Why and what next?

Let me nail my colours to the mast. On balance, I am in favour of remaining in the EU, and in the USA I’d have voted for Hillary Clinton. I can see some problems with each of these positions, but I can see many many more problems with the option that has actually been chosen. In each case my pros and cons list strongly favoured the progressive choice, because of the potential negative consequences of the other option. But I was in the minority in both cases, and so were half of the electorate (maybe more in the case of Clinton). So rather than just be fed up about that, I want to understand it.

When it comes to Brexit I think it is wrong for the UK to leave the EU for a number of reasons. The unity of many nations ensures that we all maintain basic human rights and the fair rule of law. It prevents the rise of extremists and reduces the risk of international conflict. It was a large single market, and am important strategic alliance. I believe that calling the referendum was a foolish whim from a complacent leader who was too cowardly to face the consequences of his actions. It was supported by xenophobic self-serving politicians and by far-too-influential media moguls with a right wing agenda. I think it has been divisive and stoked xenophobia, as well as causing enormous economic fallout. However, I’m not saying that the EU doesn’t have excessive bureaucracy, or that it hasn’t been excessively harsh on southern European nations like Greece, Portugal and Italy, or that it doesn’t enshrine market capitalism in doctrine.

Likewise I think Donald Trump is a repugnant man whose attitudes to women and minorities are repulsive. He is a sex pest and a tax avoider. His business practices are dishonest, he is a blatant liar and his much touted business acumen is such that he would be three times as rich if he’d just stuck his inheritance into index funds. I find his racist rhetoric abhorrent, and I think he will foster international conflict and unhealthy alliances. So I could never vote for him, and would have voted strategically to avoid him reaching power. However, in choosing Clinton as the lesser of two evils I’m not saying that she doesn’t have vested interests, didn’t support arms sales to the middle east, isn’t associated with numerous scandals or wasn’t stupid to use a private server for her email. In fact I think Obama was right to sum her up in 2008 as someone who would “say anything and change nothing”. If she was running against a more palatable candidate who genuinely supported progressive ideals, I’d be advocating against her. I’m just saying that the idea that Trump could be president was even worse.

In both cases, it was a two horse race, and although I didn’t love either option I felt that one was clearly preferable to the other. That says something about modern politics – that we are voting for the least terrible option, rather than in favour of something we truly believe in. And I want to think a little more about why this is the case. I also want to think a little bit more here about why the results in both these votes went against the polls and against the incumbent business-as-usual candidate, and why the results have been so divisive and triggered such hateful behaviour from segments of the population.

So why did people vote for Brexit and for Trump? It seems that a number of factors contributed. Firstly there were demographic factors – these regressive options particularly appealed to white men and their wives, in areas that have been hit by economic recession. They tapped into a sense that the world is changing and they are being left behind. There was also a real desire for change, not just more of the same select few in the top one percent making all the decisions. The less people feel they have to lose, the more they are willing to gamble that any form of change will be an improvement. Trump carefully marketed himself as an outsider and a voice for change, but that is a carefully designed misrepresentation. It is also contradictory to his simultaneous positioning of himself as a tax-evader and shrewd businessman who is successful and super rich. In reality his businesses face a constant stream of lawsuits for not honouring contracts or dealing with people fairly and it is clear he is out for nobody’s interests but his own. He also has vested interests and hidden agendas all over the place, but this is something we now take as a given for politicians. So how can he connect with the man on the street more than other politicians? The answer seems to be by bucking convention, appealing to the desire for change and speaking in much more simple terms, as well as appealing to fear and self-preservation (some of which sadly overlapped with racism, sexism and homophobia).

Being wealthy and embedded in the establishment is something that also describes the majority of British politicians. Nigel Farage, for example, similarly markets himself as an everyman who always has a pint in his hand, but in reality is a privately educated millionaire ex-banker who claims every EU allowance possible for himself and his German wife, who he employs as his secretary. Cameron led a cabinet of millionaires, and May is herself a millionaire with a network of wealthy donors and has placed even richer men like Philip Hammond and Boris Johnson into her cabinet whilst claiming she will build a fairer Britain that “works for everyone”. They have no idea about the experiences of people who survive on minimum wages or benefits, but they have learnt to talk as if they care, whilst their actions clearly indicate the opposite. And so we have reached a position that everyone in politics is saying much the same things, and nobody appears to be sincere.

