How to recruit (and what to do with my therapy company)

My working life has been increasingly focused on improving outcomes for Looked After Children. I deliver training and consultancy to care providers such as residential care companies and fostering agencies, as well as to health, social care, education and legal sector professionals. I have also developed a suite of online tools to help commissioners and providers to assess needs, track progress and evaluate outcomes for Looked After Children, including www.BERRI.org.uk  I think the introduction of clinical governance processes to the social care sector is long overdue, and I’m hoping that I can contribute to a culture change that drives up standards for Looked After Children. Signs are good, in that Jonathan Stanley chair of the Independent Children’s Homes Association (ICHA) said “you have set the gold standard for care providers” and Sir Martin Narey said “this is the missing link” when it comes to residential care. So I am trying to make this my business.

I’d like to find someone to help me take that forward, who has the kind of financial/business/admin skills that will complement my clinical skills and ensure we run efficiently as a company. Perhaps a business graduate with lots of energy, or an experienced admin who wants a new challenge. Ideally able to come to meetings in Derbyshire at least once a week. I’ve been inundated with demand, which is great, but it means I need help to keep organised and on top of all the competing demands in my new line of work. And that means that I need to give up, hand over or sell on other things I have been involved in.

With that in mind, I am wanting to make a plan for what to do with my existing therapy and court work business in Milton Keynes when I move out of area in a month from now. It’s a profitable business, and meets the needs of a client group who fall between health and social care. We offer edge of care assessments, psychological therapy and support to prevent kids coming into care, to support placements, enable rehabilitation to family, or for children and families who want help with parenting or a mental health issue. We also do court expert witness work for the family courts, and provide consultation into two sets of children’s homes.  However, the only other qualified CP involved is going on maternity leave soon and there is nobody else to provide cover. If I was staying in the area and/or had the time and mental capacity to continue running it myself, I would. But given I can’t, I want to make a good landing for it. And that means either recruiting a temporary or permanent clinical psychologist, or selling the business on to somebody who has the capacity to build on it.

I also need to recruit to provide cover for the services that I supervise within Keys group whilst various staff are on maternity leave, as well as to new vacancies within Keys. But despite the enormous importance of the work, and the fact it is highly valued, and as part of a well-equipped team without many of the niggles of the NHS (for example, we provide tea and coffee, you get your own desk and computer, and the caseload is manageable) recruitment pathways are not as easy when you are outside of the NHS and the first point people look at when seeking work is NHS jobs. We’ve tried BPS appointments memorandum and various recruitment agencies and websites, but so far nobody suitable has applied. So what now?

If anyone has any ideas, the company information is below:

1) My company in Milton Keynes

Lifepsychol/Evolving Families offer therapy to about 10 families, some court expert witness work, and consultation at a day rate into Keys in south Bucks and Peterborough. The qualified CP is going on maternity leave and I am moving out of area. We therefore either need to:
a) sell the business as a going concern to somebody or a company who can pick up the clinical provision (this could potentially include the evolving families business name, bank account, social media, website and email address, with ongoing referrals and enquiries – to run either as a traditional company or as a social enterprise)
b) recruit a member of staff to pick up this work and be an ongoing employee
c) recruit sessional cover of 2 days per week for 6 months to cover the maternity leave

2) To help run my BERRI project

A business graduate or experienced admin who can turn their hands to all kinds of tasks to make a small business work effectively, from responding to email and telephone messages, to keeping on top of the finances, client account management, customer support and converting enquiries into subscribers. Basic salary, plus bonus related to success of company, and the chance to grow with us and earn ‘sweat equity’ in year three. We are flexible and family-friendly. May be able to work some hours from home, but must be able to meet in Derbyshire at least once per week. It may be possible to start part-time and build up, if you are returning to work after a career break.

I would welcome enquiries about any of the above options to lifepsychol@gmail.com

2) Within Keys we have several vacancies to deliver consultation as part of our psychology pathway, and to supervise the APs doing assessments. There may also be scope for some direct therapy. We would either be able to offer permanent contracts for full or part time work, or sessional work which would be contracted for six months initially and then potentially extended.

Vacancies include:
– Full time or part-time posts to cover Warrington/Manchester
– Full or part-time post to cover Shrewsbury area
– Full or part-time post based at Sheffield/Chesterfield/Peterborough
– Full or part-time post to cover Taunton and/or South Wales (we have about 2 days work in each location, but can top this up to full-time with input into another project)

With all of the above, hours, location and salary are negotiable dependent on experience. Email lifepsychol@gmail.com and/or juliehamilton@bettercare.co.uk

Also, if anyone has any contacts to circulate the same around the clinical courses, we would be interested in prospective applications for trainees due to qualify this year.

Gaining Influence

Quite a long time ago, I identified that it gives me most satisfaction when work gives me the opportunity to have 5 I’s: Intellectual challenge, Independence, Innovation, Income and Influence. This month I have really been working on the last of those, and trying to connect with the right people to make change within the Looked After Children sector as a whole, rather than individual by individual or company by company.

It transpires that over time I have accidentally built up a wide professional network, and a credible platform from which to connect with higher level influencers. It seems that all the time I’ve invested into unpaid stuff helps when it comes to connecting with new people and looking like I know what I’m talking about. This is helpful for me to hold in mind as committee work can all too often feeling like a drain on my time that is almost invisible to anyone else and may have little that is tangible as an outcome for what can be quite an onerous process. Logically I know that this type of activity is rewarded by the innate satisfaction of contributing to important work that needs doing, but this is something I find easier to recognise at the start of the process when I first put up my hand to volunteer and after the end of all the graft than whilst in the middle of it.

Being chair of CPLAAC, on the national CYPF committee for the BPS, part of the NICE guidance development group and the BPS/FJC standards group have let me contribute to various publications that will hopefully reach wider audiences and influence practice. Whether that is in terms of the support and interventions offered for children with attachment problems or the standards that should be expected of psychologists who act as experts to the family courts or the chapter on best practise for psychological services for children and families with high social care needs in What good looks like in psychological services for children, young people and their families, the paper I wrote about Social Enterprises as a vehicle for delivering psychological services or the CFCPR issue I edited on good clinical practise around attachment difficulties, I feel like I have been part of some good work that establishes professional standards and reference points.

And with those things on my CV and a network of allies who share my goals about improving outcomes for Looked After Children, I have been able to meet with various decision makers and influencers about my ideas. The first important contact I made was with Jonathan Stanley, the chair of the Independent Children’s Homes Association. He has been fantastic at promoting my work to residential care providers and helping me to gain a seat at the table. I then met Almudena Lara at the DfE, although she was very new to the role of being LAC lead, and moved on before she was able to pick up our discussion again. I have also met with Social Finance. More recently I was able to meet with Sir Martin Narey, the government advisor (and ex-chair of Barnardos) conducting a review of children’s homes in the UK, and a representative of the DfE. And latterly I had the opportunity to meet Lord Listowel at a recent conference and hope to speak with him further soon.

