When Dr Harry Barry went on The Late Late Show in March, and urged viewers to "stay calm and get on with living your lives", he was hailed by some as a beacon of common sense in a storm of Covid hysteria. For others, however, Harry was downplaying the crisis, and by the time he appeared on Claire Byrne Live the following month and spoke of the dramatic mental health consequences of isolation - a "tsunami" of grief was coming, he said - some viewers accused him of changing his tune, and of replacing the minimising language of the Late Late with a series of catastrophic predictions on the psychological toll that Covid will take on the nation.
Almost two months on, Harry says that with the benefit of hindsight, he might have phrased things a little differently on the Late Late.
"At that moment in time, with the information we had then, I felt what I said was right," he tells the Sunday Independent. "At that point people were panicking - you had a lot of panic-buying, for instance - and that was something I was trying to address. I do recall also saying we needed to follow the HSE guidelines rigidly. It's difficult to go back in hindsight because, at that point, how many of us realised how serious the pandemic was? With the benefit of hindsight, I completely understand that it would be normal and acceptable to be anxious about the Covid-19 pandemic, but still, panicking doesn't help us, and that was the point I was trying to make."
He still thinks that the consequences of lockdown will be felt for some time to come.
"I've never seen such a cessation of all normality as we are seeing now," he says. "I'm really worried about the mental health effects of this coming down the line. I think there's a lot of anxiety and depression coming when we've dealt with the more immediate problems of Covid. People can't bury their dead properly and some are going to see a lot of blocked grief there. Grief is hidden behind the curtain at the moment. People feel they're letting their families down. As for the consequences of all of this, I'd expect an increase in self-harm. It's hard to call if it will increase rates of suicides. I think we may see more of that down the track."
There is a thinking with Covid that if we have prevented people from dying we have done our job, Harry says, but he takes a broader view of people's mental health, which forms the subject of his new book, Emotional Healing.
"We're all talking about mental health, we're afraid to talk about mental illness but none of us are really talking about the thing that really matters, which is emotional distress. The vast majority are mentally healthy and only a small group will go through mental illness. For instance, when someone dies by suicide, that is only rarely caused by mental illness - it's much more commonly caused by simple emotional distress, which itself might be caused by a relationship break-up or the hangover of abuse, or bullying. The vast majority of young people don't have mental illness but they are, as a group, struggling hugely because of difficulties coping with emotional problems."
Harry's expertise was forged through decades as a GP, as well as a masters in Cognitive Behavioural Therapy from ICHAS in Limerick. He has addressed the Dail Committee on the future of mental health care in Ireland and he says that central to this will be the planned regulation of the psychotherapy profession - at the moment, anyone can set themselves up as a psychotherapist here.
"If you're a doctor or nurse you're presumed to have a general standard," he says. "For them a masters is the necessary next level. But if you're training as a counsellor and you have no underlying qualification, in my opinion, a degree in the relevant field should be necessary first."
A natural understanding of human nature imbues Harry's writing, and this might partly have grown from a peripatetic childhood and young adulthood, during which he moved around a lot and saw all human life. He was born in Dublin and reared in Louth, but his family also moved to Wexford, then Tipperary. He studied medicine at UCD and spent time training at the Mater Hospital in Dublin. Following that he worked as a medic with missionaries in Africa, which was, in some senses, a trial by fire.
"In Tanzania there was a 120-bed hospital run by just myself and one other doctor. It was very tough at times. I did the most horrific obstetrics. For instance, we had a situation where a baby was dead and half in, half out of the womb. I once spent nine hours with two mothers who came in unconscious and bleeding - operating on one, resuscitating her and the baby, and then with the second mother, the baby was already dead. All this played out over nine gruelling hours.
"I dealt with typhus, cholera and meningitis epidemics. I even looked after a boy who died of rabies. It was tough but also great training because you saw every possible medical situation and you had to handle these with the equipment that was available."
Harry and his wife Brenda took their four-month-old baby with them to Africa, and while they were there, he ended up delivering their second child by bush lamp.
"He was 31 weeks - very premature. In a hospital in the Third World the lighting would only go on at night if you were doing a C-section because there was only a certain amount of electricity; and the midwife had gone off somewhere else, so I had to do it myself. There was no place for emotion but of course, all the emotion came later. We hadn't known if it would be a boy or a girl. We had to place him in a warm cot, there were no incubators. I'd worked in Holles Street in the neonatal unit there so I was more aware of the risks of prematurity, and that experience stood to me."