One of the big issues of the reaction to the American presidential election result, and to Brexit, is in how we think of ourselves and our fellow voters. It is all too easy to make sweeping brushstrokes about ignorant, selfish, racists. But I’m not convinced that there is as much difference between us as these dichotomous choices imply. Whilst there are some vocal and visible extremists who identify as Brexiteers or Trump supporters, the message clearly resonated with a lot of people in the middle ground who don’t identify with the racist or sexist undertones, but also don’t identify with the current power structure. I suspect a lot of people are fed up with the status quo, and feeling disenfranchised by the current political system. And maybe that has motivated a lot of people to vote for candidates who seem to be anti-establishment, straight-talking and authentic. This Jonathan Pie sketch, which is full of swearing and therefore NSFW, is worth watching.

I can’t say that a desire for change and for authenticity over spin is a bad thing. In fact having sincere politicians who mean what they say and are not motivated by self-interest or masking their true agenda is something that has been sorely lacking in the political arena over the last decade. Likewise a willingness to explore more radical change is something that I would want myself and a lot of more progressive people would support. But in the absence of such messages from the left and centre of the political spectrum, it has instead been harnessed by questionable individuals and causes. And voters have been sufficiently enticed by this message that they have been willing to disregard all of the bile it comes packaged with, a task made easier because it is addressed to groups outside of the main voting demographic. In response the progressive candidate is left to defend these minorities, and ends up looking like they care little for the main group. The regressive candidates and policies make more headlines, perhaps because of bias in the media and lies that have not been sufficiently challenged. Other parties and messages appear reactive, and end up fuelling that discussion rather than presenting their own position.

The more progressive candidates and causes need to work out how to tap into that feeling of disconnection with the establishment and the increasing desire for radical change. If they can do so with policies that will genuinely benefit those who are being left behind in the current austerity politics then they can avert the swing to the right. That will take the right mixture of passion and authenticity, a willingness to be plain spoken about who is to blame for problems, and a push for greater accountability for political claims.

So where now? First, I think we need to learn from our mistakes and not be complacent that progressive politics are now the default position. We need a return to politicians that mean what they say, and speak with authenticity and passion. We need people who get fired up about the issues and speak from the heart, rather than with spin and polish that hide vested interests.

Second, we need to explain that the same few people have all the power and are increasingly gathering the wealth away from everyone else, and to show the economic value of being kind to the more vulnerable sectors of the population. We need to demonstrate that the threat comes from above (the rich and powerful people who control the media and the corporate and private interests that have powerful lobbies that manipulate our political system) not below (immigrants, benefit claimants, people in minority groups). We need to name the organisations and individuals who are spreading hate and cheating the man on the street by avoiding paying their fair share of tax, and turn the rhetoric of blame to more appropriate targets.

Third, we need to show that the system is rigged to support the establishment, and needs to be overhauled. That may mean setting fair boundaries and catchments to prevent gerrymandering, preventing conflicts of interest and restricting lobbying, looking at the terms and roles for nominated unelected officials (eg striking out members of the house of Lords that are not actively involved in political debate) and/or changing the first-past-the-post system.

Fourth, we must hold people and organisations to account for their lies and false claims. We must give consequences for propaganda, misinformation and promises that are not fulfilled. We need to hold politicians to account for the claims that they make, and ensure that they cannot benefit from lies and deception.

Fifth, we must do much more work to engage those who are feeling disenfranchised, rather than excluding them because they have turned their resentment to the wrong place and are being selfish/xenophobic etc. We need to explain the issues, using short clear soundbites rather than long intellectual explanations whenever possible, so that these can be accessible to a wide audience and shared over social media. We need to be down to earth and not make assumptions about underlying knowledge or values. We need to understand that many people are feeling excluded and shamed for not sharing progressive values, and reach out to them starting with empathy for their current situation, their hopes and fears.

But finally, and most importantly, we need to continue to educate our children to be better than the generations that came before them. We can teach kids to care about each other, the environment and social issues and to not discriminate by gender, race, sexuality etc. We need to help them to become critical thinkers who can evaluate what people say and don’t just accept a lie as the truth. Then over time, the population will change, and progress will continue beyond what seems possible in the present.

I can see that right now it seems overwhelmingly sad and frustrating and many people don’t know what to do with those feelings. This negative focus and tendency to turn towards anger and fear is not surprising. We are sensitive to threat, and fear impedes our ability to use empathy and rational analysis. Our brains are programmed to look at immediate risk and the local picture. We are sensitive to potential threats and we easily catastrophise and generate worst case scenarios. We find it hard to conceptualise the bigger picture as this involves timescales outside our own lifetimes, and populations we have never met and can hardly imagine. But my real hope is in the inexorable march towards progress that is happening over the last century around the world. So whilst we seem to have taken a depressing step backwards it is good to remember that progress is often two steps forward one step back.

