Trauma and the return of hope

I wanted to write something about the recent traumatic events including the Manchester arena bomb, the London Bridge incident, the Grenfell Tower fire. These are very painful and raw events that have been quite distressing to learn about, and I am aware that we still don’t have the full picture. I also wanted to touch on the reaction to these tragedies including the One Love concert, and to give my reaction to the election results. I hope it doesn’t seem disrespectful to connect the two, but to me they represent both the fear and sadness of recent events, and the compassion and hope that have followed them. I should warn you now that the second half of this blog is less psychological and more political than usual. That probably isn’t surprising when I am writing about the election, but I know that type of content is not for everyone so I’ve marked where you might want to skip to the end.

Barring 9/11 I can’t remember a month in my lifetime with more traumatic events. The Manchester bomb killed predominantly young people and parents, and felt very close to home for me. The idea that innocent young people and families going to a concert could be the target for terrorists was unbelievably horrific, and the ages of the victims made the story identify with people of all life stages around the country who could imagine it being their child, grandchild, sibling, friend or parent who was affected. This wasn’t some far away event in another country, where people speak another language or have different culture or appearance that can let us abstract the horror away from ourselves.

The impact of the explosion was felt in ripples that spread far wider than just those who tragically died or were injured in the blast, to those who lost friends, relatives and loved ones, and wider again to those at the concert who witnessed the horrific scenes and felt scared by the situation, the emergency services and NHS staff who responded to it, and those who were peripherally involved in the aftermath of helping people find ways home or places to stay, or in looking for people who were missing. As well as the terrible loss of life, and lasting physical injuries, psychologically these events will have changed the course of people’s lives in various ways and to various degrees.

The same was true of those involved in the events on London Bridge and Borough Market. These were ordinary Londoners and tourists going about their daily life. On another day, or with another roll of the dice this could be any one of us or people that we know. Again, the ripples spread far and wide.

And now we have another unspeakably awful tragedy, where the Grenfell Tower fire has killed and injured large numbers of people representing the full spectrum of age and cultural diversity. What they had in common was living in a tower block built by the council in the 1970s. Preliminary commentary suggests that the decorative and insulating cladding used in a refurbishment of the block was highly flammable and caused the fire to spread rapidly and the compartmentalisation system to fail. If that is true, and it was cost-cutting and a delay in updating the fire regulations that was to blame, then that is unforgivable and needs to lead to legal consequences for those responsible, as well as learning that prevents similar tragedies occurring in the future. I can understand the level of anger that is being expressed by the local residents whose concerns were ignored, and by those who feel that the balance of power in the current political situation means that the lives of people with below average income are given little value compared to the profits of the rich.

Here too the psychological consequences will ripple out widely beyond the horrendous loss of life and physical injuries to those who were bereaved, traumatised by what they witnessed, those who tried to raise the alarm but couldn’t reach everybody, the emergency services who responded so admirably against insurmountable adversity and those more peripherally involved. There will be complex feelings for those who survived when others perished, and I can’t begin to imagine how it must feel for the person whose flat the fire started in. If it is true that a faulty washing machine started the blaze, they must be wondering whether there were any choices they could have made differently that would have prevented or reduced the terrible outcomes that followed. Likewise those on lower floors or adjacent buildings who escaped early on and had to watch others jumping from windows, throwing out children, or being trapped too high to do either. I can’t begin to imagine how that will impact upon them over time, as it was overwhelming to even watch on the limited TV coverage.

Yet, everywhere there is tragedy, we see good people come out to try to help. From the emergency services and NHS staff, to those running charities and organisations to help those affected to those doing practical things on the ground because they happened to be there and felt compelled to do something. The One Love Manchester concert had the highest viewing figures of the year and the fundraising for Manchester victims and charities has topped £11 million. Likewise the fundraising for victims and organisations that can provide support in relation to the London incidents and the Grenfell fire have been astronomical (last figures I read suggested there had been donations of over £1.5 million in 24 hours to causes related to the fire). Overall, following these tragedies we have seen an outpouring of love and kindness on an unprecedented scale.

So perhaps in that context it is not quite as surprising as the political commentators think that the election results suggest the tide is turning against austerity. Public sector workers with frozen pay are those who have been responding to these crises, killing and arresting the terrorists and identifying their networks, fighting the fires and patching up the injured. That means that the public have remembered what heroes they are, and look in a different light at the cuts to the public sector that are preventing them from doing an effective job and mean we are not rewarding them adequately for the essential work that they do. We have also been roused into action to prevent further victims. We can no longer ignore the fact that the NHS and fire service are warning of their inability to provide sufficient cover to meet the need with budgets cut to the bone. Hospitals are struggling to sustain staffing, let alone recruit, without nursing bursaries and international staff. Children are being harmed and dying because of insufficient social care services, and people with disabilities and health problems are suffering and dying because of cuts to their benefits and support packages.

In short, as events have awakened our empathy it has become clear that the government’s policies are without compassion, and are all about protecting big business and the super-wealthy. They are making the rich richer and the poor poorer, and the vulnerable are dying as a result. Tough talk about immigrants and scroungers has been used to justify a lack of public spending coupled with policies that harm the most vulnerable in society – yet the sudden change away from austerity when their electoral majority was lost confirms that these were idealogical rather than economic choices. The negative focus on blaming disadvantaged groups in society has turned the spotlight away from much bigger abuses of the system by international corporations who manage to pay little or no UK tax, and who exploit staff on zero hours contracts, or even force them to work for their benefits through work fare schemes. The wealthiest in society are able to pay accountants and lawyers to help them avoid tax the most, and to hide income in off-shore schemes for tax avoidance purposes.

