After working in mental health for the past ten years, It has given me a greater understanding of my own issues, plus many many stories.

During my days working with the homeless I was running for at least six or seven hours a day rammed with one to ones, back to back. My clients were straight off the streets, I had no risk assessment, no background information and no panic button, the most enjoyable job I've ever had.

One soon gets to know the difference between addiction madness, perhaps someone coping with a trauma and madness being controlled usually by escape type drugs, Heroin, Alcohol, Benzo's, central nervous system depressants. The most un-nerving is pure madness, unboundaried, desensitised insanity, you soon realise that anything can happen, it can be many different shapes and forms but there is a certain look that I and others who work in the same field can see. It's a millisecond glimpse difficult to describe but once you've seen it and it has been quantified by behaviour you don't forget that almost indescribable look/feeling.

I've looked over the precipice myself and yes I've looked in the mirror at the bottom of the ravine. Ive experienced, seen the look in my reflection and thought 'you really shouldn't be going out today boy', the look is unique and I know it personally.

I noticed it in a passing through homeless lad who the front desk buzzed up and said he just wanted to talk through a few personal issues with someone. In walked a tall bloke in full combats with a massive Alsatian dog without a lead but heeling perfectly. As he sat down the dog stood to alert staring at me ears down, he clicked his fingers and she lay down 'It's ok, she'll do what I say, she's combat trained', this to me had some irony re my personal safety.

He had the look in his eye, the glimpse of madness one gets to recognise, at these moments one has to be locked and loaded and look really really chilled or it can all go tits up. There is usually an unknown trigger word that you mustn't use but you don't know what it is.

I thought oh fucking hell,

just what I needed on a Friday morning, I really wanted an easy day, perhaps just putting a smile on a few faces to see them through another weekend of begging to maintain their habits, re-packing an abscess, bit of first aid etc. but oh no I've started the day with a touch and go.

He wanted to ask me the chances of signing up with a temporary GP so he could maintain his Valium prescription, the alternative was going through some horrible evil demonic Valium withdrawal, delusion, fear n fits adding to the prevalent madness. I suggested he played it thus :

As he would only be in the area for a short while, sign up with a doctor who is sympathetic to someone with a benzo addiction who wants to reduce. my point being the doctor would start him on his normal dosage and keep him there for a couple of weeks before he would reduce the script, standard practice at the time. He'd be covered for at least a couple of weeks and could always re-negotiate with the doctor if he decided to stay around.

If we go back to the word 'reduce' in the last para. that was the trigger word I had feared, he only heard 'reduce' and immediately stood up, his right hand went quickly into his pocket, the dog had become upright ears back staring at me. I thought he was going for a gun which immediately induced enough Adrenalin into my system for 'Oh well shouldn't hurt if it's a head shot'.

He pulled out what looked like a piece of twisted metal with gaffer tape wound round each end, still having a massive rush of Adrenalin I thought 'Oh shit torture' more Adrenalin.

To my relief he started doing hand excerises while snarling and breathing heavily through his nose, his dog too snarled and bared its teeth at me, 'Sorry' he shouted amongst the snorts, 'Anger management, gives me time to think!'. In my mind I was screaming with laughter, 'Fuckin hell this is so different to project management, and as real as it was I was trying to figure out whether it was Monty Python or Mike Leigh based, fuckin hell we have fusion comedy, I'm sure Death Race 2000 was in there as well somewhere.

He continued making a half inch piece of twisted steel look like cooked spaghetti until he calmed down. I talked him through the process again describing it as a bit of a blag which seemed far more palatable for him.

I couldn't resist at the end of our session to ask about the hand exerciser, he handed it to me, the dog registering every millisecond of movement. Obviously I didn't even try to operate it, I just felt the weight, it was heavy and worn. 'Seen a bit of action?' I handed it back 'Yeah, my mate made it for me, the one's you buy from the shops break, my anger management courses have tought me to hold it in the hand I knock someone out with, which takes the power out of the hand and gives me time to rationalise, sometimes'

He thanked me and snapped his fingers to prime his dog. As he left my office I noticed the twenty yard stare again, I prayed he'd get medicated.

Once something has enabled one's fight or flight response it is hard coded for future reference, the sign of madness is burnt indelibly.