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Post-traumatic stress disorder

Last Chance Saloon is the story of Neil ‘Twink’ Tinning, a troubled, magnificent man living with bipolar disorder, and his unique attempt to understand the science behind his, and many other, mental health conditions – all while getting ready to play the biggest gig of his life.

In part 7, gig rehearsals gain momentum, causing the band to up their game, while Twink experiences a musical revelation that helps him come to terms with the loss of his parents. He also ventures into the Brecon Beacons, the running territory of former British Army psychiatrist Professor Jonathan Bisson. Together, they tease apart the nature, causes and treatment of post-traumatic stress disorder (PTSD).

Previous episode: Part 6 - ADHD, Newsnight and knowledge

Next episode: Part 8 - An excuse to live


[Previously on Last Chance Saloon…]

Twink: Because I hadn’t realised at the time that that sort of high and low was going to be for the rest of my life. Unbeknownst to me I think I’d been bipolar all my life. My imagination of the gig, the amount of emotional investment I’m putting into the 28th of March is what you’d expect Oasis to be emotionally committing to at Knebworth. It’s that huge a gig for me.

We don’t know enough, we don’t know enough about the brain, we don’t know enough in research terms about bipolar, but I still want to continue doing the films.


Twink: I control the camera from the Mac, so I know what’s being recorded, because obviously you can’t get behind the camera to see the film of the shot, so I can take stills or I can do movies. So I’ve just pressed record and it’s got 18 and a half minutes–

Band member: You can edit it.

Twink: Oh yeah, I just send all this stuff to Barry and Barry sorts that out for me.

So I’ve got my intro which is going to be [plays music on banjo] – right, so I do my fiddly bit and then [plays] and soon as you go down there it’s two As, two Bs intro. [Plays longer piece of music]

Hi Barry, just sitting in the airport lounge waiting to get the flight to Cardiff. The news this week has been about the riots and the looting. I’ve watched the riots and I think it’s anarchy actually, and I don’t think this is the last we’ve seen of the riots, I think society is going through a very, very difficult time.


Twink: Rock and roll.

Thanks for bringing us here John, it’s fantastic. What a beautiful location.

Jonathan Bisson: Hi, I live in Wales, I come here running and walking and things, so I thought it’d be a nice place to come.

Twink: So you actually run up this thing?

Jonathan: Yeah I do sometimes, yeah.

Twink: Wow.

Jonathan: When I have a good day.

Twink: Right, what I want you to do – Jon, yeah you could go that way, just – I’m just going to do some – just look straight into the lens.

Why did you agree to be part of this series of films?

Jonathan: Something I’m very passionate about is trying to raise awareness of post-traumatic stress disorder, what it is, what can be done to help people with it and to encourage a better understanding of the area for the future.

Twink: If you ask the general public they would tend to associate that with the military.

Jonathan: Obviously within the military individuals often are exposed to very traumatic events, so it is a condition that you can develop as a result of military experience, but essentially it’s a condition that can develop out of any extreme traumatic event and the vast majority of the events we see actually are non-military events, ranging from road traffic accidents, assaults, adverse experiences during childhood such as child sexual abuse, unfortunately, industrial accidents – we’ve seen several individuals who’ve developed post-traumatic stress disorder following that. And also witnessing horrific things is certainly a key reason that individuals present to us with PTSD.

What we’re looking at are traumatic events that most people would see as being very traumatic and would actually threaten the integrity or the wellbeing of an individual or another person that’s close to that individual, or witnessing something very extreme to somebody that they don’t know at all. So bullying would probably be out on that definition but a severe road traffic accident would be in.

Twink: My mother used to hold me and sing me lullabies. One of the songs that we’ve just discovered from my sister is a tune called ‘Ally Bally’, which is a song from the Borders, so the song’s actually been remembered and been passed down. My mother used to sing it to me. “Ally Bally, Ally Bally bee, sitting on your mammy’s knee, waiting for a wee bawbee, to buy some Coulter’s candy.”

You’re better off doing dawn or dusk, it’s much more flattering.

Jonathan: Oh right, okay. I’ll have to remember that.

Twink: So what I’ll do is I’m just going to do a couple of like…

Is there a percentage of people that suffer post-traumatic stress disorder? Can you put a number on it?

Jonathan: The risk of you suffering post traumatic stress disorder at some time in your lifetime is probably around about 7% overall.

Twink: As high as that?

