A Sore Throat

For those of us macho – sickly types who like to think that unless you are being force – fed a cocktail of mind – altering drugs while chained to  bed in a locked ward of a high security psychiatric hospital you aren’t really ill, the sore throat ranks as one of the weediest of complaints. 

But as a cyclist who likes to think of himself as a ‘grimpeur’, a climber, I am familiar with the sand – paper soreness in the throat and the fire in my chest, as I turn the pedals at little more than walking pace up the Sussex hills I like to think of as my local Alps. 

It’s not uncommon for people who suffer depression to come down with low – grade infections and these in turn can eventually chip away at one’s mood leaving the sufferer in a serious state.  It’s a vicious cycle.  Depression lowers the immune system, and triggers minor irritants such as coughs, colds and sore throats, which damage one’s mood still further. 

Withdrawal and isolating one’s self are common symptoms of mental health problems.  This can lead to self neglect which can have serious consequences.   In the mid – 1990s, when I first worked in the mental health field, I used to accompany David (not his real name), a man in his 20s, to regular dental appointments.  He was having his teeth extracted.  This man had so isolated and neglected himself during a prolonged bout of depression that he hadn’t taken care of his teeth and gums; in other words he hadn’t picked up a toothbrush in almost a year before receiving help.  When I first met him he hardly spoke, and yes, he was constantly in bed with coughs, colds and sore throats.  Before he had become ill he had been a script writer for a number of soap operas.  He had the gift of putting words into the mouths of his characters, and now he could barely muster a word. 

He taught me one of the most valuable lessons of supporting people with mental helth problems.  I used to fill our time together- in the mental health hostel where he lived, or on our way to and from the dentist, with chatter. A constant hum of white noise about what I cannot even remember, other than I would return home after having spent time with him with, you guessed it, a sore throat and an increasingly difficult to ignore feeling of helplessness. 

Eventually, we would meet for weekly ‘key work sessions’.  And still he barely offered a syllable  Finally, after a few sessions like this, I gave up, at least I thought that I had given up hope of offering any help to David, other than to support him in going to the dentist while he lost his teeth.  I sat in his room on his chair, sometimes on the edge of his bed and listened.  For weeks I listened to him breathing  labouriuosly due to his constant dental work, and various infections.  For weeks I listened to the sounds in his room.  For weeks I listened to the creak of the floorboards, the chair or bed as I shifted my position this way and that, never comfortable for very long.  For weeks I listened to the ticking of his bedside clock, stern and impatient. 

I cannot say that I gradually drew him back into conversation, that he regaled me with anecdotes of his time as a t.v. script – writer.  But when I left the hostel to work in a mental health day centre he wrote me a card wishing me luck and thanking me for having listened to him. 

That shut me up alright. 

I have written about the importance of actively listening, and the importance of, and different kinds of, silence before.  I don’t kid myself that I was listening well to David in his bedroom during those key work sessions.  But I must have made a pretty good act of appearing to listen, to accepting him as he was then. 

He taught me that listening is as much about bearing witness to someone as it is about gathering information, hearing their story.  Therein lies acceptance, and without that how can we begin?

Johnny Learns the Language


in order to explain myself

I locked myself away

with an old alphabet,

with the hand – me – down phrases for which

I had no use but to which

I ws already addicted.


while considering how absurd it was

that everything has a name

I discovered that the mayfly

was weighed down by a single vowel.

Under the threat of not being understood

I began to understand

how words were the nets in which

what I was floundered.


you come with your bowl of words,

fat words, puffed with kindness.

And father

you come with your silences in which

words sneak about like thieves.

I was learning your language.

‘Loss’ ‘Defeat’ ‘Unredeemed’ ‘Regret’ –

Without understanding

You would have these be

the blueprints for my future.

Brian Patten ( 1946 – )

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