politics

All change!

Someone once said to me that, if you can manage the stress, change can be an opportunity. They argued that a time of confusion is a good time to put forward ideas that could be seen as potential solutions, as nothing is set in stone yet. Derren Brown (the skilled TV hypnotist, cold-reader, sleight of hand maestro and showman) said something similar when he talked about how confused and stressed people are at their most suggestible. I think he said it whilst persuading bookies at the races that he had won on losing tickets, which was not something I felt was ethical to replicate (even if I had his skill-set) but I do have some anecdotal experiences of this being true. I remember a few years ago going shopping in early December and queuing up to pay in a very busy clothes store. I had a loyalty card which gave a discount for the event at the store, but when I got to the till I couldn’t find it. The poor cashier was on hold to the accounts department to see if they could find my details when, whilst making small-talk, I asked if the discount was the same as the student discount. The cashier then decided it would be easier to put my purchase through as a student discount (which did not require a card number), so that she could deal with me more quickly. Thus I got the discount without the card, and she was able to move on to the next customer. I could see that my comment had unintentionally introduced the potential for an easy win into her mind. Of course as soon as I left the crowded store I was able to find the card, but it made me think about the attractiveness of offering an easy option when the demands are overwhelming. I find this a reassuring concept to think about when the public sector organisations seem to be constantly in a state of organisational change, demands that exceed resources to meet the need, and a pervasive level of uncertainty and confusion! This idea that sometimes a suggestion with serendipitous timing could influence change in a positive direction offered an interesting alternative perspective to my pessimism about how difficult it can be to get even solid, evidence-based, cost-saving ideas accepted into practise (see previous blogs).

I’ve also been talking about the need for change in how I work in my personal development coaching sessions. I’ve previously blogged about feeling a bit burnt out by the emotionally harrowing content of some of my work, the need for me to get better at prioritising and how I am trying to get a better work-life balance. One of my motivations to start the coaching was my sense that I have so many plates spinning I have almost lost track of why I am spinning them and what my goal is. I wanted to re-evaluate what my goals were, and to find the joy in my work again. As I have begun to clear space in my life to reflect on this, I have recognised that my beliefs about what my career would look like have not really kept pace with changes in the public sector and in my own interests and ways of working.

At some level, my template for a good career in psychology was based on my Mum. She worked in child psychology and CAMHS, and was Head of Child Psychology for a county at the point she retired a couple of years ago. I had always assumed that was pretty much how my professional life would pan out. I had qualified in 2000, worked my way up the bands to make Consultant Grade and be part of the CAMHS management team in 2008, and expected to end up as Head of a Child Psychology service somewhere. In metaphorical terms, that was the train journey I bought a ticket for. But something changed when I had kids and went through a lot of stress related to the organisational changes when the CAMHS contract was won by a competing trust and we were TUPEd over. In the end I left the NHS and did something different. In the metaphor, I got off the train. My early plans for my company were very much based on wanting to replicate what I was doing within the NHS, but without the systemic problems I experienced in the NHS trust that I left. So in the metaphor I caught the bus, but I was still headed for the same destination. At various points I meandered, detoured to explore things I had heard about, joined groups to see the local sights, even hiked across country with my own compass, but underneath it all my destination was still the same.

Of course once you are going off the beaten track, sightseeing, hiking and choosing your own route, the journey becomes a bit more scary but much more interesting. In turn, the destination becomes less fixed and also less important, because it can continue to change and there may be steps beyond each destination to another. You can also grow in confidence and tackle bigger challenges and find new things inspiring, so you end up setting goals you had not considered at the beginning of the journey. Once I was off the train, I didn’t need to follow the tracks, or try to make my way by other means to where they led. I didn’t need to replicate CAMHS or to try to set up a LAC service outside the NHS, and I didn’t need to be Head of a Child Psychology service. Indeed I was offered an NHS post with this title last year, which was my expected destination, but I declined the offer. I learnt things about the post that made me concerned that I’d be jumping back into a train on a route where everything was running late and all the passengers were unhappy, whilst I was no longer afraid of being off the rail network and doing my own thing – in fact I had remembered how much I could enjoy the journey if my focus was in the here and now and not about trying to get to the destination ASAP. I started to think of myself as being a much more adventurous person and put my skills to use in much more flexible ways.