So at a time when compassion is so needed, and so evident in response to terrible events, there has been a political shift. It hasn’t happened in isolation – we have seen increasing unpredictability in public voting over the last year. I can only make sense of this in terms of a desire for radical change. Young people and those who have felt disempowered and disenfranchised by a political system that seemed to occupy only the middle-right and work only to sustain the vested interests of those who are already wealthy and powerful have been voting for the option that they think will upset the establishment. Sadly, the only options for rebellion available last year were to vote for Brexit and for Trump, or to not vote at all. But this year, as the government has moved the Overton window further right since the Brexit vote, clear blue water has emerged between the parties. And to the surprise of many, the Labour Party has moved left from their centrist policies and candidates of the last decade. Somehow a genuine socialist candidate has been voted into leadership in the form of Jeremy Corbyn, and despite all the efforts of the press and his own party, he has stuck in there stubbornly, growing support from the ground up, and now he seems to have popular support and the potential to be a future Prime Minister.

[If you aren’t a fan of politics, feel free to skip to the last paragraph now, because the second half of this blog is about the election results and what they might mean].

Corbyn might be an unlikely leader following past templates, as he does not use glib press-friendly soundbites. But he is a man who has stuck to his principles throughout his political career, and has been a voice of reason and negotiation when others have been shouting. From day one he has been an authentic voice in a world of spin. Although he was damned for it at the time, he acknowledged the complexity of the issues and did not ally himself fully with either of the polarised sides of the Brexit debate (though he said on balance he would prefer to remain). He has subsequently been able to make a positive campaign in a time in which the fashion is to blame and ridicule. In the words of Michelle Obama that I like so much “when they go low, we go high“. It doesn’t mean not being outraged or angry. It means choosing to focus on how we can solve problems, rather than on denigrating opponents. Corbyn was not only an underdog that would upset the establishment but an opportunity to say enough to austerity. That message has connected with people whilst Theresa May was curiously defensive and robotic, repeating the same soundbites over and over again and refusing to engage in the debate.

Corbyn’s politics roused a new generation of political campaigners (Momentum) who fought a savvy campaign on social media, where it is said a budget of just £2000 reached more voters than over a million pounds spent by the Conservative party. Over 12 million voters saw a facebook post started by a Momentum member in the week before the election. Partly as a result of this, 622,000 people registered to vote for the first time. This image of Facebook reactions to a live stream of the Prime Minister made me smile:

It is obvious to anyone that knows me or anyone who reads what I write that I identify as being on the left of the political spectrum. I was alienated by Labour’s move to the centre, and have become a lifetime member of the Green Party, despite being pragmatic enough to recognise that whilst we have a first past the post voting system the UK will be a two party political system. So I have been quite interested in the rise of the left within the Labour Party, and a fan of Corbyn as an individual politician for some time (I wrote about Corbyn on this blog a year ago).

So, unsurprisingly, I saw the election outcome as a great result. I was afraid that the Tories would get a landslide victory and use it to push through ever more austerity, and channelling of wealth to the super rich. So to see them lose their majority was a brilliant outcome. I’m delighted, and the more I have thought about it the more I think a hung parliament is about the best possible result.

First off the Tories have lost the mandate for their hard right, hard Brexit plans. And young people have been engaged in politics. Hopefully we can prevent repugnant policies like the dementia tax and fox hunting and cuts to education because the majority is so slender and these policies haven’t played well with the public. But I like that brexit will be a Tory problem to resolve, because when it gets messy they will have nobody else to blame. There is a stronger position to oppose boundary changes and to press for electoral reform. Maybe we can improve the terrible cuts to benefits and the regime of sanctions whilst their focus is on damage limitation and Brexit. And the next election might be one in which change is possible.

I don’t think it is a panacea. After so many cycles of hope and disappointment in recent politics, I’m cynical about whether this is the beginning of a sea change, and worried there is still a lot of conservative thinking about the economy and UKIP influenced blaming of foreigners around. I’d like to believe that things will get better from here, but I don’t think we should expect too much too soon. Some of the optimistic predictions of having a Corbyn government by the end of the year, and reaching a point at which the populace don’t want to go through with Brexit by the two year deadline seem just too good to be true. However, I am optimistic about the long game, because of what the analysis about voting patterns shows. Corbyn’s support is younger and more educated than that of his opponents. That is supported by this chart from the Financial Times:

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You can see that over 65s were 35 points more conservative than the UK average, whilst under 45 year olds are more prone to voting progressively. That split by age is a relatively new thing and it has been much more marked over the last two elections. Then I think about what the five year interval between elections means to the population. With half a million older people dying every year, and half a million younger ones becoming eligible to vote, surely over time that will tip things in a positive direction. The only question is whether the tendency of people to swing right as they get older will continue as the current population ages and/or whether the Tories can start to market successfully to these new voters.