In all of these meetings, I have been promoting the value of clinical governance in the social care sector. That is, the importance of being able to evidence clinical outcomes and substantiate that you are doing what you claim to do – in this case, that placement providers are improving outcomes for children and young people in their care. My wider goal is to allow commissioners, social workers and Ofsted to be able to see what kind of placement a child needs, whether a placement is making positive change for a child and who can provide the most suitable and effective placement. I’m also keen that the idea of “therapeutic care” is better defined, and that therapists working within care organisations need to be qualified, supervised, regulated by a professional body and practice within their areas of competence. But my main goal is to stop the situation in which placements are paid to provide care for the most complex and vulnerable young people in society, and do so by providing accommodation, food and transport to education but do nothing to address their emotional, behavioural, mental health, developmental/learning needs, risk to self and others, or ability to form healthy relationships with others. I think the tools I have been developing, like http://www.BERRI.org.uk, and the training I provide for staff/carers can help with that, but my goal is nothing less than to change the culture of care in the UK.

Evidence has shown that money invested in the most complex children during their childhood is repaid tenfold in savings to the public purse in reductions in use of mental health, social care and criminal justice services over their lifetime. So why is it that the placements for the most complex children and young people are primarily provided by carers with very low levels of qualification and training? The first steps to improving standards are to ensure that all carers in the foster and residential sector get training about managing the impact of trauma and disrupted attachments, and that all children in public care are regularly monitored on outcome measurements. But these need to be meaningful, and linked into practice, rather than done as hoops to jump that are disconnected from daily care.

I can think of nothing more worthwhile to do with my professional life than to improve care for Looked After Children in the UK, and I hope that I can achieve enough reach and influence to make a genuine difference.

 

 

Some thoughts on causing offence: 2 Trigger Warnings

The idea of cultural appropriation being offensive (which I discussed in part one of this blog entry) seems to go hand in hand with other recent social movements towards being more aware of the emotional well-being of others. This includes the use of social media to document the pervasiveness of small everyday actions that are a cumulative indication of how pervasive some prejudices are in society. The everyday sexism project has highlighted examples of how women’s daily experiences differ from men’s because of their gender, and there are similar projects to highlight the pervasiveness of racism. These small and often individually minor experiences, particularly in the context of race, are being termed “microaggressions” to denote the harm they cause when considered across a lifetime. I think these projects are helpful because, like the short films ‘Homoworld‘  and ‘Oppressed Majority‘, they humanise concepts that might otherwise be hard to explain, and show the massive quantity of incidents that might each in isolation seem too petty to raise. Without such examples or dramatisations it can be very hard to put ourselves into the perspective of another and to realise that their everyday experience is different to your own. And awareness is the first step towards behaviour change.

This change is happening at both the individual and organisational level. There is an increasing perception that organisations such as businesses, universities, public services and broadcasters having some responsibility for the impact of their content on customers, employees, students or their audience. This means being more aware of how the meaning of various content can impact differently on different people according to their experiences. This includes the use of ‘trigger warnings’ to orient readers/viewers/listeners about the aspects of the content that will follow that may resonate for them in negative ways. This could include mention of rape/sexual assault, violence, trauma, child abuse, racism, hate crimes or other forms of prejudice. The intent is to ensure that any person in the audience who has had traumatic experiences in their past is not re-traumatised by unintended exposure similar material without the option to prepare or opt out of that experience.

Although widely mocked, I think trigger warnings are quite sensible in principle. They aren’t there to molly coddle the delicate sensibilities of a whole generation of students (or social justice warriors) that don’t like being challenged, they are there to protect the small percentage of the population that have had traumatic experiences from post-traumatic symptoms. When I hear people on social media bragging about how they intend to trigger others, it seems like they lack either insight into what this means, basic human empathy, or both.

A trigger is a very specific word for what happens in the brain of people who have experienced serious trauma – normally experiences they have perceived as life-threatening – where the brain becomes sensitised to threat. When similar sensory stimuli to those associated with the event are detected, the amygdala goes into overdrive, and will put the person into a state of high physiological arousal (readiness for fight or flight) and make it harder for them to use brain functions apart from those associated with survival. Because the brain does not encode memories in narrative form very effectively during survival situations (due to much reduced activity in the prefrontal cortex) these sensory links often activate sensory memory fragments from the trauma, causing flashbacks and high levels of distress. This means that certain triggers can cause them to re-experience their trauma later on in their lives. Just as a war veteran might get flashbacks or nightmares about their war experiences, so people who have been seriously abused, raped or tortured experience unwanted intrusive images and memories of what they have been through when they see, hear or feel something similar to something they experienced during the trauma.

This isn’t something that has been made up, or reflects certain people being “sensitive flowers” either innately or by choice. It is a scientifically evidenced change to the brain after trauma. Intrusive images or thoughts, including re-experiencing of trauma is one of the diagnostic features of PTSD, and it is well established that certain experiences trigger these flashbacks. MRI scanners show the limbic brain (eg the amygdala) lighting up faster and brighter to threat signals that would not be perceived as threatening by others without the trauma, and the resulting decreased activity in the prefrontal cortex. Neurochemical analysis (eg from swab tests) have shown that this has a significant effect on the person’s neurochemistry and chemical messengers (like adrenalin and cortisol) are released that prepare the body for fight or flight. In short, this is a serious and well-documented physical response to serious trauma that I have blogged about previously. I’ve worked with lots of traumatised and/or abused children and adults and it is a really horrible thing to go though. It seems like a double dose of adversity for those whose abuse/trauma continues to echo through their life months or years later. It is not something to make light of or mock, and only a truly repugnant person would do so.

But being thoughtful about the impact of content on others, and orienting the audience about what is going to be covered, does not have to equal censorship. We should still talk about the tough stuff, study it, make art about it and even sometimes joke about it. It often makes for the most interesting debates, and it is through engagement with these complex and challenging issues that people learn to analyse the motivation of the writer/speaker and to appraise the context as well as the content of what is said.

As uncomfortable as it can be when people use it to say annoying, idiotic and offensive things, I am a believer in free speech. I don’t think being offended is a reason to silence someone. It is a reason to reply so that others are not persuaded by them, to ignore them, or to deny them their audience (because free speech doesn’t entitle you to a platform, and any website, venue or business can decide not to welcome/endorse somebody). But it isn’t a reason to stop them saying their piece, unless it incites violence or racial hatred and is therefore against the law. As hateful and bigoted as Donald Trump is, for example, the answer to the awful things he says is not to ban him from the UK, it is ignore him and deny him the oxygen of publicity, or simply to laugh at him. Mock his ignorance. Share your disgust. Highlight how hateful and harmful his ideas are, and how he has not earned the right to lead by showing any personal qualities that are admirable. Ensure that he faces legal consequences if he oversteps and breaks the law by inciting racial hatred whilst in the UK. But don’t censor him and allow him to take the role of being oppressed, as it would be counter-productive.

