As a visiting researcher at NIMHANS, I had the privilege of working in one of India's premier mental health institutions in Bangalore, Karnataka. My focus for this visit has a dual interest: I was there to develop a prenatal yoga module for women of ethnic minority backgrounds with the Integrative Medicine Department. I was also interested in learning more about transcultural and perinatal psychiatry from a clinical standpoint. Perinatal psychiatry deals with mothers’ mental health during pregnancy and after childbirth and, recently, the well-being of their newborns and partners. I am a postdoctoral researcher at the SPI Lab, and I have spent the last three and a half years studying and researching perinatal mental health. I am particularly interested in interventions to improve mothers' mental well-being and social support (see my recent blog on the SHAPER-PND study). I am also fascinated by how society and culture influence perspectives on mental health. My first impression of NIMHANS was that it was a quiet haven, with manicured botanical gardens, ancient trees, monkeys, dogs, patients, visitors, and healthcare staff, with buildings that camouflaged beautifully in the greenery. Yes, it is a bustling and busy hospital, with many departments and clinics dedicated to mental health and neurology areas. I was particularly interested in the Mother and Baby Unit (MBU), where mothers and their babies (up to 2 years) can stay together, frequently with the maternal grandmother or the father. This is the first and, as far as I am aware, only mother and baby unit in India led by Professor Prabha Chandra, whom I deeply admire. This unique inpatient ward caters to the mental health needs of pregnant and postpartum women and the needs of newborn babies and infants. The MBU provides various services, including psychiatric assessment, counselling, and pharmacological interventions, to ensure the mother’s and child’s well-being. In India in particular, where social services are in their infancy (excuse the pun!), mental health care also means social care, with provisions in terms of financial, housing and disability support, as well as the management of interpersonal household issues (domestic violence, abuse, and addiction in the household). The care they provide holistically impacts the well-being, recovery, and support of patients in the short and long term. With NIMHANS being a tertiary care centre, many patients had symptoms for a while, first seeking care from Ayurvedic doctors, religious leaders, informal care in ashrams, and psychiatrists from local hospitals and eventually finding their way to NIMHANS, as perhaps a more severe stage of symptomatology. Indeed, I was struck by the level of stigma surrounding mental health in India, particularly in the context of pregnancy and childbirth. Many patients expressed concerns about being labelled as "crazy" or "unfit" as mothers, held beliefs around mystical and religious phenomena (being “possessed” by a deceased person or a deity is still very common in India), and many patients describing what I thought was severe and obvious symptoms of mental illness as “tension”. One of the cultural differences that really surprised me (though, in hindsight, it appears to be a reflection of the culture) was the reluctance of many women and young girls to disclose their mental health history to their prospective husbands. For example, take Latha’s story (not her real name), who I met one Friday morning in the Perinatal Outpatients clinic. Latha is from a low socio-economic background, left school at 15, and has worked as a maid since. She has experienced periods of prevalent low mood and social withdrawal, punctuated by a few episodes of elated mood and dangerous behaviour. She was assessed at NIMHANS at the age of 14 and was diagnosed with bipolar disorder; she has been offered medication since. Shortly after her second episode of mania (extremely elevated and excitable mood usually associated with bipolar disorder), marriage was arranged without her consent. At 19, she was married to a stranger. Her family, fearing that she would not be seen as a “good prospect”, hid her diagnosis and told the groom’s family that she had minor sleep issues in the past. Latha stopped taking the medication that helped her with the psychiatric issues just before her wedding, so her new family didn’t know she had a psychiatric diagnosis. After her wedding, she moved to her husband’s house (that included her in-laws and other family members in a “joint family” setting, prevalent in India). She was expected to cook for the entire household (7 people in total), clean the house and look after the children in the family while having no social ties in a new and unfamiliar city. Her mother-in-law criticised her appearance, ability to look after the household and temperament, and pressured her to have a child as soon as possible. Within a year of marriage, Latha gave birth to a girl to the disapproval of her husband and their family (who wanted a boy, still very prevalent in India and a common finding in mothers at the MBU). Less than a month after delivery, she experienced another episode of mania. Her husband’s family have decided that Latha is not worthy of their family and has insisted that she move back to her family of origin and their son to re-marry a “more suitable” girl. Latha is at risk of poverty, social exclusion, and stigma, not just due to her diagnosis but also due to her being abandoned by her husband. When I heard stories like this, and trust me, there were dozens of similar cases daily; it really made me feel that there is so much more to mental illness than just a diagnosis; mental illness is a result of context, social circumstances, and mostly, privilege just as much as it can be a biochemical dysregulation. I must admit that there were some biases in my observations — India’s middle classes (and the less privileged too, but perhaps to the cost of indebting themselves) will rely on private healthcare. A government psychiatric hospital — and I am paraphrasing from what I heard many psychiatrists say, in the vast majority, is for the less privileged (many files were marked “BPL”, below the poverty line) or for the ones that have exhausted all their options in the private sector. This means that severe mental illness and complex cases are disproportionately represented at NIMHANS, but that gave me a birds-eye view of how psychiatrists manage heavy workloads (the waiting areas in clinics were always completely full), complex cases (where entire families and communities were being taken in consideration in treatment plans), and very limited resources (from minimal funding or grants used to support the largest number of BPL patients possible). This was an incredible experience for me, possible only thanks to the support of Prof Carmine Pariante (ITM’s Editor and my supervisor) and generous contributions by the British Association of Psychopharmacology’s Hannah Steinberg Award. Keep an eye out for my next article, on NIMHANS Centre for Integrative Medicine with Yoga and Ayurveda. I will leave you with a cup of steaming spiced chai in the sun.

I am a "millennial snowflake" psychiatrist hitting middle age with all its crises and needs. As Apo Whang-Od appeared on the cover of Vogue Philippines at the age of 106, I believe that we do enjoy talking about living a long and healthy life. But are we really prepared to reshuffle our stereotypes about age? Today, we live in a stressful, anxious, and extremely polarised society that triggers generational conflicts. These generational conflicts were never more apparent than there were at the beginning of the COVID-19 pandemic. The long and intense debates on sacrificing the young generation to save the older adults at that time motivated me to write a blog on ageism. Today, we might say those were all unnecessary debates as the pandemic affected us all. And like in every serious conflict, words like "zoomers", "snowflakes", and "boomers" aggravate the clashes and disagreement between groups. What is ageism? According to Word Health Organisation (WHO), "Ageism refers to the stereotypes (how we think), prejudice (how we feel) and discrimination (how we act) towards others or oneself based on age". This definition emphasises that ageism can be institutional, interpersonal, and self-inflicted (self-directed). Institutional ageism can be seen as related to interpersonal ageism and implies introducing most of the ageist principles in our laws, decisions, different organisations, and institutions, including the health system. Interpersonal ageism occurs during the interpersonal relationship between two or more individuals. Self-directed ageism can be an internalisation of institutional and interpersonal ageist principles. In 2021, the World Health Organisation (WHO) published its Global Report on Ageism, which summarises the current research and evidence on ageism. It proposes solutions and recommendations to reduce ageism in healthcare, the workplace and other institutions. How does this affect younger adults? Generation Z (born between mid-1990 and 2010) is also called the iGeneration because of their easier and more regular access to electronic devices. The young generation born in developed countries is more educated and uses more social media to get news. There is greater difficulty finding a job as many graduated in a society affected economically by, most recently, the pandemic and the war in Ukraine. In a world where depression is a major cause of disability, and suicide is "the fourth leading cause of death among 15 and 29 year olds" (according to the World Health Organisation), the younger generation tends to be more aware of mental health conditions. Ageism against younger adults is less studied compared to ageism against older adults. In a European study, the European Social Survey from 2008–2009, 55% of the interviewed young adults between 15 and 24 years of age experienced interpersonal ageism, such as being disrespectfully addressed (ignored and patronised) and 41% reported being insulted and abused. Several studies have highlighted the effects of different forms of discrimination (ageism, sexism, racism) on mental health. In a more recent longitudinal study from the USA, in a population of young adults from 18 to 28 years of age, ageism was amongst one of the most prevalent forms of discrimination, and it was associated with increased substance use, high psychological distress, and diagnosis of psychiatric disorders. How does this affect older adults? The population of older adults is increasing all over the world. The 2021 census in the UK shows that there are 11.1 million adults over 65 years of age in the UK, which is more than one-sixth of the total estimated population of 67 million; meanwhile, the British population aged over 90 years of age is more than half a million. Moreover, by 2015 it was estimated that roughly two-thirds of the global population aged over 60 lived in low- and middle-income countries. According to the WHO global report on ageism from 2021, one in two adults holds ageist attitudes towards older adults. We do see a demographic change, and it is a challenge to reduce the mortality from non-communicable diseases, including psychiatric disorders. More research and public health policies are focused on addressing modifiable risk factors and health factors to improve people’s health and well-being. As mental health professionals, we strive to offer our patients the best care. However, when we encounter older adults, our own stereotypes related to age can affect the professional relationship. Studies suggest that mental health professionals lack adequate training to diagnose and work with older adults with psychiatric disorders. In addition, older adults are often excluded from clinical trials for new psychotherapeutic drugs and receive less psychotherapy treatment. For example, in a high-income country like Sweden with an increasingly ageing population, the need for developing old age psychiatry is certainly acknowledged, but it is unfortunately often under-prioritised. During the COVID-19 pandemic, I met older adults in relatively good health who expressed their concerns and disappointment on how they feel excluded from a digitalised society. These stories made me think about ageism against older adults and the development of all these digital technologies. Digital technologies have advanced extremely rapidly in the last few years. Although these technologies have been mainly designed to be used by the younger generations, the determination of older adults to adapt to the new challenges in society is sometimes remarkable. This was even more impressive during the pandemic lockdowns. At that time, many older adults started to use modern technology to stay in touch with their loved ones and even communicate with their healthcare professionals. But I have also heard different stories about when older adults feel excluded from society or dependent on their families, as they are not able to master all these techniques, such as online banking, ordering food online, and booking appointments with healthcare services. I do hope that the future will bring us a more age-friendly digital world. Insights on self-inflicted ageism As I get older, I can see the difference between my real age and the age I feel like I have (my "subjective age"). For me, the discrepancy between these two different ages is the way towards self-inflicted ageism, which seems very difficult to handle. I read a study on ageing satisfaction, or one individual self-perception of their own ageing, which suggest that ageing satisfaction is associated with better physical and mental health. New physical and mental changes, new opportunities, friendships, and challenges are ahead. Every day, I learn to embrace my age with confidence.

