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

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

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of it was hard to navigate, and key documents were hard to find, the documents and information on the site were often out of date and much of the content was hidden behind walls for members and separated into silos by the Society structure that were impenetrable by topic.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

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

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

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

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

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

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

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

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

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

Disappointment

I have been let down by someone I trusted again. In fact, in the last three months I’ve been let down by four separate people that I have trusted, in three different separate sets of circumstances, and two of them have been clinical psychologists. That feels like an unpleasant cluster of disappointment. In each case they made me lots of promises and didn’t deliver. I was relying on them and now have to pick up the pieces. I was assuming that my ethical values would be ones that we commonly held, but in fact each person turned out to be entirely self-serving, despite the high cost to others. In each case the other party has taken what they wanted and left me to deal with the fallout.

Being exploited by others always makes me very sad, and it erodes my faith in people. But this time it has coincided with me being physically unwell. It may even be the cause of my health problems. If so, that is something new, and something I need to address robustly and never let happen again. But as ever in real life the picture is complicated and hard to unpick.

I’ve normally been a pretty resilient person, and hardly ever take time off sick. However, the minor road traffic accident in which I was rear-ended by a lorry 18 months ago transpired to have cracked three of my teeth*. One cracked wisdom tooth was removed soon after the accident and the second patched up with a filling. However the third was a visible tooth that had already had a root canal, so it needed to be removed in a way that would allow an implant to be fitted to fill the gap. I paid for expensive specialist dental work to preserve the bone and fill the gap with collagen to encourage regrowth. Unfortunately, removal of the tooth root was harder than expected and involved half an hour of brute force, breaking off a piece of my jaw bone in the process. That led to dry socket pain. I then required bone grafts along with a pin to support the implant, and six stitches to pull my gum back together. I’m not normally anxious about dental work, but it was stressful enough to make me shake before subsequent appointments and involved several weeks of painkillers and a course of prophylactic antibiotics whilst I recovered. So I suspect I was already somewhat physically depleted.

Then the interpersonal disappointments started to compound things. After a particularly unpleasant bit of news in early December I had to go home from work due to what felt like a migraine starting. I’ve subsequently been off work for six weeks with a “severe otitis media, probably herpetic” written on my sick note. The GP was concerned it was a variant of shingles due to the blistering inside my ear, so I was prescribed antivirals as well as antibiotics, but thankfully it didn’t develop into the full shingles presentation and has just felt like a prolonged ear infection. Subjectively I’ve mainly felt like I’ve been underwater, with periods of more marked earache, dizziness, fatigue and a kind of general malaise. Driving in particular has been difficult (as acceleration and even small hills tend to trigger pain), as has going outside (perhaps due to the changes in temperature) but it has also stopped me from playing with the kids in the way I normally would (as spinning, chasing or sudden movements can bring on earache/dizziness), thrown my sleep out and confined me to the sofa for much of each day.

It seems it has also reduced my ability to weather stress, and made it express in a more physical way than I’ve ever experienced before. I’ve had stomach cramps and waves of nausea that appear when I read emails from certain people. I can’t tell how much of the overall problem is a somatic expression of stress, and how much is my resilience being depleted by physical illness and making it hard to cope with the emotional stuff. But it has been an interesting learning experience. I’ve had to stick on an out of office message and binge watch TV serials. It is a big behaviour change for me to disconnect with my work, but I have to accept my own limitations. If it is shingles, then it can do lasting damage to the facial nerves or lead to hearing loss. No contract, colleague or past employee is worth that.

So I’ve made a pledge to myself never to let this happen again. Work is going to be a smaller part of my life, and I am going to make more time for art and music and going out into nature. Within my work I’m going to follow my heart more. I will only work with people I trust, who share common goals, and a sense of fun. I’m going to focus on doing what I enjoy, and what makes me feel I am having the most impact for those who need it most. I’m not going to bend over backwards for people who wouldn’t do so for me. And I’m going to challenge my inflated sense of responsibility for others.

Maybe it comes from being the oldest child of hippy parents, but I’ve always been a person that enjoys helping others, and giving a leg up, or a treat to people around me. Whether it was spending my pocket money on sweets for my friends at school, raising money for charity, or helping someone else out, I’d always put in a little more effort than other people seemed to. When I look backwards I can recognise that sometimes this has led to other people taking advantage, and me ending up feeling exploited.

