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

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

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

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

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

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

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

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

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

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

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

 

 

Starting over: Selecting offices and staffing

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

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

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

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

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

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

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

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

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

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

Reflections on renting an office from Regus

Regus rent serviced office buildings. If you want the short version of this blog it is this: I had a really bad experience and it took far too long for them to resolve it.So I recommend you think very hard before you sign up with them, and ensure anyone you know who ever considers renting an office in a serviced office building does likewise.

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

———————-

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

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

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

In total Regus took 11 weeks and 17 complaints from me to put a lock on the door and seal up the gap, but over the whole 16 weeks before the office was never made confidential so my business was unable to deliver an essential component of our work and we had to move out before they completed the promised repairs.

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

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

There is more to the story (and a whole other story about the first time I rented a room there) and I am far from alone in having negative experiences (check their twitter feed and google for reviews) but although I might be stubborn I try not to hold grudges and at least it has a happy ending now.

Folding Stars – a blog about loss

Tomorrow is a promise to noone

I would do anything for another minute with you because
It’s not getting easier, it’s not getting easier

I hope that you’re folding stars

Simon Neil from Biffy Clyro sang these powerful words about the death of his mother, Eleanor, in the song Folding Stars (I’ve always assumed the title is a reference to her doing patchwork). And this week I’ve been thinking a lot about people who have died myself.

I think it started because I watched the songaminuteman videos and read their facebook page in which a man about my age, Mac, is singing with his 80 year old father, Ted, who has dementia. Mac described on their justgiving page (which has nearly reached £100,000 for the Alzheimer’s Society) how difficult it is for him and his mother to cope with Ted’s aggressive and disoriented behaviour, and how singing has been a great reprise from that. Ted has been a club singer and Butlins host for much of his life. Singing is clearly something he loves and shares with his son. You can see from the videos that as soon as the backing music starts, it is something he immediately connects with, recalling the lyrics of a huge range of songs, and the banter and demeanor that used to accompany it.

That reminded me of my paternal grandfather, Jack, who died in 2009. He was also a talented singer, who had the opportunity to make a professional career from it had he been willing to emigrate to America, although he chose to remain in South Africa and have a more conventional lifestyle, running a shop and later working in commercial real estate. I didn’t ever get to know him very well, as my parents had emigrated to England before I was born, and so we would typically spend two to four weeks per year with my grandparents, alternating visiting them in South Africa with them visiting us in England. After I was twelve and needed an adult seat on the plane, the cost of flights became prohibitive and we only visited South Africa once when I was a teenager, and I can only remember them coming to visit twice more. When I got married in 1997 they were unable to come to the wedding as my grandfather had recently had a stroke, so they sent us the airfare to come and visit them the following year. I took my husband to see South Africa and meet my grandparents, and my parents overlapped with us for a week during the trip to show us some of the places they had grown up. We also visited Cape Town and the Kruger Park.

After that trip I heard about their decline  through my parents. My grandmother sank gradually into Alzheimer’s style dementia, to the point she is now almost non-verbal and needs constant nursing care, and my grandfather had the stepwise decline of multi-infarct dementia, with Lewy body type hallucinations, until his death 7 years ago. I don’t have a very clear sense of Jack as a person from my childhood. I can recall his wry smile, the habitual sequence of cleaning out and restocking his pipe with fresh tobacco and the pungent smell of him smoking it. I can recall the paranoia and acceptance of racism that years of living in South Africa had normalised contrasting with the fact that they had been very much ahead of their time in how they had supported Ben, their black “garden boy”, to have accommodation and paid employment in Johannesburg, rather than having to commute from Soweto (the nearest “township” or black slum). I can recall the taste of sugar coated dried fruit sweets in various colours and flavours, and the enormous avocados that would fall from their tree. I remember trying to explain how to use their new video recorder and remote control. I can picture the pale blue of the air letters he used to send to us regularly, and the way we would all take turns to talk on the phone to them when it was the birthday of any member of the family, long before the internet and skype made the world seem smaller. Overall I remember him being a bit of a grumpy man, who was anxious about single lane country roads, and didn’t like my grandmother’s religious rituals.