A couple of years ago, I wrote an article for Inspire the Mind entitled, "Why Perfectionism May Be Damaging For Our Mental Health". Inspired somewhat by my own perfectionist tendencies, my research took me on a journey of discovering the impact that this particular personality trait can have on our mental health. Discussing how for some, perfectionism can be adaptive (helpful), yet for others it can be maladaptive (having more of a negative effect), we looked at the ways that perfectionism is sometimes linked with mental health difficulties. In the article, I touched a little on my realisation that my own perfectionist tendencies were more about being scared to make mistakes. Little did I know at the time, I would soon be introduced to a whole other take on perfectionism that strongly related to this: "moral perfectionism". Due to its multi-dimensional and multi-faceted nature, I’m still learning all about perfectionism in its many shapes and forms, but the features described as "moral perfectionism" struck me as something particularly interesting and not so widely spoken about, yet when I recalled the concept to people around me, so many seemed to resonate. When I’m not acting as a writer and co-editor for Inspire the Mind, I’m a researcher in mental health. So, embracing that very researcher spirit, I rolled up my sleeves and decided, once again, to investigate all that I can, relating to perfectionism. This time, of the moral kind. Moral, existential... but what is it? What I have learnt about perfectionism is that there is a lot to learn. Broadly a personality trait, there seem to be three different dimensions and many different subtypes, some of which appear to be more formally established than others. Moral perfectionism may be one of these less formally established. First coming across the concept under the label of "moral" perfectionism, I was stopped in my tracks during my research, finding little to no resources linking it to mental health. From what I had understood of it, the negative side of moral perfectionism is best described as worry, even panic, when thinking you have done something remotely wrong. Having intense feelings of guilt and ruminating past actions, even dating back as far as your childhood, and feeling this strong desire to have a clean slate, erasing any wrong-doings or things which could be interpreted as such. There being no discussion about the possible implications for, or links to, mental health seemed unlikely given its description. That is until I learned that it is also referred to as "existential" perfectionism, and suddenly some more doors were opened. Upon reading the word "existential", your mind may instantly go to the term "existential crisis", and you wouldn’t be wrong to do so. An existential crisis may be best described as a deep, internal conflict surrounding your own purpose in life — most typically only focussing on the negative. Apply this to perfectionism, and we are looking at the idea of striving for perfectionism in your value and worth as a person spiritually, and morally. Perfectionism is a is said to tie into three different dimensions described by Hewitt and Flett and discussed in my previous article. This idea of a moral, or existential, type of perfectionism has features which appear to tie into what they call "socially prescribed" perfectionism, which surrounds the belief that others have standards for you (almost impossible standards might I add) that you need to meet. These standards set by others in socially prescribed perfectionism can manifest in different contexts such as academically or socially. Oftentimes, the kind of worries experienced regarding values and your moral standpoint relates to how you will be perceived by others and concern that they will see you as anything but an entirely good person. The terminology of moral or existential perfectionism is used relatively sparingly, and from what I can see, mostly in philosophy. It’s hard to determine the validity of "moral perfectionism" as recognised formally in psychology, but there is no denying that the experiences it encompasses are a shared experience for many. If we think back to that idea of adaptive versus maladaptive, moral perfectionism could be something positive for some, an inspiring force to do good. But, on the other hand, the daily experience of worrying about your mistakes may include some quite negative and stressful feelings. We can of course assume that the latter most definitely causes some stress in everyday life. So, what do we know about the implications for mental health, and what can we learn from socially prescribed perfectionism? The link between perfectionism and many mental health difficulties is repeatedly reported. With little research relating specifically to the idea of a moral perfectionist, we cannot be sure of the true effects had on our mental health. We can assume that added stress may come to play but without explicit research to say so, we cannot be sure. We can however look to the literature and see what we can learn from socially prescribed perfectionism. Last year, Flett, Hewitt, and colleagues authored a review to address the lack of understanding surrounding the impact of socially prescribed perfectionism; important to address given that this type of perfectionism is arguably the most maladaptive in nature and therefore has subsequent concerns for public health. It was notably discussed that the number of people who demonstrate socially prescribed perfectionism is on the rise, demonstrating the need for increased awareness of how this may impact the younger, and next, generations. I wonder, how much of this is linked to the idea of moral perfectionism? Socially prescribed perfectionism is linked to stress in many ways, not just due to the stress the experience causes. Research has suggested that these perfectionists tend to have more negative emotional responses to stress and may generate interpersonal stress for themselves. We know from lots of research the impact that stress can have on many aspects of our lives and has important implications for our mental health. Studies have also shown links between higher levels of this type of perfectionism and mental health difficulties including depression and eating disorders, but that’s not to say it is a guarantee. So, while socially prescribed perfectionism is on the rise, as is the research on its implications for mental health, we still lack clarity on the validity of moral perfectionism from a psychological perspective. For now, we can take learnings from perfectionism in general and remember to use self-compassion. Being a perfectionist, moral or otherwise, isn’t always a bad thing. In fact, striving to be the best version of yourself is even considered an admirable quality by some, you just want to make sure to go easy on yourself and remember that we are all human. No one is perfect.

