hypnotism and also past life regression using hypnosis. And this person wants to get into the minds of people with OCD?! She may sincerely believe that she can help, but OH-MY-GOD! There was also reference to NLP (neuro linguistic programming) and life coaching. Whenever I see the unholy trio of hypnotherapy, NLP and life coaching, it sets off the QUACK ALERT alarm bells. Every single one of these life coaching people I have met at small business networking events, I would guess 17 or 18 of them, have been lovely, earnest, keen, deeply damaged individuals who should NEVER be allowed to tinker with another person’s fragile mind. 

I was wary about letting anyone into my head, even a properly trained, accredited, experienced medical professional. It only eventually happened as a last resort, when it was a choice of either that or death by suicide. I’m glad that I chose the former, not the latter. But even then, it was difficult to trust someone else. Now imagine if I had been looking over the edge of the abyss and a friend who had lost some weight by going to a hypnotherapist had recommended them to me because they “did OCD too”. It makes me shudder in fear and disgust. That person would have “had a go” at treating somebody, using hypnosis, who needed immediate crisis care from specialist mental health professionals. 

It’s this kind of example which makes me instinctively wary of all alternative remedies and therapies. There are just so many jolly, well meaning, utter fruitcakes out there, willing to “have a go”. If the laws were less strict, would they “have a go” at being amateur dentists too?

I have seen the following “therapies” and remedies touted online as suitable for curing OCD:

  • Number therapy
  • Hypnotherapy
  • The Linden Method
  • The Lightning Process
  • NLP
  • Life coaching
  • Crystal healing
  • Herb therapy
  • Nutrition therapy
  • Vitamin therapy
  • Dietary supplement therapy
  • Vegan diet therapy
  • EFT – Emotional Freedom Technique
  • Exorcism
  • Faith healing
  • Prayer therapy 
  • Experimental electric current therapy

The U.K. National Health treatment regulator NICE (national institute for health and clinical excellence) recommends none of these for treatment of OCD. The only one to have shown evidence of even a short term benefit is hypnotherapy and there is still no objective scientific evidence of any kind of efficacy. The approved therapy is CBT (cognitive behavioural therapy), sometimes used in conjunction with medication. CBT works for many, but not universally. I’m not an unquestioning cheerleader for CBT, but it has worked and does work for me. 

I am not totally closed to the idea of using other things to help improve mental health and resilience, just very difficult to persuade. 

I reluctantly tried mindfulness. With its links to Buddhism, prayer bells and incense sticks, it seemed a bit hippy-drippy and ethereal to me. It also smacked of being the latest fashionable lifestyle fad bandwagon to jump aboard.

But a couple of trusted friends had achieved some success in using mindfulness, so I chose to give it a go. In my usual thorough way, I investigated the possible ways of trying it out. Local practitioners? Surprisingly few. And heavy on the prayer bells and zen. Online then? I looked for mindfulness apps and discovered Headspace. 

After persisting for several weeks, with my OCD conditioned mind wrestling with the completely alien concept of letting thoughts go, it started to work. I’ve found it to be a useful, real life tool and technique to use, alongside CBT techniques, to expedite my own recovery. 

So, you see, my mind isn’t closed to a broader approach to achieving recovery. I just recognise a snakeoil salesman or dangerously wellmeaning amateur when I see one. I believe there should be tighter regulation on what supposed “therapies” can be offered commercially as being effective for overcoming serious mental illness. I can’t set up a business as a mender of broken legs using a hot bread poultice, but I could set up a business tomorrow offering hot bread poultice cures for depression, #OCD, #PTSD and other anxiety disorders. This would be laughable, if it wasn’t so incredibly dangerous and happening RIGHT NOW. 

In the meantime, whenever I encounter an enthusiastic, well meaning idiot, I try to persuade them to leave treating actual mental illnesses to trained, accredited medical professionals and for them to stick to business performance coaching. And I also report the few genuinely cynical charlatons I come across, preying on vulnerable, fragile people who may be at the lowest ebb. 

