empathy

Why did I think that?

On Sunday morning I moaned to my husband about the fact I always seem to wear the same familiar items of clothing over and over in rotation. He pointed out that this might be because I had less than half of my clothes in circulation, as the rest hadn’t been unpacked since we had moved – two years ago! How had I not noticed this? It suddenly made sense of my nagging sense of absence in my wardrobe. Looking back I could identify that over the last couple of years I had felt short of smarter clothes to wear to work, and aware that I was wearing more of the casual comfortable clothes I had previously worn at home even when doing work activities. It wasn’t a huge problem because I have been doing less court work, and doing more work from home. But I had sometimes felt self-conscious about whether I would appear too informal*. However, instead of having recognised that these feelings reflected a genuine shortfall, I had just acted on the vague sense of deficit by buying replacement items. When I retrieved the missing clothing from the packing cases and sorted through my total wardrobe I had bought more than ten pairs of work trousers since we moved here, and as many new work tops – meaning that when combined with my rediscovered store of clothing I suddenly had an excess of them. Doh!

I also struggle to part with old clothes that I love, even when they are quite worn out, or get damaged. I have particular favourite tops that have gained punctures or pulled threads over time, but these are not visible unless you look closely so it feels wasteful to throw them away. Our washing machine also seems to create small punctures in items from time to time – particularly just above the knee of thin cotton trousers. It isn’t that we can’t afford new clothes, I just don’t like the environmental and sociopolitical ramifications of buying cheap and disposing of things frequently. However, with my children I have a strict rule that if an item is damaged we fix it or bin it** (perhaps fuelled by having observed so much neglect, and a bit of parental indulgence) and we sort through their clothes twice a year to give away those that they have grown out of. It is a notable contrast that I find that process of review and quality control harder to implement for myself. As I said, I have a general preference for buying good quality things that last compared to buying often to follow fashions, and a strong dislike of wastefulness. Plus my body shape and size has been fairly consistent over time***. This combination means a lot of my clothes have been around for a long time – I still sometimes wear a T-shirt to the gym that I bought the week I got my A-level results, I sometimes wear hand-me-downs from my high school best friend that I haven’t spoken to in twenty years, and I only recently retired a long sleeve T-shirt I’ve slept in more nights than not since my teens (I’m in my early forties). That means that I have gradually accumulated clothes to the point they fill a two-metre hanging rail and two drawers, plus three smaller drawers for underwear and socks. I’m not convinced I need so many. Even when I had all of my clothing available to me, I didn’t wear it all and some items would get worn less than once a year, whilst favourites would get worn again each time they returned from being washed. So why do I buy them?

I also have a tendency to buy too many shoes. Part of the problem is that I am strongly attracted to shoes that I can imagine myself wearing in some kind of fantasy world where I don’t actually have to walk very far or stand up for very long or drive the car, but that I don’t choose to wear when faced with the reality of my plans for the day ahead. So I have about twenty pairs of shoes with wedge heels and/or platform soles in the bottom of my wardrobe upstairs, whilst I mainly wear sensible comfortable shoes/boots that I keep in the shoe rack by the front door. I also have quite a few sets of what I think of as silly shoes, as I have often been enticed by designs that are a contrast to traditional expectations in some way – perhaps as a small act of rebellion – that are sometimes practical enough to wear, but sometimes languish unworn in the cupboard. I’m not a big spender, as I mainly buy fairly modest brands and usually in the sales, so it isn’t that I’m wasting lots of money. But it feels quite contradictory to my wider values to be hooked into any form of consumerism. In particular, it seems to conform to stereotypes about women, and our willingness as a gender to suffer discomfort in order to appear more attractive that I don’t consciously endorse.****

So I have spent the day diligently trying on every item of clothing I own and sorting out those that are damaged to dispose of, and those I won’t wear to give to the charity shop. I’ve also sorted out ten pairs of shoes I have never worn that I intend to sell online in the hope of recouping some of the money I have wasted.

But, being a psychologist and being curious about this stuff, I’ve also been wondering about the thinking patterns that have put me into this situation. Why was it that my brain kept telling me to buy more work clothes without identifying that some of my existing ones were missing? Why is it that I set higher standards for the appearance of my children than I do for myself? Why is it that I repeatedly buy shoes that I don’t wear? I think it must reflect a discrepancy between my sense of self, and the reality. My inner sense of myself is younger, slimmer and more unconventional than the overweight middle-aged mum you see from the outside, and has almost infinite time and energy, so I have some positive delusions about myself. But, like many (most?) people, I’m also more self-critical, both about the things I don’t get done (both at work, at home and creatively), my disorganisation (kindly reframed by several people I trust as “taking on more than it is possible for one person to keep in order”), and of my face or body when captured in unflattering photographs (which seems to be pretty normal, given the prevalence of filters now in use, the selectiveness with which photos to share are selected from massive numbers taken, and the use of photoshop on celebrity images). The standards I set myself are high, and at some level I compare myself to an unrealistic ideal. That Miriam can dance about in fancy shoes without looking ungainly or falling over, and can fit in twice as many things as I do in a week, whilst appearing glamorous in photos, and coming across as organised and well-presented at all times. That Miriam can be the perfect wife and mother as well as running a business and having a load of creative side-projects. She can have a social life, be involved in the community and support the causes she is passionate about. And compared to her I will always fall short.

Yet if it was someone else, I’d be the first to appreciate them as they are, and tell them that their cup is quite full enough to not waste mental energy on comparing themselves to unrealistic ideals. When I see photos of friends and family I see the person that I love and their relationships, activities and emotional expressions, not the awkward posture, double chin, or spot on their nose that they see first. There are times I feel frustrated with others, but if they are apologising about being late or messing up a plan, the chances are I’m probably viewing that as trivial in the context of what they mean to me, and all the times they’ve been there when I needed them. So on balance I think I judge myself harshly, and my friends and loved ones generously, but I have a strong sense of them as an individual.

With people I meet through work, I don’t know them as an individual before we meet, and there is often a negative narrative that is being told about them, but I find empathy as I hear their story and see their challenges in the context of their (usually traumatic) history. That is true of the parents I meet through court proceedings or social services, as well as with the children and young people themselves. Even if the person has done some bad things, I can usually find something to like about them, or feel sympathetic about their experiences. Yet with a stranger or when thinking about a population demographic (eg “rough sleepers” or “brexiteers”), we don’t have these relationships or individual narratives to inform us, so we often fall back onto stereotypes, no matter how much we try to resist them – perhaps because we don’t have the additional information required to flesh out that initial impression.

