Wisdom, sycophants and advice that won’t work

I have been watching and reading a lot of Brene Brown stuff recently, and for the most part I feel like she has been able to identify and tap into some important concepts that chime true with my own understanding of attachment, shame, perfectionism and self-compassion, but there is a part of me that is a bit uncomfortable. When I’ve watched recent interviews, such as this one with Oprah I find myself responding to the comments like “that is so powerful”, “right, right, right” and “there are so many things I love about you” with a bit of a cringe. I think it is partly that it feels like a sycophantic mutual love-in amongst a particular group who have formed their own self-improvement echo chamber, and partly that the whole American over-the-top-ness of it makes it come across as less than sincere.

Obviously Oprah is in herself an incredibly impressive person: She is self-made despite horrible early life experiences and someone who adds welcome diversity to the line-up of bland white males and slim, magazine-beautiful young women that populate American TV, she has popularised acceptance of LGBT people and been empathic about a wide variety of life experiences and mental health problems. Plus she is a significant philanthropist (albeit that her charitable activity in itself is not entirely without criticism). However, Oprah and her ilk are so non-critical of patent nonsense from self-help books about spirituality and positive vibrations to dodgy hormone treatments that it feels like a huge missed opportunity to have not put a threshold of scientific scrutiny (or at least critical thinking) to claims when she has such an enormously influential platform.

Likewise it is hard for me to reconcile why a credible researcher like Brene Brown would be prepared to be thrown in that mix and start marketing self-help courses for Oprah watchers. It doesn’t seem to make sense without attributing a financial motivation for accessing the wider audience that is more powerful than professional ethics.

I’m going to read all her books and then I’ll be in a better place to comment, but I’d like to think I’m not being naive or rigidly judgemental here. I’m sure if I felt that I had an important message to share and Oprah offered access to her audience of millions, and I felt that would help to change the world I would make compromises too, both to get the message out and to get the book sales, raised profile and funds that would enable further work. And I fully accept that there have to be coffee table books that are accessible to wider segments of the population than the referenced texts of scientists and clinicians that are more closely tied to the evidence base from which they are drawn. But something still feels uncomfortable.

So, is it just a cultural divide or my own hatred of insincere praise, or is it something deeper that is rotten about the self-help culture?

I’ve started to think that the self-help world, like the diet industry, is rotten at the core because it is invested in failure. I don’t mean the books often recommended by mental health services as ‘bibliotherapy’ that address mental health problems based on well-evidenced psychological techniques like CBT here, which are predominantly helpful. I mean the 2000+ books per year of home-brew wisdom about how to be happier, grasp control of your destiny, be more successful, fix your marriage in a week, get more energy, unlock your chains! Most of these have no evidence base whatsoever, and the authors often have no scientific or mental health credentials. A cynic might say they are selling false hope. Yet the same unhappy people try again and again to change their lives by reading the next book, spending more and more money to make changes presented as easy that are actually unsuccessful for the vast majority of those that try them out.

Just like the diet industry, self help is an industry that has had meteoric growth. Yet little of that is based on any evidence of either the underlying principles or the efficacy of outcomes. There is minimal evaluation, and what there is isn’t promising. In fact, recent research (albeit on a very small sample) has shown that reading self-help literature actually makes people more depressed and anxious!

“The sale of self-help books generated over $10 billion in profits in 2009 in the US, which is a good reason to find out if they have a real impact on readers,” said Sonia Lupien, Director of the Centre of Studies on Human Stress (CSHS). The results of the study showed that consumers of problem-focused self-help books presented greater depressive symptoms and that growth oriented self-help books consumers presented increased stress reactivity compared to non-consumers. No difference was found in any variable according to whether people had read self-help books or not, suggesting they have little impact on functioning. In fact “the best predictor of purchasing a self-help book is having bought one in the past year” suggesting that the same group of people repeatedly buy self-help books but aren’t actually changed by reading them.

In the same way, every new year consumers with weight-loss resolutions in the UK spend £335 million, yet a month later for more than half of them there is no measurable impact on their weight or fitness. Overall the diet industry has an incredible failure rate: 95% of people re-gain the weight they lose. Yet the consumers keep on spending. In the USA consumers spend more on diet-related purchases than the combined value of the government’s budget for health, education and social care. And yet a little basic knowledge of the subject could inform them that most of the things they try won’t work, and that there are very well established links between diet and health.

It seems I am not alone in this discomfort, and Brene Brown herself has felt it and responded. I still think she is one of the good guys, and clearly there are gender politics and marketing influences she struggles to counter, but it remains a fact that there is little to distinguish the good from the bad in the self-help field. I wonder if it is time for those of us who write from an evidence base to respond to that and to start a website to evaluate claims from self-help literature?

Some thoughts on the recent atrocities in Paris

The news of ordinary French people watching sport, chilling out at a cafe or attending a gig this week being gunned down by violent extremists, really brings home how it could have been any one of us. Its unthinkably awful that anyone would target random innocent civilians like this.

But the response from the public has been split in several directions. Do we need to toughen our stance on asylum seekers? Tighten border controls? Crack down on Muslims more generally? Do we need to show solidarity with the French by lighting everything from water fountains to facebook profiles in red, white and blue? Has this finally brought terrorism to us in Western Europe? Or does it just highlight how we are constantly ignoring the stories of so many people of other nationalities who have been killed across the world recently without making headlines of outpourings of sympathy? These are complicated questions to unpick.