I first noticed it in an adult reflective way a long time ago. I remember helping someone with a paper they were writing for a journal submission. Their draft was really very poor, and I made a lot of changes, but they didn’t add my name or even acknowledge my input. A year or two after that I coached someone who wanted to get onto the clinical training course I was on, and let her present a small analysis we had done together on my research project data, only to find out that she had presented the whole study as her own and not credited me at all. I also got her a summer job, from which she was fired for her poor attendance and timekeeping, for which she later attempted to use me as a reference, claiming that the service had subsequently closed and omitting to mention the reason for her departure**.

When a friend of a friend (I’ll call her Jo) sent me an email about being suicidal a few years ago, I cancelled a day of work to go and take her to A&E, and spent 24 hours getting her to attend and waiting for various services. Over the next fortnight I helped Jo sort out problems with her rented accommodation and to get a settlement from her job instead of being dismissed. After a second depressive incident a few weeks later, I brought her back to my house for the weekend rather than leave her alone and unsupported, a visit that subsequently extended to a six week stay.

I tried to be a supportive friend. I got Jo a new job within my network and a week later I agreed to be guarantor on the lease for a lovely flat. However the next day after a clash of opinions with a colleague she decided to quit the job. That left her no means to pay the rent, which would therefore have fallen to me, so I withdrew from being guarantor and the flat fell through. Jo was upset that I prevented her leasing the flat she wanted, but concluded that she would continue live in my house, rent-free, until something else came up. I felt that as well as not being the right choice for our family, this would have been enabling her dependence. There were various problematic incidents, but I still agonised before saying she had to leave and helping her move in with a family member instead. I took another day off and drove a 5 hour return trip to take her and her possessions to a new location. Despite all the efforts I put in, Jo remains angry at me for the perceived rejection and feels that I let her down. She periodically tries to shame me in our social group for “abandoning a vulnerable mentally ill woman”. For me it was all cost and given there was no benefit to Jo it was actually a lose-lose situation, but I did not recognise that until long after it was obvious to everyone else around me.

More recently it has been colleagues and collaborators who have let me down. I’d consider that par for the course if I was unreliable myself, but I don’t think that is the case. I always try to treat people as I would want to be treated myself, and to be really clear about the contract between us (whether that is a literal written agreement or an implicit verbal arrangement). I tend to assume that anyone who has the same profession or client group as me will have the same ethics and the same drive to do the right thing as I do. I always assume that people will care about the quality of the service, prioritise what is in the best interests of clients and keep their word, because that is what I would do in their shoes. Sadly, it seems that is not the case, and lots of other people prioritise their self-interest over anything else.

I don’t think I have unrealistic expectations. If someone signs a contract with me then I expect them to honour it. If someone agrees in writing to deliver a particular piece of work, be it training or clinical work, I expect them to turn up and do that work on the date they agreed. If someone agrees to take on clinical responsibility for some of our clients, I expect them to provide a good quality clinical service for those people rather than nothing at all. If someone agrees to purchase our services for a particular period of time, I expect us to have to deliver those services and for them to pay for them. If someone agrees to buy something from me and I deliver it to them, I expect payment. It doesn’t seem a huge leap of faith to me. Yet somehow these very simple expectations are too much for some people.

I’ve spent too many words justifying why, but I am disappointed by that. And, whether by coincidence or causality, I have been physically unwell in the immediate aftermath. But I am not the kind of person that just rolls over. I might be a sucker and go beyond the call of duty to be helpful when I can, but I don’t let people play me for a fool. I have a very strong sense of fair play and once people cross the line, then I feel obligated to do something about that. Just as I am a demanding consumer who will assert my rights for a refund or compensation when things go wrong (and gave Regus merry hell a few months ago for their terrible service with the office I was going to rent), so I will also take action to ensure that professionals honour their obligations. The way I see it is that many people don’t have the resources to address problems (be that intellectual, time, financial or personal) so those of us that do need to help put the checks and balances into the system.

So my plan is three-fold. Firstly I will address each issue head on and reach a resolution. And secondly I will make plans for the future that mean I am not put in the same circumstances again, gather better allies and do more of what I enjoy. I’ve already got a good team around me and lots of irons in the fire for new projects, and I have had helpful legal and practical advice from a number of sources. So it will all pan out in time. However my top priority is to get well again. And that involves the foreign concept of taking time out to rest. For a workaholic that might be the toughest part of all this!