Sadly, the kind of NHS I envisaged spending the next 25 years in isn’t there any more, and the jobs at 8C and above bear a lot of the brunt of the change by having to take on the new political and financial pressures, whilst the lower banded staff continue to do much the same work (albeit with increased pressures of throughput and whilst hot-desking). There are good services remaining, and some people will still think that is the best career option for them, and I’m glad about that as I love the NHS and want to see it survive and hopefully thrive in the future with more investment. But for me it isn’t the only option any more. There are other opportunities for adventures outside of the NHS that hang on to my core ethics and values, and put my clinical psychology skills and experiences to good use, but without some of the constraints of the NHS. I can write my own job description, choose my own working pattern and be paid for what I do, rather than on a fixed set of salary points for a set number of hours. Perhaps surprisingly to me, I’ve learnt I’ve got competencies and ideas that are useful and marketable in lots of places. Despite the austerity in the NHS, I continue to have more opportunities and offers of work than I can accept, and some of these are quite well paid. In short, I have learnt that I can actually think much more creatively about what options for my professional life will make me happy if I let go of the template of how I expected my career to be.

With that insight, I’ve got a growing desire to start afresh and do the things that have most impact and bring me most joy. That means I need to look hard at all the options in front of me, and all the plates I have been spinning, and figure out which of those I want to focus on, and which I want to pass on to other people or drop. There may also be entirely new projects that I can develop because they are interesting to me, but I can recognise a future market or source of funding for.

There is big change ahead. But my business is small and agile, I’ve got an entrepreneurial attitude, and I’m lucky enough to have some interesting offers on the horizon. I’m in a position where I can embrace the change, so I am seeing it as an opportunity.

The battle isn’t won yet: Why feminism still matters and is relevant to everyone

It is easy for me to be complacent about equal opportunities. I’ve never personally been held back by discrimination. I mean, I’ve had people think it is their right to comment about my appearance, and I’ve even had a few individuals who have bordered on stalking because of my internet presence, and my gender has certainly been a factor in that, but I’ve never not been able to do anything because I’m a women. Likewise, although I’m a second generation immigrant and my heritage is from a cultural minority, I’ve grown up as a white British atheist and have never experienced discrimination (even if there have been occasional incorrect assumptions about my religion or politics). I’ve had a broad social network, but I’ve never witnessed my friends or colleagues experience overt discrimination either.

I’ve always seen gender stereotypes as something of a challenge, in fact. I was one of three female students who did A-level physics, compared to about 50 males, and got good marks in maths and hard sciences before I went into psychology. As a student I bought a Haynes Manual and replaced the starter motor of my Vauxhall Astra along with an oil and filter change, because I couldn’t afford the quote from the garage. Likewise I have learnt all about the construction of houses, and was involved in the design and manual labour of various home improvements. I’ve been an early adopter of technology and a fan of video games as an emergent art form. And now I lift big weights at the gym, defying the gender pressure to lose fat through cardio rather than build muscle. I’ve encouraged my daughters to be brave and strong as well as kind, and to want more to the story than for the main character to marry the prince and live happily ever after.

So from my position of relative privilege it is hard not to assume that the battle for equal opportunities has already been won. However, as soon as I look a little more broadly at the world this is clearly not the case. So many different examples illustrate how my experience is the exception rather than the rule.

In the UK women on average earn 21% less than men per hour. This is the case in most of the developed world and the disparity is much worse in less developed nations. Although there has been significant progress over the last 50 years to reducing this disparity, economists admit the gender gap in wages is likely to take at least the next 100 years to close. Even in the most conservative figures, when all the variables that affect wages, such as lower experience due to career breaks and lower levels of qualifications for some population groups are taken into account, women still earn 5-10% less when equivalently skilled and doing equivalent work. In the most senior roles there are far fewer women, and those that are present earn substantially lower salaries. The earnings gap is larger as people get older, and in the higher earning percentiles of the population, suggesting that choosing to care for children does sacrifice status and earnings for the remainder of the woman’s career. These are figures I find appalling.