If you’re going to let anyone inside your mind, it’s reasonable to be cautious, even with trained, experienced professionals. It is a great thing to be helped towards recovery, but the mind is as delicate as the human heart and more intricate than the human cardiovascular system. You wouldn’t place your heart into the hands of anyone but a highly skilled, experienced professional. Why risk the mind with anyone less capable or trustworthy?

    Interesting times

    There is a Chinese curse: “May you live in interesting times”. Too much of my life was far too interesting. 

    I normally don’t put trigger warnings on any of my posts, but I am making an exception for this one. This post discusses some of my experiences in Northern Ireland. Please don’t read it if you have been affected by any sort of violent trauma. Also, please don’t read it merely out of morbid curiosity. I have kept some details vague in order to avoid identifying other people. 

    I saved this topic as a draft blog post 50 days ago on July 7th. It has taken me 50 days to summon the courage to face writing it. One of the conditions I suffer from is PTSD (Post Traumatic Stress Disorder). Four days ago I referred myself for PTSD treatment. I am writing this as I prepare for the telephone assessment to see if I will be offered treatment.

    I was born in South Africa, but my parents were from Belfast. When I was about 9, my family moved back to Belfast “because Johannesburg was getting a bit dangerous”. This was 1979. The Northern Irish Troubles were raging. For the first few weeks, we stayed in my grandparents’ 2-up-2-down red brick urban terrace house, with no bathroom and an outside toilet.

    I very rarely tell “tales from the warzone”, but for this I think I need to. I need to document why I have PTSD. I don’t want to. I really don’t want to remember any of that, but I feel that I have to. This is likely to be a very long post, sadly.

    One of my first traumatic memories in Northern Ireland is of someone who was shot dead by terrorists for being a police informer. I was playing in the street near my grandparents’ house. A van screeched to a halt. Several men in balaclavas bundled another man out of the back of the van and dragged him up an alley. They shot him either two or three times in the head, then drove off in the van. I remember him lying there in the dirty squalor of the back alley, with his skull caved in and the thick, dark blood running steadily from his head. There was no doubt he was already dead. The image which haunts me from that incident is of two younger children, maybe 5 years old, poking with twigs at the stream of blood running down the footpath out of the alley, innocent in the aftermath of something so evil.

    A few of us kids found the badly burned body of what turned out to be a soldier in a derelict house in the same alley a few months later. 

    Northern Ireland was a surreal place during The Troubles (the phrase used by people in Northern Ireland for the conflict). It resembled an Orwellian dystopian nightmare. There were constant police and army foot patrols, police vehicle checkpoints, ever present police helicopters in the sky with searchlights, army vehicle patrols. Police stations, army bases and government buildings were bombproof fortresses.

       
     

    Cities like Belfast had a “ring of steel” around the city centre, with high metal barriers and gates. All vehicles were searched and checked for bombs before being allowed to enter. Only vehicles with permits could enter. All pedestrians were searched before being allowed to enter: body searched, bags searched, scanned for explosives or weapons. Additionally, every large shop performed a bag search and explosives scan before letting customers in. I also lost count of the number of random police stop and search stops I was on the receiving end of over the years.

      

      

    Whole streets of houses had been burned out in the late ’60s and early ’70s by both sides in cowardly acts of ethnic cleansing. High “peace walls” separated divided communities, Protestants on one side, Roman Catholics on the other. Rioting by youths on both sides was commonplace, with barricades and burned out buses & lorries blocking roads.

       
       

    In this draconian state of existence, ordinary people did a very strange thing. They went out of their way to be “hypernormal”, trying extra hard to live ordinary, quiet lives. People were house proud. People got on with their jobs. People socialised. But underneath the forced normality there always lurked tension and paranoia. 99% of the time Belfast was about as safe and peaceful as Hull, Glasgow or Leeds, like any tough Northern British industrial city, but that 1% of the time was what everybody feared. A gun attack, a car bomb, a kidnapping, a riot, an RPG attack, a roadside bomb, a firebomb, a massacre, a sniper. Any of them could happen at any time, but mostly didn’t. Mostly. Sometimes they did.