I was a child morbidly obsessed with anything spooky, landing me with the affectionate nickname ‘ghost girl’ during my primary school years. It comes as no surprise that this has seeped unconsciously into my adult life. My name is Rachael and I suffer from a nightmare disorder. I am 34 and are a keen creative writer and decorator and live at home with my wonderful and supportive partner and my squishy Pug, Lois (who is also wonderful and supportive). I decided to write this blog as dealing with horrible visions and images almost every night can make you feel isolated, and dare I say it, even a little crazy, but if one other person reading this feels even a small flood of relief that they are not alone, I know my attempt to document this disorder hasn’t been in vain. What is a Nightmare Disorder? It is first important to distinguish nightmare disorder from night terrors. Night terrors are episodes of panic and confusion that can awaken the individual abruptly, and can then be difficult to bring back into a calm or rational state. Those who are sufferers of night terrors have no recollection of their dream's narrative. A nightmare disorder, also known as ‘dream anxiety disorder’, is a rare type of sleep-related disorder or parasomnia that causes the sufferer to endure repeated instances of incredibly unnerving and frightening dreams. Nightmares commonly occur in children, but according to the American Academy of Sleep Medicine (ASSM), approximately 4% of adults can experience them too. It is essential to understand that this condition can be debilitating as it can cause severe distress, disrupt your sleep and cause chaos when it comes to your quality of life. My very first demon Nightmares are horrible cesspits that exist in our minds, quietly waiting for us to slip into the throws of slumber before their distorted forms turn our peaceful dreams into, well, our worst nightmares. I am old enough now not to get scared during the night when I hear a faint bang, nor do I panic and refuse to enter a room in the dark or sleep with my TV on, I am perfectly rational when it comes to things going bump in the night… or so I thought. Sleep paralysis occurs just before or after falling asleep as you slip between wakefulness and sleep: you are essentially paralysed even though you are or believe you are fully awake, and this can cause hallucinations, such as seeing or feeling a weight on your chest, pining you down to the bed, seeing a figure hovering over you or even sitting on your chest or stomach. My first sleep paralysis experience happened when I was living with my parents. My bed was an old pine frame with a headboard and raised part at its foot. I remember being awake, lying on my back and I recall seeing (my then) partner standing at the foot of my bed. He was leaning forward with his hands resting on the wood frame, with a yellow and red rucksack on his back. At the time, I assumed my eyes were hazy from just having woken up, as his features looked somewhat odd like I was looking at him through mottled glass. I wanted to sit up, to speak (and to ask why on earth he was wearing a red and yellow rucksack), but the more I fought against the invisible force pinning me to my bed, I realised the entity at the foot of my bed was not my partner at all but what I can only describe as a cross between Slenderman and ‘the pale man’ from the 2006 film Pans Labyrinth (yes, that guy). Imagine laying on your back, unable to move a single strand of muscle, unable to scream or cry out for help as this insidious creature stands only a few feet away from you, slowly leaning closer. This instance is what made me truly believe in the supernatural as I was convinced, I had seen a ghost. Lucid dreaming isn't always fun and games I know this is probably incredibly common, but, as often as I experience nightmares, I also experience lucid dreaming. Lucid dreaming occurs when you are in a dream state, and you know you are dreaming. This can usually be a fun and quite amazing phenomenon as in this state, you have the power to alter your dreams. We have all experienced being chased in a dream but either can’t move or move incredibly slowly. Well, if you happen to lucid dream, you can magic yourself some super speed. Awesome. However, lucid dreaming mixed with a nightmare tends to have different results, or at least it did in my case. After my Grandad passed away a few years ago, I found myself dreaming of him constantly, usually heart-breaking scenarios of walking into his house and him being sat in his chair smiling, or my mother telling me it was all a mix-up, and that he was alive and well. My dreams would usually start a run-of-the-mill, weird but not unpleasant dream. Then, all at once, I would walk into a room and my Grandad would be there and …. BOOM. Nightmare time. This repeatedly happened night, after night, after night, after night. It became so frequent in my dream that if I saw my Grandad, my response would be “This is going to turn into a nightmare now”. And it would. I have even been roaming around in a dream anxious that I may bump into him. A nightmare within a nightmare. This part of my life became very distressing, and I developed a fear of falling asleep and would physically begin to panic the moment I felt tired, which in turn gave my nightmares more fuel. I think this is how my brain deals with emotional situations, it concocts them into nightmares, leaving my subconscious to deal with them. It’s not as simple as ‘not watching scary films’ It would seem logical to assume the link between my nightmares and my passion for ghosts/ anything remotely spooky are the main cause of my sleep disorder, but I know that isn’t true. For as long as I can remember, I have had trouble dealing with and expressing my emotions. I tend to keep things bottled up and would rather ignore a problem than have to confront someone about how they’ve made me feel. The fear and experience of being told it was my fault and that my feelings were invalid have turned me into a bit of an emotional recluse. Sleep disorders tend to be higher among those who have emotional issues and mental health problems such as depression and anxiety. I am convinced there is no real correlation between my interest in the supernatural and my nightmares, but rather emotional distress and the inability to communicate this in a healthy manner. For anyone else out there reading this, whether you suffer from nightmares chronically or every so often, take note of your emotional state. With regards to therapy, I am currently undergoing person-centered therapy and are in the very early stages of this processes. It’s hard and emotionally draining having to express my feelings when, as you can see from my blog, it is something I struggle to do. Yet, my therapist is very good, even after only a few sessions part of me is starting to feel a slither of hope that eventually, I will be able to overcome my obstacles and resume peaceful, sleep-filled nights. There are many helpful avenues out there that can help you, such as counselling, therapeutic activities such as yoga, and meditation and even active sports such as running or swimming. Combined, these instances should help your mind become more relaxed, less tense and improve your mental wellbeing, so you can not only live a wonderful life but also experience wonderful dreams.

Trigger Warning: This blog discusses sexual assault, hate speech, and fatphobia which some readers may find distressing. Our selective memory of influential but problematic figures re-writes their flawed legacies. Last week’s Met Gala honoured the controversial Karl Lagerfeld. This served as a stark reminder that commercial enterprise and art can supersede social justice, sometimes at the expense of the marginalised groups that they appear to protect. Each year, as I eagerly await the "first looks" of the Met Gala’s red carpet, I am often conflicted. My love of fashion often clashes with my core values as a psychiatric researcher. I struggle to reconcile with the impact on society of an unsustainable, exclusive, and elitist fashion industry. But this year I could not consume the Met Gala. "Fashions biggest night out" paid tribute to the late designer Karl Lagerfeld. Whilst Lagerfeld’s contributions to fashion were venerated and celebrated by Hollywood’s most famous, his contributions to racism, sexism, and fatphobia were conveniently ignored. The impact of this on the wellbeing and mental health of those affected by his comments should not be underestimated. Lagerfeld’s notoriety is rooted in his impressive career. As creative director of Chanel for 36 years, Fendi and his eponymous brand Karl Lagerfeld, he worked with the world’s most influential fashion houses. He was arguably one of the most prolific fashion designers of all time. Lagerfeld was and still is revered within the fashion industry and heralded for his contribution to art. However, perhaps equally infamous are his controversies and lack of inclusivity. He held problematic views, with women and minority groups predominantly in the firing line. Lagerfeld defended Karl Templar (creative director of Interview magazine) after sexual misconduct allegations stating "If you don’t want your pants pulled about, don’t become a model! Join a nunnery, there’ll always be a place for you in the convent. They’re recruiting even!". He sent flowers to Dominique Strauss-Kahn, former Chief of the International Monetary Fund, after he was charged with sexually assaulting a hotel chambermaid. He said of Strauss-Kahn: "He is a sweet guy — as long as you are not a woman". The Model Alliance recently reported that 30% of models have experienced inappropriate touching in photoshoots. Former model for Vanity Fair, Maxim, and Vogue, Nikkie Dubose, spoke out about the sexual assault she experienced in the industry and described being "drugged and raped… by a photographer at a lunch". When she confronted her agency director, she was "shot down". Dubose has since struggled with an eating disorder and mental health issues. Such mistreatment is unsurprising when people like Lagerfeld, who was the head of the world’s largest fashion houses and proclaimed the "Godfather" of fashion, normalised this behaviour. Lagerfeld’s suggestion that women in the modelling industry should expect and accept sexual assault was accompanied by disdain for the #MeToo movement. Lagerfeld stated he was "fed up" with the movement saying "What shocks me most in all of this are the starlets who have taken 20 years to remember what happened. Not to mention the fact there are no prosecution witnesses", seemingly questioning the credibility of the reports of the sexual assault that he had indicated was implicit to the job. Lagerfeld also spread damaging fatphobic and dehumanising ideas calling Heidi Kulm "too heavy", Adele a "little too fat" and said Pippa Middleton should "only show her back". He claimed, "no one wants to see" plus-sized models and described fashion as the "healthiest motivation for losing weight". Women were not his only targets. Lagerfeld made shocking, racist comments in response to Germany opening its borders to Syrian Refugees, in 2017, saying "One cannot — even if there are decades between them — kill millions of Jews so you can bring millions of their worst enemies in their place". And, on the same topic, he was reported saying "I know someone in Germany who took a young Syrian and after four days said: The greatest thing Germany invented was the Holocaust". Whilst Lagerfeld's comments frequently caused outrage and calls to "boycott" him, his many high-profile friends continued to support him. At the time of his death, many celebrities expressed heartfelt tributes, including Cara Delevingne (model and Lagerfeld's muse) who described him as "one of the most interesting and caring men" she had ever met. In an article published in Vogue, Anna Wintour (co-chair of the Met) described him as her "colourful compatriot" and "dear friend". But many did acknowledge his flaws. The BBC published an article describing his '"controversial genius" and one Guardian article expressed a balanced view, referring to him as a "bully" whilst emphasising his "visionary" and "brilliance". Although the Met Gala is no stranger to controversy, this year's theme seems to have been a step too far for many people. The decision to honour Lagerfeld has triggered discourse across the internet. The New York Times published an article calling him a "Fire hose of Offence", The Guardian described his views as "odious", British actress and activist Jameela Jamil (a long-standing critic of Lagerfeld) expressed outrage at the theme and condemned his "cruel outbursts" and Ashley James (model, presenter and DJ) took to Instagram to express her disappointment at the theme and in those who attended. But behind the Tweets, Instagram posts, and trending hashtags, are victims. Lagerfeld’s comments are not just the outdated opinions of an eccentric artist from a different time, they are damaging hate speech. Research has shown that hate speech can have the same psychological impact as other traumatic events. The symptoms experienced by those on the receiving end of hate speech are similar to the symptoms experienced in Post-Traumatic Stress Disorder, including anxiety, nightmares, pain, fear, and intrusive thoughts. Such hate speech has far-reaching consequences, also feeding into the values of wider society and contributing to the microaggressions faced by marginalised groups. By definition, microaggressions are verbal, non-verbal, or environmental slights that denote members of stigmatised groups (e.g., racial minorities, women) as lesser. A recent study demonstrated that there are harmful effects associated with experiencing microaggressions including reduced psychological well-being and health. As Lagerfeld’s legacy is re-written and the Met Gala remembers him as an idol, rather than a talented, but deeply flawed individual, his responsibility for this damage is excused, the ideology is unchecked and those affected are undefended. As a society, we must decide: Does influence and power absolve discrimination and hate speech? At what point do our values come before our desire for art? And where do we draw the line on artistic licence extending to hate speech? Lagerfeld has a complicated legacy. But just as his influence and talent cannot be denied, neither can the damage he inflicted on the wellbeing of those at the receiving end of his most controversial comments. If we chose to turn a blind eye to such bigotry, we are complicit.