I also remember being unkind to him once as a child, and being told off by my parents. The memory is of being quite young and making a den with my cousin out of blankets hung between furniture in my grandparents’ back room. We would have been about seven or eight years old, and we were pretending to be cats. I don’t remember what my grandfather said exactly, but I remember that he said something mean that implied he thought our den was stupid. We wrote him a note that said it didn’t matter what he thought because he was a big rat who wasn’t welcome in our den, and signed it “the two cats”. As a kid it seemed like a fair response in kind, but my parents said that although he was grumpy it was a mean thing to do because he was old and had arthritis, and I remember feeling ashamed. As an adult I gained another layer of empathy, as I learnt about how much happened during my grandfather’s lifetime. How as an infant he had to flee persecution in Eastern Europe with his parents and move to South Africa where they had to learn English as a third language and live in a single room. He used to study by torchlight so as not to wake his father who worked night shifts. As my grandparents reached adulthood and got married, Jack had to do military service, and there is a photograph from when he was a fitness instructor in the army. They lived through the second world war and heard about how two thirds of the Jews in the world were murdered in the holocaust, including 91% of the Yiddish speaking Ashkenzim to which they belonged. They saw the inaction of the world turning a blind eye for far too long. Then after the war, as they became parents, they saw the survivors return to their community with tattooed numbers from concentration camps. Having been brought up as a British atheist I have no idea how that must have felt, but it can’t have been easy.

I heard about my grandfather dying two days before I gave birth to my twin daughters after a very complicated pregnancy, at a time when I had enormous other stressors in my life and I was caught up in a protective bubble. And I just accepted it as a fact and got on with everything that was going on. I don’t think I had cried about it before this week. But I am sad that I didn’t get a chance to ask him more about his life or to hear more of him singing. Nor did I express my thanks for how much he changed the path of my life before I was ever born. It is an impressive achievement to progress in a single generation from being immigrants in a single room learning English as a third language to owning a home and a business and funding your child to complete university and travel to England for postgraduate study. He was probably the reason that my parents were able to choose their own path as London hippies, and therefore a big influence on my sense of identity. I’d like to think he’d appreciate how badly my Dad sat shiva with my much more devout aunt, given his disdain for religious ritual.

I had also lost a colleague and friend who had died unexpectedly a week before the death of my granddad. Phil was someone I had worked closely with for several years, and had great respect for. He was in his fifties and had teenage children. It was a mark of my great trust in him that I had cried twice when talking to him – once about seeing a small deer get run over and killed on my way to work, and once when he told me about the death of a child I had been working with. And yet, like with my granddad, when I heard he was dead and I would never see him again I just processed the news as a fact, and felt no emotional response to it. As with my granddad, it has only been over time that I have been able to mourn his passing. I think of Phil each time I travel to a new country or walk on a beach, because of his habitual request to “bring me back a stone” if you went somewhere far away, and the pile of stones he would bring back from the most northerly beach in Scotland. I have often made stone towers or arches, written his name on a stone and thrown it into the sea or photographed the stones thinking how much he’d have liked them.

Death is an enormous topic to even try to think about, perhaps because it is connected with such painful experiences of loss, but also our own mortality and the inevitable eventual death of all those that we care about. As an atheist, I believe death is the end. Trying to imagine death is like staring into a black hole – somewhere in the uncomfortable abyss between terrifying and impossible to conceptualise. Having children has made me much more aware of my own mortality, and more fearful for theirs. I always text before takeoff whenever I fly for work, and I tell them I love them an extra time every night as they fall asleep, because I’d want them to be sure of that if I ever don’t return. But I remain of the opinion I expressed as a five year old to a babysitter, that even if a butterfly lives only for one day that isn’t a sad thing if the day was a happy day, because all they would have known is happiness. And I feel the same about my life, that I’ve already had a huge measure of happiness from a wonderful family, good friends, and amazing experiences, so even if it were to all be over tomorrow I couldn’t feel short-changed.