       

       

    I saw a lot of rioting. Soldiers on fire, people getting shot with plastic baton rounds, people getting shot with live rounds. Dozens of vehicles ablaze at any one spot. Petrol bombs and blast bombs being thrown. Rioters getting mown down by army and police vehicle charges. At the time, as a kid, it seemed exciting and dangerous to see. Now I just shudder at the memory.

    On the 27th of August 1979 (36 years ago today) my dad and I were walking along a beautiful deserted beach in County Sligo in The Republic Of Ireland, far from The Troubles in Belfast. Mullaghmore Beach. Just beyond the harbour, a fishing boat exploded into smithereens. We had just witnessed the assassination of Lord Mountbatten and murder of three other people. The next day we found debris and part of a hand as we walked the beach again.

    My sister and I used to walk the mile or so to primary school together every day. One day when she was 6 and I was 9, we were walking home as usual from school. About half way home, where there were large areas of waste ground on either side of the road, a man tried to grab my sister. I held onto her tightly and started to kick the man hard and repeatedly in the shins. I kept kicking until he let go of her. We sprinted the remaining way home, with me gripping tightly to my sister’s arm the whole way. I opened the front door with my key – we were latchkey kids – and quickly locked the door behind us. We hid upstairs with the lights off until my dad got home a couple of hours later. We didn’t have a home phone and the police wouldn’t have responded quickly anyway, in case it was a trap to lure them into an attack. We told my dad what had happened. He and some other dads went down to the waste ground. The police were there already. The man had snatched and raped another girl instead. He was long gone. He was apparently a prolific predator. He was eventually caught and shot dead by terrorist vigilantes.

    I used to like to escape into the hills around Belfast with my dog. One day a friend accompanied me with his dog. We were ascending the hillside, over rocks and moorland, when we literally stood onto a dug-in observation patrol of the third battalion of the parachute regiment. They were incredibly well camouflaged, with simulated grass oversuits. Our two dogs went berserk as the ground rose up in front of them. One of the squaddies started shouting, “Shoot the dogs! Shoot them! Shoot them all!” Thankfully he had neither the balls, nor the presence of mind to shoot us with his own L1A1 self loading rifle. We started to shout, “we’re just kids, we’re just kids” and calmed the dogs down. We both had one hand up in surrender and one hand on a dog collar. Thankfully, the group had an officer with them, who told his men to lower their weapons and calm down. They held us and questioned us for about an hour, then let us go when they were satisfied that we were just a couple of kids walking our dogs. We were very lucky that the officer had been present. Several other people had been killed in similar circumstances. 3 Para didn’t mess about.

    Some time in 1980, the IRA took my whole family hostage for two days in our house. They held us at gunpoint – AK-47s and oddly, an M16 assault rifle (It might have been an old AR-15) – keeping us mostly blindfolded, and held an AK-47 to our heads when we had to use the toilet. They had taken over our house in order to mount an attack on an army foot patrol, using an M60 heavy machine gun. They used me, a 9yo and my 6yo sister as a human shield at the window, an AK-47 muzzle pressed hard into my left temple, as they prepared to attack. The foot patrol didn’t appear as expected – probably tipped off about the possibility of attack, so the terrorists bound and gagged us, before leaving. A year later they did the exact same thing to our next door neighbours, but this time got their target.

    Later that same year, five men in balaclavas, armed with handguns tried to take my dad’s van from outside our house. My mother, a fearsome woman of 4’10”, ran out with a claw hammer and started breaking arms. She was trying to reach skulls, but only managed to smash one head in. The prone man was carried away in haste by his accomplices. God knows why they didn’t shoot us all. Cowards. If they hadn’t run away, my mother would have kept hammering until they were pulp or they killed her. She never knew when to stop.

    For a while my dad sold Aran knit sweaters from a market stall. At the weekends, I went to the markets with him and worked on the stall. Travelling home one evening, past a Republican area, several armed men in balaclavas stood across the road to stop the van. We didn’t know if they planned to kill us or highjack the van. My dad slowed the van as we approached, but at the last second turned on high beam headlights, accelerated and smashed through the line of men. The ones still standing shot at us as we sped away in the van. We never travelled that road again.