In today’s busy culture, I’d be surprised to find anyone who wasn’t keen to discover a new way to boost their focus, sleep and relaxation. Particularly if this could be accomplished by merely tuning into a certain kind of sound. TikTok is bombarded with various trends promoting new techniques aimed at improving our health and mental well-being. While some simply may be fads, a particular craze has gained a lot of attention over the last year: #brownnoise is currently sitting at 118.5M views on the popular social media platform. Being a Neuroscience student at King’s College London, I was intrigued as to whether there was any scientific evidence to support the anecdotal relaxing and focus-boosting effects of brown noise, and how exactly it may be working. What is brown noise, and what is it reported to achieve? Unlike its better-known counterpart 'white noise', which is ‘staticky’ and contains both high and low frequencies, brown noise is predominantly made up of low-frequency sounds which are produced through Brownian motion – the random movement of particles in liquid. While the low frequencies are more prominent, brown noise contains every frequency of sound the ear is able to detect at once. It is a compilation of constant deep and minimal sounds with no change in frequency or tone. It is difficult to explain exactly what brown noise sounds like, and in fact, different playlists sound slightly different, but I would compare it to anything which resembles the hum of a fan, heavy rain, strong winds or thunder. Have a listen here Brown noise has gained popularity online due to its apparent ability to create an immersive experience to boost focus, tune out racing thoughts, enhance relaxation, reduce anxiety and promote sleep. People online claim it allows them to focus better at busy workplaces, or when concentrating on one task is difficult with a mind full of racing thoughts. The praise for brown noise is embodied throughout TikTok, with people commenting on videos of the sound with statements like “It’s like a weighted blanket for your brain”. However, brown noise has received most of its praise within the ADHD (Attention deficit hyperactivity disorder) community. ADHD is a disorder in which individuals may experience symptoms of inattention, causing them to find difficulty in focusing and executing tasks. Online, sufferers of ADHD comment on videos of brown noise with claims like: “My brain is melting into quiet”; “It’s like putting the volume down in my brain”; “I closed my eyes and literally thought of NOTHING”; and “my brain is quiet for the first time ever”. A close friend of mine with ADHD told me she is “unable to get anything done without it”. I myself am at a stage in my master’s degree where I find my mind is full of thoughts. With looming deadlines, exam season, financial stress and the frightening question of ‘what is next?’, I decided to try brown noise out for myself. In the week before my exam, I tried out doing some revision at home with a brown noise playlist from Spotify. In reference to my concentration, I personally did not notice a difference. However, I definitely noticed a calming effect of the noise. So much so that I often now turn to listening to brown noise when my anxiety is preventing me from sleeping. It is important to note that brown noise is not for everyone. Some people listening to it claim the noise is actually distracting or even anxiety provoking. Some people with ADHD may find it unsettling to silence the inner monologue which they have learnt to live with, and some simply claim that the sound is more annoying than calming. Considering that many people begin listening to brown noise with preconceptions of the outcome, it may also be that there is an element of placebo effect to its benefits. Lack of scientific evidence… Unfortunately, there have not been any scientific studies into the benefits of brown noise as of yet. However, there are other similar sounds named after colours, and research over the last few decades into how these may be working may shed some light. These sounds include, for example, pink noise and white noise, which are very similar to brown noise but separated by the volume of the varying frequencies they contain. For example, pink noise is soft at high frequencies, but loud at low frequencies, while white noise is spread across the spectrum. There is even some thought that different ‘colours’ of sound may each be better at providing specific benefits. For example, a study in 2012 exploring the benefits of pink noise has suggested it may function to promote sleep through the slowing of brain waves. Currently, white noise has been the focus of the most compelling clinical studies. Professor Daniel Berlau from Regis University in Colorado wrote a review published in 2019 on the possibility of white noise as a therapeutic avenue for people with ADHD. In this article, it is suggested that white noise, or any kind of noise therapy, may be producing its benefits through a mechanism known as ‘stochastic resonance’. Within this, it is believed that white noise promotes the brain's ability to concentrate on signals which would otherwise be too weak to be detected. In other words, under the stochastic resonance theory, listening to white noise can promote clearer focus. Following the article and since the rise in brown noise’s popularity, Professor Berlau has received many questions on whether his research into white noise can help explain brown noise. In an article for the Guardian, he claims that brown noise is potentially capable of “sound masking” and creating a “blanket” over all other sounds to help calm “brain noise”. He suggests that while any definitive research into how brown noise is working to promote concentration and relaxation has not yet been completed, it does “make sense” that the calming sound can help to tune out an internal monologue, even if it is simply working by blocking out other more distracting sounds. The scientific evidence for the benefits of brown noise is lacking. However, it seems to be helping a lot of people, which can only be a good thing, regardless of how exactly it may be working. Further, it is not dangerous (unless listening at unsafe volumes) and is an easy, non-invasive technique which is universally accessible to anyone with a phone, speaker or computer. Both YouTube and Spotify are bombarded with long videos and playlists dedicated to brown noise. So, if you struggle to concentrate, relax or focus, try it out yourself and see what you think.