Even President Obama has weighed in to say “Anybody who comes to speak to you and you disagree with, you should have an argument with them. But you shouldn’t silence them by saying, ‘You can’t come because I’m too sensitive to hear what you have to say.’ That’s not the way we learn.” I’m inclined to agree. We are all responsible for this conversation, and in the therapy professions, genuine empathy has to include acknowledging the difference between the client’s perspective (or a colleague’s) and your own.

 

Some thoughts on causing offence: 1 Cultural Appropriation

Cultural appropriation” seems to be something increasingly causing debate, especially in the USA, and reading about all the new terminology and topics of debate, I feel like I’m playing catch up. There are certainly some pretty extreme emotions being raised by some of the incidents (eg a student screaming at an academic whose wife sent an email expressing that the restrictions around halloween costumes recommended by the intercultural affairs committee might be excessive). It seems to have hooked into the fraught racial tensions in the USA, and a broader debate about whether to protect people from offence versus being able to speak freely and discuss any topic.

Cultural appropriation is the term used when people dress up/make up to look as if they are from a different culture or ethnic group. It is particularly controversial when white people impersonate or borrow from minority ethnic cultures. It seems to be an increasingly widely used term. The perception of it being inappropriate to stereotype racial groups by borrowing from their culture has spread much more widely from it being taboo to use ‘black face’ makeup into examples that have until recently been considered to be more acceptable, like a pop star wearing an outfit referencing a particular country or culture. Some people find this highly offensive, and feel it is appropriate to publicly shame anyone involved in doing this. The gist of this viewpoint is that people who have not experienced the oppression of being in the less powerful group should not be able to cherry pick and borrow the superficial bits they like of exotic cultures, especially when these same cultural traits have been disparaged within western cultures by the dominant white narrative.

As a fairly privileged white British woman who hasn’t experienced this first hand (despite being a second generation immigrant and having high levels of prejudice and persecution associated with my cultural heritage), it is sometimes hard to see why the reactions are so extreme. However, I understand from what I have read that for people who have been shamed for their culture and forced to conform with white norms, the adoption of non-white symbols or traits as a mark of difference or rebellion by white people is a reminder of that oppression. It is notable that it has a different meaning to those observers than the positive interpretation that is typically intended by the person involved, or that which is construed by other white people (who may not hold the same negative associations). Sometimes people can be absolutely blind to stereotyped imagery that they do not have personal associations with (see this example regarding racial imagery in a video game).

However, there is now a backlash saying that these complaints are part of a whiny politically correct subculture that enjoys being offended, and takes offence on behalf of others as part of a progressive agenda. More regressive voices like to scathingly label this as a desire for social justice, as if this would be a bad thing. See the comments on any article on this topic published online for plenty of examples.

So let me start by saying that I absolutely see the core legitimate grievance within the wider label of cultural appropriation. I can completely see that having white people ‘black up’ or ‘red face‘ is racist and would be offensive to people of colour, and that using cultural or religious artifacts when stripped of their meaning or commercialised (eg feathered head dresses, or the Hindu bindi) is controversial and could be considered to be in pretty poor taste. I also acknowledge that these appearances often go hand in hand with other elements to the role that make it more racist (such as using stereotyped accents or behaviours). I think it is right that overtly racist caricatures like ‘golliwog’ logos and toys, or racist scenes in early cartoons are relegated to the history books. Similarly, the use of logos and names that stereotype native Americans by sports teams in the USA has persisted for far too long. However, I can’t help but feel that the issue of cultural appropriation isn’t as clear cut as some people make out. It seems to me that the rules being made to restrict the risk of offence over culture (eg in American universities) are becoming as much of a problem as the issues they seek to address, and obscuring the very genuine issues of race inequality that lie underneath.

So are Halloween costumes on campus really oppressing people from minority groups? Is it really of concern if someone morphs her own white face to represent endangered African tribes? Or if white models get braided corn-rows? Are musicians like Madonna, Selina Gomez, Iggy Azalea and Beyonce really being “disrespectful” when dressing with elements of Indian costumes, such as wearing a bindi, sari or facial jewellery, or when Katie Perry wears a Geisha-like outfit, or Lady Gaga references a burqa? Is Miley Cyrus twerking disrespectful to working class black women?

If these examples are offensive, how far do we take this? What of actors who play people with different nationalities, religions or accents within a particular skin-tone? What about able bodied or neurotypical actors taking on roles of characters with physical, developmental or learning disabilities? What about actors who have not experienced mental health problems playing characters experiencing them in films/TV? Can musicians/artists only draw on influences within their own country/ethnicity/experience? Can writers only create characters of their own ethnic background? Can art or media not be provocative or controversial any more? Can I not cook curry or sushi or chow mein? The slippery slope could continue ad absurdum.

Surely, several issues are being confounded here. Firstly that there are many areas in which there is very little diversity of representation. For example, we clearly need more ethnic and gender diversity in business leaders and politicians in this country, as most of them remain white men. We also need more varied faces, accents and perspectives in the media, and as role models across the board. We need more diversity in the people who win awards (all white oscar nominations two years running is ridiculous, for example) and we need more diversity in those making decisions. Secondly, we can’t compensate for this lack of diversity by putting yet more of the same group into costume to represent others, and doing so would disrespect the lived experience of those being represented. There is a real need for representation and not just for increased mindfulness from those in power.

I’ve sat on a committee in which we have tried to ‘hold in mind issues of race, age, gender, religion, culture, sexuality, disability and other aspects of diversity’ but I don’t think it was possible when very few of those characteristics varied much within the group, and those which did vary were not much spoken about. The focus tends to be on what the group have in common, and each individual might feel unworthy of their status (particularly if they feel they don’t fit in as well, or are there because of a particular minority status), and that makes it much harder to highlight times when a devalued characteristic of an individual might be relevant. For example, in a mostly male boardroom, women tend to take on more traditionally masculine forms of discourse, and to feel less able to express emotions or feminine characteristics or needs. So, it seems likely that it is even harder to speak up about other aspects of diversity. It felt brave yet somehow risky for Crispin Blunt MP to talk about his use of poppers and how banning this would be criminalising a substance used widely by gay men. However, this is more the exception than the rule. Diverse voices tend to be marginalised and to find it hard to reach a platform, and this is something that needs to change. And that change needs to start right from the top. Having a minister for equality who voted against gay marriage is patently ridiculous, for example, yet we have had two in a row, neither of whom have any more experience of inequality than their privileged example of being female.