That would tie in to lots of psychology research about how poor our judgements are about ourselves, and the fundamental attribution error. It also ties into our inherent prejudices about ourselves and about others. For example, it is fairly prevalent at the moment to associate being overweight with laziness, gluttony and lack of self-control, as I mentioned in my first blog, when in reality it seems to reflect socioeconomic factors, trauma history and low mood more than personality deficits. I’ve previously talked about my own excess weight as a security blanket after feeling at risk of rape in my late teens but I might not have mentioned that as a vegetarian fruit and veg junkie I actually eat very well, swim regularly and was quite serious about weight lifting before my minor RTA. I don’t care too much about conforming to social expectations of appearance, but I do like to feel like my body is healthy and has the ability to do stuff (and I get a lot of secret joy from having “ninja muscles” – a term I use because, like ninjas, unless I want to reveal them nobody else would know they are there) – yet this is the reverse of what might be perceived of me by others, who might associate my body shape with a bad diet or sedentary lifestyle. Weight lifting wasn’t something I had thought of before a friend trained as a personal trainer, but when I tried it I liked. The measurable gains were rewarding***** and it felt like it might become a way to shed the security blanket whilst still feeling safe, so it is something I am trying to return to. Building some hidden muscles made me feel strong and healthy, but also tickles the part of me that likes to buck expectations – as nobody expects a middle aged mum to be deadlifting a 19 stone barbell!

Having reflected on the way I see myself and others for a while, I think the challenge is to be more self-aware, and to find a way to be authentic. The process of keeping a reflective journal that we discussed on the clinpsy forum is one means to achieve that. Personal therapy can also serve a similar purpose. Or just having a regular time in which to reflect, perhaps as part of a mindfulness practise. It is worth being aware of the common cognitive distortions, so that you can spot them in yourself too. Having rediscovered some lost bits of my aspirational self, I think I’m going to try to be a little bit more playful, and a bit less self-critical. And maybe I’ll express that by being more mindful about the clothes I choose to purchase and to wear in future. I also want to express more of the positive parts of that inner self into the world – so who knows, the next time you see me maybe I’ll be wearing those silly shoes.

Footnote (added 25/5/18): I wore some of those fancy shoes I’ve been hoarding to visit the House of Lords the week before last. They seemed really comfortable when I set out that morning, but by 6pm I had quite severe blisters. I ended up walking back to the hotel barefoot before buying some flip-flops the following morning.

*For those who care about these things, I’m not referring to wearing jeans or T-shirts with pictures or slogans on them, or anything that is distressed or damaged. I tend to favour soft T-shirt like fabrics or those with a slight stretch built in, rather than very smart clothing that is stiff and fitted. I generally like to wear trousers and tops in warm dark colours that are either plain or bold prints. I sometimes wear print dresses or skirts – and I do own four trouser suits for court work – but my staple is trousers and a top. Thursday would be fairly typical of how I dress – I wore aubergine trousers with a jeans-like cut and slight velvet texture, coupled with a three-quarter sleeved plum coloured top and a longer open dark purple top over it like a twinset.
**Or more accurately recycle or use it as rags, as we try to be a low-waste household
***I currently weigh two pounds less than the day I first tried on my wedding dress in 1996, which would be impressive if I wasn’t already obese by then
****It is strange that as a gender we seem to have a shared perception that propping ourselves up on high heels makes us look taller and slimmer, and forces us into a posture more flattering to the legs and bum – and that we are willing to sacrifice not only comfort, but our ability to move through the environment at speed or on uneven ground to do so.
*****Something I think is also true when using outcome measurement to demonstrate the impact of therapy or interventions

Is empathy finite? Part Two: Brock Turner

This is the second of two blogs about recent sex offences that have made the news, and is about Brock Turner. The prior blog was about prolific child abuser, Richard Huckle and can be found here. In that case, my ability to have any empathy for the perpetrator was severely tested. In this case, it isn’t my empathy that is under question (because I don’t have the same discomfort in trying to understand the position of all the different parties in this case), but that within our whole culture.

I’m sure you will all have read the story about how Brock Turner sexually assaulted an unconscious woman outside a frat party and her eloquent response to his six month sentence.

What was notable was that the case polarised the world into two camps. Either this was the fault of one individual who did something awful, or he was just the unfortunate example that got punished of a problematic culture of drinking and promiscuity amongst young adults at American universities. Here is how the two alternative stories are framed:

1) Everyone was drunk at the party and coupling off with strangers for casual sex, and that was part of what is expected at frat parties, everyone knows that. The guy was very drunk and paired off with the girl by mutual agreement. They were kissing and she consented to go back to his dorm, but they fell over and were kissing and fumbling on the ground mutually enjoying the sexual activity and he didn’t notice that she lost consciousness at some point before vigilantes interfered. He was a promising scholar and sportsman who has lost a prestigious place at Stanford and will serve six months in jail and be on the sex offenders register for life. He has been an unfortunate example of taking accepted culture one step too far and the poor guy will be paying for that for his whole life in the change in his career trajectory.

Or

2) The victim was really really drunk whilst the perpetrator was just a bit drunk, and he had a pattern of being sexually aggressive to women in similar circumstances. He had made sexual approaches towards the victim’s sister and was knocked back, so he tried it on with her and realised she was too drunk to resist (despite having a long term boyfriend she was committed to) so he led her off and she fell down unconscious by some bins on the way out. Instead of calling for help for her he sexually assaulted her injuring her genitals and would have raped her if not for the intervention of two passing cyclists who noticed her being obviously unconscious. She regained consciousness three hours later with no memory of what had happened, injured and bleeding in a hospital where she then had to be forensically examined for evidence of rape, whilst he expressed no concern for her during several hours of being questioned by police, claimed she gave consent and denied she was unconscious. She then had a year of stress building up to the trial, where she was cross examined and blamed for what happened to her. She has been traumatised for life, and this sentence sets a precedent of rape culture on college campuses being not such a big deal.

I think the evidence best supports the latter version, and the conviction suggests that the court agreed. But I think there is some truth in both stories, because as I have often said before, behaviour almost always reflects the person’s experience and the context as well as the choice that they made. There is a massive problem in modern western culture, particularly amongst young adults, in which sexual coercion is normalised and blamed on alcohol, which is consumed to excess. It is also scarily prevalent. You might call it a rape culture. About 20 million out of 112 million women (18.0%) in the United States have been raped during their lifetime. Only 16% of all rapes were reported to law enforcement. In 2006 alone, 300,000 college women (5.2%) were raped. Among college women, about 12% of rapes were reported to law enforcement. There are similar figures for the UK. And it makes me wonder – why do we not have basic empathy and respect for each other, even when we are intoxicated and disinhibited?

