Difference as a strength

I read an article recently entitled “There are no black people in Africa“. The idea seems like one of those obvious-once-you-think-about-it things that needs to be said more: People don’t inherently identify by skin colour, we identify by our culture, language, geography, function within a community etc and it is only when colonialism and migration put people in a context where they are seen as “foreign” or “different” that the labels of others (often those with power) group them with everyone else in the world with their skin colour as if this is a simple homogenous group. So in America or Europe there is a notion of “black” (or BME/BAME or BIPOC) being defined by being anything other than the majority “white” skintone, whilst in Africa or the Caribbean (or Asia) people are not defined by that (majority) characteristic, but by things that are more meaningful to them.

I agree with the author of the article that lazy stereotypes then follow from this overly simplistic labelling of others, which allow people to make assumptions about whole races or continents (eg the fictitious belief that all of “sub-Saharan Africa” comprises impoverished tribal communities reliant on western aid, whose lives bear little in common with those in industrialised nations, because all many Europeans know of these nations is the charity appeals during times of war/famine). It also ties into the white saviour thing, where people without relevant knowledge and experience arrogantly believe they can go and solve the “simpler” problems of more “primitive” countries, where their unremarkable skills will bring remarkable insights by comparison to local knowledge.

Even the language exaggerates and simplifies a multitude of difference into two categories; using white and black as polar opposite colour terms for what are actually countless shades and variants of colour from pink to deep brown. Whilst the language then links together people with wildly disparate geography and culture, simply on the basis that similar coloured paint would be used to capture a portrait – which seems a rather weird and arbitrary thing to see as a primary defining characteristic. It reminds me of arranging to meet someone at a conference that I had never met last year, where I described myself as “short, overweight, with long dark hair and a colourful dress” and the person I was meeting said exactly the same description could apply to her. We successfully recognised each other from the description, and we realised we had very similar professional interests also. However, we also realised the one thing neither of us had named was our skin colour – she was black and I was white.

I don’t think the author of the article that triggered this blog has the clearest writing style to convey his point – and he is almost certainly not the first person to name this exact thing. Nor do I think that his insights in the other articles I glanced at are unique or always right (eg other sources don’t support the 7 phrases he says we should stop using because of racist connotations) but I’m glad to have read the article, because it did really clarify some stuff I hadn’t put together myself. The fact I had not, is in the end a mark of privilege; the fact I’m not personally impacted and therefore haven’t had to do the work that so many others have to do day in and day out when thinking about race. I’m lucky to have never experienced racism, despite being a second generation immigrant (nor have I been on the receiving end of antisemitism, despite the fact my Jewish heritage carries its own burden of discrimination). I attribute that to being white and secular in appearance (I’m an atheist by belief).

As an aside: Identifying my own privileged position does make it feel awkward to write about race – there are so many things that I could get wrong, and so many people who are rightly feeling angry or depleted, or who might rather have minority voices amplified than another middle-class white woman add her two pence. All of that is true. But sometimes hearing things from a different perspective also has value, or gives the easily digested intro in familiar language that helps people to access voices with more lived experience. So I hope that if I’ve written anything that rubs anyone the wrong way, you’ll let me know so I can fix it up for others and keep learning.

Recent world events really have higlighted the extent of the problem, and how easy it is to foment division during stressful times – with Trump undermining democracy with his increasingly desperate attempts to cling to power, social media and much of the press amplifying divisive rhetoric and expressing the propaganda of their billionnaire owners, Johnson appealing to the worst elements of nationalism and the pandemic highlighting growing inequality, whilst the national act of self-harm of Brexit is reaching it’s final act. So it is no surprise that racial tensions have bubbled to the surface too, with the again so-obvious-it-shouldn’t-need-to-be-said Black Lives Matter protests gaining traction all over the world. Here in the UK the unequal death toll of covid-19, and the inequality enhancing manouvres of our xenophobic current government have really highlighted how prevalent and dangerous this unspoken level of latent racism in systems and the population really is. It is another stark reminder that what appears like a meritocracy in which everyone has equal opportunity only feels like that to those who are not weighed down by the adversities inherent in the system.