My Mum’s father died before she was born, and her mother died when in her late forties, when I was an infant. In my childhood my Mum felt it was likely that she would also die young, and I remember her having life insurance to protect us from the financial repercussions if that was the case. She was the only person I know to be grateful to have greying hair, as it was a marker that she had lived long enough to go grey. She is now retired, with fully grey hair and is thankfully still in good health, but she has been a good role model of appreciating the time you have got. And that is such an important thing, to savour the present. We are taught to invest for the future, in terms of putting our time and energy into long-term plans, focusing on building our careers, saving money, accumulating possessions. But as Alan Watts so neatly explains, we need to make the most of now, and dance while the music is playing. We need to have time for relaxation, creativity and fun. I’m trying to change things around a bit, so I do that more. I’ll give the last word to Biffy Clyro also (from Machines):

Cause I’ve started falling apart I’m not savoring life
I’ve forgotten how good it could be to feel alive

Take the pieces and build them skywards
and
Take the pieces and build them skywards
and
Take the pieces and build them up to the sky.

 

Rape culture and blame

I blogged a couple of months ago about the Brock Turner sexual assault case, and intended to write this post then, but I left it as a draft for some time – perhaps out of discomfort for the personal disclosure involved, or a sense of distance from the incident that made me want to post about my own experience. But it has never really gone away, because it is so prevalent, both in the tip of the iceberg of individual rape cases, and the massive underlying mass of the pervasive cultural acceptance of male sexual coercion of women (eg the horrifying statistics about misogynic beliefs and rape myth acceptance amongst male college students, particularly those involved in sports that I shared in a previous blog). It seems that just as racial tension has come to a head in America over police shootings, rape has come to a head with the Brock Turner case – with 1.3 million signatures on the petition calling for the judge to be sanctioned for his decision to go for a sentence well below the ordained minimum. And this week debate about whether the olympic diver proposal was romantic or inappropriate*. It seems that themes of sexuality and gender have become fault lines, showing wider problems in society.

Of course there have been many other cases making headlines since my previous blog on the topic, and rape and sexual assault are rarely out of the news. A woman who was raped in Qatar was found guilty of the crime of having sex outside marriage and given a suspended prison sentence and fined (I suppose we should be grateful that she didn’t get the 140 lashes that her rapist got, given they were nominally convicted of the same crime), whilst a woman in Argentina was convicted of murder for possibly having a miscarriage (though the only proven miscarriage in the case was the miscarriage of justice). Here a photographer lured young men to his home for photoshoots where he drugged and raped them. Another victim of campus rapists from athletics teams. This man used a woman’s desire to protect her children as leverage to stop her resisting his rape. This 7 month pregnant woman was raped at gunpoint. The list goes on and on and on. And there is evidence of systemic problems in how US police handle rape cases. Meanwhile lots of people have been brave about talking about their own experiences of “rape culture”. For example, this one, and this one.

I thought I might share some of my own experiences, to talk about both what it says about the culture, and the blurry line around consent. To give this some context, I’m not an extraordinary woman. Nowadays I’m a middle-aged mum. Non-smoking, rarely drinking, overweight and a bit of a workaholic, with that boring but comfortable lifestyle that many families fall into of school and work and supermarket shopping and homework and swimming and weekend outings to parks and historic places, with the occasional family visit or trip to the cinema. I’ve been happily married for 19 years this month, and I lived with my husband for 3 years before that. But even before that, I wasn’t extraordinary in appearance or behaviour, and I wasn’t reckless.

So when I say there were two occasions in my life when I felt I was at significant risk of rape, I’m pretty sure that other people have had similar experiences.