The culture of deifying talented sportsmen in American universities and the tendency for athletic teams to spend a lot of time together and sometimes live together also appears to have contributed to the answer. A recent study shows that male intercollegiate athletes accounted for 19% of all sexual violence cases reported but only comprised 3% of the student populations. Amongst these groups, attitudes to women are problematic. The researchers found many more “beliefs and situational definitions that excuse rape or define assaultive situations as something other than rape” in athletes. Amongst sportsmen there were also distinctive narratives. The researchers reported that amongst athletes “hypermasculine discourse includes war-like, misogynistic, and sexually violent analogies” and that this was directly related to the difference in attitudes towards sexual coercion. 29.5% of college men in the study sample had insisted on having sex when their partner did not want to, and 5% have used force and 5% have used threats to get a partner to submit to sexual activity. Attitudes toward women were less progressive and rape myth acceptance was more prevalent amongst athletes. You can see echoes of this in the letter from Turner’s father, which blames a culture of drinking and promiscuity rather than his son’s actions and displays no empathy for the victim. Likewise the same theme is present in Turner’s testimony, and in the (repugnant) letter sent to the judge by a childhood friend of Turner who claimed that the accusations levied against him were down to “political correctness”.

The truth is that whilst we can take actions to help reduce the availability and vulnerability of potential victims by helping to educate teens and young adults about the dangers of binge drinking, the main problem is in the attitudes and actions of those who use coercive sexual behaviour. In the words of an infographic from facebook, the causes of rape are 0% slutty clothes, 0% alcohol, 0% college culture and 100% rapists. And in the words of another infographic:

“She was drunk, what did she expect?” “A hangover, that’s what she expected.” Drinking isn’t a crime, rape is. Stop victim blaming.

Whatever else contributed to Brock Turner being in that position, let me quote the letter from the survivor of this incident, “we should not create a culture that suggests we learn that rape is wrong through trial and error”. We need to teach every child about privacy and consent from when they are very small to when they are adults. Here is how I explain it to young children: If somebody wants to touch a part of you that is covered by your swimming costume or to put anything in your mouth, then they need to ask you and not do it unless you say it is okay. And if you want to touch any part of another person that is covered by their swimming costume or put anything in their mouth then you need to ask them, and only do it if they say it is okay. You should only say yes to someone doing that if it is someone who needs to touch you to help with an illness or injury and Mummy or Daddy are with you and say it is okay. If anyone does something like that when you don’t want them to or it doesn’t feel right, you should always talk to me about it or someone else that you trust”. Here is how I explain it to a teenager “Don’t ever pressure anyone else or let anyone pressure you to do things that don’t feel right or comfortable to you. If you aren’t sure, you can always talk to me about it. That includes anything about sex or relationships”.

Whilst the mythology of false allegations implies otherwise, and real life is always more ambiguous than it appears in theory, consent is actually pretty simple. If somebody is in a fit state of mind to make decisions and actively says yes and reciprocates, then they consent. If that isn’t the case then they don’t. When this video came out I wondered why they needed to spell out that if a person is unconscious they can’t consent. Now we know why. It is only a basic level of empathy that is required. The golden rule of do as you would be done by. But it involved placing yourself in the other person’s perspective and understanding that the person you really want to have sex with might not really want to have sex with you, and if they did they might want to do so after a gradual progression of the relationship and without intoxication that would impair their judgement.

On the other hand, one bit of empathy is transparently clear from this case. The judge, a former Stanford athlete himself, appears to have had too much empathy for the impact of the sentence on the life of Brock Turner, perhaps because of over-identification. Whilst I respect that he was a prosecutor of sexual offences, and may also be comparing this assault (which was interrupted, and thus never progressed to what we in the UK would define as rape) to other cases from his career that involved violence or threats, and whilst it may well be that Turner has now learned his lesson and will be very clear about obtaining consent in the future, I was not persuaded by anything I have read that Turner accepts responsibility for his actions. In fact, it appears he only accepts responsibility for drinking, and not for any sexual offence. He pleaded not guilty, and amazingly, he is going to appeal even this remarkably light sentence. On that basis I believe it is important that the sentence reflects the gravity of sexually assaulting an unconscious woman, and his lack of genuine insight or remorse, as well as setting an important precedent to show that college culture or use of alcohol is not an excuse for sexual assault.

In my next blog I may talk about my own experiences of unwanted sexual contact. But for now I want to finish by remembering that two students noticed what was happening and intervened. Many people would ride right on by, and it may be that their Swedish rather than American/British norms were part of what protected this woman from being raped, but in this instance two people saw what was happening was wrong and they did something about that. And the victim has not only become a survivor, she has found her voice and used it amazingly articulately to become an advocate for all women who have experienced unwanted or coercive sexual interactions. I think that is a salient reminder that no matter how skew the norms can get within certain small pockets of society, the rest of us can still recognise right and wrong, and protect each other. However dark the world is, we are not entirely powerless. We can prevent some people from being harmed, and can help others to recover from these experiences. We might not be able to change the world immediately, but we are making slow steady progress over time, and at an individual level and at a societal level, things can be better if the rest of us play our part. No matter how overwhelming the rape culture might feel, we can all be part of the solution.

Edit: I have since read that Brock Turner may have photographed the breasts of the victim whilst she was unconscious, and another stranger may have seen him do so, then checked she was still breathing and put her into the recovery position prior to the sexual assault. If this is true, then any pretence that Turner was unaware of her being unconscious is thrown out the window. It would also appear that he had a history of drinking and using drugs prior to attending Stanford, so the attribution of the cause to the culture of drinking and promiscuity at the college seems like even more of a red herring than it did before.

Is empathy finite? Part One: Richard Huckle

There have been two challenging stories in the news this week. In the UK Richard Huckle was given 22 life sentences for sexually abusing around 200 Malaysian children, and in the USA Brock Turner was given 6 months in county jail for sexually assaulting an unconscious woman outside a frat party. Each of them has been hard to read and aspects of each case have brought me to tears. The stories have made me feel grief for the victims and anger at the perpetrators, frustration about the cultural norms that gave them opportunity and in their mind justification for their actions, and vexed at the justice systems that somehow seemed inadequate in the face of each situation. And in each case, it has been really hard to hold on to any empathy for the perpetrator, despite my strongly held belief that people are the product of their experiences and influenced by the context, rather than ‘born evil’.

Because I have read and thought so much about these two cases, and discussed them online, I thought I would write a blog post about each. This is the first of those two blogs, and is about Richard Huckle.