    On another occasion, my dad used a heavy spanner to knock a gunman unconscious as he tried to highjack the van at an illegal terrorist checkpoint. We had a few relatively lucky escapes like that.

    I somehow managed to only get shot at a few times during my teens. The many random plastic bullet baton rounds fired by bored soldiers didn’t count, as you could hear them coming and see them if they ricocheted off the ground first. They weren’t lethal, unless you took a direct hit to the head or heart at close range. 

    I was on the receiving end of a couple of very bad kickings from sectarian gangs; one because they thought I was Catholic, the other because they knew I was Protestant. I stayed on my feet on both occasions and fought back with a knife, before escaping. I would have been kicked to death otherwise. I was also stabbed/slashed twice with Stanley knives by smaller groups, but managed to get away both times. As a group, my friends and I regularly had stones, bricks, bottles and the occasional petrol bomb thrown at us, as we walked past enclaves of one side or the other.

    I wasn’t too close to any exploding car bombs during my teens, only seeing them go off at a distance, the blast wave hardly registering. I was closer to too many blast bombs though. A blast bomb was a crude anti-personnel device, made from a galvanised metal bucket filled with a mix of homemade explosive, a rudimentary detonator and nails. They were normally thrown over a high wall at army/police foot patrols on the other side of the wall. The wall forced the blast and shrapnel away from it. They were lethal at short range, but the shockwave at a slightly greater distance induced nausea and ringing ears. A large firework sounds exactly like a blast bomb going off against a wall.

    There were a lot of hoax bombs too. You never knew when one would be real. If a vehicle, object, manhole cover or piece of ground looked suspicious, you avoided it, just in case. I still cannot step on a manhole cover today. 

    One day, when I was 17, I was cycling at speed along a main road. A guy lifted his dog and threw it at me. I had no time to avoid it. The bike’s front wheel went over the dog. I went over the handlebars, landing knees first on the road. My jeans had ripped open and skin and flesh had been grated down to the bone on both knees. My legs and the palms of my hands were covered in blood. The dog was shocked, but seemed to be OK. Thank God there wasn’t a vehicle close behind me, or I would have been much more seriously hurt. I lifted my bike off the road and remonstrated angrily with the dog thrower. It became quickly evident that he was completely off his head on glue or drugs. I checked the state of my bike. Amazingly, it was only scratched, with slightly bent handlebars. I got on and rode the further two miles to my intended destination. I don’t know why I didn’t go to the hospital, but I didn’t. The knees didn’t scar too badly, but I still have problems with the left knee.

    When I was 18, I occasionally worked as a camera assistant for a photojournalist friend, to help him out. We were covering an event, photographing a big crowd. Terrorists attacked the crowd with grenades and gunfire. The first grenade landed 6 feet from us. I dropped to the ground, but my friend stayed standing and photographing events as they unfolded. He had been hit in the leg with shrapnel. A woman near me was shrieking. I put myself on top of her to shield her and quieten her. I remember lying there, loading film into the cameras thinking, “if I’m going to die here, please let it be a clean shot to the head, not a grenade.” We couldn’t run away. Anyone on their feet was a target to be shot at. 

    I had to stop typing at this point, as the memories, sounds and imagery overwhelmed me. That was on 23rd September. Today is 3rd of November. I have had my first face to face therapy session today, so I’m going to try to continue this record of events. I hope I can. I will try. 