Jonathan: Yeah. So it’s not an uncommon condition. Some people would argue that that’s a slightly exaggerated figure; other research has shown that it’s perhaps more like 3%, but between 3 and 7% I would say is a fair figure. Not surprisingly you’re much more likely to develop post-traumatic stress disorder after some traumas than you are after others, so for example rape, a horrific, traumatic event, is the trauma that most research shows is most likely to result in you developing PTSD, so some studies have shown that over 80% of people who are raped go on to develop post-traumatic stress disorder.

Twink: I think music has always been a lifelong love, I mean music has the power to make me cry and since I’ve got ill I haven’t cried very much. In fact I was with the Cardiff Mood Disorder team and we talked about the last time we cried and I felt totally emotionally out of my depth because it’d been 15 years, something like that.

I mean how do you actually treat the PTSD?

Jonathan: The main treatments that we provide are something called trauma-focused cognitive behavioural therapy, and that would often involve and individual coming in to see somebody like myself, a therapist, build up a relationship, a trusting relationship both ways and then very gradually expose themselves to the trauma itself. So we might initially start talking about the day before the traumatic event and then asking them to give a detailed description of exactly what they went through. So in other words I helped them to relive the event with me in the room, we often tape record that or make a digital recording of that and then I ask them to listen to that over and over again. And the theory there is a bit like if somebody’s frightened of spiders for example, just trying to help them expose themselves to the spider can help them become less fearful of them. And it’s the same with traumatic events, that often by exposing ourselves to things that we found traumatic, it’s easier to deal with them.

Twink: I saw my sister a few months and I was talking about doing the album and stuff and she says, “Oh you know, do you not remember ‘Ally Bally’ that mam used to sing?” And I looked it up on the internet and I started strumming the chords and I broke down. The tears that just – streaming out of me. It reminded me of my mum and my dad, and I mean even when I mean my dad died in ’91 and my dad died in ’92 and I still have bereavement issues. It was like I haven’t done that for many, many years ,and it was like, well, perhaps I am getting a bit better.

Jon, can you just lean on here because I want to get this perspective of the –

Jonathan: Like that?

Twink: Yeah.

So when it comes to post-traumatic stress disorder, what are the big questions left to be answered?

Jonathan: Well I mean the biggest question is what’s the cure for it? As with most conditions I think that’s the big question and the holy grail for a lot of us. And it’s only really by understanding more about the science behind post-traumatic stress disorder, so the neurobiology of it, the psychology of it, that we can gain a better understanding of the condition and then develop treatments that may be more effective than the ones we’ve got at the moment. I’d like to see a big push into us understanding the condition more fully so that we can then develop the effective treatments that are going to help people and prevent a lot of suffering in the world.

Twink: I’m going to have to hold the beat back a bit because I think that was a bit rushed.

Band member: That was fast, aye.

Twink: And of course when you go on stage your adrenaline is pumping and you’re going to be – it will have to purposely hold back, so there’ll be lots of signs on the floor saying ‘Play slow, play slow,’ in big letters. [Laughs]

We’ve done like the demos for the album so we’ve got everything in place but we’re going to re-record some of the stuff to the demos, which we’ll be doing tonight. The albums, yeah, we’ve got the material.

Right, promise me to do one thing. On your way to work and when you come back from work you play the Tinstones CD in your car and then you’ll remember. That’s the only way to get it into your subconscious.

Band member: That’s right.

Twink: Well this is so, so important, you’ve got to get that tightness and you only get that by doing it. So one favour for me, you play the CD going into work and you play the CD coming back from work.

I know we’ve got enough stuff in the locker to do, whether people will like it or not.


Twink: You’re singing the wrong note.

Band member: I’m singing the wrong key.

[Plays notes]

Band member: Right, go for it again.

Twink: Yeah, two As, two Bs intro. Right, one, two, three, four…


[Coming up in part 8…]

Twink: I’ve had three bad days on the trot and last night I got very, very ill and when I say ill I mean suicidally ill. And the wife was fantastic and I took my meds and went to bed and I woke up this morning feeling not suicidal but full of anxiety and dread.


And we’re talking to the Treasurer for the Royal College of Psychiatry and the Head of Neuroscience, is that correct?

Scientist: Yes that’s correct.

Twink: Of the Wellcome Trust. So I’m going to ask you a question, correct me if I’m wrong but it appears to me that mental ill health is the poor relation of physical health. Nick, I’ll go to you – why?


But it’s amazing, you get into a cab and somebody talks to you or the driver talks to you and says, “Oh what are you doing?” and “Oh I’m doing this series of mental health films.” “Oh well, I’ve had depression,” or “My wife’s had depression,” or somebody they know’s had an issue. So as far as I’m concerned the more the merrier, the more people talk about mental health as far as I’m concerned is the way forward.


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