*I don’t believe this to be a common result of an RTA, but I have brittle teeth due to tetracycline damage as an infant

**I didn’t feel able to provide such a reference, and gave them the contact details of the service instead.

Identity and Change

This was the blog I wrote a few days before the US election. After the election I felt like the other stuff was more pressing, so that skipped the queue. I’d be interested in feedback about the topics and intervals of this blog, and whether the pot-luck and intermittent nature of it is disconcerting for readers. So do feel free to tweet or comment to let me know. Anyway…

My kids were given brass instruments at school recently, that they will get to use for the next 4 years. Every child in the school gets the use of a brass instrument for free, along with the group lessons to learn how to play it. One chose a trumpet, the other a baritone. It seemed like a nice idea, but I wondered why there was a scheme to learn brass instruments in particular, rather than woodwind, strings or percussion. The penny finally dropped when I searched for clips of brass bands on youtube and ended up with colliery bands and a poignant scene from Brassed Off! We now live in an area in which the coal mining industry was a major employer until the 1980s. There were nearly 200 mines in the county at the turn of the last century, and there are none now. So presumably the brass music scheme is linked with the idea of preserving local cultural heritage.

It made me think about other disappearing parts of British culture, from learning Gaelic and Welsh to Morris dancing, and how each culture around the world has different bits of heritage and culture to keep alive. There are stories told through the generations, losses to commemorate, celebrations to mark particular dates and events, rituals and arts to keep alive. Language and history seem to be bound into our identity. But why do we want to keep some parts of the past alive, and does it have any value? I’d hope that at least we can learn from our collective experiences, avoid repeating problems and continue the things that give us joy and bring us together. Which brings me back to music.

Music has been an integral part of human existence for an extraordinarily long time. Wikipedia tells me that “Music is found in every known culture, past and present, varying widely between times and places. Since all people of the world, including the most isolated tribal groups, have a form of music, it may be concluded that music is likely to have been present in the ancestral population prior to the dispersal of humans around the world. Consequently, music may have been in existence for at least 55,000 years and has evolved to become a fundamental constituent of human life”. Maybe that is why it is such an enjoyable thing to participate in. I know I value the half hour of singing I do with the children each night before bed as a time to wind down, but it also reconnects me to past experiences and brings out particular emotions dependent on the songs I choose.

I think there are loads of skills to be gained from being part of playing music with others. These include patience, persistence, co-operation, and other aspects of social skills and executive functioning. It reminded me how powerful various musical projects have been in changing the identity of people in socioeconomically deprived situations. The El Sistema project in Venezuela, although criticised for its strict regime and some examples of exploitation, has been praised for opening opportunities for young people from disadvantaged backgrounds and getting over 2 million children involved in orchestras. The Landfill Harmonic helped children living in a slum community on a rubbish dump to learn to play classical music and to have aspirations that were previously unthinkable to them.

The Big Noise project in Scotland has drawn on El Sistema but applied it to deprived Scottish communities. Independent evaluations cite positive impacts on different facets of the children’s lives, beyond just the gains in musical skills. Their education shows improvements in concentration, listening, co-ordination, language development, school attendance and school outcomes. Their life skills show improvements in the domains of problem solving, decision-making, creativity, determination, self-discipline and leadership. Their emotional wellbeing shows increased happiness, security, pride, self-esteem, emotional intelligence, an emotional outlet, resilience. Their social skills have improved along with increased mixing, cultural awareness, strong and diverse friendships and support networks. The project also has wider benefits to health, as there has been encouragement for healthy diet and lifestyle choices. The children have also had additional adults to confide in, a calm, safe environment and report reduced stress.

What I like about all these projects is that they help people to learn new skills and change their own identity to reflect that. Instead of being members of a deprived and devalued community pervaded with hopelessness, they have a new identity as musicians who can enjoy the process of creating, sharing and performing and gain aspirations outside of their previous horizons. Even the sense of belonging when singing along to a well-known track being performed live at a festival is up-lifting. How much more so to be performing music in front of an audience, and to travel to new places to perform.

But music isn’t the only thing that inspires change. We are all changing all the time. Life changes move us from being a child to an adult, through education and into professional or employment roles, bring changes in living arrangements and new relationships. In turn, aspects of our identity are sometimes defined by our role within those relationships and settings. We take on certain expectations and responsibilities when we become a being a partner, parent, aunt/uncle, grandparent. Our educational or work experiences can similarly add a facet to our identity (I am very much a psychologist as part of my core identity, even outside of work). So can being part of many different positive community projects or group activities, or even the act of learning new skills or trying new things at an individual level. I learnt to scuba dive a few years ago, and gained a new identity as a diver and a new world to explore. Likewise, the random act of supporting a friend who wanted to set up as a personal trainer introduced me to weight lifting, and for a couple of years that became part of my identity too (frustratingly since an RTA injured my shoulder I have not been able to lift for over a year, though I do hope to get back to it soon). I also like to grow fruit and vegetables, and to make preserves and bake, adding gardening and cooking to my repertoire and identity. And of course I am now a writer and blogger! Likewise I watch other members of my family gain new skills. This year we moved to a dilapidated farmhouse, and my husband has gained a new identity from learning to cut wood, keep chickens, and mow the fields with a tractor. As well as learning their brass instruments, my kids are learning to swim, ride bikes, write stories and poems, make art, and take part in outdoor activities. Their identities have expanded to include facets of artist, poet, writer, scientist, explorer and many more.