    The gunfire and dull booms of the grenades seemed to last about ten minutes. Eventually, from where I was lying, I could hear the gunfire getting further away. As the terrorists fled, I started to notice the dead, dying and injured. The injured were everywhere, all around. My first reaction was utter rage at the fleeing terrorists. I wanted to chase them and inflict some small token of vengeance for what they had just done. My friend collapsed. We had used up all the film rolls and he was losing blood from the wound in his thigh. I ripped a long strip off my t-shirt and tied a makeshift tourniquet above the entry wound. We started to check ourselves and each other for bullet wounds and shrapnel wounds. Amazingly, apart from my friend’s leg wound, we only had superficial cuts from stones and shrapnel from the two grenades which had landed closest to us. An old woman, no more than about six feet from us, was exsanguinating badly. I tried to staunch the blood flow, but couldn’t. The lifeblood was literally pumping out of her and there was nothing I could do but hold her hand as she was dying. I looked up and saw a young man who had been shot. His skin was grey/blue. His eyes were open, but his life went as people tried to help him. I then helped my friend to his feet and supported his weight on his injured side. I could do no more to help anyone else. Amid the chaos, there was no chance of calling an ambulance or hailing a taxi. Somehow, we walked the two or so miles to the nearest hospital emergency unit. We laughed hysterically the entire way. Probably with shock and relief at being alive. We were covered in blood and dirt. So much blood. I burned my jeans when I was back home later. The emergency unit was bedlam as the injured arrived in ambulances, cars, police jeeps and as walking wounded. It was a major incident, but just one of many many in Belfast during The Troubles. The emergency staff dealt with injuries in order of severity. It only took just over four hours for my friend to be seen. His wound was cleaned, dressed and he was discharged. We went to the nearest pub, had a double whiskey each and called a friend to give us a lift home. By then we were cold, numbed and shaking badly. I have not included photos of this event. Nobody should have to see that. I can’t cope with seeing them anyway.

    So-called joyriders were an endemic and very dangerous problem in Belfast. They would regularly mount pavements in order to mow down pedestrians. Or they would deliberately ram other vehicles or police jeeps. One evening a stolen car sped past me and a group of friends. Ahead was a young woman with a toddler, pushing a stroller buggy with a baby in it. The joyriders mounted the pavement to try and run them over. We shouted a warning and the woman managed to get out of the way of the stolen car. We ran up to get them clear, but the joyriders had done a handbrake turn in the road. Our group split; two helping the woman and kids, me and a friend trying to draw the joyriders away. They drove straight at us. We jumped and scrambled at a tall, metal railing fence, as the car smashed into it. The fence buckled and we landed on the crumpled car bonnet. The joyriders reversed at speed, spilling us onto the footpath. We expected them to ram us again, but they had swung the car round backwards and drove about 300 yards on the footpath, mowing down and killing an old lady. She was dead. Killed instantly, thankfully. There was nothing we could do for her. We ran to get help and get the woman and kids home. We rounded up dads and neighbours, with the intention of stoning the car and apprehending the joyriders. Some local vigilantes had gotten there first. The joyriders had smashed the car into a raised roundabout and were trapped. The vigilantes had used the spiked metal railings from the rammed fence to impale the two of the four joyriders still alive in the stolen car. We left as police sirens approached. Justice had already been served.

    None of my relatives was killed in The Troubles, only injured, but three of my friends’ dads were murdered. One because he was Roman Catholic, two because they were Protestant. One of my dad’s colleagues, another carpenter, was abducted, brutally tortured and murdered by the Shankill Butchers terrorist gang, who indescriminately murdered over thirty Roman Catholics and Protestants.

    One morning in the early ’90s, I was walking to work through Belfast city centre. I had been walking along Great Victoria Street, but I decided not to walk past the Europa hotel (the most bombed hotel in Europe). I took a right turn into a side street just before the hotel. As I walked through the pedestrian square about 100m further away, partly shielded by low buildings, a huge 1,000lb car bomb exploded outside The Europa. The initial blast wave knocked me to the ground and winded me. Then the eerie silence. Just for a second. I knew at that point to roll towards whatever cover I could find. I tucked myself in tightly to a raised concrete flowerbed. The debris started to rain down. Lots of glass, pieces of building, pieces of vehicles, pieces of people. The aftermath of the blast ricocheted off the surrounding tall buildings like a rumbling peal of thunder. Glass continued to fall for what seemed like minutes, from shattered windows giving way. I lay where I was, curled up tightly. Crying angry, ferocious, petrified tears. I was frightened, shocked, but very very angry. When things stopped landing, I stood up and retrieved my work bag. My ears were ringing, but everything else was silent, except for building and car alarms going off. I picked a couple of pieces of shrapnel out of the leather surface of my bag. I started to pick pieces of glass out of my clothes, hands and scalp. I wasn’t bleeding too badly, so I dusted myself down and continued in to work. I was crying profusely, but I was angry at the cowardly terrorists who had left the huge car bomb. If I could have got my hands on one of them at that point, I would have gladly strangled them on the spot. But they were long gone, safely crawled back under their stone. So instead I went on into work. The best “fuck you” I could manage under the circumstances. I was a shaking wreck when I got to work. Not much use to anyone, but I was there. Defiantly. Hypernormally.