Thankfully there are movements and books containing advice about how to counter this effect. Cheryl Sandburg’s “Lean In” movement encourages women to take a seat at the table where big decisions are being made in big companies. The excellent “Give and Take” by Adam Grant advises people who are natural givers to advocate for their dependents when making decisions and entering salary negotiations, if they are not assertive/demanding enough when arguing for themselves. And many women and men are advocating helpfully for the value that women bring to senior positions.

In psychology and therapy professions we hit another facet of gender politics, with the dominance of women in the workforce reflecting the idea that empathy and caring are perceived by much of the public as feminine qualities. This message that facts are the male domain and feelings are the female domain is seen to be natural and innate, because of the typical division in gender roles between hunter and home maker in the origins of our species. However, since industrialisation and the invention of effective contraception, these roles seem to be transmitted more as a story based on past experience than in terms of reflecting the current reality (in which we can purchase food by selling other skills, and few of us would be very good at hunting or gathering our own food if this involved strenuous physical activity). After all, women being naturally suited to be the home-maker was ‘true’ in a time that it was also ‘true’ that the earth was flat, bathing frequently would have been seen as a wasteful fad, nobody understood the connection between hygiene/sanitation and disease, and very few people stayed alive beyond their 40s.

I believe that providing attachment relationships is probably the single most important job in society. That quality of caring about another person, and holding them in mind is essential for each of us to be happy. It is a powerful gift, whether in terms of parenting, friendship or a therapy relationship. However, I have seen no evidence that efficacy in this role is determined by gender. It may be true that in general women have slightly better ‘folk psychology’ and men have slightly better ‘folk physics’, as Simon Baron-Cohen’s research has shown, but apart from the head start that pregnancy and breast-feeding give to mothers, there is a paucity of evidence that the gender of parent who takes the primary carer role affects outcomes for children. Certainly, women feel more guilt about returning to work or choosing not to be the primary carer, but does that reflect a genuine concern about attachment security or the projections of a society where a women is supposed to ‘have it all’ in the form of balancing work, parenting and their own identity, having gained expectations of being an equal provider whilst not having handed over equal expectations of looking after home and family.

By devaluing caring and empathy for men, we lose a significant proportion of the potential workforce for psychological therapies. Those that remain often have less traditionally masculine qualities than are typical for males (whilst women who gain places in clinical psychology typically have more of the ‘masculine’ qualities of assertiveness, ambition and intelligence than are typical of their gender). We also make it unacceptable for boys and men to express their feelings openly, or to seek help for emotional problems without shame. And of course there is the wider issue of devaluing homosexuality, and through association any gentler or more feminine traits in men (for example with the playground taunt of “gay” for disliked characteristics or outcomes). This leads to lower uptake of psychological therapies or treatments for mental health problems, along with greater rates of completed suicide in young men.

More recently social media has provided a new means of networking which have been widely taken up, especially by young people. Mobile phones, text, Facebook, Twitter, chatrooms, Vine, Snapchat, Instagram, Tumblr, forums, multi-player gaming and video chat have allowed people to find those with similar interests and to communicate in new ways, but have also been media in which new forms of bullying and harassment have emerged, along with pockets of rampant prejudice including misogyny. In these contexts sexism, racism and discrimination has emerged in new forms, and some media are better at moderating this than others. Online video gaming spaces, Facebook and Twitter in particular have proved to be free playgrounds for “trolls” (those who gain enjoyment by harassing others online) due to their lack of willingness to intervene about abusive content.