There has always been a pattern of economic booms and busts, political cycles including changes that seem awful, and international conflicts that kill hundreds of thousands and displace millions. When we focus on these negatives, it feels pessimistic and makes us worry it is all downhill from here. Like a panic attack, we see worst case scenarios and look for escape, rather than realising we can work through it. But over human history we have rebounded from all of these things before, and the same problems have been around before only bigger. For all his hateful rhetoric, Trump isn’t Hitler. Although he is set to enact policies that are homophobic and xenophobic, he has already backed away from some of his more extreme claims, and even in a worst case scenario he won’t kill millions of people. And like with May as Prime Minister here, things will continue much like normal for most people. I’m not dismissing the horrible impact of the rise in prejudice against various minority groups, or the risk of repealing some rights, but in the bigger picture they are temporary and against the overall direction of travel.

When we look at the wider view, the future seems much more optimistic. Science continues to make new discoveries that enhance our health, reduce energy consumption, deal with environmental issues and better understand our place in the universe. Technology and access to information and media are allowing people all round the world to access information and different perspectives. Life expectancy has increased remarkably (even in the face of increasing obesity bringing a rise in diabetes and heart disease, and austerity politics increasing mental health problems and suicides). Smoking is declining. Cancer treatment is more effective. Deaths from road traffic accidents are steadily falling. Even HIV is now treatable and prophylactic medication is available. Despite the constant headlines that make us feel otherwise, deaths from homicides have fallen over time in Europe and wavered and then fallen in the USA. Deaths from wars have massively decreased over time, and even the horrible events in Syria, Afghanistan and Iraq are of a smaller scale than previous international conflicts. More and more nations have democracy, women’s rights, gay rights, access to justice and protection of human rights. I believe that the future for humanity is one of steady progress with temporary set-backs. And we should never forget that from enough distance we are just a pale blue dot.

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”.

Hiding in plain sight: On Louis Theroux and Jimmy Savile

I watched the Louis Theroux documentary on Jimmy Savile tonight, and I wondered why it wasn’t obvious to Louis how slimy and two-faced Jimmy was. It stood out for me from the original documentary, let alone from the rushes shown in the update, how clear it was that he was inappropriate about personal space and made a number of particular types of comments – normalising sexual content, implying connections to power and influence, and schmoozing/bestowing favour – that I associate with people who sexually abuse children that I have met through work. He also behaved differently when he wasn’t on show, and was with someone he didn’t perceive as having influence, in the unguarded footage shot by the producer late at night. I’ve learnt to take note of that too, from bitter experience.

It reminded me that my initial gut reaction to the original documentary was “ugh, my sense of him being creepy as a kid was right – it appears he has a sexual interest in children, and from the way he talks about enjoying his time with her body it seems likely he had sex with his mother’s corpse”. Yet that response at the time was unspeakable, except to my husband. After all, you can’t just say someone is a criminal, a necrophiliac, an abuser and a risk to children without proof and based purely on second hand information. That would be inappropriate, and potentially defamatory, particularly for a professional.

But Louis was there with Savile and heard his entirely unsatisfactory responses to questions, his jokes and inappropriate behaviour, saw his invasion of people’s personal space, heard him made threats to sue and name drop his connections to both establishment and underworld power. Yet, despite being an intelligent guy with suspicions about Savile, Theroux’s reaction wasn’t one of repulsion and scepticism. He was won over by Savile’s charm, and carried along by the fiction Savile had created that he was some odd relic of the 70s with his own rules not quite being in sync with the present overly PC world, and being inappropriate was harmless and par for the course. He probably felt flattered by the attention, and tantalisingly close to being the confidant that would get the big scoop when Jimmy was ready to tell his story. But he stopped being a critical observer and started to consider him a friend, and was present when he continued to behave in inappropriate ways and failed to remark on it. And that shows how easily it is done.

Because if it is your mate, and they just go one step further than you are comfortable about as if that is perfectly normal, then perhaps that is just the way that they are, and you can start thinking that maybe they are too old and odd to have to conform to social norms. And once you start to think that, your own boundaries shift and you become complicit. Something you would instantly baulk at from a stranger, is somehow normalised. You turn a blind eye without realising you have done so. Louis said that he didn’t feel he had been groomed, but I think he was wrong. Sure, he hadn’t been targeted as a potential victim of Savile’s sexual advances, but he had been drip-fed the self-crafted story of the harmless oddball doing so many wonderful things for charity. And he had been slowly habituated to be complicit in accepting the small infringements into the unacceptable, the misogyny, the recurrent sexualised content of his interactions, the invasions of personal space. And he tolerated the evasion, the flattery, the name-dropping, the sinister undertones as part of the special relationship they had developed. And that, to me, is grooming.