To go back to cultural appropriation more specifically, I’m not sure it is the action or costume in isolation that is the problem. I suspect that the context has a lot to do with the derived meaning. If actors and public figures were more varied and included people with physical disabilities, learning difficulties and mental health problems, a variety of religions and cultures, diverse ethnicities, all sexualities, genders, ages and body shapes, then everybody would feel represented and emotions would not be so heightened. If musicians, celebrities and scholars gaining funding and media coverage were more diverse, then the cliched references to other cultures would have much less power. Similarly, if the fashion industry routinely used models with a variety of skin tones for all campaigns, and treated their sources of inspiration more respectfully, then the hairstyles of models used to showcase collections with international influences would be much less problematic. If people from different perspectives had similar levels of power, then speaking up to criticise someone from a majority group would not be so difficult do or as easy for critics to attribute to sour grapes. But attitudes and power structures take a long time to change, and can be very resistant to progress, particularly where this threatens the status quo. The difficulty is therefore twofold – how we move towards the bigger goal, and what we do to manage the problems that will continue to appear until we get there.

Broadly I think we should allow people to express themselves, but also encourage thoughtfulness and conversations that challenge people’s preconceived ideas. Dressing up is usually playful, and done for fun rather than to make a statement. Sometimes, being a little ‘edgy’ is part of that fun. I would hope that a certain degree of role play allows us both flights of imagination and greater empathy. It would be a great shame if children couldn’t dress up as anyone outside of their own cultural group in play, for example, or if fancy dress costumes were similarly restricted. However, we should also be open to learning from other’s experience. So if a costume is culturally insensitive or causes offence, people need to speak up to say so.

However, there are two very important provisos to this. Firstly, it isn’t the responsibility of disempowered minorities to challenge the actions of the majority group, it is everybody’s responsibility. And second, highlighting a different perspective should, as far as possible, be done without publicly shaming the person involved, unless they continue to repeat the same actions which are causing offense. We can all have times when we accidentally do or say something thoughtless, and that shouldn’t be an irreparable error. It is what we do when that is drawn to our attention that is the measure of the person. Publicly shaming a person who makes a mistake or poor judgement is the kind of black and white thinking (if you excuse the pun) that polarises opinion and drives a wedge between different population groups.

I would also note that there are times that it is perfectly appropriate to join in with traditions and wear costumes as an outsider, and would be disrespectful not to. For example, for female western tourists to cover up exposed skin and perhaps their hair when visiting various religious sites, such as mosques and temples, or for guests to festivals and weddings to be dressed and decorated in the local style as part of the ritual preparations. Similarly it is sometimes helpful for somebody independent of a particular culture to study and document aspects of it that those within the culture might take for granted. It doesn’t replace the voices from within that culture (which we need to facilitate and amplify), but can be a helpful supplement. Similarly, I can’t see that use of influences from other culture as inspiration for art can’t be done respectfully or that having different perspectives isn’t generally a way to drive progress in any area of study. We wouldn’t have mathematics, a calendar, politics, written language or many sports if we relied solely on our indigenous and anglo saxon heritage.

Overall, I think nowadays we are in a melting pot whether we want to be or not. Our culture isn’t static, it is fluid and constantly evolving. There is increasing globalisation, and our history has gained from many different cultural roots. We travel internationally more than ever and we all have heritage in our DNA that we can track across continents. Our fashions, arts and sciences are enriched with knowledge and influences from all over the world. I’d see that as a positive thing, and an opportunity for ongoing dialogue and learning. To me, the key to drawing on other cultures is the context and respect with which we do so. There are some good examples of cultural appropriation. If we want to be sensible about culture, then giving credit to our sources, being open to feedback, and doing it with respect and admiration seems like a good place to start.

Happily ever after: Some thoughts on trauma in the movies

I watched a romantic drama this evening in which a man and a woman who has a child from her past relationship fall in love. The ex-boyfriend is controlling, threatening and manipulative and tries to sabotage the relationship. He is shown getting drunk and grabbing the woman’s arm tightly to stop her leaving twice, and at another point he threatens the man with a weapon. Towards the end of the film the ex-boyfriend is drunk and upset. He threatens to take the child, who runs away and falls into a river. The ex-boyfriend rescues the child at the cost of his own life, and the mother and child witness him meeting a sudden grizzly death. Then the couple get together, become a family with the child and the film ends, leaving them to live happily ever after.

Having watched a set of characters for an hour and a half that were portrayed sympathetically and realistically enough to feel invested in, this seemed like a weird ending. I was left with this really disconcerting feeling that the writers, producers and large numbers of reviewers of this film (who gave it respectable scores on Amazon and IMDB) thought that this climactic scene tied up the ends neatly and left us with the uplifting moral righteousness of the baddie getting his just deserts, the couple unimpeded in their romance and a perfect nuclear family.

But how could a child who just witnessed his father’s death (and probably felt responsible for it) not have any emotional reaction to that? Would it not be yet another loss of a close male relationship for this young child, who had already lost others as part of the back-story? How could the mother not have complex feelings about the death of a guy who has been emotionally and potentially physically abusing her for five years? Would her relief perhaps be tinged with guilt that her new romance triggered these events, or at being relieved to see the back of him? Would a mother not feel sadness in empathy for her child’s experience of trauma and loss? Would she not feel echoes of the loss of her own father in childhood, or her brother the previous year? Perhaps their different ways of dealing with grief and loss would challenge the romantic relationship? How about our leading man, who was mourning lost friends and showing signs of PTSD at the beginning of the film. Would it not re-awaken all the unresolved grief he is repressing? And what of the ex-boyfriend’s parents and their stoical thanks to those that tried to rescue him? Does nobody cry for this man, who gave his life up to save his child? Was his inept handling of the relationship that resulted from an unplanned pregnancy in his teens so bad that he deserved to die?

Why couldn’t the film have been one that illustrated the reality and complexity of modern family relationships? Surely the alternative was for the father to have shown his priority was the wellbeing of the child, during the rescue scene, but to have survived and been part of a renegotiated family configuration in which the child was able to have both a positive experience of contact with him and to live in the new family unit with Mum and step-Dad? As I often tell children who feel that any affection to foster or adoptive carers is disloyal to their birth family, love is not like a cake where you have a finite amount to share out between all your relationships, love is like candles where using your fire to light others just creates more brightness for everyone. But if the father had to die, then they needed to show the emotional fallout of that. They can’t have one without the other, any more than they could show a person standing in sunshine without showing their shadow.

