A former patient of mine has just discovered Scientology and he wanted to tell me all about it. I know about it already. I have concerns over it – but not as many as I do over the use of psychotropic medications and electroconvulsive therapy. I think there are better ways of helping people other than through Scientology or the use of medications and the potentially damaging interventions of general psychiatry.

Attribution theory says that people who blame themselves for their predicament will tend to stay stuck in their depression and self-defeating actions, whereas people who attribute blame to outside circumstances or influences will find it easier to lift their spirits and move on.

I understand this principle but initially it seems to go against the grain of my recovery in the Twelve Step programme, in which I take my own behavioural inventory rather than that of anyone else. After twenty four years of reflecting each night upon my own behaviour during the previous day, I have become more of an accepting rather than blaming person. I believe that other people have their own motives for their actions and I may have little insight into them because I have little knowledge of those people’s full experience.
Reflecting upon my own experience in recent years, I know that I did my very best to provide responsible care to my patients and the best training for my staff. One of my shortcomings might be that I focused so much on those goals that I may not have given sufficient attention to what else was going on. I do not know how accurate that statement is because I do not think that any one of us has totally clear insight into our own thoughts, feelings and behaviour. That is why I work the Twelve Step programme in the first place. At any rate, I think it appropriate now to at least accept that I was not solely and totally responsible for all the disaster. I need to express some generosity of spirit to myself as well as to others, neither more nor less.

He is a phenomenon: extremely good at what he does and in how he puts it over. That should be sufficient: he doesn’t need fame and fortune on top of that – but maybe the quest for these false Gods is an inevitable companion to charisma.

She came over to me of her own accord, squatted down and peed on the carpet. It wasn’t the greeting I had anticipated but no matter. I suppose it comes to us all in the end. Even so, I hope I don’t follow that precise example of decrepitude just yet.

I’m not good at waiting around. If I am going to have a break, I like to know when it will start and how long it will last. Then I can simply switch off. Being left not knowing anything is very frustrating – so I’ll write a blog about it.

Richard Bentall’s book on the politics, economics, practicalities and sheer skullduggery of providing care to people emotionally or mentally unwell is absolutely brilliant. Please read it.

Of course things do not always work out as one would wish. Sometimes disaster strikes. Neither disappointment nor disaster necessarily lead to despair. Preferably they should lead to an examination of my own behaviour. Were my expectations unreasonably high? Did I have my head in the clouds and live in a fantasy world so that disappointment was ultimately inevitable? Was I the cause of the disaster? Could I have done something to prevent it? All these are sensible questions if my intention is to learn from my mistakes and avoid repeating them. Despair is a different concept altogether from disappointment and disaster. It is a choice of reaction: a bad choice. There are better choices that I can make.

Edward heath, on being deposed by Margaret Thatcher, had the Great Sulk for many years. I have seen sufferers from alcoholism do that: resenting their abstinence for year after year. This ‘dry drunk’ state is pitiful for the individual and his or her family, friends and colleagues. Sometimes families wish the sufferer would return to drinking. In fact this wretched resentful state illustrates addictive disease in its ‘untreated’ state; it shows the mood disturbance that the sufferer is trying (inappropriately) to treat with alcohol or other mood-altering substances or processes. The appropriate treatment is the Twelve Step programme. It certainly works for me. Of course I can be sad at times when sad things happen but I do not sulk: life is too short for that. I have lost enough; I don’t need to lose my family and friends as well as everything else.

I have a good sense of rhythm as a writer but I never did when I was a semi-professional singer. I am comfortable in a television studio or in a lecture theatre but not on stage. I am well coordinated but no good at sports. I have an eye for a picture and for where it should go but I can not draw nor paint. It’s odd, that.

She has the most extraordinary beak of a nose. At forty, she also has more than enough money for cosmetic surgery, if she wants it, but clearly she does not. She wears her honker with pride.

Another woman of the same age chose to change her nose when I could see nothing wrong with it. After the operation she wondered what else she should change. I might have suggested changing her brittle personality – but I am sure that would have ended our relationship.