I’ve been trying to understand the reason for these demographic shifts, to judge whether the current middle aged moderates are the retired conservatives of the future. From what I have read I’m not sure that the fade from red to blue is inevitable. I think a lot of us who will be entering the top half of that graph soon age-wise grew up under Thatcher and have much more reticence for those kind of policies than the current over 65s who grew up during and soon after the war. We are also more educated (and education is associated with more progressive values) as well as growing up in a more socially liberal world, with greater exposure to diversity. As this article puts it “When my parents first voted in the 1960s, homosexuality was illegal, abortion was largely illegal, the death penalty was still in force and openly racist attitudes were widely acceptable. Now, the death penalty is a distant memory, abortion rights are firmly entrenched, gay marriage is legal” and (perhaps with the exception of the Brexit effect and islamophobia) racism isn’t socially acceptable. Environmental issues are really embedded in the values of young people, and the scientific consensus for climate change and the need to preserve our limited resources has become overwhelming over the last decade or two. Every school has recycling bins and anti bullying policies, every home has energy efficient light-bulbs and lots of products market their green credentials. There is an increased focus on making healthy choices for ourselves and our planet. Anyone under 40 is also growing up immersed in social media, and with the perspectives of the whole world available to them immediately, rather than just the opinion of the local community and the newspapers. The media barons have less influence, and the circulation of the tabloids is decreasing (and there is increased coverage of celebrity “news” within them, and less coverage of the more serious topics).

So I’m optimistic. Despite all of the things in the world that are upsetting people and setting them against each other, I think the march of time takes us towards an increasing prevalence of progressive values. I hope by the time my children are voters the world will be a nicer place, and the Overton window will have moved back to the left.

 

My opinions about representing Clinical Psychology and the future of the British Psychological Society

I’ve probably been a member of the BPS for 20 years now, and with it the Division of Clinical Psychology and the Faculty for Children, Young People and their Families, and within that the network for Clinical Psychologists working with Looked After and Adopted Children (CPLAAC). I’ve been to the annual Faculty conference every year since I qualified, except for the one early in my maternity leave. I read some of the publications and I follow some of the social media. Over the last decade, I’ve done a long stint on the Faculty committee, and I’ve spent 5 years as chair of the CPLAAC network. I’ve responded to policy documents, represented them on committees, written papers and edited a periodical. So you’d think with all the energy and time I have put in that I am a great fan of the organisation.

Unfortunately, whilst I am hugely admiring of many of the individuals involved with the DCP and Faculty, and some of the recent Presidents of the Society, I’m pretty ambivalent about it as a whole. I think their website and social media suck. I spent ages looking at how to help them with that through the faculty, only to find out the scope for change was minimal and was within their user-unfriendly structure. Most of it was hard to navigate, and key documents were hard to find, the documents and information on the site were often out of date and much of the content was hidden behind walls for members and separated into silos by the Society structure that were impenetrable by topic. I was censored and then locked out of the BPS twitter account whilst live tweeting talks from a conference on behalf of the faculty because I quoted a speaker who was critical of the BPS’s communication with the media and public.

My experience of running clinpsy.org.uk is that we make everything accessible, searchable and google indexed (apart from the qualified peer consultation forum that is a closed group, and the archive of livechats and other member content that can only be seen when logged in). We are also able to respond to things immediately, and often talk about current affairs. So it is quite a contrast. The view of the BPS on the forum is fairly negative, despite myself and several other qualified members trying to put the advantages of having a professional body.

One theme comes up across both spaces – that lots of people like to moan, but very few are prepared to take the actions that help to change things for the better. So, when a document is put out to consultation, or members are canvassed for views by BPS Divisions or Faculties it may be that no clinical psychologists respond at all, or perhaps just one or two nominated by the committee, someone with a vested interest, or the same old voices who feel a greater sense of responsibility for the group. I’m sure the same would be true on the forum, as lots of people like to read the content, some like to ask questions but few actually write up content for the wiki, or help with the maintenance tasks like checking and updating links. However, people pay quite a lot for their BPS memberships, whilst the forum is entirely free and run by volunteers, so it is perhaps fair to have different expectations of service. The difficulty being that the BPS expect the few members who do contribute to do so for free, in their own time, over and over again. I worked out that one eighth of my working time as a self-employed person was being spent on unpaid committee and policy work, and I don’t think that this was unusual. Certainly the chairs of networks and faculties give up a large amount of their own time, and although higher up the tree some days are paid, these are not paid sufficiently to reflect the amount of time that is spent on the job.

So when the DCP sent me a link to a survey recently, I had to reflect my views and tell them that I don’t think that the BPS works for clinical psychologists in the UK, and this is predominantly because of the nature of the larger organisation.

I have witnessed time and time again that clinical psychologists, including those on faculty committees and in the DCP committees, are inhibited rather than facilitated in responding to topical issues, speaking to the media, expressing opinions or taking action by the slow, conservative and censorial wider organisation of the BPS. Even sending representatives to sit on government fora, guidance or policy making organisations involves an overly bureaucratic process of formal invitations and nominations that often means the window has closed to have our voice heard. Likewise the process for agreeing documents for publication is onerous and slow and means months of delay. The Royal Colleges and bodies for other health professions make responses to news items in a timely way, but we don’t. We are constantly told not to be political by expressing any opinion, when, as I understand them, the charity rules are not to be party political rather than not to express opinions that affect political policy at all. I would argue that our role as powerful professionals, effective clinicians, supporters for our clients and compassionate human beings requires that we are political in the wider sense, because we should be advocating for the psychological wellbeing of the population and putting the case for provision of adequate mental health services. I would consider that this includes an obligation to argue against policies that cause hardship and emotional distress, and to put forward a psychological understanding of events and individuals in the news.