As it stood, the film profoundly failed to acknowledge the impact of trauma on the different characters. And this film was far from alone in that. So many traumas occur in films and TV shows that it seems they are very much part of the expectation nowadays. In every vampire franchise I’ve seen the head counts of characters close to the main protagonists who die are extraordinary, and yet they briefly mourn and then move on. In Vampire Diaries, an average of 19 characters shown on screen die per episode, and the main character, Elena, has lost almost every living relative and most of her friends, as well as dying herself, twice! Many other shows track medical emergencies, murderers, serious crimes, drug dealing and power battles, yet they are dealt with in an entirely sanitised, emotion-free way. Sure, a pathologist would be well-used to the physical nature of human corpses, but even in the most hardened professionals some cases creep through the cracks into your psyche. The person that looks a little like someone you know, or reminds you of something in your past. The tragic story that becomes apparent from the cause of death, or the untimely demise of a child. We are not robots analysing data, surely we recognise that people are like us and the people we care about?

The latest Star Wars film showed planet-scale genocide without that even being acknowledged by the cast. It’s a really good film otherwise, and I really enjoyed it, but the scriptwriters chose to show genocide as shorthand to make the baddies bad. It could equally have done so through less wide-scale slaughter, or by showing the snatching of children to indoctrinate as stormtroopers or many other plot devices. Including the slaughter of millions of people was a plot choice, and given that the film is part of a historical franchise that is pitched to the whole family and used to market toys to children, that is a pretty weird choice of plot. To then skim over making light of it makes that more disturbing, rather than less, once you think about it. I’m not saying the main characters should have processed the emotional impact there and then; I’m sure if you are busy fighting for your life or have 20 minutes to save the world and see some planets blow up, that isn’t the moment you down tools, lie down and cry. But even an extra second of footage showing sad faces, one person humanising the loss by mention of having lost individuals there, or an additional comment about how awful that loss was, would have given some hint of the emotional connections of all the people whose lives were extinguished in an instant. In the original trilogy when Alderaan was destroyed they used the change in the force to acknowledge how monstrous it was. I still remember the scale and momentousness given by the line “I felt a great disturbance in the Force, as if millions of voices suddenly cried out in terror, and were suddenly silenced. I fear something terrible has happened.” And this is what was missing in The Force Awakens.

But I think this lack of acknowledgement of millions of deaths was also illustrating something very poignant about human processing of events; we identify much more emotionally with death or distress at the individual scale than we do at a population level. Think of how the discovery of the body of young Aylan Kurdi humanised the treatment of Syrian refugees in the news narratives, for example. Prior to that point, they were treated like an invading army of ants, but in the weeks immediately afterwards some individual stories were told and people felt more sympathetic and we were shown footage of refugees being welcomed into various European countries. I think that change in response according to the scale of deaths is part of human nature, as is our ability to shut off from suffering and get on with life, if that is necessary to our survival. At the extreme end, people living through wars or in areas of high risk or conflict are probably coping by living in “survival mode” and using more primitive parts of the brain in favour of the prefrontal cortex, which has reduced activity under threat. It makes sense, logically, as we do have to compartmentalise awful stuff to just keep on going sometimes. I think back to all the life events that happened whilst I was pregnant (including a car accident, my granddad dying, a close colleague dying unexpectedly, my job being placed at risk, my babies being born very prematurely) and think I only coped with everything I couldn’t avoid by going into a psychological bubble and putting all that bad news aside to deal with later.

Maybe these fictional narratives of unacknowledged loss that have become so prevalent in TV and film are using this tendency – our ability to put emotional distance between ourselves and tragedy through various forms of displacement. If something awful happens far away, or it happened in the past, or in a different cultural context, or in fiction, then we are able to distance ourselves from it and deal with it at a purely cognitive level. We think about it but don’t feel it. The shame is that this seems to be how many politicians and decision makers deal with the problems affecting people in our day to day lives. Although it is ‘psychologically expensive’ to allow emotions in, it is only with empathy that we can really make informed decisions. So in real life as well as in fiction, I think a bit more feeling would be a good thing.

Video games and violence

The relationship between playing video games and violent behaviour isn’t as black and white as most people assume. There is neither the causal evidence that would support the tabloid alarmist headlines that blame Mass Effect, Call of Duty or World of Warcraft for mass shootings nor the evidence that video games are entirely benign.

We know from research that trauma has a significant and lasting impact on the brain, a pattern widely accepted across numerous studies. For those who have already been traumatised and/or have maladaptive social skills, that increase in arousal sensitises the brain to further threat. It also makes them more likely to respond with anger or fear to a neutral stimulus, perceiving it as a threat. We also know from research that when the threat sensor in the the brain is activated (the amygdala and limbic system) the prefrontal cortex pretty much goes off-line until the threat is resolved. That significantly reduces the person’s capacity for empathy, complex reasoning, social skills and ability to be aware of the impact of your own behaviour on others. This effect is amplified where there is an absence of healthy real life relationships and/or physical exercise (which produce oxytocin, and help to mediate cortisol and adrenaline). And of course we know that people who have raised arousal levels deliberately seek out experiences that match or use that level of arousal, so they are often much more interested in violence and gore than their peers.

That’s all well established neuroscience. We also know that these brain changes can be perpetuated by exposure to violence or the representations of violence in our daily lives or the media we consume. Exposure to violence is an unseen public health epidemic. We also know that this pattern of being over-sensitised to threat and in a heightened state of physiological arousal gets ‘stuck’ for a proportion of maltreated children, particularly where there is an absence of secure attachment figures, and that ‘acting out’ with violence in this group is much more common. The neurological basis for moral reasoning and antisocial behaviour implicate similar brain regionsSimilar areas are also implicated in violent behaviour when this is related to a lesion, dementia or atrophy.

Having reviewed the evidence, I think it is clear that video games do not in themselves cause violence. But playing violent video games increases physiological arousal levels (readiness for fight or flight) just as we know is the case for exposure to real life conflict such as domestic violence within the family. This can create a lasting effect which shows in MRI scans. But the effect is quite specific. We know that MRI studies show differences in the brain when people play violent video games but not when the video games do not involve aggression. We also know that it is dependent on the social acceptability of the behaviours chosen in the game.

It seems likely that watching films or TV can similarly cause an increase in physiological arousal, but this would only be the case with a high level of violence/action/drama, something which is not normally sustained for hours upon end the way it can be in some video games. Also, video games are more immersive because they are interactive, and I suspect you don’t become as habituated to them because of the fact that there is variation on every presentation of the stimulus, whereas rewatching the same film gets dull and predictable and no longer gives us that visceral response. Thus I think that it is reasonable to consider violent video games as a particularly concentrated form of this stimulus.