Exploring the intersection of depression and cardiometabolic health Everything that you start out with is a tool, but your hope is that it actually comprises a theory. - Cormac McCarthy, Stella Maris- “The Rise of Immuno-Metabolic Depression” was the title of a symposium at the 2022 meeting of the PsychoNeuroImmunology Research Society (PNIRS). I was invited together with other speakers from diverse fields of psychiatric research at the symposium, where we presented results obtained from different types of studies exploring the novel concept of “Immuno-Metabolic Depression” (throughout the piece I will use the acronym IMD for the sake of conciseness). But what is exactly IMD? In broad terms, this label is generically applied to research examining biological processes related to immunity (the body's defence system against pathogens) and metabolism (the body's conversion and utilisation of energy) in depression. Nevertheless, a clear definition of IMD is not yet available in the scientific literature and the speakers at the PNRIS symposium provided different descriptions. I am a clinical psychologist and researcher in Psychiatry and Epidemiology at the Department of Psychiatry of Amsterdam UMC. In 2020, I proposed together with other colleagues a model of IMD, which was based on our previous research and progressively shaped in the attempt to address a specific research question. The connection between depression and cardiometabolic diseases The prevalence of depression among subjects with medical diseases is elevated. For instance, among subjects with cardio-metabolic diseases (e.g., coronary heart diseases, diabetes) up to 30% suffer from depression; proportion that is much lower (~5%) in the general population. Multiple complex mechanisms could explain the strong connection between depression and cardiometabolic diseases: psychological maladjustment to the disease, unhealthy behaviors (smoking, sedentariness, excessive alcohol consumptions), lack of treatment adherence, effect of medications and common underlying biological pathways influencing both conditions. A recent study showed that poor body health, particularly of the metabolic and immune systems, is a common manifestation in several neuropsychiatric disorders including depression. Results from longitudinal cohort studies (which are studies that follow a group of subjects over an extended period of time to examine how their health changes) showed that depression subsequently increases the risk of cardiovascular morbidity and mortality with about 80%. It has been estimated that a substantial part of the increased mortality of depressed patients is due to biological dysregulations such as obesity or metabolic syndrome (high blood levels of glucose and triglycerides and lower levels of the “good” cholesterol, high blood pressure and excess fat around the waist) which are precursors of cardiometabolic conditions. However, not all individuals suffering from depression develop such biological alterations and related cardiometabolic disease. Depression is very heterogeneous: individuals with the same diagnosis exhibit very different symptom profiles and biological mechanisms. Thus, a crucial question is “who are the depressed subjects at higher risk to develop cardiometabolic diseases?”. Around this research question, we built our IMD model. We started by focusing on relevant biological mechanisms for the development of cardiometabolic diseases, such as inflammation (determined by a low-grade chronic activation of the immune system) or alterations in metabolites involved in energy storage (lipids) or hormones governing the body energy intake/expenditure balance (leptin and insulin). We then examined which of the very diverse symptom profiles expressed in depression are more consistently linked with these immuno-metabolic biological alterations. We found across different studies that these immuno-metabolic dysregulations tend to cluster consistently with depressive symptoms indicating a shift in the body homeostasis toward an increased need of energy, such as increased appetite, increased sleepiness, fatigue, and leaden paralysis (that is feeling that the limbs are weighed down). Furthermore, we showed that the connection between some of these symptoms and biological dysregulations arises from a common genetic vulnerability: for instance, subjects expressing symptoms like increased appetite during their depressive episodes had also an increased genetic risk to develop inflammatory and metabolic dysregulations. In our model, the clustering between energy-related symptoms and biological processes is the expression of IMD. To convey my idea of IMD I often borrow the concept of “field” from physics, where a force is applied to all points in a space. If the space is depression, the area in which the IMD “field” is stronger, characterized by high expression of energy-related symptoms and immuno-metabolic biological dysregulations, is the area in which depression overlaps with cardiometabolic disease (see the schematic figure). A tool for the clinic? Following the expression of IMD-related symptoms and biological alterations, we could identify a portion of depressed patients at higher risk of developing cardiometabolic complications. Could this application of IMD be useful in the clinic? Certainly. The identification of patients at higher cardiometabolic risk may be relevant for secondary prevention efforts, where the cardiovascular and metabolic health status of this subgroup of depressed subjects could be more closely monitored to prevent the onset of highly disabling diseases. Furthermore, we could also think of a more direct impact on depression treatment strategies: IMD could be used as a tool to stratify and select depressed patients to offer treatments targeting specifically the identified altered biological mechanisms, such as inflammation. We are currently testing this approach in the INFLAMED clinical trial at our department, that I am leading together with my colleague Femke Lamers. This study aims to test the efficacy of adding an anti-inflammatory medication in the treatment of a selected group of depressed patients expressing IMD features, which include elevated energy-related symptoms (increased appetite, increased sleepiness, fatigue, leaden paralysis) and raised inflammatory blood markers. Other ongoing clinical trials are similarly testing anti-inflammatory add-on treatments for depressed subject selected with criteria in line with those of IMD, such as high levels of inflammation and depressive somatic symptoms including fatigue and appetite/sleep alterations (the INSIGHT trial in UK), or obesity (the SIMCODE trial in Germany). Results from this new generation of clinical studies will provide key insights on the validity of this stratified approach and will be helpful in the development and refinement of the IMD research hypothesis. Multiple perspectives: the blind men and the IMD elephant. The image of IMD described here is taken from a very specific point of observation: our point of observation, which is enabled and simultaneously limited by the type of research methodology we apply (mainly epidemiological analyses of large-scale studies). This means that our image of IMD is a partial image because it is limited to the type of data that we could measure and test in our research. This may explain, for instance, why the speakers at the PNIRS symposium provided different descriptions of IMD: partial images of the same phenomenon taken from different points of research observation. Various groups are exploring this research area with different approaches, focusing on different depressive symptoms (e.g., anhedonia, the inability to experience pleasure), biological processes (e.g., mitochondrial respiration, the process by which cells produce energy) and subjects (e.g., those with overweight/obesity). This multiplicity of perspectives reminded me of the ancient parable in which a group of blind men come across an elephant for the first time and try to describe it according to the limited portion of the animal’s body they were touching. One man touches the elephant's trunk and says “It's a snake”, another touches its leg and says “It's a tree”, while another touches its side and says “It's a wall”. At the current stage of research on IMD this conceptual confusion is vital and necessary; a strict definition of IMD would only chain our scientific ingenuity. It is only with time, when these multiple research perspectives converge and be integrated, that we will have a more comprehensive image of IMD and its potential usefulness to improve the care of depressed patients at risk for cardiometabolic consequences.

After a three-year-long hiatus, the Festival of Italian Literature in London (FILL) has made an exciting comeback on Saturday 22nd of April, at the Coronet Theatre in Notting Hill, where every edition, since the festival’s inaugural one in 2017, has taken place. The title of this year's event was SAFE WORD, a play on the big issues of our time: from the need to establish rules and boundaries within language, to the healing, expressive, and transgressive possibilities words can afford us. In keeping with this, each event was signposted by a word around which the conversation revolved. I have been a part of the team behind the organisation and curation of FILL since its first edition in 2017 and was genuinely thrilled to see it back in full swing this year. As a literary scout (my main job), I look for exciting new voices that can transcend borders and speak to large audiences in translation, so it was a real honour to be in the presence of so many of these on Saturday, April 22nd. My friend Antonella Lettieri last week published a piece on the Festival where she explored the ways in which translation plays a significant role in helping us to cross borders. Here, I would like to zoom in on a few of the conversations that happened on the day, and insist on a fil rouge that runs through them all: place. Something that’s always been a key feature of the festival is to broaden the scope of what literature means, not just in terms of voices, but also in terms of forms. This year we gave the floor to novelists, poets, critics, journalists, scholars, and performers. Conversations were held on a range of wide and diverse subjects, taking often surprising routes and breaking new ground. Several authors brought up the importance of talking about mental health, and what creativity can do to improve it. It’s a subject dear to us at FILL and we were glad to have ITM as a partner this year. We opened the day by hosting a creative writing workshop, led by the icon that is Rossana Campo, which had a wonderful response from the public. Called "The Body I Live In", Campo worked on the ways in which it is possible to write the body and its lived experience into a text. We closed, aptly, with a performance tribute to the poet Patrizia Cavalli, one of Italy’s most popular contemporary authors who passed away in 2022. The scholar Alberica Bazzoni guided the audience through Patrizia Cavalli’s life and work, accompanied by readings performed by actor Amelia Donkor. The body has been a theme at the centre of this edition, and it is no coincidence these two events bookended it: from writing the body into a text, to a text that is being embodied. And central to the experience of the body is place, and how the two exist only in relation to each other — a subject that’s been dear to FILL since its inception, given it was born outside of the wound from body and place that Brexit caused. What does it mean to write a place? Writers Philip Hoare and Marco Belpoliti discuss this with author Gianluca Didino. Belpoliti’s last book, Pianura, is a journey through a section of Italy often forgotten because "flat", static, and uneventful, but which has enjoyed the love of titular Italian artists such as photographer Luigi Ghirri, filmmaker Michelangelo Antonioni, and author Gianni Celati — figures that Belpoliti "encounters" through his journey. Hoare’s obsession, on the other hand, is with the ever-transforming sea (5 out of 10 of his books are about the sea). On the day, the authors