The first was when I was sixteen and had just started at sixth form. I would go out drinking with a particular group of friends from school most weekends, but I usually just had two or three single shot drinks with a mixer to make them last longer (vodka collins was a favourite, and much like a Smirnoff Mule now). One night I was with a group of friends outside a pub and one of the lads bought a bottle of “Thunderbird” fortified wine from a shop. He was pretending to drink himself and with nothing more than encouragement and peer pressure, he effectively persuaded me to drink more than I wanted to. I was a very innocent 16 and when he walked me away from the group and down the dock road out of sight I hadn’t expected more than a snog and a fumble.

However I suddenly became aware of my own vulnerability once we were away from the group. I was wobbly on my feet and nearly fell over, and in an amazing demonstration of both his strength and sobriety he practically picked me up and walked me firmly down the street. A minute later he put me on some concrete ground up a few steps from the road, hidden from sight by a lorry. It was then it became apparent that he was very determined to have sex and started taking my clothes off. I was putting them back on as best I could, but I didn’t know him well and didn’t want to risk him becoming violent (he was a foot taller than me, and I was too drunk to run away) so from his point of view I didn’t give a clear ‘no’. I was still kissing him to buy time to pull my clothes back up and trying to figure out whether anything else would appease him or whether there was a means to escape. But there was nobody in sight, and he was bigger and stronger than me, and this was in the days before mobile phones, so I felt completely on my own. Thankfully after half an hour or so he gave up and walked off. He left me dishevelled and alone, down the dock road of a town that was closed up for the night, having missed my lift home. But even as I stumbled back to the phone box, called my parents for a lift and made excuses about being drunk, I was feeling relieved that things hadn’t gone much worse. I look back and feel it was a lucky escape as no form of penetration occurred.

It was a frightening but in retrospect enlightening experience. Firstly, I learnt never to be drunk enough to lose my ability to run away or plan an escape with my full faculties. Secondly, I realised that from his perspective he was just trying to persuade me to do with him what another guy had lied and said we’d done at a party. He thought that it was just a matter of persuasion and persistence, which are socially acceptable aspects of the interplay between potential sexual partners – and importantly I never said no. Maybe if I’d have said “look Chris, I don’t want to have sex, stop it” he would have. However, maybe he’d have been angry that I was leading him on. I have no way of knowing. If we’d have been interrupted or I’d escaped and I hadn’t experienced him leaving without sex, I think I would have felt it was a near miss. I don’t know if I’d have ended up reporting an attempted rape, but I certainly felt that repeatedly pulling my clothes back on was a pretty clear indication of lack of consent that he should have respected but didn’t.

Finally, I learnt that within that group of mutual friends he had done nothing wrong. They saw me leave willingly with his arm around me, and therefore everything that followed was presumed consensual. When I tried to steer clear of him they wanted me to make up with him as he was part of the group, despite the fact that I found his behaviour pretty sinister. However, for a teenage boy, plying a girl with drink, getting her to go somewhere private, trying to take her clothes off and ignoring the signals that she did not want to participate seemed a legitimate strategy, both to him and our mutual friends. He wasn’t a stranger, or someone menacing. He was an ordinary guy who was above average in appearance and intelligence. He now manages IT services for a bank.

The second time, was after the tragic abduction and murder of toddler Jamie Bulger. A friend of a friend at university came to my door and said he was from Bootle and really distressed about it and wanted to talk. Although it was clear he had been drinking, in light of his distress I let him in, and we went up to my room as other people were in the sitting room of my student house. We later heard them leave, and after that the conversation changed to how, despite having a girlfriend, he wanted to have sex with me. He tried to kiss me, but it was unpleasant and unwanted so I moved away. He started to undress, and try to grab at me. I realised I was cornered in the attic room of a house by a drunk man of substantial build with nobody else within shouting distance. However, this time I was sober and a bit more streetwise, so the balance of power was different. I told him that I wasn’t interested and wouldn’t be taking any of my clothes off. I suggested he get dressed and go back home, and I kept myself out of reach until he acquiesced. He knocked at the door the next day to nominally apologise in order to ask me not to tell his girlfriend.