Make no mistake, what he has done is unthinkably awful. Genuinely evil, to the point it is hard to even comprehend. He deliberately targeted vulnerable children and babies in deprived communities for his own gratification, and shared his activities with others for financial gain through the dark web. He even wrote a manual advising other paedophiles how to sexually abuse children in less developed countries. He was clearly without conscience or empathy, or able to override any remaining scraps of either in favour of sexual gratification. The psychiatric assessments were reported to say that he justified his actions and showed no remorse. His ledger and writings on the dark web boasted about his activities. So I can understand why he got such a hefty sentence, and why many people feel he should have been tried in Malaysia where he could have got a death sentence. He has harmed hundreds of children and families, and changed the course of their lives for the worse. No sentence can ever compensate for that.

I found myself thinking that if he committed suicide or was killed by other inmates very few people would be sorry to hear the news. In fact many would argue that the cost of 25+ years in prison is money that will be wasted on an individual that is beyond rehabilitation. Comments on the internet below the breaking news stories said things like:

“Hope he rots in hell he doesn’t deserve to breath air”

“It’s time to bring in capital punishment for paedophiles. Why should we pay for his upkeep? Death is the only appropriate punishment for this creep”.

“How tragic for his father and mother, who were obviously conscientious and committed parents. It just goes to show, you can give your children a good upbringing but you simply can’t control how they turn out. This guy is a slave to his perverted sexuality and his condition is incurable. He really should be locked up for the rest of his life because he will always be a danger to children. What a terrible affliction for any human being to be born with”.

And a woman in the public gallery shouted “a thousand deaths is too good for you” as he was led away from court.

Despite all of my psychology and experience with child protection issues and knowledge that most people who harm children have been harmed themselves, I found myself hating him and feeling no empathy whatsoever. It was as if he had stepped outside of the range that my empathy could stretch. I wanted him to suffer because he had made others suffer. If I’m honest, I’m still very conflicted about it.

However, like the awesome film Arlington Road illustrates, there is rarely a lone gunman. As much as it is an attractive narrative that distances us from responsibility, I don’t think that one person in a million is randomly born evil and will inevitably do things like this. I believe there are things we can do to make such events less likely to recur over time, and it is that belief that stops me feeling hopeless and helpless when the news constantly bombards me with all the evil in the world.

When I took a step back from the emotions raised by the awfulness of what this man did and thought about what I have learned from both research and practice, I found that there are in fact lots of pieces of knowledge that can help us to make sense of what happened and what we can do to reduce the chances of it happening again. In other words, I started to think like a psychologist again, and I wanted a formulation that would help me to reach some understanding of how he got to the position of doing such evil things. Such an understanding would let me sidestep my helplessness, anger and desire for retribution, and instead focus on something constructive; doing something positive to prevent similar cases from occurring again in the future.

As I mentioned earlier, I believe that people like Huckle are a product of their experiences as well as their innate character, and their offending happens within a context. Of course I still believe in free will, and that people are culpable for the outcomes of the choices they made, and clearly Huckle made very very bad choices again and again and deserves to face the consequences of that. But we don’t make those choices in isolation. Although he was particularly prolific in his offending, Huckle was far from the only person to perpetrate child sexual abuse in the UK. In fact, there are over 100,000 people in the UK who have committed a sexual offence against a child and around 5000 new convictions are made each year. About a fifth of the population have experienced some form of unwanted sexual contact before they reach adulthood. Police recorded 36,429 sexual offences against children in the UK in 2013-14, and estimates suggest that only one in eight offences are reported. So this is a massive problem. (To put it into context, 1600 children per year are diagnosed with cancer, so sexual abuse is more than 20-180 times as prevalent). I believe that when it comes to any form of antisocial behaviour, violent or sexual crime, particularly on this scale, such actions are also an indication something is wrong in our society. It doesn’t surprise me that numbers on the child protection register are rising during this decade of ideological austerity that is widening the wealth gap in the UK. Just as suicide rates, substance use, homelessness and the incidence of mental health problems are increasing as a result of political decisions, so domestic violence and child maltreatment is rising as people fail to cope with the additional stressors imposed by benefit cuts, sanctions and reductions in public services.

There are several likely risk factors that relate to the abuser. First we know that whilst experiencing sexual abuse is neither necessary nor sufficient to create a perpetrator, the chance of sexually abusing children is increased threefold if he was sexually abused in his own childhood, and that experiencing sadistic emotional or physical abuse can also increase risk. We know little about Huckle’s family, but attachment disorganisation and the absence of any secure attachment figures seems much more prevalent amongst abusers. It is known that many sex offenders have sexual dysfunction. Isolation, low mood, loneliness and lack of social skill seems to also contribute, as do neuropsychological impairments – and Huckle was described as a loner who spent most of his time on the computer, as well as “uncharismatic” and on the periphery of things. Finally, the majority of people who sexually abuse children are religious (studies show 93% of abusers to report a strong religious identity, and around 5% of priests have been named in disclosures of sexual abuse). In between trips to Malaysia to abuse children Huckle was actively involved in the church and described himself as a devout Christian. Was that just an act, designed to gain the language and credibility to access children, or was there another motivation? Was he perhaps conflicted about his actions and trying to compensate or seek forgiveness? Or did he believe he was already going to hell, so he might as well do what he wanted in the meanwhile? Or did he have outwardly strong morals as compensation for lacking an internalised moral code? I suspect we will never know.

The part of this picture that is less often a focus of attention is the contribution of online communities to the normalising and even encouragement of abusive activities. However, we know that using the internet gives people an (often false) sense of anonymity and privacy, that brings out certain traits in their behaviour that might otherwise be inhibited because of the social consequences. On top of that certain communities have developed that collect and exaggerate certain types of behaviour. For example, the notorious bulletin board 4chan has boards within which particular patterns of behaviour from trolling to internet vigilantism (such as the hacker group Anonymous) have become the norm. Likewise certain boards have allowed the gathering of gamergaters, men’s rights activists, furries (people who like to role play anthropomorphised animals), bronies (adult male fans of the children’s cartoon My Little Pony), otaku (Japanese nerds), toonphiles (people who want to have sex with cartoon characters), adult babies, truthers (people who believe in elaborate government conspiracies, such as that 9/11 didn’t happen), those trying to give up masturbating to pornography, and many other quirky groups that would not be able to express themselves within a mainstream community. There are groups that advocate in favour of all kinds of risky behaviour from anorexia to suicide, drink-driving to barebacking (unprotected sex between men, which includes “bug-chasing” – having unprotected sex with men who are HIV positive with the intention of gaining HIV positive status). Online people can present with whatever persona they want to create. Instead of being lonely and powerless they can be charming and popular. In that context, it is not surprising that there are websites that normalise and encourage child pornography, and create demand for more content (including a financial incentive, which Huckle had used to seek crowd-funding for pornographic material he had made related to his abuse of a 3-year-old girl).