In terms of whether the right response is to call for harsher actions towards violent extremists, I am reminded of an article I read in the psychologist, and an evidence review in the BPS research digest about the psychology of terrorism and extremism respectively. The main point I took from it is that acknowledging the kernel of legitimate grievance behind such actions and engaging in dialogue with moderates from similar demographics are both actions that make it harder to for extremists to recruit, whilst moving towards more polarised positions (eg all this tough talk about closing borders and not negotiating with terrorists) or language blaming the whole of a culture or religious group make more people within that broader group feel inclined to sign up to the more extreme positions.

Whilst the actions of ISIS are deplorable, the generalisation of negative feeling to all muslims is appalling. I even read about a tragic story in which a Hindu man had been pushed into the path of a train and killed by someone who thought this was a suitable reprisal for 9/11. Islam is a religion as large and diverse as Christianity. Nobody thinks the Klu Klux Klan represent Christians, yet large swathes of the western world appear to think ISIS speak for all muslims, when they are just as misrepresentative of the mainstream view within Islam. And alienating Muslims from the western world is a big mistake. The huge amount of moderate representatives of Islam (over a billion of them) are ordinary people who are just as appalled about the action of extremists as members of other religions or none. And they also form the moderate pole of the spectrum from which the extremists are drawn to ISIS. So we need to ensure that we engage this group in how we address these atrocities, and to integrate them into our societies to ensure this polarisation does not continue to play out across the world.

Extremism comes from perceived injustice and powerlessness amplified in small groups of like-minded others, and justified with reference to religion. Reducing injustice, allowing grievances to be heard and addressed, and being inclusive to moderate representatives are the only variables that anybody outside of the individual and those very small cultural subgroups has any control over, and it is these things that let South Africa get out of apartheid and Northern Ireland get out of the troubles there. I can’t see any other way to address the other conflicts going on in the world, be they in Afghanistan, Iraq, Gaza, Nigeria, Syria or Somalia. Surely, even if we accept that some human beings will always turn to violence, the aim is to reduce the scale of conflicts down from wars to individuals, so that less people get caught in the crossfire?

As to whether we have reacted with more sympathy to deaths in France to deaths elsewhere in the world. Again I think this is a complex issue. There is implicit bias in the system, coupled with habituation. We are more attentive to stories that feature people we identify with, and we pay more attention where the events seem novel, rather than recurrent. Think about children going missing from home and the coverage that white kids from ‘nice homes’ get when compared to any other ethnicity, or kids from the care system (by way of example, the other day I noticed that three kids went missing from the same place on the same day and only the white girl got news coverage). The British media definitely place more focus on events that affect white, western nations. Even though non-mainstream media and some voices within social media are picking up on this theme and people are starting to question the systemic bias in the news, I think it is fair to say that we do have endemic problems with racism in the western world. Whether that is due to prejudice, vested interests or the fact that telling stories about familiar protagonists or showing photos that look like the customer is more likely to sell newspapers or screen time, I don’t know.

However, people are always illogical about world events. An individual story you can relate to humanises what would otherwise be too overwhelming to process. Genocide, war, famine are all too big to conceptualise, so we figure we can’t make a difference and don’t give them much head space. We don’t know anything about the refugee camps outside Syria, or the day to day grimness of so many of these wide scale conflicts. However, a mother who can’t feed her child in the news coverage of the famine, an orphan who plays football on a LiveAid appeal video, the shock of an ordinary looking person at a gig or a cafe talking about how they saw their peers getting gunned down, or a dead baby washed up on a beach – those are the individual stories that we can relate to. They call out to us, and force us to place ourselves in the shoes of the protagonists, and that makes us sympathetic and much more drawn to positive action.

So do we speak up about all the missing stories when friends share content about Paris, to show their virtuousness is not evenly applied? I’m not so sure. It seems to me that the solution is not to criticise those people who do feel empathy with the individual stories they can relate to, but to tell the stories of the other conflicts in more relatable ways also, so they get a similarly empathic and constructive response. Compassion isn’t like a cake that is a finite resource that has to be shared out between all callers. It is something we can cultivate and broaden, and help to bring out in others.

It reminds me of a quote from Martin Luther King: “Returning hate for hate multiplies hate, adding deeper darkness to a night already devoid of stars. Darkness cannot drive out darkness, only light can do that. Hate cannot drive out hate. Only love can do that”.

And we have to reach beyond the boundaries of religion, ethnicity or nationality. Does it never seem absurd to you that people on this little blue-green planet we have evolved through the millennia to share are arguing about where somebody drew lines on a map hundreds of years ago, or whose stories about creation and morals are correct, without recognising that people are just people? Whatever colour of wrapping they come in, or language they speak or whether they believe in a God, and what name they call it makes no material difference to their ability to experience joy or suffering just the same as us. No matter how strange their lives seem, we’d have done the same if born into their community, and they’d be like us if born into ours.

So let us reach out in compassionate and loving ways to those around us, and especially to those showing ignorance or being excluded from our society. We are all in this together.

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

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

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

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

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

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

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

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

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

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

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