Again, when I told my friends (and this time they were my friends, as opposed to mutual friends) they didn’t really see it as a big deal. I’d guess they didn’t see as having any bigger emotional connotations than “Drunk guy embarrassed himself. Assertive girl put him in his place”. But it’s never quite as simple as that. Because even if it is only for one moment, the awareness that somebody else in your social network could force you to have sex against your will is a pretty stark realisation, even for an extraverted assertive girl. And however you think about it, it has an impact.

Whether by coincidence or subconscious drive, I put on weight after those two events, adding 40% to my bodyweight over a four year period that has stayed with me ever since. I thought it might be due to the contraceptive pill, or a less active lifestyle at university. But it seems more likely looking back that I just didn’t want unwanted sexual attention, and a fat suit is quite good at narrowing your appeal and not conforming to the socially accepted norms for attractiveness.

But it does feel like the psychological equivalent of wearing anti-rape pants. That sucks because anti-rape pants are a terrible idea that I object to in the strongest terms**, because they place the responsibility for not being raped onto the individual women. Rather than stopping a few men being rapists and a heck of a lot of men feeling so entitled that they act like overcoming the woman’s resistance is a normal and acceptable part of the process of dating, it makes women take the responsibility for not being raped. Why should it be that we need special pants to indicate we are not accessible for non-consensual sex, rather than the default position? And why should I feel that being a more attractive version of myself would make me more vulnerable to unwanted sexual advances?

I should perhaps state the obvious here. I’m not a man hater, and I’m not tarring all men with the same brush. I don’t think of men as Schrodinger’s Rapist or at least, I don’t want to, because the vast majority of men I know are lovely human beings who care about other people. But yet, our survival instinct is a powerful thing. One fall down the stairs 20 years ago, and I am still careful about stairs and escalators. Two situations in which I felt vulnerable to sexual assault (and a fair few clinical cases in which I have heard stories of rape, sexual abuse and/or domestic violence) have made me see risk in men that I don’t know well, and to view being perceived as sexually attractive to those outside my trusted circle as a potential vulnerability. It is a troubling conclusion, and one I don’t know how to resolve.

*We’ve got men today saying it is ridiculous that people have questioned the romantic gesture of the Chinese diver proposal, even when the recipient of that proposal looks uncomfortable about it. They’ve been led to believe every woman wants to get married and is just desperate for her long-term bf to propose, rather than that deciding to get married and how to tell everyone about is should be a mutual agreement, or recognising that there could be duress involved. For me, the seed of doubt is in the body language and facial expressions when I watched the video. Of course, it might be a cultural difference, or the amount of adrenaline and anxiety about being in the spotlight with cameras all around her, but her face doesn’t suggest delight. It suggests hesitation and uncertainty. Quite the opposite of the rugby player and stadium manager involved in the proposal the previous day. From the silver medal diver’s reaction you could imagine the subtitles of the whisper in her ear, or the sentence after holding up the ring being “I don’t want it to be over, please say yes, don’t shame me in front of all these people” just as easily as you could imagine it being “I love you so much I want everyone in the world to know it, please forgive me for doing this in public”. And her response involved no grins, no kisses, no seeking physical closeness, just discomfort, tears, a delayed nod and then acceptance of his actions. Whilst we may never know the answers about the specific example, the themes have echoes in how gender roles are perceived across the world. So I believe the discussion is worthwhile and should not be shut down.
**I should also add that there is no evidence that these pants are effective. Instead it seems likely that a man motivated to remove the underwear of a non-consenting woman would play out in other forms of sexual assault or violence if he was thwarted by her pants. They also add to victim blaming of anyone who doesn’t use the product; “but if you didn’t want to get raped why didn’t you wear safer pants?” Similarly, a rapist might threaten the woman to get her to remove the pants, and this might then be twisted by defence lawyers to imply consent. I think this product shows a profound mis-reading of the problem. Most rape is by someone known and trusted by victim, not the kind of opportunistic attack by a stranger that will be thwarted by her wearing lock up knickers. Some thought about who will buy them, and how they will change behaviour suggests problems too. It seems to me that their main customer base will be women who are anxious about being raped who probably won’t put themselves in a position where stranger rape is possible, whilst women who buy these pants to mitigate a risky lifestyle might have false faith in their ability to prevent negative outcomes (eg if they wear them so that they can drink to unconsciousness they probably aren’t addressing why they are making themselves so vulnerable, or the risk to physical, emotional and financial well-being that this might lead to). It made me wonder about when you would wear the pants? Every day to reinforce helplessness and anxiety or just when you feel likely to be raped? If the pants are a means to say no to a partner when sex is not wanted that says something very disturbing about relationships that needs to be addressed in more than just her choice of underwear. Finally, would another person such as a partner or controlling relative ever make the woman wear the pants like a chastity belt?