    At the end of the day, I made my way back from work along the same route. I am very set in my routines. I walked back across the open square. Much of the debris and carnage had been cleared. The main indication in the square of the bomb were the gaping office buildings, devoid of glass, and the continued police cordon around the blast crater in the next street. Hypernormality had returned. I was reflecting on how I would be glad to get home and how I had had another lucky escape.

    A blast wave knocked me to the ground again. Another huge bomb. Nobody was expecting two car bombs, so close together, on one day. I was in the open. Too far to roll to safe cover. I got into a foetal position where I lay and put my work bag over my head to protect myself a little. The second car bomb had gone off in the street beyond the opposite side of the square. The buildings on that side were taller and more bomb resistant, so bore the brunt of the blast. Also, because most of the windows had been already blown out, not as much glass rained down this time. I eventually sat up, covered in dust and a few pieces of glass. Thankfully no body parts. I sat and bawled hot tears in futile rage and despair. Unable to hear myself, because of the ringing in my ears.

    I went home, burned my clothes and stood in the shower for over an hour, sobbing and trying to scrub the mental contamination away. The next day, I went to work as normal. Hypernormal. I walked the same route as the previous day. Defiantly. The terrorist cowards would not win. I stopped and looked at the crater in the road outside what was left of the Europa Hotel. I walked down a side street and into the square again warily. I crossed the square and went down another side street, which emerged at the other bomb crater, in the road, between the wrecked façades of two tall government buildings. I was so lucky to have cut through the square both times the previous day.

    I have just made the mistake of looking at online photos of the immediate aftermath of both bombs. Most are too graphic to include here. I am currently in tears again. My memories are like moving versions of some of the photos. I hadn’t ever looked at these before. I have included a couple of more general photos to give an idea of the scenes.


      
      

    Those were the two car bombs I was most affected by. I experienced others, but thankfully not quite as closely. 

    By then, I was living just outside of Belfast, in a mostly Protestant seaside town called Carrickfergus. Each day I drove into Belfast and parked my car in a side street of a very rough Protestant area called Sandy Row. Most joyriders came from Roman Catholic areas and wouldn’t go into staunchly Protestant areas to steal cars, so my car was safe. One evening, as I walked back to my car, I noticed that I was being watched and followed by several individual men. I walked straight to a nearby police station and managed to gain entry through the security gates. The police took my statement and escorted me on foot back to my car. As I and the policemen checked my car for boobytrap devices, an old woman from the area approached us. She passed on a message from the local terrorist group who controlled the area. “People from Carrickfergus shouldn’t park in Sandy Row”. It was the terrorists letting me and the police know that they knew who I was, where I lived and that they had let me live because they had found out I was Protestant. I never parked near the area again. The next day, terrorists shot dead a Roman Catholic man in Sandy Row, as he returned to his car, which he parked there regularly.

    I lived in a semi-detached house. My neighbour turned out to be in the UVF (a Protestant, loyalist terrorist group). I didn’t worry about Billy, but I did worry about Republican terrorists coming to kill Billy and getting the wrong one of the two houses. We had a heavy curtain and heavy locks on the front door at night to impede forced entry. We had a back escape route planned. I had a large empty gas canister to throw down the stairs at anyone coming up. I had a crowbar, a baseball bat and two hunting knives beside my bed. Not much use against an AK-47, but I was prepared to go down fighting, if necessary. The terrorists never came for Billy, but the police eventually did. The family who then bought the house were lovely. The baseball bat, gas canister and crowbar were put back into the cupboard.