However, there is much that is unknown about the relationship between use of the internet, viewing child pornography and sexual abuse of children. Does the availability of “edgy” content pull users of legal pornography towards more extreme material that they would not otherwise access? Does the market create an increase in abuse to provide the materials that can be sold? Does viewing child pornography online become a stepping stone to contact abuse? Or does it allow potential contact abusers to meet their needs without harming additional children? Is it related to the grooming of children online? One in eight people convicted of viewing child pornography on the internet had a known history of offending against children in person but it is still unclear which is chicken and which is egg when it comes to a sexual interest in children and viewing of child pornography. But it is clear that law enforcement resources are totally outnumbered by the prevalence of child pornography online.

Finally, there are factors which make some children more vulnerable to become victims of child sexual abuse than others. These include the lack of a secure attachment figure, shame, isolation, neglect, disability, the presence of other forms of child abuse, socioeconomic deprivation, stressors placed on the family (eg unemployment, bereavement, divorce), cultures in which secrecy is encouraged or permitted, prior sexual abuse in the family (particularly if this was not reported and discussed), alcohol or substance misuse, domestic violence, and settings in which there is sexual language, pornography or exposure to adult sexual activities. These same factors make it harder for children to disclose what has happened to them, and for such a disclosure to lead to suitable protective action. Only one in eight children who experiences abuse receives any professional input to assess or intervene with it.

So there are things that we can do to mitigate the risk of future harm. We can protect future children by addressing inequality, providing more support for parenting and attachment, providing more prosocial opportunities for engagement for disenfranchised young people, being more proactive about responding to child abuse, having more investment in policing the internet so that access to child pornography reduces or is perceived as more risky. We can help victims of abuse to speak up early, to the right people, and to be believed. We can encourage the investigation and prosecution of sexual offences against children, and ensure that conviction rates and sentences are sufficient to act as a deterrent. We can specifically develop international policing solutions to address sex tourism. And most importantly of all, we can also help victims to recover from the abuse they have experienced, to feel safe and protected and develop healthy norms about relationships.

Huckle has done evil and unforgivable things. I still can’t find much empathy for the person he is now. However, if I think back to him being born, and the experiences that must have taken place to take him to the point at which he could abuse children, I am able to feel sad for that baby and angry at those who harmed him and failed to protect him or to intervene much earlier to divert him from his path and recognise their contribution to his development and the harm that he then perpetrated. And if behaviour is learnt, then no matter how unlikely, there may be a future point at which it can change. So maybe in 25 years from now it is worth reconsidering whether he still presents a risk, or whether he has gained insight and empathy that he is currently lacking. Perhaps new treatments will have emerged by then to make it possible. It seems hard to imagine that being the case. I’m usually an optimist, but for Huckle, I can’t foresee a happy ending – and I’m not sure I want to.

But there is a note of optimism in the bigger picture. Despite all the evils of austerity, and the massive burden that is creating on the wellbeing of the world population, and a few horrific cases that have been well-publicised in the media there is some progress. Sexual abuse is being talked about more, and more resources are being targeted at prevention and intervention. And there is fairly solid evidence that although there has been a dramatic spike of reports of abuse in the UK over the last two years, the overall prevalence of sexual abuse in the western world appears to be decreasing over time. Hopefully, that decrease will continue to accelerate over time, until sexual abuse really is the one in a million exception, rather than an all too present reality for a significant proportion of children.

 

Some thoughts on causing offence: 2 Trigger Warnings

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

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

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

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

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

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

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

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

 

Some thoughts on causing offence: 1 Cultural Appropriation

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Happily ever after: Some thoughts on trauma in the movies

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

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

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

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

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

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

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

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

Slow burn: Reflecting on the emotional impact of working with chronic trauma*

*This post contains vignettes of harrowing material which may upset some readers. Case examples are all anonymised.

When I decided to do work in child protection, people warned me it was the fast road to burnout. Twenty years later I think they are right about the direction, if not about the speed.

Burnout is an insidious thing. It sneaks up on you as a chronic accumulation of many tiny things, rather than having an obvious trigger, like a single life threatening event that causes PTSD. A thousand small examples of vicarious traumatisation. Experiences that I shouldn’t complain about as I’ve chosen a career that inevitably brings exposure to distress and tragedy. It feels like I’ve chosen to wade through the grottiest parts of life, until I’m normed on that 1% of stories that cause the most concern. It saturates me. Pollutes my perceptions of life. It has been building up for a long time.

Fifteen years ago my two specialist placements included post abuse work with survivors of sexual abuse, a group for non-abusing parents of children who had been sexually abused and work with “complex” children and families, such as those on the child protection register. I knew it was emotionally harrowing work then. I talked about it with a good friend, and concluded that my drive was to go where I was most needed, to grapple with the most complex cases, and that I’d worry about burnout when I got there. I graduated onto a clinic for children who were “failing to thrive” and most of my clinical time being with Looked After Children and therapeutic work with those who had experienced trauma or maltreatment. Right from the start, it was an induction of fire, salved only by the fact that it was important work that needed to be done.

It started with individual stories.

The sad silent child who ate 7 digestive biscuits and carefully stowed extras in his pockets during clinic, but whose parents claimed he had a digestive disorder that meant he wasn’t gaining weight despite eating plenty.

The young woman with learning disabilities who repeatedly played out how the daddy bear lay on top of the baby bear and thrust, but said baby bear was a liar and nobody believed her when she told.

The adult relatives who revealed at the last moment the sadistic physical and sexual abuse that their step-father inflicted, after he had charmed the professionals enough to get residence of his grand children, when their mother was unable to cope and had reverted to chronic drug use.

The maps of children’s bodies in medical notes, used for annotating injuries, including one for babies. The paediatricians sharing photographs of torn orifices, injuries, malnourishment and legs with rickets. “This one has burns on their hands up to a straight line on their arms, showing they were held in boiling water as a punishment”. No, I don’t want to see, thanks.

The little girl in a religious cult who couldn’t disclose her abuser as she had been taught it was as bad to think or speak badly of others as what they had done, and shown pictures of people rotting in the ground or burning in hell for their sins.

The boy who was conceived through rape, whose mother couldn’t look at him, and whose grandmother thought any challenging behaviour showed he was “living up to his genes”.

A girl asking how she got the zigzag scar on her stomach. The family didn’t want to tell her about how her mother tried to cut her open to let the devil out during a puerperal psychosis. They don’t want to spoil the relationship as she goes to Mum for alternate weekends. When I meet Mum she talked incoherently about spirits and auras, telling me she likes climbing on the roof to be nearer to God. She has no need of adult mental health services, thanks.