Spreading too thin

In general I’m a frugal person. I buy foods that are reduced because they have reached their best before date and most of my clothes and shoes in the sales. I collect coupons and shop around for good offers. I try to waste as little as possible, and to recycle as much as I can. So I can understand wanting to get good value for money.

On the other hand, I like doing things properly. For example, when it comes to a sandwich, I like a thick slice of granary bread, fresh from the oven, with generous amounts of toppings. As it happens I’m not a big fan of butter or margarine, perhaps a symptom of being overweight in the 1980s and 90s when fat was literally seen as a cause of fat, whilst the carbs underneath were seen as relatively healthy. But whether it is soft cheese and cucumber, avocado and salad, cheddar and chutney, hummus and roasted veg, or toasted cheese and banana, the topping needs to cover the bread, with sufficient depth to make the sandwich proportionate. If the cheese has nearly run out, I’ll have half a cheese sandwich that tastes good rather than a mean whole.

So when it comes to services, I can see the motivation to get value for money, and to ensure that resources are being used in the most cost-effective way. I’ve developed pathways, clinics and groups to meet needs more effectively, and I’m happy to delegate less complex work to less experienced or less qualified staff. I can’t see the justification for paying psychiatrist salaries to deliver therapy, when a member of staff with half the hourly rate can be an equally good (if not superior) therapist. I can see the importance of capping the cost of agency staff, so that this money can be invested in increasing the substantive workforce. And when it comes to staff who are not pulling their weight (my record being a member of staff who had spent a whole year with a caseload of four clients, whilst colleagues in the same job had five times that along with other responsibilities) I can see the need for performance management.

However, there comes a point that too much pressure for efficiency actually makes services less effective. I saw this happen gradually over the 16 years I worked in the NHS. If we cut out all the conversations between cases, all the informal supervision, all the CPD opportunities, the time to bond as a team and to reflect and process information between appointments, then clinicians are less able to be empathic and individualised with clients. If you also give people tougher and tougher cases to work on, expecting faster throughput than with the more mixed caseload that preceded it, and couple this with cuts in admin despite there being more and more paperwork to do, you increase burnout and time off sick. Add some pay freezes, lose a proportion of posts, put people in smaller premises and tell them to hot-desk or become mobile workers and they no longer feel valued. Make it a set of competing businesslike trusts rather than one amazing non-profit organisation, tender out services like cleaning and home visiting to allow them to be done on minimum wage without the terms and conditions of the NHS, allow private companies to win contracts, and keep people in a perpetual state of change, then morale falls. Nobody has any loyalty or job security and it no longer chimes with the ethics of the people who work there.

The sandwich has been eroded down to bread and butter, and then to crackers and margarine, and then to a value brand version of the same that is 30% smaller. It might look like costs have been driven down, but the price is a reduction in the quality of services, and in the wellbeing of staff. It reduces the willingness to go above and beyond that has been the backbone of the NHS, and increases presenteeism – the tendency to feel that you need to be at work longer, and look like you are working harder, without this making meaningful impact on the work you get done. The UK has lower productivity than most other developed nations, perhaps because we have longer working hours, and work expands to fit the time available.