discussed their approach to the writing of a place, which often starts from memory (collective and individual), and segues into the history and culture inscribed in those places. What emerged from this conversation is that, for these authors, it was impossible to embark on this project without keeping in mind their personal relation to the Italian flatlands or the sea, and that separating body and place is impossible. I had the pleasure of hosting one of the events in the auditorium, ROOTS, with authors Thea Lenarduzzi and Yara Rodrigues Fowler, in which we asked ourselves similar questions about the entanglements of body, place, history, and memory when writing. Dandelions is Lenarduzzi’s debut work of narrative nonfiction, in which she traces back four generations of the history of her family, Italian migrants who moved back and forth between the north of Italy and the north of England. There Are More Things is Rodrigues Fowler's second novel, a sweeping intergenerational story about the friendship between two young women in London, both of Brazilian ancestry, set between London in the 2000s (up until the present day) and the Brazil of dictatorship. In both novels, the authors use the fragment and non-linear narrative structures as devices to mimic the wandering nature of memory itself: where a face or a moment in time emerges inconsequentially from the past as we are thinking about something else entirely. There are things we simply don’t remember and things we choose to black out. Much like in Belpoliti’s and Hoare’s work, it is memory that dictates the pace of the narrative, with its flaws and gaps, conceptual jumps and free associations. In Dandelions, Italy doesn’t emerge as a coherent country: it’s a feeling, a mood that’s constantly shifting; sometimes, it’s something missed and beloved, others, it’s a place to escape. For Thea’s grandmother Dirce, the protagonist and repository of all of these memories, Manchester is an appendix of Italy itself, because when she lived there she was immersed within a community of Italian immigrants who spoke the same language, but different dialects, to each other. The same goes for London and Brazil in There Are More Things: places and people are never neutral but a nexus of personal and collective experiences, a layer of official historical records and personal mythology. FILL has always wanted to create conversations between different perspectives (historically between Italian and foreign authors: British, French, Spanish, Turkish...), but this edition, in particular I think, has seen on-stage authors who embody this duality within themselves. In DISTANCE, Paolo Nelli spoke to writer and artist Ornela Vorpsi and writer and scholar Lea Ypi, who both left Albania for Italy before moving to France and the United Kingdom respectively. In this conversation, they discussed what it meant for them to grow up in Albania and then live across different countries, often ending up in a state of what Ypi called "linguistic illiteracy": the lack of fluency in English, Albanian, or Italian encountered when approaching the writing of her memoir Free for the first time. Both authors, who have written books that entangle family and personal events with the larger events of history, discuss their "in-betweenness", and how it is possible to welcome that inside a text. In general, throughout this edition, we have seen the necessity to welcome more fluid, hybrid, forms of writing, ones that mix the personal with the historical (lower case "history" with capital "H" history), that disseminates facts with fiction. In THE END, authors Luke Williams (Diego Garcia), and Paolo Giordano (Tasmania), discussed this in conversation with Marco Magini, whilst they reckoned with the shifting role of the narrator in the present day. Whilst in the 19th century narrators were god-like figures endowed with bringing history forward and shining a light on events, the contemporary narrator is often drowning in history and struggling to make sense of it all. In Diego Garcia, the two protagonists Damaris and Pablo come across the story of the Chagos Archipelago through the poet Diego Garcia, whose mother and her community were forced to leave by British soldiers in 1973. Damaris and Oliver Pablo become obsessed with this notorious episode and the continuing resistance of the Chagossian people, and want to write in solidarity. But how to share a story that is not theirs to tell? During ROOTS, we spoke about the concept of "world-building", a term often used in the fantasy genre but, I believe, wrongly not used often enough for other kinds of literature. Every time we open a book we step into something someone else has created for us and, for a while, suspend disbelief. In this sense, authors should be mindful of the opportunity they have for world-making and for giving readers an opportunity to re-imagining current structures FILL started as a reaction to the Brexit referendum, at the time we thought it more important than ever to bring together authors from different linguistic and cultural backgrounds. Seeing that, 6 years later, with a lot of water under the bridge, including a 2-year long pandemic and an ongoing financial crisis, we’re still here to discuss what can literature and art do to help us reimagine our world, all I can say is that I’m very proud, and excited to do it all over again next year. If you’d like to stay up to date with our upcoming events, please visit our website: https://www.fill.org.uk.

Despite all efforts, women remain underrepresented in academia, particularly in leadership positions. We have come a long way with initiatives like Athena SWAN (a framework used across the globe to support and transform gender equality within higher education and research). Still, research shows that these tend to fail due to, quoting a recent paper: “resistance to or unwillingness to support equality initiatives involving quotas or affirmative action.” I am a postdoctoral researcher who has worked in academia for 11 years; I currently work in a fantastic research group, but over the years, I have experienced some of the issues discussed below. Ultimately, I am using this opportunity to explore what research has highlighted, but also what I have experienced first-hand, and heard from colleagues over this decade of being part of the academic world. So, what are the issues women face in academia that could get in the way of their progression to senior or leadership positions? One major issue women face in academia is unconscious bias, which can be defined as attitudes or stereotypes that unconsciously influence subsequent actions and decisions. These biases are present in everyday interactions. For example, I am positively biased towards dogs and will greet them and expect them all to be friendly. On a more serious note, biases that women in academia face can manifest in a variety of ways, including: in hiring and promotion decisions: women are more likely to need career breaks due to childcare responsibilities, which can hinder securing funding and promotion. in career progression: women are less likely to be appointed professors, at least in the US. in the way that women’s research is received: papers with women as the first or last author are less likely to be cited; research has found, which can hinder securing funding and promotion in the way women scientists are perceived by society: a good example is how Psychology is seen as a “soft” science (or not like science at all!) due to the high representation of women (at least in junior roles). A lack of opportunities in sight can significantly impact women’s mental health and well-being in academia as they may feel undervalued or unsupported in their careers. One can be “stuck” in short-term contracts (postdocs will usually last for a maximum of three years), but unable to secure independent funding afterwards (in the form of a fellowship) or to be appointed Assistant Professor. It’s a highly competitive field; I have seen a fellowship application to request the candidate to list ten first-author publications, but the cut-off for applicants was a maximum of 3 years post PhD award, which is not an easy ask! I want to highlight to you, my reader, that academics are traditionally people that have been praised for their academic achievements (“getting good grades” or “getting into good universities”), and that may have been, for years, putting undue value in their scholarly accomplishments. In fact, as an academic myself, I can recognise how much my identity has been tied to my career; I AM an academic, even outside of work. In academia, particularly, the “Leaky Pipeline” concept has been gaining traction. The “Leaky Pipeline” refers to the phenomenon of women leaving the academic track career, especially at the postdoctoral (after completing a PhD) stage. One crucial factor contributing to the “Leaky Pipeline” is the need for more flexible working arrangements for caregiving responsibilities, which often include small children at the postdoctoral stage. This is not the only contributing factor, but it is a highly prevalent one. A recent report highlighted that women face more significant barriers than men in their academic career progression, citing “poorer employment conditions, a poorer working environment and greater difficulties concerning both funding and promotions”, all contributing to the “Leaky Pipeline”. This need to “keep everything under control” or, like Amy Westervelt, in her book “Forget Having It All”, sums up: “We expect women to work like they don’t have children, and raise children as if they don’t work”. This can lead to feelings of guilt, stress, and burnout, which can negatively impact mental health. Another factor contributing to the leaking pipeline is the need for more mentorship and support for women in academia. Where are the mentors if no women are in senior or leadership positions? As women are often underrepresented in leadership positions, they may need more access to the same resources and opportunities as their male counterparts. Interestingly, a recent study found that women outperform their male counterparts when promoted to the Professor level. This can make it difficult for women to advance in their careers and lead to feelings of isolation and frustration. The “Leaky Pipeline” can significantly impact women’s mental health and well-being in academia. However, by creating policies and programs that support flexible working arrangements, mentorship, and inclusivity, we can work to improve the representation of women in academia and create a more inclusive and equitable academic community. We can’t lose out on all the intelligent and driven women that don’t get a chance to leave their mark as senior academics. It’s important to acknowledge the mental health aspect of the “Leaky Pipeline” and work towards creating a more supportive work environment for all. However, steps can be taken to address these issues and improve the representation of women in academia. Some of these steps include: Increasing awareness of unconscious bias and working to reduce its impact : initiatives must be built with impact and longevity in mind, not just a “tickbox” exercise. Providing training and resources to help women succeed in academia. Creating policies that support working mothers. Encouraging men to take on a larger role in caregiving so that women are not forced to choose between their careers and their families. Creating a culture of respect and inclusivity in academia by educating all levels of seniority, starting with the leaders, so that the effects of new, inclusive policies trickle down. Ultimately, it will take a collective effort from everyone involved in the academic community to make meaningful progress, not just women fighting for other women. This includes institutions, departments, mentors, colleagues, and individuals themselves. It’s important to note that the underrepresentation of women in academia is not only a problem for women but also for the institutions and the field. When diversity is lacking, a significant portion of the population’s perspectives, ideas, and contributions should be showcased. They remain invisible.