Whilst there are great people involved in the committees and a lot of good will and energy, the BPS itself makes contributors impotent. It inhibits rather than amplifies the messages we should be sending outwards and it fails also to represent us as a professional group. It is not effective at representing our interests in government policy, national or regional workforce issues, professional negotiations, disputes about funding or other professional matters.

The structure of the BPS also drowns out the fact that the majority of practitioner members are clinical psychologists by giving equal weight to tiny factions and much too much weight to academics and students – the focus on the latter two groups means that the BPS failed to address issues of regulation properly and has left us with a legacy of problems with the remit and standards of the HCPC (including who is included and excluded in the scope of regulation and the criteria for equivalence of international psychologists, which I will no doubt blog about another time). In these areas it has not only failed to promote the profession, but also to protect the public.

Unlike other professional bodies, the BPS does not offer much by way of professional advice and representation for its members (eg about workforce and pay issues, disputes with employers). It doesn’t act like a union to defend individual members or the interests of the profession, or provide us with insurance or collective bargaining. It doesn’t show our value to the public or those in power through media statements, responses to news and current events and policies, representation on government and policy bodies. It is ineffective in building the status and public awareness of the profession. I believe our professional body should constantly articulate the need for proper mental health services and highlight the useful role the profession can play in meeting those needs. Likewise it should constantly express opinions about government policy and other issues that may be harmful to the psychological health of the population, and highlight what we think would help and the role we as a profession can play in systemic changes and in planning strategies at the population level that prevent or reduce distress.

So I think radical change is needed. If that isn’t possible as a program of reform from within, and Jamie Hacker Hughes’ Presidency suggests it wasn’t, then we need to split the DCP away from the BPS and/or build something new that is fit for purpose.

If you also have an opinion about the BPS and/or DCP, whether or not you are a member, please answer their survey here. Feel free to cut and paste any part of this blog into your response if you wish to do so. Likewise feel free to share a link to this page, and if you are an aspiring or practising clinical psychologist you are welcome to join in the discussion about the BPS on the clinpsy forum.

A promise to my daughters

As well as being on the progressive left politically, I’ve increasingly identified as an active feminist over the last decade. I’m sure that this has been apparent from my blog, which has at times posted about this topic explicitly. So this has been a depressing few months for me. After the inauguration of a racist, misogynist sex pest as the POTUS, and in the context of the thoroughly depressing situation in the UK with the toxic politics of austerity and Brexit, I have been thinking about the kind of world I want for my daughters. I have also been thinking about what I can do to to instil in them the values that I think are important and will help them have the kind of future I would want for them.

The massive turnout across the USA and around the world for the Women’s March has been a heartening message in a hard time. It is empowering to think that women all around the world and for several generations, as well as their allies, are working towards the same goals of equality and to further progressive causes (such as caring for the environment, LGBTQ and BME rights, and the value of science/evidence over propaganda and opinion). That sense of community and caring for each other and the future is also a refreshing change from all the aggressive posturing, selfishness and commercialism that seem to saturate the narrative at the moment.

The placards and quotes from the Women’s March have been particularly inspiring. I particularly like those shown on the MightyGirl blog. They illustrate how women all over the world are bringing up the next generation of girls to approach the world on their own terms and have whatever aspirations they want, without the boundaries of sexism and prejudice holding them back. There is one placard that says “I am only 4 years old, but I know everyone is equal” and that is the simple truth – until children are skewed by the prejudices they see around them, they understand the fundamental truth that whatever differences there are between people in how they look or how they live their lives, we are all equal in importance and all deserve to be treated with kindness and respect.

My children have often surprised me with their insight into international conflicts and world events. I remember driving them home from the supermarket when they were four years old, and them asking why the rich people of the world couldn’t give jobs to all poor people so that they could afford the things they need like food, clothes and places to live. I couldn’t really answer that, because I don’t think there is any justification for levels of inequality that mean that the richest eight men in the world have more money than the poorest half of the world population. Yet we have stopped seeing how odd and obscene that is, because we are implicitly given the message that we live in a meritocracy, and wealth is earned through hard work (when the reality is that many people inherit wealth, and few would argue that even the self-made plutocrats work harder than anyone else in the wealth spectrum). A year later, after explaining why poppy badges were being sold I remember having a conversation about whether there were still wars in the world. I said that there were, and most of them were to do with people having different religions. We talked about how wars don’t only affect soldiers, and how a recent bombing campaign had destroyed schools and hospitals. My daughters suggested that “we need to send people in that country postcards to remind them that schools are really important”, as “that is where children will learn that people are equal even if they are different, and you need to be kind to everyone”. I’ve never felt prouder.

I’d like to think I’m good role model of a woman facing the world on my own terms, setting up my own business and being “the boss” at work, as my kids see it, and being an equal partner in my relationship, which does not conform to traditional gender roles. We’ve worked hard to expose our daughters to a range of interests, and given them a variety of experiences. I’d hope that they can make choices about what they enjoy or how they want to present themselves unencumbered by narrow gender expectations or unhealthy/unrealistic body norms. Our bedtime stories have characters of both genders who solve their own problems, rather than princesses passively waiting to be rescued by a prince to live happily ever after. I’d like to think we’ve also modelled the way that we interact with each other, and with a wide variety of people with respect. We have taught them to appreciate diversity and to admire those who defy convention or achieve something despite adversity.