It seems from the meta-analysis that a small scale shift towards higher readiness for fight or flight and lower empathy/insight/reasoning is happening all over the place amongst people who play a large volume of violent video games with the result of small but measureable increases in the risk of aggressive behaviour. I’d extrapolate from this to what is currently happening with the threats and harrassments towards women and minorities in the gaming space, to suggest that this combination of lack of nurture and exposure to violent material may be contributing to the lack of empathy and insight into the impact of their behaviour amongst people involved. But I suspect that the impact of video game play on real life aggressive behaviour is only a significant issue at the individual level where this is combined with the presence of trauma and/or the absence of nurture. After all, the move from enacting violence in a video game to doing so over social media is much smaller than the move to take actions outside of home technology where you can see the impact on the recipient.

It is only in the extreme examples, where you combine violent video game use with people with horrendous histories, a lack of secure attachment relationships and/or who have entrenched extreme views (eg about women), nothing else in their lives to constrain them, an echo-chamber of harmful views including incitement to violence, and perhaps mental health problems on top that the mixture becomes truly toxic. Amongst this group a small proportion take the threat-talk that is so prolific online and in video game spaces into horrific real life actions.

I can’t see that being so different to the proposed mechanism for lots of other phenomena. As with the relationship between cannabis use and psychosis, or alcohol consumption and suicide, the former is something most people consume without harm so it cannot be causal in isolation, but for a much smaller number of  people with increased vulnerability (genetic, epigenetic or experiential) it can be a contributory factor towards a more negative outcome.

Wisdom, sycophants and advice that won’t work

I have been watching and reading a lot of Brene Brown stuff recently, and for the most part I feel like she has been able to identify and tap into some important concepts that chime true with my own understanding of attachment, shame, perfectionism and self-compassion, but there is a part of me that is a bit uncomfortable. When I’ve watched recent interviews, such as this one with Oprah I find myself responding to the comments like “that is so powerful”, “right, right, right” and “there are so many things I love about you” with a bit of a cringe. I think it is partly that it feels like a sycophantic mutual love-in amongst a particular group who have formed their own self-improvement echo chamber, and partly that the whole American over-the-top-ness of it makes it come across as less than sincere.

Obviously Oprah is in herself an incredibly impressive person: She is self-made despite horrible early life experiences and someone who adds welcome diversity to the line-up of bland white males and slim, magazine-beautiful young women that populate American TV, she has popularised acceptance of LGBT people and been empathic about a wide variety of life experiences and mental health problems. Plus she is a significant philanthropist (albeit that her charitable activity in itself is not entirely without criticism). However, Oprah and her ilk are so non-critical of patent nonsense from self-help books about spirituality and positive vibrations to dodgy hormone treatments that it feels like a huge missed opportunity to have not put a threshold of scientific scrutiny (or at least critical thinking) to claims when she has such an enormously influential platform.

Likewise it is hard for me to reconcile why a credible researcher like Brene Brown would be prepared to be thrown in that mix and start marketing self-help courses for Oprah watchers. It doesn’t seem to make sense without attributing a financial motivation for accessing the wider audience that is more powerful than professional ethics.

I’m going to read all her books and then I’ll be in a better place to comment, but I’d like to think I’m not being naive or rigidly judgemental here. I’m sure if I felt that I had an important message to share and Oprah offered access to her audience of millions, and I felt that would help to change the world I would make compromises too, both to get the message out and to get the book sales, raised profile and funds that would enable further work. And I fully accept that there have to be coffee table books that are accessible to wider segments of the population than the referenced texts of scientists and clinicians that are more closely tied to the evidence base from which they are drawn. But something still feels uncomfortable.

So, is it just a cultural divide or my own hatred of insincere praise, or is it something deeper that is rotten about the self-help culture?

I’ve started to think that the self-help world, like the diet industry, is rotten at the core because it is invested in failure. I don’t mean the books often recommended by mental health services as ‘bibliotherapy’ that address mental health problems based on well-evidenced psychological techniques like CBT here, which are predominantly helpful. I mean the 2000+ books per year of home-brew wisdom about how to be happier, grasp control of your destiny, be more successful, fix your marriage in a week, get more energy, unlock your chains! Most of these have no evidence base whatsoever, and the authors often have no scientific or mental health credentials. A cynic might say they are selling false hope. Yet the same unhappy people try again and again to change their lives by reading the next book, spending more and more money to make changes presented as easy that are actually unsuccessful for the vast majority of those that try them out.

Just like the diet industry, self help is an industry that has had meteoric growth. Yet little of that is based on any evidence of either the underlying principles or the efficacy of outcomes. There is minimal evaluation, and what there is isn’t promising. In fact, recent research (albeit on a very small sample) has shown that reading self-help literature actually makes people more depressed and anxious!

“The sale of self-help books generated over $10 billion in profits in 2009 in the US, which is a good reason to find out if they have a real impact on readers,” said Sonia Lupien, Director of the Centre of Studies on Human Stress (CSHS). The results of the study showed that consumers of problem-focused self-help books presented greater depressive symptoms and that growth oriented self-help books consumers presented increased stress reactivity compared to non-consumers. No difference was found in any variable according to whether people had read self-help books or not, suggesting they have little impact on functioning. In fact “the best predictor of purchasing a self-help book is having bought one in the past year” suggesting that the same group of people repeatedly buy self-help books but aren’t actually changed by reading them.

In the same way, every new year consumers with weight-loss resolutions in the UK spend £335 million, yet a month later for more than half of them there is no measurable impact on their weight or fitness. Overall the diet industry has an incredible failure rate: 95% of people re-gain the weight they lose. Yet the consumers keep on spending. In the USA consumers spend more on diet-related purchases than the combined value of the government’s budget for health, education and social care. And yet a little basic knowledge of the subject could inform them that most of the things they try won’t work, and that there are very well established links between diet and health.

It seems I am not alone in this discomfort, and Brene Brown herself has felt it and responded. I still think she is one of the good guys, and clearly there are gender politics and marketing influences she struggles to counter, but it remains a fact that there is little to distinguish the good from the bad in the self-help field. I wonder if it is time for those of us who write from an evidence base to respond to that and to start a website to evaluate claims from self-help literature?

Some thoughts on the recent atrocities in Paris

The news of ordinary French people watching sport, chilling out at a cafe or attending a gig this week being gunned down by violent extremists, really brings home how it could have been any one of us. Its unthinkably awful that anyone would target random innocent civilians like this.

But the response from the public has been split in several directions. Do we need to toughen our stance on asylum seekers? Tighten border controls? Crack down on Muslims more generally? Do we need to show solidarity with the French by lighting everything from water fountains to facebook profiles in red, white and blue? Has this finally brought terrorism to us in Western Europe? Or does it just highlight how we are constantly ignoring the stories of so many people of other nationalities who have been killed across the world recently without making headlines of outpourings of sympathy? These are complicated questions to unpick.