Changes to our identity can also be out of our control, and negative as well as positive. Many of us survive traumas, or difficult relationships, or experience rejection or failure. From redundancy to car accidents, cancer to infertility, losses of people we care about, changes of home, job and relationships, we are each shaped by our experiences even as adults. I have blogged before about the impact of adverse childhood experiences, but how we recover from these also forms part of our identity. Do we remain wary and cynical, or learn to trust again. Do we try to shut out the past, or work through it. Do we aim to get closure. These questions have never been more live than in the aftermath of institutional abuse, and in the wake of the historic sexual abuse cases that were triggered by Savile and other cases coming to public attention.

Over the last few years I have been talking to a man in my extended social network who was groomed and then raped as a child by a member of the Catholic church, whilst at a Catholic school. He has had to make a series of decisions about whether to disclose his experiences to anyone at all, whether to share them with members of his family, with his therapist, with his partner, and with friends. Then he has had to decide whether to come forward as a witness and victim in a public enquiry, and whether to seek compensation from the government and/or church. Each decision has an impact on his sense of identity, which has been slowly evolving from a victim hiding the shame of his experiences into a survivor who is able to look back and place the blame firmly where it belongs and manage the consequences on his life successfully. That isn’t an easy journey.

Over the time I have known him, he has talked very movingly about how his childhood experiences made him question his gender identity, sexuality, sanity, and whether he would in turn present a risk to others (something I know not to be the case, but which has been his darkest fear, based on the fact that many perpetrators report having been abused themselves in childhood, despite the fact that the majority of survivors do not go on to perpetuate the cycle of harm). He felt that he did not want additional sympathy or allowances making, and said that other people had been through much worse. Nonetheless, his experiences have had a considerable impact on his well-being. He has experienced intrusive flashbacks and images, panic attacks, stress, depression, time off work sick, and at times coped through self-harm. He has struggled to have enough self-belief to assert himself appropriately, and always tries extra hard to please others even at great personal cost – a trait that has been exploited by some members of his network and employers. I know he has had mixed feelings about giving evidence in an enquiry; wanting to come forward to represent and protect others and to ensure that concerns are not dismissed or covered up, but knowing this will be at some personal cost. And he has had very contradictory thoughts about applying for any form of redress, whether an official acknowledgement and apology from the church, or compensation from the fund for victims.

I can empathise with the ambivalence about accepting money. I can understand that survivors don’t want paying off and that money doesn’t make their abuse go away. And yes, possibly things could have been worse, there are people who have crappier experiences or less positive aspects to their lives in mitigation. I get that the people who are in the lucky position of considering claims are already survivors, and probably don’t want to look backwards to the time when they were victim and to have to relive that experience for another second, let alone in statements and testimony and the flashbacks that will bring. I also know there is a discomfort with the idea of financial settlements as a panacea, and that it feels wrong to benefit in any way from the harm that was done to them.

But when we look at the population level we can see that experiencing abuse changes the path of people’s lives. There is impact to the person’s sense of self, their ability to form healthy relationships and to be happy. People who are abused in childhood have their norms and expectations about themselves, other people and the world changed compared to those who aren’t. They have neurochemical pathways that are more primed for fight or flight, and perceive threat that others do not see. As a result they are less able to concentrate and focus, more likely to switch to anxiety or anger, less able to aim high and achieve in school and employment, less able to trust in relationships. Their self-esteem and sense of identity is damaged, and this permeates their ability to enjoy life in the present and to plan for the future. So whilst that doesn’t have a monetary value, there is a quantifiable loss to their earning power and quality of life, and the compensation is just making a nod towards acknowledging that.

Those responsible for compensation are also massive organisations, and in the case of the Catholic church, organisations that have accumulated massive wealth that for the most part they are not using to benefit the needy – it is kept in stocks, shares and property, and some is used to fund the legal defence of the perpetrators and those who knew about the abuse within the church. That is one of many reasons that lead me to say that victims should always apply for any compensation on offer. My general advice is to “take what you can get, use it for whatever feels right, and build upwards from where you are”.