The young woman who always claims to be pregnant. Partners are less likely to harm her that way. She is couch surfing at the moment, which is the new name for homeless. Her only possession is a photograph of her son who was removed at birth and adopted. After physical and sexual abuse at home, and attempts to stay with numerous relatives, she grew up in care. She had a sexual relationship with her male carer at 14 which she views as consensual.

Since 2000 I have done expert witness work for the family courts. That means reading bundles of documents about trauma, child abuse, neglect, loss, violence, family breakdowns and mental health problems. It means speaking to parents who have been maltreated in their own lives, lack coping resources and instead of being able to create healthy relationships and flourish have limped from one bad experience to another. It involves speaking to children who have seen too much, had to cope with awful things and missed out on the love and nurture that you’d want every child to take for granted. I read about and sometimes see the state of the home, with rubbish heaped up and rotting, flies circling, dirty nappies on the floor, no clean clothing, nowhere to store possessions and no space that isn’t filled with clutter. I hear about broken bones, bruises, burns, rapes and assaults. Sometimes there are x-rays, photographs or medical records. I see sadness and anger accumulated over many years of getting a raw deal. I measure problems with learning, attention, behaviour, life skills, self-esteem and mental health. I observe who denies the problems, who spills over with them, and who recognises themselves doing as they were done by despite all their best intentions otherwise.

I read, and I listen. I measure and observe. I pull the pieces together to see what fits and what conflicts. It is an active process, trying to understand what happened, how and why. Evaluating insight and future risks. A computer couldn’t be programmed to do this. It takes empathy, curiosity, critical thinking and detective skills. I am the barometer of relationships, of what would feel okay, of what is causing harm. If I felt nothing, I couldn’t do the job. But there is so much pain to feel. So many sad stories.

A little girl with curly dark blond hair who the foster carer told me “shook with excitement to get her own dolly for the first time and promised to keep it pristine so that when mummy gives it to her little sister she will still think it is new”. I nod politely. Take verbatim notes. I have to stop the car on the way home for a cry.

A teenage boy tells me how his father often pinned him up against the wall by his neck or beat him with a belt. He wonders why he dissociates when he perceives threat or criticism now and worries that he is going mad. I try to explain his brain learnt to protect him when nothing else could.

I observe the baby that was rescued from the fire. Her scars are healing slowly, and the medical treatments are painful. She can’t bear to be touched. There is too much pain for someone so young.

A mother tells me how it hurts her watching the foster carer do a better job than she was able to at caring for her children. “I always swore I’d be different to my mum, make better choices of partner than she did, keep my kids safe from harm. I look at where we are now and see it has happened all over again and I can’t bear it”. And neither can I.

A teenage girl tells me she took the overdose because her step-dad broke the door down and overturned the bed to reach where she and her mother were hiding, and hit her mother repeatedly with the broken bed leg. She shrugs and smiles, and says “its just how it is, you know”. I don’t know. But trying to imagine it makes my guts curl and my eyes leak involuntarily.

A mother tells me about the culture she grew up in, and how grateful she is to be here, even though the whole family live in a single room in slum conditions, and it is hard to find work as an illegal immigrant. If her son is hungry, developmentally delayed, and being beaten for misbehaviour at least he is safe. I think that isn’t safe. It is all relative.

A father tells me that his uncle sexually abused him as a young boy, but there was too much stigma to tell anyone and he was afraid to lose this special relationship. He still spends time with his uncle now, and trusts him implicitly with his own children. A few sentences later he says he is baffled why the children are showing sexualised behaviour. I am baffled that other people can’t see how obviously the pieces fit together.

I assess a couple that smell so bad I struggle not to gag. I open the windows but it is not enough. I go out for air every hour. A social worker sprays perfume on my sleeve so I can raise it to my face to mask the smell. I learn the phrase “body odour to an extent causing discomfort to anyone in the proximity”. They don’t own toothbrushes and show me teeth rotting in swollen gums.

A woman tells me she has put on 9 stone as she needs to have fat deeper than the knife blade is long, since she was stabbed by her ex-partner. She wheezes for a long time after climbing the stairs at the contact centre, and she struggles to get down on the floor to play with the baby. I worry when she is slower than expected to return from the toilet, do I need to check if she is okay?

The child was born with HIV. His mother died of it. He lives with his grandmother. She doubts the diagnosis. “He doesn’t look ill, the English doctors don’t know about us”, she says when I ask why his prescriptions have not been collected.

A lady tells me that she must have had post natal depression. If she wasn’t ill she would keep the house clean, but when she is ill she can hardly get out of bed, and gets ideas that the world is very unsafe. That is why she kept the children in her bed with her, rather than sending them to school, until they were no longer able to walk. She’s on antidepressants now, and saw a counsellor for six sessions, so everything will be fine. The social workers are making a fuss about nothing.

A man tells me he has exercised to pass the time whilst in prison. He is proud that he is bigger and tougher than his father now. He says the robbery was the fault of the friends who bought him the beer and suggested the idea, and much exaggerated by the victim. I am glad I brought with a student to observe, as the room is quite isolated and his body language makes me tense.

This couple have managed to sustain the acrimony of their separation for five years. She says he was controlling, violent and obsessive about having every last penny accounted for. She tolerated his promiscuity for far too long. He says she was moody and manipulative, and it is probably her mental health that’s the problem, and her jealousy that he moved onto another relationship. It makes me cross that both of them seem to have forgotten the kids in the middle of their conflict.

A little boy tells me what it felt like to be buggered. I try not to think about it that night in bed. I play tetris on my phone until I fall asleep at 4am.

A woman tells me that all of her relationships have been with men who present a sexual risk with children. They are all so different, she says, that whenever she learns what to avoid the next one is nothing like it. And why wouldn’t you move in with someone you’ve just met? How else do you get somewhere to live after the last relationship has turned sour?

The story stems of a girl of eight show the family repeatedly pushing the girl off a cliff and laughing at her. For variation they poison her and laugh as she vomits. She repeats the loop for 90 minutes, then returns to lying foetal under the table as I leave, just as she was when I arrived.

“I had a cold, mum caught it, and it made her sick so she fell down the stairs” says the boy with autism. “That is why she had to go to hospital”. It wasn’t the head injuries her partner caused, it was his fault. But later in the conversation “Daddy gets out of prison soon. When he finds us he will kill us this time”. It is deadpan. An emotionless fact of life.

The girl in the children’s ward tells me “I didn’t want to go home. I jumped off the bridge because it would be better to be dead. They say I will need to be in hospital at least six weeks whilst my leg heals”. She smiles showing me the metal cage and all the pins reassembling her bones, and counts the pieces in the x-ray. She won’t say what is wrong at home.

“He spat right in my face and pushed me over. I was so angry then. I hit him with the lamp until it broke, then I whipped him with the cable. I could see the shape of the switch in the bruises when I was done. They might have seen it, but that’s not the same. I’d never hurt the children.”

