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

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

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of it was hard to navigate, and key documents were hard to find, the documents and information on the site were often out of date and much of the content was hidden behind walls for members and separated into silos by the Society structure that were impenetrable by topic.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

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

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

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

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

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

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

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

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

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

A promise to my daughters

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

 

Hope out of chaos

I’ve written a lot about how distressing I’ve found the vote to leave the EU, the increase in overt racism, and the move to the right politically. In fact I’ve been quoted more widely than expected on this topic, with my letter published by the Psychologist website, a quote in a fantastic column in New Scientist and even this blog being quoted on Buzzfeed because I used to work with one of the Conservative Leadership contenders. Theresa May has just become Prime Minister, and my feeling is that she was the best of a bad lot. However, what saddens me at the moment is all the in-fighting in the labour party.

Let me nail my colours to the mast. I consider myself to be political, but not party political. I’m significantly left of centre when it comes to the political spectrum, and believe in progressive policies. I’d like to reduce the wealth gap, strengthen public services and reduce inequality through improved education and opportunities (including properly funded legal aid). I want to remove donations and corporate lobbying from our political system, and replace them with a fixed fee for membership and proportionate central funding. I believe in taxation on inheritance and property, bonuses and the top 1% of wages, but also the Robin Hood tax on financial transactions. I don’t believe in taxing sanitary products, heating, e-books, or any services provided to support free-at-the-point-of-access health or social care.

In terms of current political parties, I have a lot of admiration for the Green Party and the SNP, but I’ve never been in a location where there is an option to vote for either of them. In fact, I have always lived in safe Conservative seats. Until the death of John Smith I would probably have considered the Labour Party as my closest match politically. After that I felt homeless. I voted for the Lib Dems once, but felt betrayed by them entering the coalition with the Conservatives and supporting tuition fees.

Authenticity, empathy/mentalisation and reflective capacity are skills that I look for in the parenting assessments I do for the family courts. I consider them to be essential attributes when it comes to forming human relationships, so whether or not I see them in a politician really is make or break for me. And they are much rarer than you would hope.

John Smith was the last place I saw authenticity in the Labour leadership. I never could trust Blair, because his smile never reached his eyes, and his body language never seemed congruent with his verbal content. It was as if he had been so carefully schooled not to give away his true feelings that there was a hint of the uncanny valley. Likewise, Brown looked as forced when he smiled as May and Leadsom’s recent grimacing contest, like early models for Blade Runner style replicants. Milliband was so socially awkward that he was hard to feel any connection with (though in the pre-election interview with Russell Brand he seemed to relax a little and I saw a glimpse of something likeable and real that I’d not seen before).

The millionaire cabinets filled with chums from Eton and Oxbridge that have formed the last two governments have all looked to me like posh teenage boys that had teleported into adult bodies and, like the plot of a formulaic film, were trying to pretend to be grown ups doing responsible jobs and hoping they got to have sex before the switch was discovered. Bumbling Johnson and Trump have both learned to mask the threat they present by modifying their body language to appear ridiculous enough not to be taken seriously.

In short, politics has become a world full of phonies. The exception to this has been Barack Obama. His election gave me hope for the world, and I think he has been pretty authentic throughout his two terms (though any real power to create change, such as gun reform, has been leached away by the broader politics around him). I have particularly enjoyed him as he has become less guarded and shown his sense of humour more as he reaches the end of his term in office. His books are high up on my list of reading material next time I go on holiday, or if I ever have more time available.

And now there is Jeremy Corbyn. Since the death of Tony Benn, I see him as the one authentic option amongst a sea of vested interests and spin.

If I’m allowed to metaphorically liken the political changes around Brexit to a flood, then it has felt like we are wading through knee deep brown water contaminated with the sewage of repulsive opinions that is pooling in the homes and buildings all around us. Much of the established political road network has been flooded or washed away. My every instinct is telling me to get as far away from the mess as possible. However, the only person not being swept along with that tide has been Jeremy. He’s just been quietly organising teams that are going around door to door checking if people are okay, and trying to plan what needs to be done to clean up and repair the damage. He doesn’t have the uniform or back-up of the emergency services, but nobody has really seen them doing anything beyond trying to divert the water around the corporate skyscrapers, so he’s become something of a local hero. The news is blaming excessive rainfall up river, and congratulating the emergency services for keeping the businesses dry, whilst criticising “have a go heroes” for interfering, and saying it will take many years before flood protections or repairs can be organised.