In terms of whether the right response is to call for harsher actions towards violent extremists, I am reminded of an article I read in the psychologist, and an evidence review in the BPS research digest about the psychology of terrorism and extremism respectively. The main point I took from it is that acknowledging the kernel of legitimate grievance behind such actions and engaging in dialogue with moderates from similar demographics are both actions that make it harder to for extremists to recruit, whilst moving towards more polarised positions (eg all this tough talk about closing borders and not negotiating with terrorists) or language blaming the whole of a culture or religious group make more people within that broader group feel inclined to sign up to the more extreme positions.

Whilst the actions of ISIS are deplorable, the generalisation of negative feeling to all muslims is appalling. I even read about a tragic story in which a Hindu man had been pushed into the path of a train and killed by someone who thought this was a suitable reprisal for 9/11. Islam is a religion as large and diverse as Christianity. Nobody thinks the Klu Klux Klan represent Christians, yet large swathes of the western world appear to think ISIS speak for all muslims, when they are just as misrepresentative of the mainstream view within Islam. And alienating Muslims from the western world is a big mistake. The huge amount of moderate representatives of Islam (over a billion of them) are ordinary people who are just as appalled about the action of extremists as members of other religions or none. And they also form the moderate pole of the spectrum from which the extremists are drawn to ISIS. So we need to ensure that we engage this group in how we address these atrocities, and to integrate them into our societies to ensure this polarisation does not continue to play out across the world.

Extremism comes from perceived injustice and powerlessness amplified in small groups of like-minded others, and justified with reference to religion. Reducing injustice, allowing grievances to be heard and addressed, and being inclusive to moderate representatives are the only variables that anybody outside of the individual and those very small cultural subgroups has any control over, and it is these things that let South Africa get out of apartheid and Northern Ireland get out of the troubles there. I can’t see any other way to address the other conflicts going on in the world, be they in Afghanistan, Iraq, Gaza, Nigeria, Syria or Somalia. Surely, even if we accept that some human beings will always turn to violence, the aim is to reduce the scale of conflicts down from wars to individuals, so that less people get caught in the crossfire?

As to whether we have reacted with more sympathy to deaths in France to deaths elsewhere in the world. Again I think this is a complex issue. There is implicit bias in the system, coupled with habituation. We are more attentive to stories that feature people we identify with, and we pay more attention where the events seem novel, rather than recurrent. Think about children going missing from home and the coverage that white kids from ‘nice homes’ get when compared to any other ethnicity, or kids from the care system (by way of example, the other day I noticed that three kids went missing from the same place on the same day and only the white girl got news coverage). The British media definitely place more focus on events that affect white, western nations. Even though non-mainstream media and some voices within social media are picking up on this theme and people are starting to question the systemic bias in the news, I think it is fair to say that we do have endemic problems with racism in the western world. Whether that is due to prejudice, vested interests or the fact that telling stories about familiar protagonists or showing photos that look like the customer is more likely to sell newspapers or screen time, I don’t know.

However, people are always illogical about world events. An individual story you can relate to humanises what would otherwise be too overwhelming to process. Genocide, war, famine are all too big to conceptualise, so we figure we can’t make a difference and don’t give them much head space. We don’t know anything about the refugee camps outside Syria, or the day to day grimness of so many of these wide scale conflicts. However, a mother who can’t feed her child in the news coverage of the famine, an orphan who plays football on a LiveAid appeal video, the shock of an ordinary looking person at a gig or a cafe talking about how they saw their peers getting gunned down, or a dead baby washed up on a beach – those are the individual stories that we can relate to. They call out to us, and force us to place ourselves in the shoes of the protagonists, and that makes us sympathetic and much more drawn to positive action.

So do we speak up about all the missing stories when friends share content about Paris, to show their virtuousness is not evenly applied? I’m not so sure. It seems to me that the solution is not to criticise those people who do feel empathy with the individual stories they can relate to, but to tell the stories of the other conflicts in more relatable ways also, so they get a similarly empathic and constructive response. Compassion isn’t like a cake that is a finite resource that has to be shared out between all callers. It is something we can cultivate and broaden, and help to bring out in others.

It reminds me of a quote from Martin Luther King: “Returning hate for hate multiplies hate, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness, only light can do that. Hate cannot drive out hate. Only love can do that”.

And we have to reach beyond the boundaries of religion, ethnicity or nationality. Does it never seem absurd to you that people on this little blue-green planet we have evolved through the millennia to share are arguing about where somebody drew lines on a map hundreds of years ago, or whose stories about creation and morals are correct, without recognising that people are just people? Whatever colour of wrapping they come in, or language they speak or whether they believe in a God, and what name they call it makes no material difference to their ability to experience joy or suffering just the same as us. No matter how strange their lives seem, we’d have done the same if born into their community, and they’d be like us if born into ours.

So let us reach out in compassionate and loving ways to those around us, and especially to those showing ignorance or being excluded from our society. We are all in this together.

Tipping points (an unusually optimistic blog about entrepreneurship in delivering psychology)

This is a really exciting month for my business. Things are seemingly reaching a tipping point at which all the effort I have put in to date is starting to pay dividends. Even some things I had given up hope on have come back in a more optimistic way.

1) I’ve been short-listed for a grant, in which I can pilot my care pathway for LAC in a new county, scope the level of need, validate my measure and find out whether my system is effective in causing positive change for young people in Care. I’ve just got to get the full application completed by next week, and get the signatures from health, social care and commissioning in that locality onto the form before the deadline. No problem. Well, actually quite a big problem, judging by the initial application where getting signatures on it in time turned out to be a total nightmare. But worth a stab nonetheless.

2) I’ve been contacted by a social impact investment fund who may want to fund a scaled up version of the diabetes project that I blogged about so bitterly here. (If you remember, it was a pilot of brief psychological interventions for people with diabetes, and we found that it more than covered its own costs in savings from physical health treatment costs within the 12 months of the study. I was immensely frustrated that it wasn’t commissioned after the pilot year and I had long since given up on reviving it). It is unclear what they are planning, but they may want to fund us to deliver the project again, perhaps on a larger scale either geographically or in terms of including other long-term health conditions such as cancer, which would be pretty exciting.

3) As if that isn’t enough, I’ve got a new little venture starting up. Its an internet based business, that has already attracted interest from a venture capitalist who likes seed funding projects from idea to proof of concept. Not something I’ll be delivering personally, or directly related to CP, but nonetheless pretty exciting.

Everything else is ticking over nicely. The therapy service we run at LifePsychol is now full to capacity, and profitable enough to consider taking on another member of staff. I’ve got a contract with Keys that takes just over half my working time, delivering training and rolling out the BERRI as part of a change to the training, culture and care pathways across their residential provision. And we are suddenly getting lots of enquiries and sign-ups to the BERRI from other organisations, and several other psychologists I know professionally are recommending it for work they are doing.