But I’m not sure I’ve done enough to show that we can take action to address issues we see happening in the world around us. I should have taken them to the march on the weekend. I think it would have been a great experience for them, but frustratingly I’m still too unwell to travel. So I need to think of other ways to involve them in activism. And I need to do more myself than donate to charities, sign petitions and write messages on the internet. At a time in which the news is dominated by a super-callous-fragile-racist-sexist-nazi-potus I want my daughters to know that I’ve done everything I can to give them the maximum range of choices for their future lives, and the best chance of being judged by their actions rather than their appearance. So I will finish with the words from a placard that resonated with me: I am no longer accepting the things I cannot change, I am changing the things I cannot accept.

Spectator sports

We are in the age of the internet. Adele’s Hello has been viewed 1.8 billion times, yet there are five other music videos on YouTube with more hits, culminating in Gangnam Style’s 2.7 billion view parody of the western status symbols rich south Koreans aspire to. Viral memes emerge and hit millions of page views in a day or two. Websites full of recycled content and filler with clickbait titles make up news stories to profit from the advertising revenue. False news engineered for the most gullible audiences makes tens of thousands of dollars a month. False news created by vested interests including foreign governments sways election results. Trivial stories that involve popular vloggers make headline news. Swedish video game blogger Pewdiepie reached 50 million followers last week and reportedly earns $12 million per year. His empty threats to delete his channel made headlines around the world. The top ten YouTube channels each make in excess of $5 million per year in revenue. Yet many people above the age of 40 have never heard of any of them. Part of what they have in common is what image-hosting site Imgur calls step 1: “Be good looking” although, as has always been the case even prior to the internet, that rules doesn’t seem to apply if the content is funny.

This new class of creators and media is packaged into bite-size content that doesn’t require any critical thinking, often with a catchy title and thumbnail that oversell the contents. Clicking from item to item across quick videos, memes, images and articles seems to make a time-sink trap that captures internet surfers in their millions. Amongst the new population of content creators are people with various different personalities, histories and views about the world, ranging from the ordinary to the extreme. And just as in the responses to any feminist video online, there are then vloggers whose content is made up of critiques of more famous vloggers and their content.

As Katie Hopkins has worked out, being sufficiently unpleasant and controversial generates clicks. It then creates responses that drives more traffic to the original content, and perpetuates discussion. There is then meta-debate about the creator themselves, attempts to shame them, and debate about what to do about them. Even publicising her embarrassing apology and substantial payment of damages for making false racist allegations of terrorist links against a muslim family gives her more notoriety and more clicks.

So it has been with the media rubbernecking the car crash of Eugenia Cooney’s weightloss, from a slim but attractive young woman into an emaciated role model of anorexia (weighing an estimated 4-5 stone) whilst denying she has a problem. A petition to ask YouTube to block her videos until she has sought help reached 18,000 signatures before being removed as inappropriate, and this has created a media circus with numerous vlogs and articles about her weight and whether this represents anorexia or not. Some have commented on the obesity of her mother and brother, and her childlike demeanour and role.

Because she has chosen to put herself in the public eye, and to make money from her audience, she is considered fair game for discussion. Yet if she does indeed have anorexia (and from the little I know of the case that does not seem an unreasonable assumption) she is very vulnerable and likely to have very distorted thinking. In the UK, there might well be a case to section her under the mental health act for treatment if there was not an alternative explanation for her weight loss, because of the lack of insight and high morbidity characteristic of this condition. So there appears to be a dangerous incentive of clicks (and the cash from advertising that follows) for being controversial, and in this case, seemingly putting her own life at risk.

Let us not underestimate the seriousness of eating disorders. One in five people with an eating disorder will die prematurely as a consequence of the condition, making it the mental health condition with the highest level of mortality. There is an increased risk of suicide, and an average duration of eight years for anorexia or five for bulimia, with less than half of all of those diagnosed making a complete recovery to the point they no longer meet the diagnostic criteria for an eating disorder. This is significantly more dangerous for your health than all but the most severe levels of obesity, and yet being too thin is often viewed as a positive characteristic and aspirational. The internet term “thinspiration” has nearly 4 million hits, with the top sites being pro-anorexia websites, with young women sharing tips and setting dangerously unhealthy weight loss goals.

Teenage online model Essana O’Neill bravely exposed the truth behind her instagram profile, which had half a million followers, before quitting social media to focus on real life. She later posted about her insecurity, depression and body dysmorphia. But she was far from alone. Photoshopping of images in magazines has become ubiquitous. Various surveys have shown that half to two thirds of selfies shared by adults or young people on social media have now been edited.

The fact that there are now dangerously thin vloggers denying that they have a problem and giving fashion and lifestyle tips to their followers must be considered concerning. It gives a new set of easily accessible role models that parents and clinicians may be unaware of, with very large audiences of young girls. Eugenia Cooney for example has 900,000 subscribers, who are predominantly teenage girls. There are several anecdotal examples of how this has been a trigger for eating disorders in girls trying to emulate them, and given 6.4% of the population has traits of an eating disorder, with most starting in this age range, that is highly concerning.