Thinking about the uneven playing field also ties into a phrase I read recently: Talent is evenly distributed, but opportunity is not. When it comes to investment in business ideas in the UK:

  • only 1% of investment went to all-female teams, whereas 89p of every £1 invested went to all-male teams, and 10p to mixed gender teams
  • black entrepreneurs receive only 1% of funds invested in the UK
  • black female founders received only 0.0006% of the funding invested in the decade from 2009-2019, with only one black female founder in the UK reaching series A investment in that period (compared to 194 white women, and over 4000 going to all male/majority white teams)
  • female and black founders who do gain external investment, secure lower sums of money than their white male counterparts
  • 72% of investment goes to companies based in London
  • 43% of funding goes to founding teams with at least one member who attended Oxford, Cambridge, Harvard or Stanford
  • investors are 91% male, and 93% white, and only 3% of VCs in the UK are black
  • you are 13 times more likely to receive investment with a “warm introduction” from someone in your own network, which reinforces social exclusion
  • 88% of black entrepreneurs self-fund their business without external investment

Yet there are so many challenges that benefit from personal insight that might only come from certain subgroups of the community. I recently read about the founders of CapWay struggling to get investment because the venture capitalists didn’t understand that there are currently people who don’t have a bank account in the USA, for example. Imagine if the founders of Air B&B had never been broke enough to want to stay over on (or rent out) an airbed in a spare room. It gives a glimpse of what might solve a problem those who have had an easier life might never encounter. I’ve met social entrepreneurs who have explained to me the need for a mobile phone in order to identify sources of food or accommodation if you are homeless, or how much female offenders value employment and how this makes them highly dedicated employees. There are also traits that come from surviving adversity that are really helpful in an entrepreneur – being resilient, persistent, being able to juggle multiple demands at once, being grounded in the reality of customers or service users. There are also strong signs that more diverse founders lead to better returns on investment – women founders return more than men, and diverse founding teams more than all white teams. So this is very much an area that is rightly getting more attention.

In my recent business networking with other social entrepreneurs there has been a wide range of people represented in terms of gender, race, country of origin and socioeconomic class. I’ve spoken to people using their links to other countries and cultures in their business, working spanning boundaries, timezones and continents, and bringing ideas to their business from all kinds of prior experiences both personal and professional. I love speaking to people who see things from a different angle, and I am convinced that it so much more helpful to throw ideas around than simply speaking to others who have had similar life experiences to my own. It is one of the reasons I love Impact Hub, as is one of the organisations where all of us in the early stages of developing businesses with a social purpose can find equal support and a culture in which there is value in different perspectives. I’ve used them as my London base for many years, because their co-working space is so convenient for Kings Cross/St Pancras, but they have been brilliant at making an online only membership to adjust to lockdown. And living through a pandemic, I have never been more grateful for my virtual networks to keep me inspired about what I am trying to achieve.

Learn more about the inequalities in business investment here and more about Impact Hub here.

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

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

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

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

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

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

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

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

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

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

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

If you build it they will come: The impact of making space in my professional life

When my personal development coach told me that the first steps towards having a happier working life and better work life balance were to a) figure out what I wanted to do most and b) clear out some space in my life for it to fit into, that seemed a bit back to front and almost too obvious.

Although I’ve always known that I want to apply clinical psychology to helping the most complex children and families, I felt a real lack of clarity about what I wanted to do. I think in retrospect this was because I’d originally envisaged nothing more creative than a career in CAMHS in the NHS. But even once I was outside the NHS I still felt this lack of vision for my ideal future, perhaps because I wanted to choose it from the options available to me, and I hadn’t explored what those might be very far beyond returning to the NHS or continuing what I was doing already (court expert witness work, with a side helping of trying to influence policy and practise by being involved with national committees, standards groups and supporting the next generation of CPs).

I had also internalised the idea that the right process was to build up my investment of time in what I wanted to do more, until that took off and allowed me to do less of the other stuff. I felt like clearing out space from my established work streams was of no value (or even a potential risk to my income) unless I had figured out what I wanted to do, or ideally created the alternative channels already. But slowly I realised that if all my time and energy was being consumed by my current workload, then there was no capacity to imagine anything better, to seek out any opportunities or plan any change, and I’d still be overloading myself and worrying about my work life balance in a year from now, or five, or ten.