I’m not implying Louis is to blame for that. He has shown his intelligence, empathy and insight in other documentaries, so my expectations are high. But it is easy to be groomed. By definition, recurrent sexual abusers who have not been caught are devious and effective in fooling those around them. Plus Savile had a lifetime of practise and an enormous reputation and network to carry him. Nonetheless, I can see why Louis has been looking back and wondering what he should have noticed. I’ve been there and done that.

The first child sex abuser that fooled me (that I know of) was more than 15 years ago now*. He shook my hand, spoke politely, seemed to have a benevolent interest in the wellbeing of the children in the family and always agreed with what the professionals said. He was well educated, middle class, and married with adult children. He was the one who reported concerns about the grandchild who was referred, and was critical of the parents. The child was developmentally delayed, but also underweight and unkempt, with no sense of personal space. In retrospect, I can see that this idealised grandfather was remarkably unsympathetic to his daughter, whose lifestyle of alcoholism and domestic violence punctuated with inpatient stays after self-harm didn’t match up with the facade of happy families he portrayed. But at the time he seemed very concerned about the wellbeing of the child. The receptionist took me aside to mention that he spoke to his wife “like a dog” in the waiting room, but turned on the charm in the presence of clinicians. I didn’t even make a note in the file. I only remembered the comment 6 months later when the social worker said to a case conference that just prior to proceedings to move the child to the residence of these grandparents, the mother had disclosed childhood sexual abuse from her father, along with sadistic punishments like having her hands held against the hot oven door if she didn’t do as she was told quickly enough. This had then been corroborated by another family member, and her records showed the school had reported the burns to her hands. The child was placed in foster care instead.

I remember how stupid I felt. The clues were right there in front of me. The child was vulnerable to abuse, and the developmental delay and unusual behaviour with no sign of organic cause showed that something was going wrong in their life. But it was too easy to attribute it all to the ‘bad’ parents and not the ‘good’ grandparents, falling into the polarised thinking of the family, despite normally having more nuanced formulations. The mother’s story didn’t match the grandparents, and her lifestyle didn’t fit with their descriptions of her upbringing, but she had been branded an unreliable reporter. So why did someone from such a happy middle class home get into such a mess? The answer was given to me on a plate – she had fallen into a bad crowd as a teenager, and ended up drinking and in a destructive relationship – so I didn’t look at other contributory factors. It wasn’t my job to pry, I was just doing a developmental assessment of the child. Yet I know that severely troubled adults have rarely had idyllic childhoods, and have often experienced multiple adverse childhood events, and that attachment styles are often carried through the generations. Likewise I know that trying to charm professionals can be a warning sign, but nonetheless numerous small compliments on your insight, empathy and skill as a clinician can flatter your ego without being so excessive as to raise a red flag. And the receptionist’s comments were given outside of the clinic room, and whilst I didn’t have the file open to take notes. Plus she wasn’t a clinician and may not have heard the full context of the comment, so the team didn’t give it much credence.

Thankfully, the disclosure came in time to protect the child from being placed with someone with a history of abusing children, but it wasn’t thanks to my skill as a clinician. Sure, I was quite early in my career and still quite naive, but I suspect most clinicians think we have uniquely sensitive radar to pick up on abuse and abusers. Sadly, we don’t. Whilst we might not rely on the stereotypes that the public are fed, of dirty old men in trench coats exposing themselves at the park, or strangers trying to tempt children into their car with sweets or puppies, I do think we have some internal stereotypes. The abusers that are easily caught are often socially gauche, lower in intellectual ability and/or socioeconomic status, and we tend to think of men who are unsuccessful in adult relationships and are prolific and opportunistic in their offending, but abusers are a highly heterogeneous group. Few have overt mental health problems, some may appear to be morally upstanding citizens, some are female, they come from all walks of life, cultures and religions, they may have functional adult relationships, and most are known to the child. about a quarter of perpetrators are under the age of 18. The majority of abusers have a single victim or a small number within their immediate network. A tiny minority with a primary inclination towards children are prolific abusers like Savile, but the damage is so wide ranging and the cases more newsworthy and memorable, which is why people are more aware of them. So there is no clear alarm bell, apart from the inappropriate interest in or behaviour towards children itself, the presence of child pornography, or sexualised behaviour or disclosures from the child.