    This is a very good example of the ever present duality of Northern Ireland at the time. At once hypernormal, pretending nothing ever happened, and at the same time hypervigilant, prepared for the very worst to happen at any second, because it could. I always carried a penknife to defend myself with. During more immediately dangerous periods, I carried a hunting knife too and kept the crow bar in the car. During the very worst times, people stayed home and hunkered down. Before starting my car, I always checked for boobytrap devices. The paranoia, fear and ever present need to have your wits about you were as bad in their own way as the traumatic events. They gnawed away at you. You even had to be careful what you said. Little things could let people know what you were. Roman Catholics said “haitch” when pronouncing “H”; Protestants said “aitch”. Your accent, your dialect, the school you went to, the area you lived, the implied ethnic origin of your name, were enough to get you into serious trouble, if you were careless in the wrong place, at the wrong time. 

    But extreme and bizarre as they seem now, these measures were part of staying alive. Appropriate under the circumstances.

    I certainly wasn’t affected by The Troubles as badly as many. One friend of mine, a policeman, had to shovel up the remains of his colleagues after a roadside bomb blew their police jeep to pieces. If he had been in the other of the two jeeps, he would have been in pieces too. I have no idea how he copes with all of the horror he witnessed in his job. We don’t often talk about our relative experiences.

    So many others, mostly ordinary civilians, were injured, maimed, scarred, disabled or bereaved. I feel a fraud compared to them. They have a right to be mentally traumatised by what they experienced. People in Syria and Sierra Leone have experienced infinitely more sustained horror and danger than me. And yet, I can’t shake it. The images still haunt me decades later. 

    Random things trigger flashbacks. The sound of a car or motorbike backfiring. The sound of fireworks. (I’m writing this last section on the evening of 5th of November, in the South Of England. A night where many fireworks are set off. What a stupid time to be remembering The Troubles). A car skidding to a halt. The sound of certain helicopters. The smell of cordite or gunpowder. The sight of an army bomb disposal truck with its Felix the cat cartoon mascot on the side. Being in certain crowds. TV news coverage of terrorist events. Images of terrorist events posted on social media. Artillery sound effects in documentaries. The dates that Northern Ireland atrocities occurred on. Sometimes the images happen without a trigger, normally when I am tired and very stressed. They happen frequently when my depression is bad.

    The images come unbidden. Unwanted. The sounds too. They cause me to be tearful. Hot. My heart rate rises slightly. I don’t panic, but become even more alert and vigilant. Ready. Prepared. I’m filled with futile anger and survivor’s guilt. Guilt that I couldn’t prevent things from happening, guilt that I couldn’t help people more, guilt that I am affected this way without having suffered serious physical injury, guilt that I was unable to hinder the terrorists in any way. The anger and heightened vigilance linger. The terrorists got away with it. They literally got away with murder. In order to obtain ceasefires and the potential for peace for the next generation in Northern Ireland, the victims of the past have paid the price for peace by seeing the perpetrators and instigators of evil walk free.

    I have written this blog post as part of the homework I have to do for my PTSD therapy. I have only listed some of the specific, out of the ordinary things that happened. I haven’t included school fights, pub carpark fights, getting stabbed at school or any of the extreme violence I experienced at home. Those were other tribulations of life. It has taken a total of 121 days and has been immensely difficult to write. I hope it helps me. I want to stop seeing the images. I want to stop feeling angry. I want to stop feeling guilty. I want the past to be the past, something that I can consign to history. Not to forget about, but to put in its correct place, in mere memory. I am sick of constantly threat assessing harmless people in the little quiet English town where I now live and hardly anything dangerous ever happens. I am sick of being ready for the next attack, which will never come. It is exhausting, unnecessary and inappropriate under the circumstances. I am so very tired. I want to stop keeping guard.

    Although I rarely drink these days, I am now going to have a glass of wine and then try to watch English fireworks on Guy Fawkes Night without flinching.