A boy tells me what is different in foster care. “It was the best day ever. We went to the garden centre. I got to look at the fish, and we had a drink and a slice of cake at the cafe. We eat at the table with the grown ups here. I got my own coat too, nobody wore it before me! And my skin is better”. The carers tell me that they had to wash the grime off the bath after he arrived, replace all his clothes and do twice daily treatments of his infected eczema. They had to get a court order to shave off his matted hair as his parents would not give consent.

A five year old girl tells me about the day she came into care. “I could hear they had fish and chips in the front room. I could smell it. I tried to walk there, but my legs weren’t working and I kept falling over”. The medical records show that a visitor called an ambulance when they saw her unconscious and malnourished. Her blood test results are marked with blue biro. Haemoglobin is captioned “how is she alive?”. She dances when she shows me the foster carers have a rabbit run in the garden.

In each family I hear many of these stories from each individual, and I see several families each month for assessment. I’ve been doing this for over a decade now. I have banked hundreds of such narratives, maybe a thousand. All involve a child or children being harmed. The stories are each unique, but the themes recur. James blurs into Joshua and Jared and Jacob. Samira merges with Samantha and Saskia and Sasha. Depression and anxiety, broken bones and bruises, filth and mayhem, conflict and violence, cancer, obesity and sensory impairment, neglect and abuse heap up in my repertoire of human experience and leak out into my life. I see those stories lurking at the edge of my vision, in the arguments partially overheard in the shops, or behind the headlines in the news. I see their echoes amongst people that I know; my neighbours and colleagues and friends.

I set myself impossible standards. I worry if my child has messy hair when she gets back from school, or I notice mud under her fingernails. Will people think we aren’t taking proper care of them? Are we not taking proper care of them? We go to A&E after my daughter burns her hand. I ask her to tell the story before I speak and she says “it was your fault mummy, it was your drink that tipped over”. I feel like a failure and a hypocrite. My cat has a jaw infection and needs teeth removed and antibiotics. I should have known. He smells like the couple I assessed at the social work centre last year.

I say we need to leave the restaurant. I can hear a mother saying “ungrateful brat, I should never have had you” to her son. Outside the school a mother pushing a baby in a pram says to her friend “look at him giving me evils, he’s going to be just like his father”. I walk away. The couple outside the pub argue incoherently and their voices get louder and shriller as we walk back to our car after a night out. The child in the park approaches me and asks me to push him on the swings. People on the internet disclose abuse. In the supermarket I hear a slap and the child is crying. The woman walks past on the street with a fading black eye. They are anonymous and legion. The scale of the problem is overwhelming. I can do nothing.

Friends of friends ask for advice as they have heard I am a psychologist. Its important to try to point people in the right direction, but I am depleted. Another 2 lever arch files arrive at work. Its an incest case and mother is terminally ill. Surely there can be no more stories this bad, but there is a queue awaiting my attention. The next one has police transcripts of the interviews of all of Dad’s victims. He might be a paedophile but his daughter wants to see him anyway. The one after that they want me to see Dad whilst he is in prison for abducting the children to a different country. He believes it is his right; fathers own children in his culture. Then back to the bread and butter of court work, another family where neglect and maltreatment has been the norm through many generations. One of the children is the same age and gender as one of mine. Don’t make comparisons. Don’t go there. Change the subject.

A letter from a solicitor tells me that my invoice has been reduced by the Legal Aid Agency on appraisal. I will get £400 less than the total billed, despite not billing for 6 hours work already because of the fee caps. The hours were “not proportionate”. Do I explain again that it takes longer to do assessments via a translator? I don’t have the energy. Another one is querying the hourly rate. I should work for £7 less if I only see the adults as I won’t be a child psychologist. I ask if a psychiatrist gets paid the rate for a psychotherapist if they don’t diagnose or prescribe. The solicitor is sympathetic but says there is nothing they can do. A father doesn’t attend an appointment that is booked to fill a whole day. I have driven 2 hours to get here, and I wait for an hour whilst phone calls are made, then drive 2 hours home, exhausted. I can do nothing else with my day. Legal Aid say a psychologist can fill their time productively with other activities and refuse to pay anything over travel costs, even though the contract says that they will pay for any appointment cancelled with less than 72 hours notice. I can’t bill for materials, venues or typing. The questionnaires cost an average of £5.31 each. I used 6 per child and there were 7 children in the family. Does it add enough to my report to justify £220 of lost income? The LAA ask what ‘capacity’ is and why it took me 4 hours to assess it. Is it not embarrassing to work for the family court system and not to know this or to have the sense to Google? The self-funding father who was supposed to have lodged the cost of the report with his solicitor hasn’t. He now wants to pay in monthly instalments, but my staff get paid next week. I have to turn away two cases a day after reading about the plight of the children, because I am booked up too far ahead. The wealthy mother from abroad hasn’t paid her share of the bill from 4 months ago, but the court wants me to do more work for her case. There are 16 follow-up questions from the report I filed last week. Why do I do this again?

Tomorrow is the appointment to assess the teenage mother in the mother and baby unit. Yesterday her boyfriend told me about how they met online, and gave me their usernames. Google shows me his dating site entries seeking single mothers, Facebook posts about the violence in their relationship and a video of the baby’s “sexy dance”. A solicitor phones. Can I squeeze in one extra case this month? Mother has been evicted. She doesn’t want to see her child and is too anxious to talk to her lawyers. Could I fit the capacity assessment in this week? I get an email to my personal account. My builder’s sister’s son is feeling suicidal. I reply with the phone numbers for the Samaritans and the local crisis service. I watch the news story about the children in the refugee camp and am horrified to find I feel nothing. I have reached compassion fatigue. I turn off my phone and computer and go back to bed.

I am empty. My emotional resources have run out. Is this constant aching tiredness what they call burnout? I run on clockwork. I am a robot Mum and a robot wife. I fall asleep on the sofa. I am exhausted. At night when I finally fall to sleep I dream about children with their eyes sewn shut. I can’t save them all. When I wake I go to work and do it all over again. I’m good at this. It is important. It is needed. It is never ending.

Then I pause and take a few weeks off for a family holiday. Soon after we arrive the bubble of numbness bursts. I cry watching a video on Youtube. It segues into crying for all the children I’ve met, and all the children someone like me never met or didn’t reach in time, including the parents I speak to so often. I cry with frustration at my own limited reach. I cry for the selfishness of politicians, the broken systems and missing safety nets. I despair at how you increasingly need money to buy justice, and how hopeless and disengaged wide tranches of society are becoming. I click to sign petitions. I donate to campaigns. I counsel compassion in online debates. But I am tired. Achingly tired. Tired in my bones and my guts and my heart. I know how much this needs to be done. And I don’t know what else I can do. But I can’t do this any more.