There were adventures too: Harry and Brenda crossed the Serengeti in a Volkswagen Beetle and he remembers this as "an incredible time, something I will always look back on with happiness," he says.
In Africa, Harry met a woman who would have a profound effect on him, Sister Kieran Saunders, a medical missionary from Longford.
"We were inseparable while we were there," he recalls. "She was an amazingly humble and spiritual woman. You have to understand that the situations you deal with in a Third World hospital are beyond your wildest expectations. You're grabbing sleep when you can. It is like being in a war. I saw a man come in with a spear stabbed into his chest. I became distressed because no matter how often I cleared the wards, it never stopped."
Harry's voice trembles and cracks as he recalls the advice Sr Saunders gave him at this critical juncture.
"She took me aside and she said to me the real lesson for life is that you can't change the world. What you can do is you help the person who is there in front of you. That is something that always stayed with me." Harry was Sister Saunders' doctor when she died of old age. "I felt very lucky, privileged really, for that. We went off to the woods and collected bluebells, and when we came back, she was gone."
Harry returned to Ireland and spent five years "in the wilds of Donegal". Then a post came up in Drogheda and he set up a GP practice there. After the chaos of a Third World hospital, it was the more prosaic practicalities of tax that presented the greatest challenge at home.
"When we came back first we lived in two rooms. Can you imagine Revenue coming to you and saying 'we're taking all your income tax for this year and the same amount for next year'? It was like, in effect, taking two-thirds of your salary. We were trying to run the practice and raise children, and money was very tight. We had hard times. I have seen struggle."
Brenda was the practice manager. "We worked incredibly hard, we were working until 9, 10, 11 o'clock at night. When people say to me I have a nice life now, I tell them I earned every bit of it."
He says these years were "another era" in terms of dealing with mental health issues in Ireland.
"There was a time in this country when Valium and things like that were totally overprescribed. It was an accepted norm to treat anxiety with Valium and Xanax. A lot of those patients became addicts as they went on. If someone is addicted to Valium, you can't just take them off it like that as they will be prone to seizures. A decision might be made to refer them to the mental health team, or even just to leave them alone.
"What really worried me was the replacement of this use of Valium with antidepressants. The use of antidepressants is really a reflection of the fact that a lot of GPs feel that psychotherapy resources are not adequate. My book shows the techniques that we could use other than medication.
"What's happening now is people are self-medicating with drugs and alcohol, they are self-harming by cutting themselves, or they are pressurising their GPs for medication. We need education in psychotherapy to teach people new coping strategies."
Now, at 67, Harry has pulled back from his practice as a GP but still works in referring people who are going through mental health difficulties. He says he has found a sense of peace and contentment that was more elusive when he was younger.
"You spend the first 50 years of your life doing: getting through school and college, getting married, raising children, getting on in work. And then, when you get into your 50s, you start to focus a bit more on being. You start to ask what was it all about. I think that was how it went for me. We rewrite our own stories day after day, week after week; our story is not set in stone." Harry has been gratified by the response to his writings on mental health.
"A father who had lost his son to suicide came to me and told me that he had found great solace in my book. I've had people, some of whom I've never met, writing to me from around the world telling me that it has helped them. That is the greatest satisfaction for me."
Emotional Healing by Dr Harry Barry is published in trade paperback by Orion Spring on June 11 , £14.99
Anger: “It is important to deal with anger, as devastation can occur when it is left to fester. You can manage anger by separating the behaviour of the person we believe has wronged us from the person themselves, identifying triggers that set us off and identifying the irrational beliefs and behaviours that underlie the anger.”
Shame: “The first technique for dealing with shame is to try to develop unconditional self-acceptance, where you cease rating yourself as a human being or allowing others to rate you but instead accept responsibility for yourself and/or behaviour. The second technique is to identify and deal with the unhealthy behaviours that are consolidating this sense of shame.”
Grief : “Dealing with grief involves separating the emotional component from the significant changes that occur when loss occurs in our lives.
It’s worth remembering that pain and joy go together in life. CS Lewis in A Grief Observed says: “The pain I feel now is the happiness I had before. That’s the deal.”
Sunday Indo Living