All over the public sector at the moment I see services trying to spread their resources thinner and thinner, and I’m acutely aware that this means they can’t do the whole job. Social Services departments have barely the capacity to maintain their statutory role, so supporting families in need goes by the wayside. Some good staff find other jobs. A proportion of the remainder go off long-term sick, leaving an ever bigger burden on those that remain. Teachers are forced to teach to tests that assess primary school pupils on aspects of English grammar that graduates struggle with that have little relevance to daily life, and squash the rest of the curriculum into less time. Children’s centres, youth clubs and leisure facilities are disappearing at a time when it is clear that parenting support and exercise are critical in improving well-being and decreasing long-term health and social care costs. We’ve been feeling the cost of ideological austerity bite, even before the financial shock of the Brexit vote, so I am struggling to see how things can improve in the foreseeable future, let alone once any steps are made to implement the extraction of the UK from the EU.

It is hard in this climate not to feel overwhelmed by pessimism. Staff are not pieces of equipment that can be upgraded or replaced at the click of your fingers. I can make a plan for how to cover a remit that needs 12 staff with 7, but I can’t then tell you how to do it with 5. I can only tell you that if you want the job doing properly it needs 12, and if you go below 7 it won’t be fit for purpose. If I sticky plaster over the cracks, you can pretend that paying for 5 is enough, and that it is the clinicians who are failing, whilst we burn out trying to do twice the amount of work each. But no matter how hard I work, I can’t be in four parts of the country at once, or do recruitment, service development, supervision and provide a clinical service in a part-time job.

Maybe the problem is that I am stubborn. I won’t just toe the line whilst covering my eyes and ears and going lalalalalalala when it comes to everything that isn’t being done. Like my exit point from the NHS, there comes a time where I’d rather leave than do things badly. And where the only efficiency available for me to recommend that fits the prevailing rationale is to pay two cheaper staff instead of my time. I’m teetering on the edge of the plank they’ve made me walk, and I’m increasingly tempted to jump. Maybe in retrospect they’ll recognise how much was getting done with such limited resources.

Seeking collaborator to change the world

LifePsychol Ltd is a company with a clear social purpose – to improve outcomes for people who have experienced adversity through the application of clinical psychology, particularly children who are Looked After in public care after trauma or maltreatment. We deliver effective psychological services for Looked After and adopted children by providing assessments, formulations, therapeutic interventions, consultation, training and outcome measurement tools for placement providers. And we are very much in demand. But at the moment we are clinician led, and we really need a COO with complementary business skills as the company scales up, to ensure that we make the maximum impact going forward.

We are at a very exciting time, with the potential of rapid growth and the first evidence of efficacy for our pathway emerging. We have started the process of applying for DfE Innovation Programme funding, and we have great support from key people (Sir Martin Narey, government advisor who just reviewed the future of children’s homes in the UK, described our pathway and tools as “the missing link for the sector”, Jonathan Stanley at the Independent Children’s Homes Association described them as “the new gold standard for our members”, whilst Lord Listowell said the government should fund part of the cost to ensure there is input from a clinical psychologist in every residential care home). Despite having done no marketing, we have more enquiries about joining our system than we can keep pace with. We are already used in over 100 children’s homes, and we have a growing number of local authorities who wish to roll out our pathway across their entire catchment. We are looking at how we train and license other clinicians to deliver the model both in the UK and internationally.

We have a great clinical team, a graduate project manager/admin, a fantastic professional network and a great product set. What is important to us now is getting the right person to drive the business side forward at this critical time. To do that we really need someone with business skills and experience, combined with a passion for making social change to take on a leadership role on the financial/business side of the company. We are therefore seeking an extraordinary COO who will help us achieve extraordinary things.

Who are we looking for?