In hindsight, it is easy to recognise signs you may have missed, and if you know there is a history of sexual offences against children certain behaviours show in a different light. And I have learnt to be both more observant and more wary. Those flirtatious comments to the receptionist, or the attempts to find common ground with or flatter the assessing clinician stand out, just like the cringe-inducing examples of Savile’s behaviour we saw in the edited highlights from the rushes that Theroux had of his time with Savile. We can only hope that we learn from experience and aren’t so easily fooled next time.

*all case details have been suitably anonymised

Everyday madness

Do you ever get days where you look at a chair, and then say the word “chair” to yourself and wonder how those things can be connected, the object and some random sound we make with our mouths? Or you are driving down the motorway and suddenly think “I’m propelling myself along in a metal box in some arbitrary location on a big blue sphere that is in itself a tiny arbitrary point floating in a massive pattern of spheres that make up the universe” and then wonder why it is we’ve developed such a complicated and unequal society that fills all its time with busy work in the pursuit of status and possessions? I do. I’m pretty sure lots of other people do to. But I’m not sure I’ve ever checked. It isn’t an easy conversation to start as our thoughts are so subjective that there is always the possibility that explaining them to someone else they would just assume we were a bit crazy, whether in the informal lay use of the word, or in a mental health setting as being symptoms of disordered thinking. So what is normal and what isn’t?

Do you ever feel a compulsion not to tread on the cracks in the pavement, or to salute a magpie to ward off bad luck? Do you feel a sort of temptation to set off fire alarms, pull the emergency stop on trains, or open the emergency exit on planes? Do you feel a compulsion to reply to your satnav? Do you ever lie in bed wondering if you locked up for the night? Do you ever go back to check if you locked the door or turned off the cooker or your hair straighteners after you’ve left the house, or phone home to hear the answerphone to be sure the house is still standing? Do you get transitory urges to drive off the road, or into pedestrians or obstacles? Or to jump in front of trains or traffic? Or to throw your keys or phone off a bridge or out a window? Or have a transient desire to do something shocking like swear in church, laugh at a funeral, flash at your boss, stab someone when you are holding a knife, throw your drink in someone’s face? Get images of the harm or death of a loved one? Or unwanted thoughts about sex? If you do, you are far from alone as these are commonly experienced intrusive thoughts that are reported by 90% of the population.

When we had a thread about normalising unusual thoughts, members of the forum gave even more random examples. One person didn’t like the way sunflowers looked at her and once threw her chips at one and ran away laughing. One person heard music coming out of the back of her head, whilst another heard the doorbell repeatedly ring. Another person warns her husband that she might have an urge to kill him during the night. One person can’t shake the idea that cows are just playing dumb and have been gossiping about her before she arrives and will continue when she leaves. One imagines flying insects are like dirty old men rubbing their hands on their thighs. Another sometimes has to put her hands out in front of her to check for glass doors she hasn’t seen when walking down the pavement. Many report urges to do cartwheels, handstands or forward rolls at work or in public. One constantly made bets with the devil in his head in which the wager was years of life-expectancy. One shouts obscenities loudly into the wind whilst cycling along. Quite a few of us anthropomorphise inanimate objects, from imbuing toys with personalities, to feeling sorry for dented tins, weak seedlings, or the families of insects we kill.

Three people feared seeing dead bodies when opening toilet cubicles, and one would imagine worst case scenarios like people dying in fires. One had the sense a person was standing next to them that they could catch glimpses of out of the corner of their eye. One asks ghosts to disappear before turning on the the lights if she returns home after dark. One can’t look in the mirror in case something comes out and eats her, and quite a few can’t look out of windows after dark. Several adults are afraid of monsters under the stairs or bed, or snipers/wasps hiding in low windows. And many people have particular rules about counting or numbers, such as wanting the volume to be on an even number or a multiple of five. Many people have strong desires for neatness or order, including one with a desire to tuck in other people’s clothing labels if they are visible.

Three people report that “If I’m somewhere important where my phone really does need to be on silent I wont just turn it to silent mode. I don’t trust it. I’ll turn it off completely, take the battery out and store the battery and the phone is separate compartments of my handbag. Just in case the battery decides to be sneaky, ‘falls’ into the phone, the phone switches itself on, turns to loud mode and horror of horrors – rings”. A fellow clinical psychologist explained that as a child “I wouldn’t look through a dark window once I was in bed, as I believed that we were experiments/pets and that the world got rolled up when we were asleep for cleaning, and that if any of us pets/subjects found out about it we would be removed from the world/pet enclosure/experiment”. Another was convinced he had telekinesis and could make his lampshade rock from side to side.

