What is Nidotherapy?

To get the best introduction to  nidotherapy just look at the film clip below.  This was shown to MP’s and other distinguished visitors at the House of Commons in London in  2018.  Afterwards one of the MP’s, Norman Lamb, said, ‘this is inspiring, and we need more of it in health services, especially if it saves money’.  Do you agree, or is this another over-statement?  Look at the film, and then read some of the other pages on this web-site.  And if you become really interested, buy the latest books on nidotherapy from Cambridge University Press or from any good publishing house, or read ‘Taming the Beast Within: Shredding the Stereotypes of Personality Disorder’, or ‘Overcoming Personality Disorder: It’s in Your Hands’ which explain why adapting to the environment can change the lives of people with personality problems.  But there is lots more.   You can read Mental Health Unblocked, a personal page on the main web-site, which includes all you wanted to know about mental illness but were never satisfied as your questions were always deflected, look at the BBC films in the Media section as they illustrate how acting and drama can be so helpful in environmental strategies, and see the details of our annual nidotherapy workshops.

Nidotherapy (first two syllables rhyme with ‘Fido’) is devoted to changing the environment in all its forms so a better fit is established between a person and every aspect of their surroundings.  If you would like a shorter soundbite in the spirit of the age the approach can be summarised as ‘find content in the environment’. In this context environment refers not only to the physical environment – where you live and work – but also the social and personal environment, so covers every aspect of your interaction with your surroundings.  Although we have been aware of the importance of environment and its effect on mental health for many years we have not examined it systematically in the scientific sense and worked out which are its important elements and which might be cast aside.  This website is a start in this process and we would like it to be an interactive one in which everybody could contribute.  We would therefore encourage you to contact us with suggestions of how the website could be improved and made more comprehensive.

If you look below you can learn more about the ideas behind nidotherapy. But if you want to know more about specific initiatives please look at the menu above.

Nidotherapy is a new concept in mental health. For years we have laboured under the happy notion that with humanity, determination and a little science, we could correct all the disabilities and handicaps associated with psychiatric disorder. But we have over-reached ourselves. A large number of mental disorders are labeled ‘chronic’, as health professionals have very little impact on their symptoms and course. Nidotherapy can be an asset to many people, but the ones who may have most to gain are those who have become stuck in the mental health system, and have been fooled by the word ‘recovery’ into thinking that by receiving more and more of the treatments that have failed they will remarkably get completely better.

Nidotherapy is particularly useful as a component of Adaptive and Acceptance Therapy for personality disorders.  The mistake people have made many times in the past is to claim they can treat personality disorders.  Sorry, they can’t do so and expect the personality to change.  But in Adaptive and Acceptance Therapy the change is made to the environment to get the best fit for personality and and so nullify the problems that appear to make the person disordered. Personality disorder is an unstable diagnosis; personality status is relatively fixed. An understanding of nidotherapy and Adaptive and Acceptance Therapy will explain why.

Although  we all take notice of the environment in mental health, we seldom go about systematically analyzing it and changing it to fit the person in a highly personal and specific way.  We have to stop thinking of the environment as something out there that just happens – we need to embrace and foster it, use it as a companion and a guide. Once we do this and hit the right environmental changes all aspects of mental health are improved. These changes, and how they are brought about, are the focus of nidotherapy and should give optimism to both practitioners and patients, many of whom who have been close to abandoning hope.

This is a short introductory film about nidotherapy that was shown at the House of Commons in February, 2018

Training

For those who are interested in being trained or knowing more about nidotherapy in practice the Nidotherapy Workshops section of the website is the place to visit.  The 2022 workshop will be held at the University of Lincoln between 20th and 21st October.  We apologise for the late advertising of this event; we had some problems in getting the right venue.  A summary of the programme is below.

Summary of Programme  Day 1

Thursday 20th October    Seminar Room VH0005, University of Lincoln, Brayford Pool Campus

10.00 Start

Morning sessions on occupational nidotherapy and nidotherapy in the performing arts

Afternoon sessions on setting up nidotherapy services in hospital settings and changing attitudes to personality disorder, followed by session on social prescribing

17.30 Finish

18.00  Dinner at White Hart Hotel, Bailgate, Lincoln

Summary of Programme  Day 2

Friday, 21st October   Lincoln International Institute for Rural Health, Brayford Pool Campus

9.00   Start

Morning sessions on nidotherapy in countries outside the UK and the development of services in community settings, followed by discussion on the digital development of nidotherapy

12.30 Close

There are both face to face and online attendance options at the meeting. Please contact Peter Tyrer (p.tyrer@imperial.ac.uk) and/or Kaatje Lomme (kaatje.lomme@gmail.com  ) if you wish to attend. No fee necessary but donations to NIDUS-UK much appreciated.

These Workshops are held annually. You can also read the two books on nidotherapy published in 2009 and 2018.  Examples of people whose lives have been turned around by nidotherapy are given there. These show that changing the environment can change lives irrespective of other treatment.  You can also read about another example in fiction, but based on fact, in the novel Poleaxed  published in 2020.  Watch how a highly nervous congenitally anxious young woman becomes transformed by environmental changes that were quite unexpected.

Developments in Nidotherapy

For those who want to find out how nidotherapy is developing nationally and internationally should take a look out our News and Research pages.

Nidopathways

The Nidopathways section of the site devoted to people engaged in nidotherapy who want to use the website to promote their preferred environmental changes and what they have to offer.