So I decided to take a gamble and cut down my work commitments for a while and give myself thinking space to figure it out. Of course, being me, I took on the new part-time consulting role that was going to pay the bills whilst giving me time to think before I had managed to reduce my existing workload. So I had six months in which I had to overlap this new role with my all my ongoing court and committee work, before I was able to wind them down very much at all, and then a minor RTA to contend with (see previous blog). So I sure didn’t take the easy route to cutting down.

But the physical jolt was the final straw to help me to realise that I needed to change my work patterns and I have been able to spend more time with my family, and have now stepped down from almost all of my committee roles. This is an enormous change after 4 or 5 years on the BPS CYPF committee, nearly double that of being involved with CPLAAC, and more recently being part of the BPS/FJC standards group for psychology experts to the family court and the NICE guidance development group for attachment interventions, and a rep from the BPS to BAAF. I am now at the very tail end of the court work, with just three small pieces of work to complete (each an addendum to prior work or work that was delayed after I agreed to complete it) and a couple of single days in court.

Although my time is still very fraught for another couple of weeks and we will then segue into Christmas (meaning my winding down schedule will have taken me almost a year to achieve), I’ve managed to get onto some tasks I have been avoiding for a long time. I’ve started to work my way through the financial tangles that constantly stop things running smoothly – this is mainly the enormous pile of unpaid invoices where parties to court work have disputed their share, gone bust, or just not paid for years and years, but also includes the un-invoiced work that we have completed, expenses I have not claimed back from the company, and the administrative task of reconciling our records with the bank statements. My team have stepped up to help me and as I have made sense of it bit by bit it feels like that tangle is turning into a single logical thread I can follow and wind up as I go.

As I sort and put away the clutter that consumes my time and energy step by step, I am starting to feel less overwhelmed by running the business. As the volume of court work I undertake reduces, so does the emotional weight of the work. And as the burden I am carrying gets lighter, psychologically at least, some small gaps between the demands on my time and energy are already starting to appear. Into those gaps has come the beginnings of the vision I lacked of where I want to take my career in the future, and what kind of life I want.

I’m sure I’ll talk more about that next time. But for now I just wanted to share that it feels great to put down some of the load I have been carrying, to untangle the frustrating little issues that have been tying me up, and to create space for the stuff that I care about the most. With the help of a new business mentor I’ve been able to connect with the motivation that started me on this journey, and to finally work out where I want to go both personally and professionally. And that makes all the steps I have to take to get there much clearer.

I made the space, and sure enough, the goals of how I want to fill it have come to me.

The double bind of trying to do research as a clinician

In my first job after university I was an Assistant Psychologist on an applied research project evaluating the impact of staff training on the quality of care in old people’s homes. It wasn’t my natural client group, but I loved the fact that we were measuring whether all our fancy psychology ideas actually made a difference to people when applied in practice. My supervisor, Esme Moniz-Cook was an inspiration in this regard, and set a pattern I have aimed to maintain to this day: innovate, evaluate, disseminate. We wrote lots of papers, and each one worked through many iterations in which Esme would cut up a print out of my latest hopeful draft and stick it back together and/or annotate it in different coloured pens. I developed a ritual to overcome the frustration: I would look at the result, take a few deep breaths and then set it aside. Then I’d move the text around on screen to match the arrows and sellotape. Then set it aside. Then do a few of the suggested edits that felt too trivial to argue about and set it aside. Then I’d look at the reduced number of suggestions that was left and decide which were worth disputing and do the rest. Then I’d send it back to Esme and the process would repeat. It was a challenging process, but the papers were always better as a result, and meant I started training with a set of publications on my CV. My doctoral research felt like a piece of cake by comparison. I developed and evaluated a computer based training tool to help people (especially those on the autistic spectrum) learn to recognise facial expressions of emotions and predict how people would feel in different situations. I published a paper from it, of course.