On the positive side, there have been growing moves to prevent overly thin models being used in catwalk shows and magazines and to indicate when images used in magazines have been photoshopped (something I would strongly support), so some progress appeared to have been made to present healthier role models to young women. There are many positive messages about health and fitness out there too (personally, I particularly like the goal of being stronger rather than thinner). However, there is a huge challenge when it comes to legislation on the internet, because of the many countries that the vlogger, hosting company and viewer can be situated in. Whilst these logistical pitfalls fail to prevent propagation of eating disordered messages (or other forms of toxic content) on the internet, there is little that we can do to prevent more and more young people normalising or idealising unhealthy role models.

Another sad day

It is very sad news for America and the world that Donald Trump has been elected president. I view him as a dangerous fascist with regressive values about every aspect of society from gender to sexuality, race to disability and an agenda that will restrict human rights in the interest of big business and the super-wealthy. He is in it only for himself, and it is shameful that such a superficial and offensive campaign connected with people in large enough numbers to elect him. I feel nearly as sad as after the referendum, although slightly less surprised. We truly are in a post-truth era, where lies and rhetoric mean more than evidence or experience.

As Caroline Lucas put it “Today is a devastating day. On this dark day we extend the hand of friendship to people in the USA who wake up in fear – we know that you are not defined by the hatred espoused by your new president. It’s at times like this when we need to unite, learn, and resist more than ever before”.

Of course this time round many people viewed it as a choice between two candidates that were both far from ideal. I didn’t see Clinton as any worse than most politicians, and viewed her as head and shoulders more palatable than Trump, but I’d much rather have Michelle Obama as the first female POTUS than Hillary. She has much more charisma, passion and colour to her character compared to the bland establishment figure and stand-by-your-man tradition that Hillary represents. Plus I just love the way Barack looks at her, and the nature of their relationship and family. Of course I wish they’d been able to do more to push through healthcare reforms and gun control, and to close Guantanamo and stop the drone programme, but compared to anyone else in politics in my lifetime they are downright inspirational. I hope that over the next few years new leaders can rise up on both sides of the Atlantic so that we can have a better result next time round.

So why did this happen? I see a number of different factors coinciding – the impact of an increasing wealth gap, the impact of two party first-past-the-post politics, white men fearing the changing power structure in the world and a generation of right-wing media propaganda. Hopefully the Brexit vote and Trump being elected are the last death throws of white supremacism.

And what can be we do about it? We need to regroup and to learn from what is happening. I’m inclined to agree with Corbyn when he says “Trump’s election is an unmistakable rejection of a political establishment and an economic system that simply isn’t working for most people. It is one that has delivered escalating inequality and stagnating or falling living standards for the majority, both in the US and Britain”. The world we live in needs reason and critical thinking. It needs education systems which encourage integration and mutual understanding, as well as showing children the value of caring for the environment and evaluating claims based on evidence rather than opinion. We also need to actively teach and reward empathy and kindness, and seek these qualities out in our leaders too.

I’ll give Caroline Lucas the last word, “I will never believe that people are inherently closed minded, or insular, but I do believe that people, the world over, are scared and angry – and are kicking back in ways that nobody predicted… I have a message for those people who will try to stir up hatred, and fear. Where you try and divide us we will stand firmer together than ever before. Where you try and pitch our communities against each other, we will build stronger bonds between ourselves and our neighbours… This is no time to mourn – instead we must organise like never before to keep our communities cohesive and our climate safe. On this dark day we extend the hand of friendship to people in the US who wake up in fear. Solidarity is a popular word, but we have to make it mean something. It’s at times like this when we need to unite, learn, resist and hope more than ever before. Today, in whatever ways we can, let’s light a candle rather than curse the darkness”.

Exploiting the ignorant: From quack cures to the rise of Trump

I was reading today about a man called Braco (pronounced Bratzoh) who is the centre of a personality cult that believes his “gaze” (looking out into a crowd and not speaking for 5-7 minutes) can heal health problems and have a positive impact on people’s lives and the lives of their loved ones. He does free online gaze sessions, and cheap or free local events all around the world in order to market books, DVDs and items of jewellery containing his golden “sun symbol” (many for $500+ each). I see nothing more than a man who learnt how profitable it was to be a fake healer from a mentor in a similar line of work, and took on his audience and methodologies (but without the stress of having to give any advice, or the risks of making any claims about himself that could be proven false).

Yet, nonetheless he has a plentiful audience of believers. People claim remarkably diverse experiences and attribute all kinds of random positive events in their lives to his gaze. One contributor believes that Braco cured the hearing loss of a newborn whose parent and grandparents went and gazed (and bought the $500+ trinket). Unknown to them, 13% of children identified with newborn hearing loss spontaneously recover, without any superstitious interventions. It reminds me of Tim Minchin’s fantastic song Thank You God [link contains swearing] that describes alternative explanations for a “miracle” in which a lady’s cataracts are “cured by prayer”. These include spontaneous remission, misdiagnosis, a record-keeping glitch, a lie or misunderstanding. He mentions the power of confirmation bias, groupthink, and simplistic ideas of causality based on temporal correlation (as was the case with autism and MMR). On the internet there is also the significant possibility that the review is fabricated.

The same story repeats all over the world. People are paying something for nothing more than woo in numerous seances, palm readings, psychics, mediums, crystal therapies, quack nutritionists, chiropractors, reiki, all energy therapies, coffee enemas, homeopathy, reflexology, magical weight loss products, Bach flower remedies, most vitamin supplements, magnetic items making health claims and anything that promises to “detox”. In fact, any one of us could invent our own snake-oil or novel form of quackery. And then we could invent some titles and qualifications and go on TV as an “expert” to promote them. The trade is worth in excess of £500 million per year in the UK alone. Quackwatch is a good reference point – I check doubtful health claims there, just as I check doubtful internet stories on Snopes.