The section on Operettas may appear out of place here but in practice is not.  Drama, acting and singing are ideal for bringing senior academics, health professionals, carers and people with every sort of mental illness down to a common level where labels, status, experience and knowledge no longer matter and people can be what they are. They are great facilitators of nidotherapy, but, more importantly, tremendous fun.

Nidotherapy for personality disorder

Personality disorder is not easy to treat, and this is one of the reasons why it has become such a stigmatising diagnosis.  Most of the treatments available are for borderline personality disorder and the rest of the population who have other forms of personality disorder (about 6 in 100 of the population) are forgotten.  This is partly because those who do not have the borderline condition do not generally demand treatment, although they consult doctors more frequently with other mental health problems. But this does not mean they cannot be helped. Nidotherapy is one of the environmental options that can be very helpful in management, as someone with what appears to be an intractable personality problem can appear to lose it altogether when they are placed in an appropriate environment. More information can be found in the books published on nidotherapy, particularly Taming the Beast Within.  What fails to be appreciated by many people, including health professionals, is that most people with apparent personality disorder can improve enormously when placed in the right environment, and then they are well-adjusted and content. Finding the right environment is the purpose of nidotherapy.  It is particularly useful for those who do not want specific treatment (i.e., that do not want the essentials of their nature to be changed and just wish to be more at home with their personalities).

Books on Nidotherapy

There are several books that describe nidotherapy in practice and other related forms of envonmentally focused treatment.  These include:

Peter Tyrer (2009). Nidotherapy: harmonising the environment with the patient.  RCPsych Press, London.  (A basic primer on the subject)

Geraldine Akerman, Adrian Needs & Claire Bainbridge (editors)(2018). Transforming environments and rehabilitation: a guide for practitioners in forensic settings and criminal justice. Routledge, Abingdon. (This is a wide-ranging book covering the theoretical and practical application of the range of environmental approaches in the management of personality disorders in mainly forensic settings. It includes chapters on the Enabling Environments initiative of the Royal College of Psychiatrists initiated by Rex Haigh,  the Psychologically Informed Planned Environments (PIPEs) of the National Offender Management Service (NOMS)(Nick Benefield), and a chapter on nidotherapy in antisocial personality behaviour by Peter and Helen Tyrer).

Peter Tyrer (2018).  Taming the Beast Within: Shredding the Stereotypes of  Personality  Disorder. Sheldon Press, London. (It is curious that many people so dislike the word Beast in the title. Ken Clarke, the successful politician who almost became leader of the Conservative Party on three  separate occasions (and would have been Prime Minister had he chosen the right party to support when he was an undergraduate) is often described affectionately as a Big Beast.  Personality can also be a big beast, for good and for ill, but it is a very large part of our being and we cannot airbrush it away.  The preferred title was Taming the Porcupine Within, as the prickliness of difficult personalities needs emphasising too, but the publisher wanted something stronger. One of the main reasons for publishing the book was to describe a completely new classification of personality disorder coming out shortly  (ICD-11) that should help in choosing treatment. The new classification eliminates all the toxic labels of personality disorder that have not helped knowledge or understanding. You can see how toxic  the labels are by reading some of the reviews of this book;  but they miss the point.  The criticisms are all ones of the old system, not the new one, which is now online in June, 2018. The book, and the new classification, also completely contradict the idea that nothing can be done to help people with personality disorder. It is ałso  worth emphasising that the new classification is not just a minor one; it is the classification that all countries in the world will have to use in the future. There is a chapter on nidotherapy that shows how many with apparently intractable personality problems can be helped by putting them in the right setting, and there is little in the way of competition from most other therapies.  Once we can show there are ways of off-setting the problems of personality disorder by placing people in the right environments the stigma of the diagnosis will slowly reduce.

Peter and Helen Tyrer (2018)(December). Nidotherapy: harmonising the environment with the patient, 2nd edition, Cambridge University Press, Cambridge.  (A wider account of the application of nidotherapy to a large number of mental disorders, expanding on the first edition that was more focused on severe mental illness). A revised edition, with a nidotherapy skills section, will be published shortly. A German edition is being published in June 2021.

Peter Tyrer (2021)(May).  Overcoming personality disorder: it’s in your hands, Impspire, Lincoln.  (A book for the general public to help destigmatise personality disorder by showing that all of us are on the same personality spectrum and that very few of us have no personality problems.  Describes the principles of Adaptive and Acceptance Therapy and contains valuable questionnaires to assess your own personality strengths and weaknesses.

Peter Tyrer (2022). Models for Mental Disorder – and Why the Conjugal One is Best, 6th edition. This book was first published in 1987. It has been constantly revised and updated over the past 36 years and no offers a chance for all approaches to mental disorder to be properly integrated without backbiting, argument and conflict.

For those interested in knowing more about how nidotherapy fits in with other environmental treatments you can read an article online in the International Journal of  Environmental Research and Public Health by clicking here

NIDUS-UK, The Charity for Nidotherapy

NIDUS-UK is our nidotherapy charity and is based in Newark in Nottinghamshire.  A great deal is going on in the town to make nidotherapy a community enterprise shared by many.  Look at Nidotherapy in Newark to learn more and read the separate page for NIDUS-UK.

The work of the charity is devoted to the development of nidotherapy and improved treatments in mental health across the globe.  Its Charity Number is 1154650 and its details and Trustees are on the NIDUS-UK page

To make a donation to NIDUS-UK you just need to click the DONATE NOW button on the heading of the website and follow the instructions.