There have been remarkably sad examples of what happens when such media allows the predatory minority to find vulnerable targets, such as the tragic story of Amanda Todd, the teenage girl who was encouraged to flash over webcam and then blackmailed with these images by an adult man until the point she committed suicide. There was also the disturbing video manifesto of Elliot Rodgers, a college student who killed 6 and injured 13 before committing suicide due to the perceived injustice of him not being as attractive to girls as he felt he deserved to be.

In amongst the array of content on the internet a subculture has developed that is profoundly sexist and has disturbing ideas about how to “play the game” in ways that “put women in their place”. Some of the members identify as Pick-Up Artists (PUAs) or Mens Rights Activists (MRAs), but the idea that women now hold too much power, and that men have seized upon feminist and progressive thinking to impress women, seems to be a common strand. There is great anger from members of these groups against men who speak up for women’s issues or social issues more broadly, who are often disparagingly labelled “White Knights” or “Social Justice Warriors” (terms which are intended as insults, despite sounding pretty awesome). Many women have learned to use gender-neutral names on social media, and not to speak when playing multi-player online video games, rather than to risk the onslaught of comments, which range from “get back in the kitchen” to violent threats of rape and murder of them and their loved ones (especially when defeated by the superior skill of a female player).

The latest iteration of this undercurrent has been the harassment of women who have highlighted the sexist tropes within video games, or otherwise become a figurehead of progressive thinking within that culture. Anita Sarkeesian’s highly accessible video series “Tropes vs Women in Video Games” has been a focal point. When her Kickstarter attracted death threats, harassments and attempts to discredit and silence her the community spoke out by massively over-funding her project and giving it a much bigger audience. However, she has continued to be subject to a variety of death and rape threats for merely casting a light on the fact that a small percentage of the content of many popular video games is a set of tired old tropes in which women are the decoration, damsel to be rescued, or die as motivation for the hero’s vengeance, rather than the protagonist of the story. Likewise a bitter ex-boyfriend’s rant about female developer Zoe Quinn led her to be a target of harassment (with a thin veneer of concern about ethics in games journalism that was not evidenced by similar hounding of the journalists who were wrongly alleged to have given favourable write-ups of her work due to personal relationships with her) and games writer Brianna Wu, for writing an article saying that the old stereotype of a gamer has been superseded by a much wider demographic (perceived as a “death threat” to “true gamers”). In each example, the profound sexism of the antagonists is evident, and the impact on the target has included them needing to move out of their homes due to the severity of threats to their safety, after their identifying information has been discovered and released into the public domain (a harassment tactic know as doxxing).

So whilst I observe from the safe space of being a successful female professional, who to date has had very limited personal experience of sexism, I am reminded that feminism is far from being a battle that has already been won, and equality is far from ubiquitous in the hearts and minds of the whole population. The internet has always been a great leveller, by forcing us to judge people on their words and not on their gender, age, ethnicity, sexuality, disability or any other aspect of their physical self, and I think that is an amazing thing and as close to a meritocracy as we will ever experience. So I am saddened by the resurgence of such hate and vitriol into places where these variables shouldn’t even be relevant, and that there are now seemingly topics about which women cannot write without fear of a personal backlash. It shames me that I have a little bit of fear about the repercussions each time I express an opinion online through this blog, or twitter or my forays towards podcasts/videos. We all need to do our little bit to change this, to speak up for equality and against harassment, and to reclaim those spaces in which prejudice is showing – for the benefit of everyone.

High on scare, low on science: a tale of charity, politics and dodgy neuroscience

In 2011 when I took a voluntary redundancy from the NHS I was asked to help set up a parenting charity* focusing on the period from conception to age 2. I agreed to be the founding Clinical Director and to help them set policies, sort out pathways of treatment and recruit staff. I worked for them one day per week. After less than six months it was clear that there was a divergence between what I felt was most clinically helpful to say about supporting parents in this critical period and the primary goals of the charity**. This was particularly evident in what was being said to promote the launch event of the charity. The title of the launch conference was the dramatic and pessimistic pronouncement, “Two is too late”. This title was cast in stone despite my repeated protests that parents would feel blamed and might think that there was nothing they could do beyond the age of two if they had not had a perfect attachment relationship before this point (when the evidence suggests that there are in fact many effective strategies for enhancing attachment relationships beyond this point, and many therapies for helping children and even adults to learn to emotionally regulate, mentalise and have successful relationships, even where there has been poor attachments, neglect or maltreatment).