On top of that I’m getting free business development coaching from Shawn Jhanji, who is a really supportive and inspiring guy, as part of winning a place on the Impact Hub scaling program (I’m one of 10 small UK businesses focused on making a positive difference to the world that are getting a year of support to enable growth and expansion into new markets, as part of an international cohort of 100). And before that I had personal development coaching from Andy Gill, who was also awesome. I can genuinely say that I couldn’t have made this happen without them. My investment in personal development coaching over the past 18 months has made a tremendous difference to my clarity of goals and the way I want to work to achieve them. It’s been revolutionary in terms of changing my perception of myself and the impact I can make on the world.

Other positive things are also happening all at once too. I’ve had 2 professional publications appear in the last month – a paper on running a social enterprise in Clinical Psychology Forum, a chapter in What good looks like in psychological services for children, young people and their families. The NICE guidance I was part of developing and the practise standards for psychologists working as experts into the family courts are also nearing publication. This means I’ve been able to step down from various committees and unpaid commitments feeling that I’ve done my share of the bigger picture stuff. Finally, I’ve nearly caught up on my invoicing and have made a concerted effort to chase some of the unpaid invoices that are overdue.

Basically, everything is falling into place with my new line of work, and past work is starting to pay dividends. So rather than feeling small, isolated and just about able to make ends meet to run the business, it now feels like the future is much more likely to be secure. This has let me stop taking new instructions for the emotionally intense and time/energy demanding court work that was making me feel so burnt out.

Hopefully pretty soon, I’ll have some time to focus on home stuff – which is good because we are supposed to be moving house by the end of the year!

All of this change has made me feel much more optimistic. Instead of feeling like I’m thanklessly hacking away at the rock face alone, I’ve got to a point where other people can see the value of joining in with what I am doing, and bringing machinery and tools to help. It is by no means inevitable that I’ll be able to achieve my goals yet, but I’m starting to feel more optimistic. And that has given me much more energy and enthusiasm, which is contagious in itself. I’ve got this feeling of travelling beyond territory I know into the unfamiliar. Who knows where it will take me, but I’m enjoying the adventure.

Thinking about vulnerability and risk

Sometimes you pull on the littlest of threads and the biggest of issues appear at the other end.

Today I have been training in quite a remote location in the Welsh borders. It is the first time in quite some time that I’ve been in a location with no mobile signal. And no mobile signal meant no satnav to find my location last night, and no means to let my husband know I had arrived. I soon found there was no working phone box, and given the late hour there was nobody around to ask directions. And all of a sudden I realised that I was lost, alone and that nobody knew where I was! For those few minutes before I found the hotel, I realised how much I have grown to rely on technology to feel safe and oriented in my day-to-day life. And then I wondered if I felt less fearless before those technologies were so ubiquitous, or whether it is just the absence of a crutch I have grown to rely on that made me feel more vulnerable. After all, what was the real risk?

I started to think about about how we are trained to over emphasise certain sorts of risk (like stranger-danger, or the risk of immigrants on unemployment rates), and to under-recognise others (like the risks to children from exposure to domestic violence, or the risks that so many families face from poverty and discrimination). It seems that the media trains us to be most afraid of the things we have least control over. A cynic might think they want us to have an external locus of control and a certain degree about learnt helplessness when it comes to social issues. Whatever the motivation, the result is that many people go about their lives with little awareness of the risks that I see as the most important in society today – how vulnerable many children and adults are to abuse and exploitation, how maltreatment is normative in certain families and communities, and how interpersonal violence, trauma and abuse can change the path of people’s lives.

One example of risk and vulnerability that has been prominent in the media recently is how the press has turned once again to discrediting victims of abuse who speak up. This has taken several strands. First the media narrative has changed from “survivors of child abuse” to “alleged survivors of child abuse”, sowing the seed of doubt about every person who makes a disclosure. Second politicians are telling their colleagues to withdraw allegations due to loyalty to their party, and trying to shame the brave few who spoke up and asked for multiple disclosures and allegations to be investigated into apologising for maligning a powerful public figure. And third we are repeatedly hearing that those with allegations against them which are dropped by the police or CPS have been “proven innocent” or that victims have “lied” or “fabricated” rather than the more accurate truth of the matter, in which there is insufficient evidence to have a high enough chance of successful prosecution to merit public funds to proceed. The climate of being willing to look into abuse allegations against the rich and powerful, which gained such momentum from the public disgust about how Jimmy Savile got away with such extensive crimes for so long, has turned once again into a climate in which victims feel that the authorities are biased towards powerful and they are not going to be believed. This blog is an eloquent example of that.

Whilst I firmly believe in the principle of innocent until proven guilty, and the need for exceptional reasons to name someone against whom allegations have been made before the case has sufficient evidence to come to trial, we are dealing with a system far more weighted towards false negatives than false positives. Let us not forget that as many as 1 in 5 children are sexually abused, and yet only 15% are able to disclose in a way that leads to a police investigation. That’s the scandal here, not the impact on the reputation of a dead politician.

We need to remember that the victims of abuse are human beings like us who have been failed by society. If all politicians see is demographics and price tags, or characters and plots in which the goody is the one who becomes rich and powerful, then they don’t treat people like people. Recognising human beings and their ability to suffer is necessary to form policy, to offer justice and to be objective in investigations. In fact, that recognition of our common humanity and how people are shaped by their experiences makes you more able to consider that the perpetrators who are too often written off as incurable and evil are mostly people who have been victims themselves and never had the positive learning experiences children need to develop healthily in their own lives.

I think tackling child maltreatment is the primary social problem in the world today. To address this problem we need a multifaceted approach. I believe that if we can prevent child abuse and help people to have secure attachment relationships they will learn to be more resilient, empathic and socially skilled. In time this will have immeasurable positive impact on society. It will reduce crime, addiction, conflict, mental health problems, and even reduce the incidence and severity of many major physical health problems such as heart disease, diabetes and cancer. And interventions to help reduce maltreatment, improve attachment relationships and support children to make an optimal recovery from abuse or poor care are highly cost effective. Every pound spent in addressing childhood adversity through evidence-based interventions is repaid tenfold to the state in savings before adulthood (for example, we know that mental health interventions in childhood can save £83 more per pound spent where issues are prevented or treated in childhood rather than remaining into adulthood). But it doesn’t stop there. These changes continue to make ripples that save costs in health, social care, criminal justice, employment, benefit, and tax spheres for the rest of the person’s lifetime, and then for their partners, children and future generations.

We just need to stop blaming the vulnerable, and imagining risks where they don’t exist, and start trying to solve the systemic problems that make them vulnerable in the first place.