Some people say Corbyn is too far left, and unelectable. To that I’d say you don’t need to be electable to be an effective opposition, and to change policy and the scope of discussion. UKIP have demonstrated that brilliantly over the last five years! Opposition has changed policy in a number of key ways over the last few years (making a series of government u-turns over cuts to benefits). If we had a coherent labour party giving a unified voice to this opposition we could achieve even more, whether or not we achieve a Labour government. It seems that the goal of gaining power has become of higher priority to some PLP members than the goal of making a difference for the constituents they represent.

I think Corbyn is one of the few people that understands that British politics is broken at the moment. Too much influence is purchased with party donations and sponsorship, and too many rich people are right at the top and making decisions with self-interest at the core. We need to reform that, and get genuine representation of the people. We need to reengage the people who are not voting more than we need to fight over the middle ground. We need to help people identify as working class and fight for their rights, despite the tide of propaganda getting them to blame immigrants, the EU and the vulnerable. Again, Corbyn is as close to that as I’ve seen in my adult life. He has no affiliations or financial interests outside of his job as a politician, and he has refused to kowtow to wealthy donors.

I fully accept that he hasn’t given his opinions in snappy soundbites. But I can’t see that as a bad thing. Issues like leaving the EU are complex, not black or white, and they merit reflection and discussion not just a yes/no answer. So I think that whilst people say he is losing the game, he is actually trying to play a different game, and one I think is a damn sight better.

I think Corbyn is a breath of fresh air in British politics. So I am very sad to see the way he has been treated by the PLP. Whilst complaining that he cannot lead, they have refused to follow him, despite his inclusiveness when it came to selecting the shadow cabinet.

To stretch another metaphor, I see it like an artist agreeing to make a mural with 200 aspiring young artists from local schools, and then finding out that 140 of the names on the list are of kids who are not engaged in mainstream education and have no interest in art. The way I see it, the artist’s only option is to try and make everyone feel included, select widely for those who are to take each role in making the mural, and then when kids don’t turn up, to fill the gaps with those who are keen to get on with the project. Sure, the artist can try to go out and meet with each kid who doesn’t turn up and try to engage them in the joys and challenges of the project, but that will mean they give a whole lot of energy to fruitless battles and will sap away the time for actually creating the art. The artist can’t fix the system that was stacked against them within the time given, so it makes sense to just get on with the art itself, in collaboration with the kids who want to work with them.

The only difference is that all labour MPs should want to create this piece of art, because in the terms of my metaphor they are art students and it is the course they signed up for, even if the style of the artist isn’t the familiar commercially driven billboards they were expecting. The result might still be surprisingly beautiful.

I believe the Leave campaign had massive appeal because it became a way to express dissatisfaction with the status quo, when the neoliberal hegemony meant that people could hardly see the difference between the mainstream political parties. Voting leave became a way for people who were feeling disenfranchised to thumb their nose at authority, to try to disrupt the established political systems. If that conclusion is correct, then I believe that this desire for change could as easily swing left as right, if the media and prominent voices from that side offered targets to blame (eg bankers and millionaires who buy politics) and promised easy solutions (tax bonuses and top 1% salaries, robin hood tax, fixed funding and no donations to political parties). The Labour Party need to unite to harness this desire for change, and to show that they can deliver it.

But not only have they not connected with the people or the media, they have allowed Theresa May to seize their territory by making a speech claiming that the Conservative Party can serve the working class (despite almost every claim directly contradicting with her voting record), whilst the only Labour news is about how the PLP don’t have faith in their leader, and have shown this in less and less dignified ways. The in-fighting has become increasingly ugly. Watching charismaless Eagle squirm whilst Leadsom’s resignation stole the press from her launch may have been the most cringe-inducing moment so far this year. But it is clear from the lack of policy or answers to any questions that she stands for nothing apart from not being Corbyn. I also suspect she has been goaded into being a stalking horse to allow other members of the party with leadership ambitions to come forward with less risk.

