politics

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.

 

Thinking about vulnerability and risk

Sometimes you pull on the littlest of threads and the biggest of issues appear at the other end.

Today I have been training in quite a remote location in the Welsh borders. It is the first time in quite some time that I’ve been in a location with no mobile signal. And no mobile signal meant no satnav to find my location last night, and no means to let my husband know I had arrived. I soon found there was no working phone box, and given the late hour there was nobody around to ask directions. And all of a sudden I realised that I was lost, alone and that nobody knew where I was! For those few minutes before I found the hotel, I realised how much I have grown to rely on technology to feel safe and oriented in my day-to-day life. And then I wondered if I felt less fearless before those technologies were so ubiquitous, or whether it is just the absence of a crutch I have grown to rely on that made me feel more vulnerable. After all, what was the real risk?

I started to think about about how we are trained to over emphasise certain sorts of risk (like stranger-danger, or the risk of immigrants on unemployment rates), and to under-recognise others (like the risks to children from exposure to domestic violence, or the risks that so many families face from poverty and discrimination). It seems that the media trains us to be most afraid of the things we have least control over. A cynic might think they want us to have an external locus of control and a certain degree about learnt helplessness when it comes to social issues. Whatever the motivation, the result is that many people go about their lives with little awareness of the risks that I see as the most important in society today – how vulnerable many children and adults are to abuse and exploitation, how maltreatment is normative in certain families and communities, and how interpersonal violence, trauma and abuse can change the path of people’s lives.

One example of risk and vulnerability that has been prominent in the media recently is how the press has turned once again to discrediting victims of abuse who speak up. This has taken several strands. First the media narrative has changed from “survivors of child abuse” to “alleged survivors of child abuse”, sowing the seed of doubt about every person who makes a disclosure. Second politicians are telling their colleagues to withdraw allegations due to loyalty to their party, and trying to shame the brave few who spoke up and asked for multiple disclosures and allegations to be investigated into apologising for maligning a powerful public figure. And third we are repeatedly hearing that those with allegations against them which are dropped by the police or CPS have been “proven innocent” or that victims have “lied” or “fabricated” rather than the more accurate truth of the matter, in which there is insufficient evidence to have a high enough chance of successful prosecution to merit public funds to proceed. The climate of being willing to look into abuse allegations against the rich and powerful, which gained such momentum from the public disgust about how Jimmy Savile got away with such extensive crimes for so long, has turned once again into a climate in which victims feel that the authorities are biased towards powerful and they are not going to be believed. This blog is an eloquent example of that.

Whilst I firmly believe in the principle of innocent until proven guilty, and the need for exceptional reasons to name someone against whom allegations have been made before the case has sufficient evidence to come to trial, we are dealing with a system far more weighted towards false negatives than false positives. Let us not forget that as many as 1 in 5 children are sexually abused, and yet only 15% are able to disclose in a way that leads to a police investigation. That’s the scandal here, not the impact on the reputation of a dead politician.

We need to remember that the victims of abuse are human beings like us who have been failed by society. If all politicians see is demographics and price tags, or characters and plots in which the goody is the one who becomes rich and powerful, then they don’t treat people like people. Recognising human beings and their ability to suffer is necessary to form policy, to offer justice and to be objective in investigations. In fact, that recognition of our common humanity and how people are shaped by their experiences makes you more able to consider that the perpetrators who are too often written off as incurable and evil are mostly people who have been victims themselves and never had the positive learning experiences children need to develop healthily in their own lives.

I think tackling child maltreatment is the primary social problem in the world today. To address this problem we need a multifaceted approach. I believe that if we can prevent child abuse and help people to have secure attachment relationships they will learn to be more resilient, empathic and socially skilled. In time this will have immeasurable positive impact on society. It will reduce crime, addiction, conflict, mental health problems, and even reduce the incidence and severity of many major physical health problems such as heart disease, diabetes and cancer. And interventions to help reduce maltreatment, improve attachment relationships and support children to make an optimal recovery from abuse or poor care are highly cost effective. Every pound spent in addressing childhood adversity through evidence-based interventions is repaid tenfold to the state in savings before adulthood (for example, we know that mental health interventions in childhood can save £83 more per pound spent where issues are prevented or treated in childhood rather than remaining into adulthood). But it doesn’t stop there. These changes continue to make ripples that save costs in health, social care, criminal justice, employment, benefit, and tax spheres for the rest of the person’s lifetime, and then for their partners, children and future generations.