The media were given soundbites to promote the event that suggested a baby is born with only one third of their brain active, and the rest relies on the quality of parenting received to grow. The news coverage in the Telegraph*** said that “a failure to help troubled mothers bond with their babies can stunt the development of the children’s brains”. The BBC coverage*** stated “a growing body of research suggests that the amount a baby is loved in the first few months of its life determines to a large extent its future chances” (when love and the quality of the attachment a parent is able to provide are quite different things, the most critical period is usually cited as 6-18 months of age, and the change in prognosis is most impacted by significant maltreatment).

Although our tiny pilot had kept 5 children out of 6 at home with parents successfully, despite them being referred on the edge of care, I had some misgivings about the marketing messages. We had feedback from service users and user groups that they felt stigmatised by some of these messages, but the organisation was unwilling to hear that. I am passionate about the value of improving attachment relationships and I had written a brief literature review on the impact of poor early care to ensure that the project was informed by the evidence. I was also writing a book about attachment and the impact of maltreatment, but I couldn’t match my views up with the politics of the organisation. I felt that to stay would conflict with my professional ethics, and my desire to honour the evidence base and respect the people who needed the service, so I quit before the launch. My colleague decided it would be unsafe to practise in my absence and left at the same time, leaving the charity with no clinical staff. Nonetheless, they decided to make a very big launch event, that I could only describe as one third professional conference, one third stately home wedding and one third party political broadcast for the blue party. It sold 500 tickets to health professionals and other interested parties, and I went along to see the show.

The speakers included a Conservative Peer, Ian Duncan Smith and Andrea Leadsom, along with Dr Amanda Jones (who shared a case study of parent infant psychotherapy). The fantastic Camilla Batmanghelidjh was also present (and made a good job of challenging the lack of empathy from politicians for the people they serve and quipping that this reflects their avoidant attachment styles). I had invited Dr Michael Galbraith (a Consultant Clinical Psychologist who has run community children’s services in Liverpool for many years) to talk about the health economics of early intervention. He did so persuasively and he also challenged the politics that came before his talk (with genuine zeal, as his entire service had been closed in a cost-saving ‘reorganisation’ a few weeks prior to the conference). But the biggest draw was that Baroness Susan Greenfield was invited to talk about the epigenetic effects of early attachment experience on the infant’s developing brain****. As I had not heard of her work prior to this event I was intrigued.

The talk that Prof Greenfield gave was baffling from the off. It massively overran her time-slot, and the program was rearranged to give her a second slot in the afternoon to complete what she wanted to say. My recollection was of a chaotic set of shock images and headlines, with provocative statements which appeared to contradict my knowledge of the literature, despite the fact she claimed they were scientifically founded in hard neuroscience research. Thankfully the pdf of the PowerPoint she used was circulated after the event, so you can see the content for yourself (zip file to download here).

Her title was “The mind of the 21st Century Infant” overlaid on a stock photograph of a baby using a computer. She immediately moved on to dramatic images of a youth celebrating in front of a fire during the recent riots, blaming the riots on the lack of attachment young people have grown up with, which she said had been replaced by technology. She then showed scary images of “artificial intelligence” before trying to define the mind. Then she made a knight’s move to demonstrate that “environment trumps genes” through a single study of rats given genes that cause Huntingdon’s Chorea which had less symptoms if they lived in a more stimulating environment. Then back to human babies, and images of how neurones proliferate during the first 2 years of life. Then a study showing that the Hippocampi of taxi drivers are enhanced, and then some blobs designed to indicate that mental practise of piano also activates the brain like physical practise. Then back to rats, showing more neural connections in a richer environment than when rats are isolated in boring cages. Then a description of how the mind shifts during development, from sensory processing to cognitive experience and gives greater meaning over time, with the view this is driven by experience.