And then there are numerous sensory distortions. Some people reported feeling their time was going faster or slower than the rest of the world, or feeling like they were very small or large compared to usual. Quite a few people reported synaesthesia (sensations from other modalities, like seeing the months of the year as having a shape, or letters as having colours). Many people get “earworms” where particular pieces of music play repeatedly in their heads at certain times. Some have a continuous internal radio station of music, which they walk, chew or tap along to.

Personally, I get what I used to call “sicky vision” as a kid. If I have even a mild fever I don’t like the textures of certain things, so wallpaper with vertical bits of string or wood-chip can look ‘itchy’ or things that are crinkled can look ‘spiky’. I don’t really quite have words for it, but they become uncomfortable/stressful to look at. It is an exaggeration of the trypophobia I get at other times (an exaggerated disgust sensation from looking at organic holes – but please don’t google it unless you have no problems with disgust at all, as you may also get an unexpectedly strong reaction). As a result I struggle with the appearance/feel of my own intermittent and fairly mild pompholyx eczema, and when I had to put ointment on my children and husband’s extreme outbreak of chickenpox a few years ago I could see/feel the texture every time I shut my eyes for weeks, and it even prevented me from reading text comfortably as it would distort into bobbles!

So what is it that distinguishes all of these odd thoughts, compulsions or sensory distortions from those which get labelled as psychosis or OCD? I think there are a few distinguishing features. First, the impact of the thoughts and experiences on us: If we are otherwise functioning well in our lives, and are able to notice, accept and dismiss the thought or experience, then they are not intrusive enough to be framed by us or others around us as problematic. Second, the meaning we give to them: If we understand them as transitory, or as a reaction to stress, exhaustion or particular circumstances (or substances) we can apply more self-compassion and are less likely to be scared by the experience or to feel they are outside of our control. Likewise the variation in meaning given to unusual experiences in different cultural group (whether a source of insight, or a sign of possession or black magic, for example). Thirdly, these thoughts/experiences are more likely to be present and construed as symptoms in people who have already got complicated lives and multiple stressors, or are subject to prejudice. With a history of trauma, a lack of coping skills, the stress of socioeconomic deprivation or within certain cultural groups, the response to such experiences may be more overt or distressed, and may compound other problems. Finally, some people are already visible to professionals or in medical settings that make diagnostic labels more likely.

When a CP from the forum described the experiences and behaviours I have listed above to various professionals working in adult mental health services, the assumption was that the person described would surely be a patient with psychosis or OCD. Many were surprised to hear that these were descriptions from healthy adult professionals working in mental health who have never had diagnostic labels applied to them. However, interestingly, when the same question was asked of carers, they were much more empathic and less judgemental and made no such assumptions.

I was reminded of the seminal Rosenhan study in which eight researchers were admitted to inpatient services as pseudo-patients to study the environment. The admissions were triggered by describing auditory hallucinations, but as soon as they were admitted they no longer feigned any symptoms. Nonetheless, all were given psychoactive medication, and seven of the eight were given a diagnosis of schizophrenia that was assumed to be in remission by discharge (the other was diagnosed as ‘manic depressive psychosis’). Again, the patients recognised that the researchers were imposters, but the staff pathologised ordinary behaviours to fit with their pre-existing beliefs about the nature of psychosis (including describing the researcher’s note taking as “pathological writing behaviour”). Rosenhan and the other pseudopatients reported an overwhelming sense of dehumanisation, severe invasion of privacy, and boredom while hospitalised. Interestingly, a hospital then challenged the research team saying they could recognise any fakers easily. Out of 193 new patients in the study period, the staff identified 41 as potential pseudopatients, with 19 identified by two or more members of staff. However, no pseudopatients had been sent at all. Rosenham concluded “it is clear that we cannot distinguish the sane from the insane in psychiatric hospitals”.

It is another salient reminder of how easy it is to make negative judgements about people according to very superficial distinguishing features, and how much it is part of human nature to fear difference. Whether we are judging “schizophrenics” as a group, or Syrians, or Republicans, or Muslims, or benefits claimants, or European immigrants, or the people who voted Leave in the EU election, it is easy to make assumptions about people that we outgroup and to forget that we are all human, and all trying to do the best we can in our own circumstances and based on our own experiences.