We are 250 years past the enlightenment in which the ideas of reason and science supposedly gained supremacy over superstition and liberty progress and tolerance gained traction over dogma. Yet here we are in so many ways believing in magic and witch hunts. The public doesn’t understand science, is wedded to superstition, or simply has overwhelming credulity and a lack of critical thinking. This is the same culture that created plausibility for Andrew Wakefield’s weird “measles immunisation” recipe that contained his own blood and goat colostrum and that pushed an appropriately skeptical professor of complimentary and alternative medicine into early retirement because he wouldn’t endorse homeopathy and reflexology on the NHS.

No wonder in the Brexit campaign and in Trump’s electoral campaign there has been such wide deviation from the facts. The public have been told to disregard experts and go with their gut feelings, or with the guy who they could imagine meeting in the pub. That is a very poor way to judge the evidence base, and (as we have discovered with Brexit) a very easy way to be sold a pup. I can’t understand why it is not a crime, or even a disgrace, to lie to the public. Why were there not enquiries and reprimands for people who knowingly lied about the £350 million pounds a week extra that was supposed to go to the NHS if we left Europe? The answer is because we have better protections against a drink being sold with false weight loss claims than we do over vote-changing political claims.

It is interesting to explore why people don’t trust experts, and here it seems that there are a few dimensions that are important. Knowledge is only trusted if it is coupled with a perception of benevolence, and presented in words that people understand and don’t feel patronised by. It is all too easy for people with expertise to use jargon or technical terminology that makes sense in their field, for readers of the journals they publish in or in conversation with their peers, but that makes the content inaccessible to lay people, who then think of the expert as being part of an intellectual elite who are sneering down at them from a position of superiority.

And some people seem to deliberately manipulate any show of expertise to make it seem that particular commentators are not connected with the experience of ‘the man on the street’. Michael Gove (linked above) was probably the pinnacle of this, but Trump also directly appeals to this distrust of experts, and seems to bank on his audience not caring about his content being proved to be factually incorrect later down the line. Tim Minchin captured my feelings and frustrations about this rising anti-intellectualism (and Brexit and even Donald Trump in passing) here [contains swearing, I’d recommend watching from 24 to 35 mins in].

But it is becoming more and more common. I was listening to the radio earlier this week and flicked over from Radio 4 to Radio 2 to hear the host Vanessa Feltz tell a labour party spokesman that the word “narrative” when used in context, with four repetitions of the word “story”, was jargon that was beyond her and her listeners and proudly proclaimed that it was similar to the teaching that went over her head at university (listen at 15:00 for just over a minute). She seemed to want him to pitch his vocabulary lower, whilst showing her own insecurity about wanting to be clever by using the word “elucidate” herself in her instruction to him to do so! It was particularly notable in contrast to Radio 4, where the words that she criticised, such as “managerial”, “technocratic” and “narrative” would not stand out in the discussion or require definition. Maybe it is just a mark of my age and changing listening preferences, but I would always prefer to have conversation pitched at the level that I learn from, than patronisingly dumbed down.

It is also a reminder that, despite a natural tendency to consider ourselves pretty much average at everything, very often we fail to recognise our own levels of skew within the population. My politics are left of average, my income and intellect above average, just as my physical fitness is below average. But this deviation from the norm does not stand out to me as I have sought out a peer group of other professional, intellectual lefties. In my peer group, the remain preference was so strong that the vote to leave the EU was quite a shock!

Similarly, despite having written a book to try to make the scientific knowledge around attachment and developmental trauma accessible to care givers and professionals from other fields, and working hard to make psychological knowledge available through this blog and various forum posts, not everyone finds my writing accessible. For every ten positive views of the book there is one person who feels I pitched it too high. I’m sure I’m as guilty as the next person of knowing the meaning I intend to convey, and therefore not always recognising when I have not communicated this effectively. So please do point it out to me!

 

 

Terrorism revisited

I feel very very sad about the referendum results, but not entirely surprised given the previous election results.

I think the campaign has been fought on dishonest ground that didn’t represent what we were voting for, and the referendum and the Brexit campaign were the culmination of a particular message being pushed by vested interests in the media and politics for many years. It is part of a bigger problem of politics becoming ever more a game of the super-rich, corporate lobbying and propaganda, and less about representing what the majority of the electorate actually want. I think it is a sign of big trouble with the democratic process when two thirds of the cabinet are millionaires, and that demographic represents only 1% of the population, whilst they are supposed to speak for the breadth of the UK.

I’m not convinced that concerns about immigration are the unspoken elephant in the room, so much as one of a number of targets that keep on and on getting vilified and scapegoated for all of society’s ills. To paraphrase the metaphor: An immigrant, a voter and a millionaire politician are sitting at the table with 10 cookies. The politician takes 9 to give to his chums and then tells the voter “watch out, the immigrant is going to steal your cookie”.

What is unspoken is the responses we need to challenge these poisonous messages and to remind us that there but for fortune we could be in the shoes of an economic migrant, an asylum seeker, a single mother, a person with disabilities, a parent of a child with special needs, someone who loved that child that died because we didn’t have proper health and social care services, someone without legal representation, unemployed, the victim of racism/sexism/homophobia, the generation that live through war, etc. We should want to protect human rights and public services, legal aid, benefits and victims of crime, and to prevent war because we are them and they are us.