A festival of literature and ideas bringing together writers and thinkers from different backgrounds After a three-year break due to COVID, FILL, the Festival of Italian Literature in London, was back on Saturday 22 April at The Coronet Theatre, in Notting Hill. As a long-standing friend of the festival and a member of the wider network of volunteers who help organise and run the event, I was thrilled to be back at The Coronet – and in its beautifully quirky bar – to see in person faces old and new. As a translator, I was delighted at the prospect of taking part, once again, in an event first launched in 2017 by an independent group of London-based Italian authors, journalists, translators, and academics as a response to the Brexit referendum and in an attempt to bridge the two cultures and literature that we inhabit every day, that is English and Italian. The day’s events kicked off with an autobiographical writing workshop led by novelist and writing coach, Rossana Campo and organised in partnership with Inspire the Mind. The participants were invited to dig deep into their memories to look for a meaningful image that could be reshaped into a short story. By the end of the workshop, the writers were ready to share their stories with each other, testing their literary voices and receiving Campo’s useful feedback. After the workshop, it was time for the panels. The theme for this fourth iteration of FILL was Safe Words and all panels focused on a safe word representing a shared thread in the work of the Italian and international writers invited to take part in the discussion. I was particularly interested in four of the eight panels: Violence, Distance, Ties, and Irony. Next week, my friend and fellow FILL organiser, Maddalena Vatti, will publish a second piece in Inspire the Mind to discuss other topics that were presented at the Festival. Violence The panel, chaired by Emiliano Zappalà, brought together novelists Fabio Bacà and Andrea Tarabbia. The authors’ most recent novels both focus on the titular theme. Bacà’s book tells of a ‘normal,’ meek man dealing with the possibility of violence suddenly upending his life, while Tarabbia’s novel focuses on the violence of a fictional – though not too unlikely – neo-fascist organisation. Both authors readily agreed that, when speaking of violence, fiction offers an extraordinary tool to explore extreme issues from the relatively safe point of view of our ‘boring,’ ordinary existences. The point that I found most interesting in the discussion, and I was quick to raise my hand during the Q&A session, was the fact that both panellists seemed to consider violence as a specifically male phenomenon – an opinion that, at least at face value, is hard to disagree with. That said, it was interesting to hear from Tarabbia how he strives to bring a female perspective into his writing, especially when dealing with complex and potentially triggering issues such as sexual and gender-based violence. Distance During the panel on distance chaired by Paolo Nelli, writers Lea Ypi and Ornela Vorpsi opened up on their extraordinarily similar life experiences: both born in Albania, the last communist outpost in Europe, they emigrated to Italy during the nineties to then move again, Ypi to the UK and Vorpsi to France. Their books, a memoir in English for Ypi and several novels in Italian and then French for Vorpsi, all chronicle their experiences of living across different countries and languages. Distance touched on many topics that are key to my own experience and reflection on emigration and literature, including writing in a second (or third) language, translation, and self-translation. Ypi’s extreme intellectual rigour (although she was discussing her memoir, she is primarily an academic at the London School of Economics) and Vorpsi’s explosive and irresistible personality proved to be a match made in heaven: the audience laughed out loud throughout the panel and – even when the discussion moved onto heavier topics such as discrimination, Marxism, and personal struggles with mental health – light-heartedness and humour remained the constant notes. Ties The panel Ties with poets Maria Grazia Calandrone and Hannah Lowe, chaired by Giorgia Tolfo, was the event I was looking forward to the most: a short excerpt of my translation from Calandrone would be featured during the event, but the reason for my excitement was not purely self-interested. Despite the different contexts in which their parents lived and then ceased to live, it was clear to me that Calandrone’s and Howe’s memoirs would resonate with each other in the most perfect and interesting ways. And so it was: Calandrone and Howe both took to their historical reconstruction of their lost parents with a two-fold approach. On the one hand, a meticulous investigation into the archives, into any trace that still exists of lives that “few cared about.” On the other hand, poetry as a means to fill the gaps otherwise destined to remain unfilled by history. As Calandrone put it during the panel, “Poetry is the translation of an invisible language.” This was echoed powerfully by Howe’s discussion of ‘diasporic imagination’ and intergenerational trauma. Calandrone and Howe charmed the audience, who several times let out unwitting ‘aws’ and ‘uh-huhs’ of agreement. Irony The final panel that I attended on this rewarding day of intense literary conversations followed a slightly different format. This event was a tribute to Patrizia Cavalli, one of Italy’s most important contemporary poets who sadly passed away in June 2022. The tribute, led by scholar Alberica Bazzoni, was an intimate and heartfelt exploration of Cavalli’s life and work: Bazzoni skilfully guided the audience through the discovery and rediscovery of Cavalli’s highly ironic and yet profoundly earnest voice. The readings in Italian by Bazzoni were followed by actor Amelia Donkor’s joyous recitation of the English translations. It was during this event that FILL’s truly international nature became evident to me, in a delightful moment when, having stifled a chuckle after the reading of the poem Bene, vediamo un po’ come fiorisci, the Italian speakers were all waiting with bated breath for the reaction of the other half of the audience to its English translation. Needless to say, it did not disappoint! It is precisely in this suspended moment between languages that FILL exists: far from being a festival by Italians and for Italians, its purpose is to foster dialogue and exchange across cultures, bringing together voices and ideas that thrive across borders rather than be stopped by them. I, for one, will be looking forward to seeing how FILL will continue to break down these borders in its next iterations.