A shallow look at fat

In her usual abrasive style, Katie Hopkins’ latest click-bait project is ‘to fat and back’ – she is putting on 3.5 stone in weight and will then lose it again, to show us how easy weight loss is and how there is no excuse for being fat. Some journalists appear to think there is something in it whilst others are a little more sceptical.

To me it seems obesity isn’t a simple matter of will power. You can’t will yourself thin any more than you can will yourself out of depression or addiction. The evidence shows diets don’t work, and once obese it is very hard to revert to lower weights again and sustain it. It is much better to aim for a healthier diet and lifestyle than a smaller body. And despite widespread understanding that fatness is associated with poor health outcomes, it is very hard to change, and often reinforced by stigma and shame. Your ability to change the pattern will depend on how long it has been around, your biology and what caused it to start in the first place, as well as your commitment to change, support network and what else is going on in your life. In Clinical Psychology we look at the biological, psychological and social contributors to particular behaviours or symptoms and make a formulation of how these interplay, so it is frustrating when people with no expertise pronounce easy solutions which ignore these factors.

If a thin person with very negative ideas about obesity puts on weight for three months, they will find it unpleasant, find losing weight rewarding, and have all the previous factors that made them thin before to revert to. If she is being filmed and paid then she has financial and performance pressures to succeed also, her reputation and career to maintain, as well as a wardrobe to return to. She has the metabolism, muscle tone, neurochemistry and lifestyle of a slimmer person. Will three months change that? She has people around her who expect her to be active and slim, and will support her returning to that familiar mould. And when losing weight she has the money for personal trainers, gym memberships and healthy food (if not diet systems and products) and the sense of herself as a thin person who is capable of exercise.

It’s a million miles away from being a chronically obese person and trying to lose the same amount of weight. To pretend this is a serious experiment that will tell us something about how to lose weight is playing at a serious issue. It reminds me of Pulp’s Common People.

A real obese person has a lifetime of thoughts and feelings about their body, and the perceptions others have of them. They carry internalised shame and self-criticism that associates fat with laziness, gluttony, lack of willpower, and lack of self-respect. They probably avoid eating in public, or showing their body shape. They might not feel comfortable going to places where attention is drawn to their size, or they would stand out compared to thinner, fitter people – like gyms, swimming pools, or exercise classes (because statistically the people who you see there most are the fittest people, and not other new starters or people who find it hard, because these attend less and are more likely to drop out over time, whilst health/success is self-sustaining).

And the weight may have many origin stories that are tied in to uncomfortable issues they wish to avoid thinking about or haven’t yet resolved. They may have put on weight after a trauma or loss, during a pregnancy, or to insulate themselves from the world, or because food is the only pleasure in their life. They might comfort eat because feeding is tied in to their experiences of nurture. The origins of the ACEs study show that morbid obesity is associated with severe early trauma, with 55% of patients in a bariatric surgery clinic disclosing childhood sexual abuse (usually incest). It can be a form of slow suicide, or a daily process of numbing out the pain and yet unwittingly reinforcing the body shame that they experience.

Or it can have less extreme causes. The individual might be ignorant about healthy eating, or have other lifestyle constraints that make healthy eating harder, like poverty or chronic sleep deprivation, or a family/peer group that consume huge amounts of calories (whether the 20 pint weekend, the endless cake in the office, massive portions or regular takeaways being delivered). They might have health conditions or disabilities that make exercise or even activity difficult. They may have developed psychological and neurochemical reward pathways for their eating pattern. They may feel shamed by the societal pressures to conform to what is considered attractive in the airbrushed models on glossy magazines and find thinking about losing weight a painful and ever-present topic (see this paper by Ratcliffe and Ellison last year). On the other hand, they may be ambivalent about weight loss. Their partners, parents, friends or kids may be used to their shape and habits, or even like it. They may have had many experiences of previous attempts at weight-loss that have been unsuccessful or were quickly regained. Change in many circumstances is really hard to make, and harder to sustain.

Every obesity story is different. I know people who feel they need to be heavier than a past abuser or dominating partner, so they can’t be pushed around again. I know people who want a layer of protection against a dangerous world. I know people who want fat deeper than a knife blade is long, in case they are attacked again. I know people who want to deter any sexual attention. I know people too anxious to leave their house to shop or exercise, or too poor to afford fruit and veg or to pay for fuel to cook with. I know serotonin junkies where food is their drug of choice. I know exhausted people who fend off tiredness with sugar. I know of people who eat because they are under stress. I know a lot of unhappy people who don’t think they deserve better, or could ever be attractive or physically fit. I know people who are hopeless about ever losing weight (often within a wider sense of hopelessness about their lives). I know people who have spent their whole lives being fat and living a lifestyle constrained by that fat – tired, big, heavy and excluded from physical activities. Mocked at every turn. Excluded from aspects of society. Disempowered. Weight loss is categorically different from that starting point, and it is not just naive but wilfully ignorant to pretend otherwise.

Of course, I also know people who like being fat, have come to accept themselves as they are, or who see their weight as a very low priority in life. There are women who enjoy defying what they see as body fascism or sexist expectations about women’s appearance, or who simply see their curves as sexy. I can see the appeal in filtering away the shallow people who care about how people look more than who they are and what they do. And I’m aware that BMI is a blunt tool for measuring obesity, as it ignores body composition and scores people with high levels of muscle as equivalently “unhealthy” to those with little muscle, despite the positive differences in health that resistance exercise is known to make.

Katie won’t be happy being fat, and maybe it will give her some perspective about how judged and self conscious people feel when they are overweight. Maybe she’ll show some hitherto hidden empathy or concern for others apart from herself, but I doubt it. The promotional spots so far suggest the usual dose of hubris and ignorance, carefully engineered to provide publicity. I see this program as part of our obsession with celebrity and appearance, and the tendency to discuss serious issues (especially those affecting women primarily) with no depth. Hopkins has become the mouthpiece of internalised sexism; the pervasive belief that women need to be decorative rather than functional to be of value, and therefore shouldn’t think about issues beyond their own appearance and judging the appearance of others. She is also a caricature “baddy” that earns her living by being controversial, and by saying things that are not socially acceptable but that reinforce the wider narratives of the organisations that give her air or column space, who like to blame the individual and turn attention away from the real underlying socio-political causes.

Finally, I am reminded of a line that is helpful to think to yourself when experiencing playground bullies: I’d rather have my weight than your attitude. For all the challenges involved in losing weight, it’s still easier than changing personality or gaining empathy after years as a callous, judgemental, self-serving, attention seeking provocateur.