Our own quirks of thought and behaviour are another good reminded that we are not so different. Mental health diagnoses are convenient labels for clusters of behaviours and reported differences in how people think and feel. But they reflect much bigger stories than just our biology. And people are still people.The baby pulled from the rubble in Aleppo could grow up indistinguishable from my child, if they had the same life experiences. The person with the label of psychosis, the scars from self-harm and substance misuse and the long stay in the mental health unit, would have had a different life path if they had been born into different circumstances. Likewise you and I would likely show equal levels of distress if we experienced similar trauma. As Jo Cox put it so well, we have far more in common than that which divides us.

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!



Starting over: Selecting offices and staffing

After the stress of my last blog about problems with the offices we were leaving in Milton Keynes*, I was keen to make sure that we set up a base I felt really comfortable with up in Derbyshire, and gather a great team up here. I viewed a lot of potential offices and tried to really get a good gut feeling about where we would belong. The plan is to rent an office or set of offices that has scope to expand if we secure the grant we have applied for, or other external funding that lets us expand more quickly.

The first place I viewed was a serviced office centre. The rooms were pleasant and good value (less than half the price per square foot that I had been paying further south) but the site was quite generic and a looked a bit warehouse-like. More importantly it was on the far side of a market town with quite a lot of traffic, and further from the motorway. I then viewed an office suite in a pretty restored station building on a quiet branch line. Despite this being my favourite option, it turned out only a single room was available there, and the tenants who had the rest of the building were spilling out into all the public areas, which were filled with their storage and materials. Plus the room didn’t have an individual lock – and I’ve learnt to be wary of that!

The next two places advertised were full, despite having road signage, listings on Rightmove and vacancies marked on their websites. The next place was a dilapidated shop with offices above, but transpired to be under offer, and to need a lot more work than would be possible in our timescales. The next a single room retail space, with no sink or loo unless you went into the next door building, that was quite a walk from the nearest parking. A small office building for sale, but cramped in a back street in a town slightly further from my preferred areas. Then a lovely large set of rooms in a very smart building with dedicated parking and reception facilities, that became less attractive as the already high rent then gained a service charge, and charges for the phone/broadband and was then ruled out by access only being permitted when members of staff from the main business were present, and the building being locked up at 3.30pm on a Friday!

Then a small set of offices that were a bit too far away and had a contract with an excessive notice period. Next was a bright but slightly run down set of rooms over a letting agent, at a good value inclusive price, but with slightly dingy rear access. Then we viewed another office building that was for sale, but was too big, over priced and came with only a single parking space. Then another serviced office building in a massive complex that contained function rooms and all sorts of entertainment facilities, but had limited parking and was rather dirty and dated looking. Again there were all sorts of extra charges for phone/internet, insurance and a per person charge per month for furniture. However, some of the rooms were nice, and they did come with two parking spaces right outside. Whilst viewing we also met a potential business advisor and heard about the exciting collaborations within the complex, but somehow it just didn’t feel right.

It is always very interesting when your head and your guts give you different messages. Logically the last place had the most to offer, yet it was the rooms above the letting agent that gave me the best feeling, and the owner talked the least and was the most straightforward. A bit of negotiation later, and he had agreed to redecorate the rooms, provide some furniture and jet-wash the rear access, as well as hanging a door so that we could still access the toilets and kitchen, but other staff and customers could not come up to our offices uninvited. Having learnt my lesson, this time the repairs will be specified on the contract as being completed before rent is due!

I also interviewed for a new assistant psychologist for our Liverpool contract. The project is going to be in collaboration with my peer supervisor, so that feels like an extra benefit to me, as I get to spend more time with him. We even had fun interviewing, in the lovely Quaker building in the town centre, and ate delicious food at Mowglis. When it came to the applicants we interviewed, we were really pleased to be spoilt for choice. We felt that three of the candidates would have been great for the job, and were able to select someone we are really comfortable to add to the team.

I have also put up an advert for a new administrator. Having had both brilliant and awful experience of non-clinical staff in the past, I wanted to make sure we recruit the former. This person will be the hub in the centre of the business, around which the rest of us rotate, and they need a mixture of administrative, financial and interpersonal skill, with the ability to keep me and the business organised! So I put a lot of effort into the job description and person specification. It is the first time I have used online recruitment advertising, so fingers crossed we find the right person. The applications seem to be numerous and impressive, so we are off to a good start.