She then claimed the mind might be “changing in unprecedented ways” due to interaction with technology, and showed alarming headlines circled in red, and book titles reflecting her view that internet use is changing our brains.

Prof Greenfield then showed a study counting children’s hours of screen time reported by parents, according to the child’s age. The source cited turns out to be a report saying that children have always used whatever media is current, mostly watching TV (which has been on for 7 hours per day since the 1970s) and although digital media is rapidly proliferating including learning toys, music and phones, total media use by white children had only increased by 38 minutes between 2004 and 2010, though it was more prevalent in low income families and had increased more in BME families. It states there is no evidence yet about how much is too much when it comes to media consumption but states that “media platforms by themselves are neutral; what matters most are the choices made by parents, educators, educational production companies, and other content providers in order to encourage a balanced pattern of consumption” using the metaphor of needing a balanced diet. This was not reflected in Prof Greenfield’s narrative about this amount of media being harmful, and it is unclear how she extrapolated the figures in her table.

Another leap, and we were onto how dopamine is the reward chemical and behind all addictive behaviour. Prof Greenfield said that it changes neural activity, inhibiting the frontal lobes. This is why children are becoming fat, sedentary and obsessed with technology. They are all addictions, and disrupt our frontal functioning. Then a leap to schizophrenia not having sufficient frontal lobe activity, and reverting the brain to sensory processing which is fragmented and without meaning. Another slide full of brains: The prefrontal cortex is not mature until your 20s. Then a claim that schizophrenia, gambling, over-use of screen technology and over-eating have a common pattern of prioritising our senses over reason, due to dopamine making us mindless rather than able to synthesise meaning. It felt very alarming to have schizophrenia and addictions linked to the same pathways as attachment difficulties and technology use. The implication was that parents could cause these difficulties in how they parented babies, or by allowing children to use digital media. These are claims for which I have never read any scientific evidence, despite being a clinician working in this area and trying to keep abreast of the research literature.

Another leap to social media and how it makes us “alone together”. Prof Greenfield told us how real communication is three dimensional, and little of the meaning is conveyed in the words, whilst 90% is in eye contact, body language, tone of voice, perhaps even touch and pheromones. But online we have only the words. According to her, this is why empathy has dropped over the last 30 years (another newspaper headline, not a scientific study, and with no reflection on the socio-political changes that might explain this). The lack of empathy required is why people with autism are so at home with technology and on the internet. People also have reduced identity, so they have to record their existence online. Prof Greenfield characterised the development of online communication as going from describing your cat sneezing on Blogger, to putting up a photo on Flickr, to a video on YouTube, to live Tweeting the action, saying that such activities reflected the author as a disconnected “nobody” who needs to prove they exist. She postulated that a rise in social networking is the cause of reduced empathy and people having a less robust identity, but it seems to me that even if these two things co-occur the direction of causality could be the reverse.

She then skipped on to the evils of video games, inserting a slide with MRI scans to show reduced listening when looking at something else, before blaming video games for the increase in methylphenidate prescriptions. Prof Greenfield claimed ADHD could be caused by video games because they lead to “fragmented attention, shorter attention span and increased recklessness” because they activate the dopamine system. Another headline in a red circle saying children who love video games have “brains like gamblers”. Then she showed us her own work bringing this together: a proposed cycle of how the intense stimulation and immediate feedback lead to high arousal and dopamine release, reward seeking behaviour and this makes brain changes which cause “conditions of childhood, schizophrenia, obesity” and a drive for sensation over cognition increasing the appeal of screen based stimulation in a continuous cycle. Again, I don’t believe any of these claims have appeared in peer reviewed publications or have any evidence to substantiate them, and even if there was evidence of co-occurrence the direction of causality is far from certain. There is however a growing body of evidence that some symptoms that could be interpreted as ADHD-like are caused by early trauma and maltreatment having an impact on neural development. To end that section, Prof Greenfield juxtaposed the “mindless” brain slide with a shot of World of Warcraft and mocked the lifestyle she believed was typical of those who play the game.