Meanwhile 130,000 new members have joined (or returned to) the Labour Party because they like Corbyn’s approach to reforming politics, and share the hope for change. And instead of being welcomed with open arms, they are having the door slammed in their face by the PLP, who assume (wrongly) that they represent militant left-wingers rather than members who lapsed during the New Labour years but have now returned because of seeing a return to principles, young people who have engaged with politics for the first time, or the disenfranchised members of the general public that they should want to connect with. Nearly 600,000 members could be an amazing force for changing politics in the UK – that’s just over 1% of the voting population, nearly four times the Conservative membership, more than ten times the membership of UKIP and the largest membership of a political party in modern times. In my opinion, making exclusionary rules as to who can vote for the party leader and chasing the centre ground is exactly the wrong move to make, and will end in anger, legal challenges and a split in the party. But it seems that touch paper was lit before the referendum, and emotions are only getting higher, so I doubt the insight to avert it will arrive now.

If there is any hope we can make politics more authentic, and/or bring it back to the basics of representing the electorate, then that could give some meaning to all of this chaos for me. The one advantage of chaos and disruption to established systems is that change is possible. And the one person who has been consistently showing the qualities I’d want to lead that change is Corbyn.

So here’s hoping that we can make something positive out of the ashes of the current firestorm. I would welcome positive change right now, in whatever form it takes!

 

Not seeing the wood for the trees: A blog on progress and setbacks

After 3 days of feeling overwhelmed with depression about the referendum result and rise of racism, to the point of being immobilised and pessimistic about the future, I went out for a walk in the sunshine this afternoon.
 
I looked at the trees that have grown for much longer than I’ve been alive, and will still be growing long after I am gone. I noticed the way that rivers travel through the landscape making imperceptible changes that can cut through stone over time. And I thought about how evolution means that current species of plants, birds, animals and insects can make better use of their environment than their predecessors.
 
It made me think how much progress there has been in the last century in terms of human society across the world. We’ve made massive steps forward in science. We’ve cured diseases and developed more effective treatments and means of prevention. World poverty has reduced, infant mortality has fallen, and life expectancy has increased. We’ve seen the world from space, and started to map the universe and the genome. We’ve become a more secular society. War and violence are reducing enormously over time. Our tolerance of prejudice has reduced massively. Human rights have been championed in more and more countries. Gay marriage is now enshrined in law in most western democratic nations. We are more aware of finite energy resources and more mindful of the environment. Through increasing internet connectivity, many more people have access to information than ever before.
 
I realised that by the time our kids are adults the world will be very different to how it is now. They have grown up in a different age, with more awareness of the environment, greater opportunities for travel, and much wider access to information than any generation before them. They are world citizens, born into an age of technology and opportunity. I hope they will build a kinder and more tolerant society because of that.
 
It is easy to focus on the depressing headlines in the news, and the latest murders or racist incidents – but they make the news because they aren’t everyday events that we turn a blind eye to. We might have just taken a massive step backwards in the UK, but progress marches onwards, and despite all the skirmishes and set-backs, good triumphs in the end.
 
I believe the UK is mostly full of decent people who care about each other. Sure, much of the British media is full of poisonous propaganda, that blames the vulnerable rather than letting us look upwards at the wealthy and powerful who are siphoning off our rights and resources for their personal gain. And yes, the ideological choice of austerity has increased the wealth gap and made many people feel they had little to lose. And yes, a lot of people feel disenfranchised and were so used to being ignored that they voted for change without knowing what the change would mean. But I think the proportion of people who are genuinely racist and hateful is smaller than it appears. And the rest of us want to find a peaceful, progressive way forward.
So we need to stop being overwhelmed, stop the collective messages reinforcing our learned helplessness, and put our heads together and push for the most positive outcome possible. We need to all engage in the political process. Let us stop mourning the loss of the country we had and work together for a better one.

Terrorism revisited

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

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

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

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

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

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

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

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

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

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

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

From a paper by Silke after 9/11:

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

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

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

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

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.