Also during the summer I met an inspirational potential collaborator, so I am hopeful that I can negotiate a productive way we can work together, whether he joins us as a part time COO, or whether we make a service level agreement between our two organisations. I only hope that I can find a few more clinical psychologists to join the team, as we continue to have more requests for our input than we can fulfil.

Finally, keep your fingers crossed for me, as I will hopefully hear back soon about the DfE grant that I applied for to expand our pilot of outcome measurement and our psychologically informed care pathway!

*Thankfully I have now resolved the issues with Regus, so I have edited the previous blog to reflect this. I don’t normally edit things I have posted, because I prefer to write honestly and leave what I say on the record. However, it was a condition of the resolution that I did so. I thought long and hard about it and concluded that this blog and my social media is not the right place for making an angry noise, and that I could tell the story equally accurately in a slightly less detailed and more dispassionate way.

Reflections on renting an office from Regus

Regus rent serviced office buildings. If you want the short version of this blog it is this: I had a really bad experience and it took far too long for them to resolve it, so I would never use them again. I therefore recommend that you think very hard before you sign up with them, and ensure anyone you know who ever considers renting an office in a serviced office building does likewise.

However, they have now resolved my complaint, thanks to their head of customer service, Suzanne Jackson. So if you aren’t getting anywhere with anyone else, I’d drop her a note instead. Unfortunately it was a condition of the resolution we agreed that I would remove the majority of this blog and my other negative social media comments about them. But I’ve left the gist of the story below.


At the time of viewing, the room offered to us was being used as a sales area and opened onto the reception with glass doors (transparent, with no lock, and a foot wide gap from floor to ceiling where a glass panel was missing). It was also full of Regus sales materials (they filled the only storage cupboard in the room, and were also in several boxes on the floor and piles on the desks). I explained we needed a room immediately in which to base some of my staff, that was suitable for conducting psychological therapy and specialist parenting assessments for the family courts (ie highly confidential work). I was told that the room would be perfect for this use. We even discussed how my administrator could move out to use the work pods during therapy sessions, so there is no doubt the sales person knew the nature of the work we undertake.

I was told that the room would be properly boxed in and secured and emptied within a fortnight, and then I’d get the first month rent free to settle in, if I signed for a year. All wifi use was included, even during the free period until the office was complete and the “moving in month”. The salesman told us to store our furniture, computers and files in a cupboard in the building from that day, as the office would be available imminently.

Unfortunately it was not. It was left open with no visual or auditory barrier to the reception and no lock. And they started to bill us for rent, and wifi, and late fees even though the work was not done and we were promised free wifi, and had never had prior invoices to make the later ones “late”. So I complained repeatedly. Still, none of the required work was done for the whole of May and the whole of June and most of July.

In total Regus took 11 weeks and 17 complaints from me to put a lock on the door and seal up the gap, but over the whole 16 weeks before we gave up on it and rented rooms elsewhere the office was never made confidential (even by something as simple as opaque sticky-back-plastic on the glass) so my business was unable to deliver an essential component of our work and we had to move out before they completed the promised repairs. They threatened to lock in my notes and materials, and sent threatening letters and emails about unpaid bills, despite the fact that no money was ever due and they had failed to live up to the contract we agreed of the work to be completed before any rent was due.

Over time the lack of access to a suitable office became a critical issue for the company, and as this coincided with me moving to a different area of the UK I was forced to conclude it was no longer viable for my business to continue to work in Milton Keynes and I had to restructure the company. Thankfully I have a trusted colleague to pass therapy cases onto, so no clients will be left without a service, but for the business it has been nothing short of catastrophic.

Regus made it very difficult to leave, and tried to say that we not only owed rent but were bound in contract for 12 months. Invoices were never amended. Complaints were not responded to, or maintained the same unreasonable position. However, after I wrote this blog, became noisy on social media and contacted the head of customer services, things were finally resolved to my satisfaction at the end of September. They accept that the room was not ready for use quickly enough, and have confirmed in writing that I am no longer in contract with them and no rent is outstanding.

There is more to the story (and a whole other story about the first time I rented a room there and was subject to a sophisticated robbery and fraud scam) and I am far from alone in having negative experiences (check their twitter feed and google for reviews). However, although I might be stubborn I try not to hold grudges and at least it has a happy ending now. Hopefully I will never have to deal with them again.

Update: They continued to try to chase “unpaid rent” for several months after we left, despite me referring them back to their own decision that nothing was due. They even referred the matter to a debt collection agency. However, Suzanne Jackson did eventually resolve this, and as of Feb 2017, I think this whole episode has been closed.