Then Prof Greenfield turned her attention to search engines, claiming they give fragmented information but nothing about meaning. By way of example she claimed that you can’t possibly understand what honour is from the search engine results produced by that term. Again, she claimed digital media is all fragmented content, lacking metaphor, depth and meaning. She strongly asserted that nobody could care about a character in a video game like you care about characters in a novel. Again, I would disagree with this. Like any media, video games are very diverse in style and quality and you pick ones that fit your taste, just as you would with a book or a film. If you don’t like violence, don’t pick a violent one. You don’t have the same expectations for the latest chick lit/flick as you do a weighty classic. Some examples are also of better quality than others, some focus on special effects over plot, others are low budget and whimsical. In my opinion if you feel immersed and the story is told well it feels like time well spent and you care about the characters and outcomes, whether the media is a video game, a book or a film. Its disingenuous of her to pick a random game she has probably never played and say nobody could care about a character in it as much as one in War and Peace.

Prof Greenfield then talked a little about the benefits for children of reading with a parent, and how we need to “make up our own minds”. She finished by advertising her books, and claiming that “mind change is the new climate change, the biggest issue facing us in the 21st century”. I’d share the comments on this claim raised here.

The whole felt to me like a mishmash of pseudoscience, headlines and speculation that didn’t even address the topic of the conference. Even if there was persuasive scientific research about the impact of using digital media (which I wasn’t persuaded), it wasn’t relevant to the conference as babies don’t use it. Her talk wasn’t about the importance of relationships between conception and two, which was what the conference was designed to highlight. She had come with a single agenda to sell. And it was clear that she was very much an outsider looking in when it comes to technology; judging it with minimal knowledge of social media, the internet, or video games.

As someone fairly immersed in that world, I could pick out numerous examples of violence in TV, film and video games, particularly violence against women and children. I might even be able to make a prima facie case that we are being desensitised to human suffering (and violence and sexism is being normalised). It is possible that the manufacturers of such products are buying into various ‘exciting’ neurochemical pathways that deal with arousal and reward (cortisol, adrenalin, dopamine), over those that deal with relationships, empathy, love and the ability to soothe (oxytocin and the work of the prefrontal cortex). But I think Susan Greenfield is making a huge correlation-causality error when she blames new media for people becoming isolated and lacking social skills and healthy relationships. I think there is much more evidence that real life experiences of maltreatment prime certain brain changes that make people more sensitive to later triggers and confer vulnerability for later mental health problems (see the work of Prof Eamon McCrory, for example) than that digital media is the cause of the problem.

I do think that if people lack templates for how to do real relationships in a healthy way, and haven’t learnt empathy and self-soothing skills, then these kind of media have a stronger attraction and a different effect on their brain, and can perpetuate rather than ameliorate this pattern. However, in the end I figure that people can always fill their time with something that disconnects them from others, or anaesthetises their pain. In other words, it isn’t the availability of the internet or video games that is the problem (any more than the presence of cheap alcohol, or drugs), it is the unhappiness and isolation that creates the void people want to fill with those things. And that has much more complex solutions, though it might generate less click-bait headlines.

* It is now nearly 3 years on, and I am confident that the clinicians recruited after I left have been able to establish a high quality service, so I would not wish to imply any concern about the services they provide.

** I felt, cynically perhaps, that there was a second agenda designed to promote the MP who founded the project and her political party which was of more importance than our clinical goals, although this was never explicit.

*** http://www.telegraph.co.uk/women/mother-tongue/familyvideo/9273569/New-post-natal-depression-charity-will-address-huge-gap-in-provision.html

http://www.bbc.co.uk/news/uk-england-northamptonshire-18117945

****The promotional flyer for the event said “We are honoured to announce that Baroness Susan Greenfield, Professor of Synaptic Pharmacology at Oxford University, whose speciality is physiology of the brain will bring you up to date on the Science, Neuroscience and Epigenetics”.