We just need to stop blaming the vulnerable, and imagining risks where they don’t exist, and start trying to solve the systemic problems that make them vulnerable in the first place.

An atheist view on the pope’s speech to congress

I may be an atheist and humanist, but I’m still impressed with Pope Frances compared to prior holders of that office (who I associate with covering up child abuse and prioritising their own power and wealth). In his speech to congress, he covered a lot of important issues.

On international politics and religious fundamentalism:
“we must especially guard against the simplistic reductionism which sees only good or evil; or, if you will, the righteous and sinners. The contemporary world, with its open wounds which affect so many of our brothers and sisters, demands that we confront every form of polarisation which would divide it into these two camps. We know that in the attempt to be freed of the enemy without, we can be tempted to feed the enemy within. To imitate the hatred and violence of tyrants and murderers is the best way to take their place. That is something which you, as a people, reject. Our response must instead be one of hope and healing, of peace and justice”.

On the responsibility of government being to serve the whole population:
“All political activity must serve and promote the good of the human person and be based on respect for his or her dignity… If politics must truly be at the service of the human person, it follows that it cannot be a slave to the economy and finance”.

In relation to racism and refugees:
“Let us treat others with the same passion and compassion with which we want to be treated. Let us seek for others the same possibilities which we seek for ourselves. Let us help others to grow, as we would like to be helped ourselves. In a word, if we want security, let us give security; if we want life, let us give life; if we want opportunities, let us provide opportunities. The yardstick we use for others will be the yardstick which time will use for us.

On poverty:
“in times of crisis and economic hardship a spirit of global solidarity must not be lost. At the same time I would encourage you to keep in mind all those people around us who are trapped in a cycle of poverty. They too need to be given hope.”

On the arms trade:
“Being at the service of dialogue and peace also means being truly determined to minimize and, in the long term, to end the many armed conflicts throughout our world. Here we have to ask ourselves: Why are deadly weapons being sold to those who plan to inflict untold suffering on individuals and society? Sadly, the answer, as we all know, is simply for money: money that is drenched in blood, often innocent blood. In the face of this shameful and culpable silence, it is our duty to confront the problem and to stop the arms trade”.

He also called for more action on environmental issues, referencing his recent publication on this topic.

Finally, in relation to families:
“I would like to call attention to those family members who are the most vulnerable, the young. For many of them, a future filled with countless possibilities beckons, yet so many others seem disoriented and aimless, trapped in a hopeless maze of violence, abuse and despair. Their problems are our problems. We cannot avoid them. We need to face them together, to talk about them and to seek effective solutions”.

As an atheist, this kind of interpretation of religion resonates with me, despite my lack of belief in a deity. Most of all, I admire anyone who uses their platform to speak for the vulnerable and to advocate for peace and altruism. This is a Pope I can admire. A wise man, and one who leads by example. If only he would overturn the church’s negative approach to homosexuality and contraception, I’d feel like he was an all round great man, despite our very different perspectives on the world. This was a fantastic speech, full of insight and compassion. Hopefully his audience, and the world, will take note.

If the bigger picture is too depressing, look at the little picture

Today we learned that we will have a Conservative government for another five years, and I woke up feeling very pessimistic about the world. Clearly there are a lot of people who were swayed by the propaganda churned out by the billionaire owned newspapers, and the scaremongering about whether Scotland would steal English money. This is a sad day for the NHS, which will continue to be fragmented and put out to tender. It is a sad day for anyone dependent on benefits or health and social care services, who will continue to be blamed, stigmatised and treated like second class citizens. It is another five years in which wealth will be leached from the poorest and most vulnerable members of our society and given to the wealthiest and least deserving. So I could have stayed in bed and despaired for the state of the world. But I didn’t.

Today I made a difference person by person through my work. I also gave blood, and hopefully helped a stranger in their time of need. I was friendly to my neighbours and colleagues so that they could be a little happier as they went about their day. I donated to the DEC appeal for Nepal to help a displaced family have clean water. I gave advice to a person I don’t know on the internet to help them get their landlord to repair the hot water in their home. I spent time explaining things to my children and helped them to understand that the decisions that benefit us personally the most are not always the right ones to make when weighed up against the greater good. In other words, I made several small positive ripples go outwards into the world.

I’ve learnt that when problems on a global or political scale seem beyond my reach to influence I have two choices, to let despair immobilise me or to take it as an incentive to action. Today I was able to take the latter path, and I hope that many of you can too.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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