As a newly qualified clinical psychologist in 2000, I was all fired up about continuing to do research. I put in a bid to two charitable funds to expand my doctoral research to a larger population and to follow up the effects after a period of time. It took me a long time to complete the proposal document and to get all the signatures, references and endorsements from both academic and clinical hosts. Both were declined. The first said the bid was so strong that it didn’t need autism specific funding, the latter said that we hadn’t accounted for poor uptake or drop-out because they didn’t know how keen the kids with ASD had been to have extra computer time. It felt like a Catch 22. In retrospect I should have researched the potential funders better; the former probably wanted research that would relate to their patented use of pig secretin in autistic children, they focused on medical interventions and were not interested in something as ‘soft’ as psychology. I was gutted. In the time I had spent preparing the two bids I could have made significant inroads into the study, but I hadn’t got off the starting blocks.

In my next job, I applied my learning to undertaking small bits of research myself by juggling my clinical time. I explored what it was that defined the young people who challenged multiple agencies. I evaluated how social workers in the adoption support team reacted to having the opportunity for consultations with a psychologist. I measured the Theory of Mind skills of Looked After Children and compared them to children with ASD and a control group. I assessed the cognitive ability and mental health of the children in residential care homes within the catchment. Most importantly, when asked to advise on how to improve adoptive matching, I undertook an audit of factors affecting adoptive outcomes across 116 families. This turned out to be the largest study of risk and resilience factors in adoptive matching ever undertaken in the UK.

I found the answers to my questions, and I learnt a lot of new things that other people need to know. But I had no funded time or academic support to disseminate the results. With the smaller projects, I let my Assistants write up the results for publication in professional newsletters and present them with me at conferences. But with the larger studies I wanted to do them justice, and my NHS role never gave me an opportunity to do so.

Once I left the NHS, I followed up my adoption audit 5 years after the initial data collection because I was determined not to let such interesting findings disappear into the ether. Then I made another bid for research funding, and by fluke or serendipity secured a £75,000 Shine Award from the Health Foundation to complete a one year study of the impact of adding brief psychological input into the local diabetes service (something I have previously blogged about). We reached the end of the year and applied for further funds to spread the impact, but were told that they do not fund follow-up data collection, or time to write up results for publication as this should be done in the course of your employment in the NHS. Of course we don’t work in the NHS, and have no funded time as part of a bigger contract or our contract of employment. So the Assistant Psychologist who was doing our data collection and analysis was only funded for the duration of the project, and has since moved on. The £2500 they did offer towards a editing our service user feedback into a short video, revamping our website, a press release and a small local event, requires a long report to release which is now overdue. I’m still trying to work out how to complete and submit the academic papers, but this takes time and means it has to compete against all the other demands of running a business.

Herein lies the big double bind: you need funded time to write bids and to write up papers to give the credibility to future bids, but unless you have academic tenure this time is not funded. For a clinician it competes with more immediate clinical demands, and for someone self-employed it competes with the tasks that actually pay the bills (in my case training, consulting, and up to 4 court assessments per month). There are also other things that demand my time and mental energy (committees, other forms of writing, http://www.clinpsy.org.uk, etc) and I sometimes even have a life outside work. Not everything can fit into the evenings and weekends, even if I allow work to expand into the rest of my life like gap-fill foam.

But I am not defeated. I am determined that the diabetes results will be submitted to peer reviewed journals by the end of the year. And I’m even more determined that what I have learnt about risk and resilience factors in adoptive matching will make its way into social work practice. I’ve considered all kinds of options including writing it up as a PhD, or a book, or a series of papers, or all of these things seeking funding as a grant, or a stipend, or a fellowship. I’ve tried to use my network to find potential funders. But nothing seems to come to fruition in a way that would allow me to have funded time to write it up with input from a statistician, whilst still having at least half my working week to run my company. Perhaps that is just asking the impossible, no matter how close to fruition the research is or how it will impact on people’s lives. I don’t know.

Meanwhile I keep asking the questions and gathering the data that will answer them, even if I can’t share the results. Innovate, evaluate, disseminate is simply part of what I do. I’ve got grand plans for what the next project will be, but I’ll save them for another blog.

BTW, if you have any ideas where I can secure funding, or want to collaborate with me I’d love to hear from you. Likewise if you can offer an overloaded clinician with big ideas a nominal NHS and/or university home, that would also be very welcome. It is twice as hard to bid for funds when you work in a small company that nobody has heard of!