They are not real but can really feel as though they are. From our own sofa, we can explore new places, encounter strange creatures and plants, and have great adventures. I am talking about imaginary worlds: places made from the human imagination, where we encounter an unknown that we can never physically go to. A Popular Phenomena Though not a new phenomenon — Homer, the ancient Greek poet, conjured up his hidden Odysseus Islands more than 3,000 years ago — imaginary worlds have really boomed over the past century. The Lord of the Rings, Harry Potter, Marvel, and Star Wars, to name but a few, and where they are set — such as that famous Galaxy far, far, away — have been huge successes at bookshops and box offices, and both creators and fans have been happy to return to them. Shows such as The Rings of Power, the most expensive series ever made, and House of the Dragon, a Game of Thrones spinoff, are popular recent releases, whilst recent reports suggest that new Lord of the Rings films are soon coming back on the big screen. Granted, we’d save energy and time by using Planet Earth, but creating and exploring whole new worlds seems to have a special type of appeal. Though maybe most spectacular through the eyes of children, such worlds are beloved by people of every age, all over the world. I’m Livia, a regular contributor at Inspire the Mind, and I love to travel to such places, though I am not sure as to why, exactly. Are dragons simply inherently cool, or does something happen in the brain when we encounter imaginary worlds? Now, new research in cognitive science may be on track to reveal why such worlds are so appealing, and it may have everything to do with our prehistoric ancestors. Prehistoric Wanderlust Cognitive scientists Edgar Dubourg and Nicholas Baumard from Paris Sciences et Lettres University have recently proposed that our preoccupation with made-up worlds may stem from how humans once evolved to be natural explorers. As modern humans evolved, tens of thousands of years ago, we were shaped by the world around us, a place much more dangerous than today. We were hunter-gatherers who constantly searched for new, wild resources, such as food and shelter, to overcome the ever-present threats of starvation and predators. To help us get to new places, new resources, and therefore a new day, we developed the dopamine system. Every time we do, or are about to do, activities that support our survival, such as eating, the dopamine system releases a neurochemical inside the brain that makes us feel pleasant sensations, motivating us to do that activity again. Led by the prospect of new berry reserves, we made our way across savannas and steppes, not for fun adventure, but pure sustenance. Eventually, we became really keen explorers, so much so that we soon spread from Africa to Eurasia and the Americas. In our comparably much safer modern world, where more people than ever get their resources from the shops, we no longer need to search for them from dawn to dusk. We do, however, have the same brains that our ancestors once evolved, and therefore the same dopamine system and the same exploratory urges, though today we refer to them more as wanderlust. The Rewards of the Unknown Even though there are never any actually useful resources to be found there, Dubourg and Baumard suggest that fantasy worlds appeal to us because they meet that natural, dopamine-fuelled need to explore the unknown. Research has shown that the dopamine system activates when we encounter new places, even when we go without physical rewards. The spectacularly unknown and unreal, such as an enchanted forest, or a brand-new planet, are basically small dopamine treasures for the forager self we have within, who always wants us to keep discovering new resources. Middle Earth, to take one example, has its own languages, plants and creatures, and even its own natural laws: the knowledge that the hunter-gatherer brain judges to be useful. Not everybody enjoys imaginary worlds, of course. We may all have a cognitive preference to explore, but how much we are individually drawn to them appears dependent on certain factors, Dubourg and Baumard say. They have found that younger people appear to enjoy them more since humans explore most when they know the least about the world, as do those who have more of the Big Five personality trait Openness. According to the Big Five theory, everybody has more or less of five broad personality traits which, apart from openness, includes extraversion, agreeableness, conscientiousness and neuroticism. People who are more open are believed to generally be more imaginative, creative, and adventurous — all attributes that probably help make magical worlds quite attractive. Dubourg and Baumard also hypothesise that other worlds should be more popular where humans have easy access to resources but nonetheless have that hunter-gatherer urge to explore the wild unknown. Now, however, many people explore the unknown at least partly through books, video games, and films. In another study, Dubourg and Baumard found an interesting correlation between GDP per capita — a measure of economic growth, and the consumption of fiction novels: as China and the United States, for example, become more affluent throughout the 1900s, their populations can afford to — and do — spend more time visiting imaginary worlds. Magic and Mental Health Such fantasy places are great for an enjoyable temporary escape — a real asset during the Covid-19 lockdown, for example — but not much evidence suggests they support everyday well-being, according to Edgar Dubourg. In a new, not yet published study, Dubourg and colleagues tested whether imaginary worlds are linked to mental health but found no correlation. “Fiction tells us about our psychology,” says Edgar Dubourg, “more than it actually changes our psychology”. Fantasy worlds may turn out to be practically useful for other reasons, however. Our love for imaginary places may be a legacy of our ancestors and their world, but that ancient psychology could, in theory, help us save our planet as we need to travel less, Dubourg continues. “It could be tested whether fictions with imaginary worlds lower the number of recreational trips because more explorative people can actually fulfil their drive to explore through fiction”. Even so, although we should never forget to explore the real world around us and collect those 10,000 steps regularly, fantasy worlds should be enjoyed for the moments of magic they bring to our minds.

Most of us know what it feels like to wake up on a Monday morning after a long weekend of clubbing, head pounding and body aching all over. The sunlight streaming through the window is blinding and the dread of having to make it to work in an hour is all-consuming. Replaying the events of the weekend leads us to question, was it all worth it? Surprisingly, the answer to that question could be YES! As the ritual of clubbing has been integrated into mainstream culture, we have been exposed to the obvious cons, but less so the pros. Things we might consider to be the ‘unhealthy side’ of partying include the overconsumption of alcohol, social smoking, sleep deprivation, and binge eating. Given these examples, we cannot deny that the cons of clubbing exist, but there are potential pros which are not spoken about as much. Research suggests that not only can clubbing pose benefits for our physical health in the form of dancing, but also our mental health as music allows for self-expression and increased social connections. From this, we might see improvements in our mood and reduced stress levels. As a psychology undergraduate, I’m currently working as a Research Assistant on the eBRAIN study. Our research focuses on the correlations between early life experiences, brain maturation, and the mental health of young people. My primary interest lies in exploring ways to improve our well-being and enhance our overall quality of life. So, whilst it can be reassuring to believe that our weekend clubbing antics are somewhat beneficial, we need to take a closer look at the ups and downs in order to make responsible and informed decisions that promote our health and happiness. But first things first... What do we mean by "clubbing" and where did it come from? According to the Dictionary, clubbing refers to "the activity of going to nightclubs, especially to dance to popular music, drink and socialize". Whilst this pretty much sums up a night out on the town, the definition may vary from person to person. For some, it involves dressing up to the nines for a luxurious night of classic R&B hits. For others, it entails seeking refuge from reality in a run-down warehouse while listening to a blend of techno records. The history of nightclubs is a fascinating subject, but it’s not without its mysteries. Tracing their exact origins can be quite challenging as they date back to the ballrooms and dancehalls of the late 19th and early 20th centuries. Since then, club culture has come a long way, shaped by different musical styles and cultural influences. From the jazz clubs of the Roaring 1920s to the disco craze of the 1970s and the rise of European electronic music in the 1980s. Given the enduring popularity of nightclubs, is it possible that they’re doing something positive for our mental well-being? (Note that individual and situational differences can affect the benefits discussed. We do not encourage reckless behaviour.) What does the research say? As published in DJ Mag, a digital magazine dedicated to dance music, research conducted by a club in Bristol found "90% of young people believe clubbing improves mental health", and there are a number of explanations as to why this might be. Dancing not only improves our cardiovascular health as a form of aerobic exercise, but it can also be a great way to release pent-up tension and stress, while offering numerous mental benefits, facilitated by social bonding. A recent study carried out in Brazil found that synchronized dancing to music encourages a sense of cohesion within a group and raises pain thresholds. This is partly due to the release of endorphins, the body’s natural "feel-good" chemicals, during dancing, which creates a feeling of closeness among the dancers and a better ability to cope with pain. For this reason, we tend to experience a sense of belonging and togetherness, fostered by a club environment. What’s more, dancing can be an excellent form of self-expression and can be beneficial for self-esteem and self-confidence. It can be used as a tool to understand our identities and connect with like-minded people. For young British South Asians, clubbing and dancing have been especially significant as it allows them to "explore a new part of their dual-cultural identity". Nightlife and dance music provides a platform for them to break free from societal expectations and unleash their creativity. An integral part of clubbing is the music, and regardless of the genre, it can have a positive impact on our mental well-being. Typically, music releases dopamine and therefore as humans we obtain pleasure from listening to a mix of melodies. Music has also been found to have therapeutic benefits, and we can use it to help us relax and meditate. This means that clubbing can be a way to disconnect from the outside world and focus on the present moment. With all these benefits in mind, it’s no wonder that a night out can help improve mood and reduce symptoms of depression and anxiety. What do I think? For me, there’s nothing quite like going out dancing with friends to release the tensions of daily life. When you enter the club, you can forget about your troubles and immerse yourself in the music and energy of the people around you. The pulsating beats and positive vibes create a unique environment where you can express yourself freely and feel accepted. The sense of community and connection that comes with dancing is unparalleled, and it’s a great way to recharge. By practising moderation and self-awareness, you can ensure that you have a safe and enjoyable time on the dance floor. What are some tips for getting the most out of a clubbing experience? Find an event that suits you: Ring up your friends and pick a local event you like the sound of. You could also try practising some mindfulness while dancing, by paying attention to your movement and breath. Take a class: If you’re not big on nightclubs, enrol on a dance or gym class with a club atmosphere to reap the benefits. Many health clubs and community centres offer dance classes for all levels, while some gyms offer High-Intensity Interval Training (HITT) sessions and spin classes with pounding beats. Conscious clubbing: These events allow you to enjoy the social elements of a night out, whilst excluding alcohol and drugs. Dance/music therapy: If you need more than just a quick fix, you might consider dance or music therapy. Dance therapy uses movement for self-expression and communication, while music therapy uses sound to facilitate relaxation and emotional expression. So, while clubbing may not be the first thing that comes to mind, the plethora of research suggests going out and having fun with your pals can be a great way to unwind. From reducing stress and boosting mood, to improving physical fitness and social connections, clubbing can improve our overall well-being. To avoid negative effects, we must be mindful of recreational substances, prioritising sleep and taking care of our bodies. So, the next time you’re feeling overwhelmed, consider hitting the dancefloor and discovering the power of clubbing for yourself!