You need to genuinely care about making the world a better place, and to share our goal of making a measurable difference to the lives of vulnerable children and young people. As a clinician CEO it is vital for me to have someone I trust to bounce ideas around with, who will ensure that we are on a sound financial footing to enable us to deliver our ambitious plans. You will be familiar with all aspects of the finances for running a business, have a good working knowledge of the UK social care system and be a dynamic manager, but with a willingness to turn your hand to other aspects of the business (from fundraising to recruitment to CRM) until we are large enough to take on a full team. You understand the value of evidence-based practice and you have a good awareness of the financial demands of the social impact sector. You are the kind of person that can nail down complex ideas and grand ambitions into concrete and achievable plans that will make genuine social change.

You will ideally be based in Derbyshire at our new Matlock office and will help to develop a team there, but with some travel to other sites. However, we already have a base in Milton Keynes that I visit fairly regularly, along with existing relationships and use of shared working space in North London (Kings Cross), so if you are the right person then these might be possible alternative locations, provided you are prepared to travel regularly to meet with me in Matlock and are comfortable using video chat in between times.

How to apply

If what we are looking for sounds like you, and you are looking for a new challenge, please get in touch and we can set up a meeting. Or if you know someone that might be the right fit, please pass this information along to them. Email lifepsychol@gmail.com to express an interest. No agencies or recruiters please.

Background information:

LifePsychol currently consists of a small clinical team who provide assessment and therapy services, particularly for children and families, and services commissioned by local authorities to support Looked After Children, adoption or families at the edge of care. Our Clinical Psychologists also provide expert assessments for the family court and to local authorities considering entering proceedings. We provide consultations advice on service development and service evaluations for social enterprise and third sector organisations. Our main specialist area is around attachment, trauma and maltreatment and how this evidence base can inform the care of children who do not live in their family of origin. We therefore provide training for adoptive, foster and residential carers, as well as health, social care and legal professionals, and have a network of associates who provide regular consultation into organisations.

However, our primary goal at present is nothing less than to improve the quality of placements for all Looked After Children in the UK. LAC are a particularly vulnerable group of children and young people because their needs are complex, and often include mental health, developmental difficulties, problems with relationships and behaviour. We hope to achieve this ambitious goal by training carers and implementing a new set of standards for care providers (PRIME) and through regular use of outcome measures (BERRI).

The PRIME standards are about ensuring that strategies carers use are evidence-based, individualised to the background and needs of each child, evolve as the child’s needs change, and are based on a thorough psychological assessment and a multi-faceted formulation of the child’s needs. We believe that having advice from a clinical psychologist to inform the care of all Looked After Children (and other children with complex needs) will both reduce stigma and improve outcomes, whilst helping carers to feel better equipped to meet the children’s needs. We have developed a training program and care pathway as one means to implement these standards for placements.

We have also developed a set of online tools for commissioners and placement providers to use to identify and track the needs of children in their care. The tools are known by the acronym ‘BERRI’ because they explore Behaviour, Emotional well-being, Risk to self and others, Relationships and Indicators of psychiatric or neurodevelopmental conditions that may require further assessment or diagnosis. We want every young person with complex needs to have a service that meets their needs in an effective and evidence-based way. We have therefore developed tools that allow us to gain a more holistic picture of children’s needs, to track how this changes over time and to target particular concerns and monitor the effectiveness of interventions to address them.

Our first data suggests that we can reduce concerns about children significantly within six months of using the pathway and tools we provide, and our services gain exceptional feedback from carers and professionals, but we hold ourselves to tough standards of evidence, and gather data about our effectiveness every step of the way.

Note: The BERRI questionnaire and online tools were developed to improve the outcomes for children Looked After in public care in the UK. However, the system is also applicable to those receiving other forms of intensive or multi-agency input, such as those on the edge of care, attending special schools, placed in inpatient services, secure units or involved with services for young offenders. The system would also be equally applicable in other countries, and could be adapted to other populations (eg adults using mental health inpatient services, people with learning disabilities, or those within the criminal justice system).