But somehow the talk was all focused on the money, and the immigrants, and the pointless bureaucracy of the EU. Maybe I am naive or cynical, but I think that a group of people have been actively driving that narrative for a long time, I don’t believe it is an organic grass-roots concern that has spontaneously bubbled up. I think there are vested interests pushing us towards greater income disparity, blaming of the vulnerable, and encouraging prejudice, selfishness and nihilism. I don’t think people are stupid, I think people have been drip fed right-wing propaganda for many many years, that blames all ills on “immigrants” and “benefits scroungers” so that we don’t look too hard at austerity politics and see all the vested interests. If there was a credible alternative, they’d as easily target that rage against the bankers, the corporations dodging tax and using zero hours contracts, and those using tax havens to hide their cash – all of which I consider to be much more legitimate targets.

As this article in the BMJ eloquently explained, the less people feel they have to lose, the more willing they are to take a gamble on a potentially risky outcome. And the results of austerity politics mean that large swathes of people are suffering financially, and feel powerless, hopeless, disenfranchised and exploited. At the same time as the referendum we have seen an even more tragic set of events unfolding that I think have the same underlying cause.

With the Miami mass shooting and the murder of Jo Cox (and longer ago, the shootings in Paris), I think that we have seen the ugly underbelly of what happens when people feel desperate and voiceless, and are radicalised by hearing poisonous messages blaming particular people for their unhappiness or lack of success in life. Both were horrendous acts, targeting people who had done absolutely nothing wrong in order to convey some kind of political message. Both were incredibly distressing to hear about, let alone for those who were personally involved.

Jo Cox was my age to within a fortnight and had a similar family configuration, so it has really hit home that her husband and kids will never see her again, just because she spoke out for compassion and inclusiveness. She is someone I had never heard of before she was attacked, but the more I read about her the more I like and admire her. She was taking action for the good of others, and she was a great example of our democracy. I have donated to the fund in her memory, and the fact it topped a million pounds in just a few days, suggests that I am not alone in wanting to take some kind of positive action in the face of such awful news.

And with that in mind, and the clear indications that this was politically motivated terrorism with a far-right agenda, I wanted to say something about all the references to mental illness. Being mentally ill doesn’t mean you kill people and killing people doesn’t mean you’re mentally ill. Doing something awful that we can’t understand is not the same as being mentally ill. One in four people has a mental illness, a characteristic as widespread as blond hair. The vast majority of them will never hurt anyone, and are at no greater risk of doing something awful than anyone else (although they are disproportionately the victims of violence). It is abhorrent to stigmatise all those people because of the actions of one person, even if he may have had mental health issues. He didn’t kill Jo Cox because he had mental health problems. He killed her because he wanted to promote his repugnant fascist beliefs.

I posted on Facebook about the causes of terrorism earlier in the week when the discussion was about the Miami mass murder, and this is exactly the same. This was what I wrote:

Just a reminder, but mental illness is not a cause of terrorism. There is pretty good research that has disproved this popular myth. People do awful things. We can’t understand that and we want to feel like they are different from us, so we assume their mind is broken. In fact the research says that it is a combination of a strong need to belong, coupled with a sense of marginalisation and injustice, dehumanisation of enemies, group processes where beliefs get hyped up into extreme actions and strong religious beliefs. Intelligent men who underachieve are particularly at risk for this radicalisation. That is, ordinary people with no genetic or mental abnormalities get pulled down a particular path by their experiences and social networks.

From a paper by Silke after 9/11:

“It is very rare to find a terrorist who suffers from a clinically defined ‘personality disorder’ or who could in any other way be regarded as mentally ill or psychologically deviant (Silke, 1998). Ultimately, the overwhelming majority of terrorists (and this significantly even includes suicide bombers) are average, normal individuals who in other circumstances would be quite unremarkable. Their involvement in terrorism is not the result of psychoses, inner traits or aberrant personalities. Rather, in most cases it is an understandable response to a series of life events.

The causes of terrorism need to be focused on – not just the actors. Once you are forced to throw away the ‘terrorists are different’ model, then attention must be given to other areas. An important realisation here is that becoming involved in terrorism is a process. Nobody is born a terrorist. Neither does anyone wake up one morning and decide abruptly that on that day they are going to start planting bombs in public streets. Becoming a terrorist is in the first instance an issue of socialisation. Any given society will possess some minorities or disaffected groups who rightly or wrongly perceive that the world is treating them harshly. In some cases there are genuine and very substantial causes for grievance. Individuals who belong to or identify with such disaffected groups share in a sense of injustice and persecution. It is from such pools that individual terrorists emerge”.

Western politicians will easily condemn muslim extremists, but in America in particular they find it much harder to look at terrorism fueled by prejudice, in this case racism (but previously by homophobia and religion) – because, like the gun lobby, it has so much popular support. I don’t have any solutions for that, but we do need to name the problem, and the problem is the rise of right wing regressive ideas, fueled by prejudice and religion, blaming every vulnerable minority whilst turning a blind eye to the rich and powerful exploiting the rest of us.

I want my country back from all this hatred and fear-mongering. We need to stop blaming the vulnerable, and start looking at the political system that has created an increasingly divisive and selfish society.