It seems there is a good message in that for us all: Don’t let your past define you. Build your identity on who you are now, your values and aspirations, and the things that you enjoy. Then find a pathway towards self-actualisation and happiness in the future. Take on new facets to your identity. Become the diver, the weightlifter, the mother, the partner, the poet, the film buff, the cook, the gardener, the video gamer, the artist, the builder, the bookworm, the collector or whatever combination of roles and interests makes you happy. And seek out personal and professional allies for the journey to support you until the wounds of the past heal to become scars that don’t stop you from doing the things you enjoy.

Hiding in plain sight: On Louis Theroux and Jimmy Savile

I watched the Louis Theroux documentary on Jimmy Savile tonight, and I wondered why it wasn’t obvious to Louis how slimy and two-faced Jimmy was. It stood out for me from the original documentary, let alone from the rushes shown in the update, how clear it was that he was inappropriate about personal space and made a number of particular types of comments – normalising sexual content, implying connections to power and influence, and schmoozing/bestowing favour – that I associate with people who sexually abuse children that I have met through work. He also behaved differently when he wasn’t on show, and was with someone he didn’t perceive as having influence, in the unguarded footage shot by the producer late at night. I’ve learnt to take note of that too, from bitter experience.

It reminded me that my initial gut reaction to the original documentary was “ugh, my sense of him being creepy as a kid was right – it appears he has a sexual interest in children, and from the way he talks about enjoying his time with her body it seems likely he had sex with his mother’s corpse”. Yet that response at the time was unspeakable, except to my husband. After all, you can’t just say someone is a criminal, a necrophiliac, an abuser and a risk to children without proof and based purely on second hand information. That would be inappropriate, and potentially defamatory, particularly for a professional.

But Louis was there with Savile and heard his entirely unsatisfactory responses to questions, his jokes and inappropriate behaviour, saw his invasion of people’s personal space, heard him made threats to sue and name drop his connections to both establishment and underworld power. Yet, despite being an intelligent guy with suspicions about Savile, Theroux’s reaction wasn’t one of repulsion and scepticism. He was won over by Savile’s charm, and carried along by the fiction Savile had created that he was some odd relic of the 70s with his own rules not quite being in sync with the present overly PC world, and being inappropriate was harmless and par for the course. He probably felt flattered by the attention, and tantalisingly close to being the confidant that would get the big scoop when Jimmy was ready to tell his story. But he stopped being a critical observer and started to consider him a friend, and was present when he continued to behave in inappropriate ways and failed to remark on it. And that shows how easily it is done.

Because if it is your mate, and they just go one step further than you are comfortable about as if that is perfectly normal, then perhaps that is just the way that they are, and you can start thinking that maybe they are too old and odd to have to conform to social norms. And once you start to think that, your own boundaries shift and you become complicit. Something you would instantly baulk at from a stranger, is somehow normalised. You turn a blind eye without realising you have done so. Louis said that he didn’t feel he had been groomed, but I think he was wrong. Sure, he hadn’t been targeted as a potential victim of Savile’s sexual advances, but he had been drip-fed the self-crafted story of the harmless oddball doing so many wonderful things for charity. And he had been slowly habituated to be complicit in accepting the small infringements into the unacceptable, the misogyny, the recurrent sexualised content of his interactions, the invasions of personal space. And he tolerated the evasion, the flattery, the name-dropping, the sinister undertones as part of the special relationship they had developed. And that, to me, is grooming.

I’m not implying Louis is to blame for that. He has shown his intelligence, empathy and insight in other documentaries, so my expectations are high. But it is easy to be groomed. By definition, recurrent sexual abusers who have not been caught are devious and effective in fooling those around them. Plus Savile had a lifetime of practise and an enormous reputation and network to carry him. Nonetheless, I can see why Louis has been looking back and wondering what he should have noticed. I’ve been there and done that.

The first child sex abuser that fooled me (that I know of) was more than 15 years ago now*. He shook my hand, spoke politely, seemed to have a benevolent interest in the wellbeing of the children in the family and always agreed with what the professionals said. He was well educated, middle class, and married with adult children. He was the one who reported concerns about the grandchild who was referred, and was critical of the parents. The child was developmentally delayed, but also underweight and unkempt, with no sense of personal space. In retrospect, I can see that this idealised grandfather was remarkably unsympathetic to his daughter, whose lifestyle of alcoholism and domestic violence punctuated with inpatient stays after self-harm didn’t match up with the facade of happy families he portrayed. But at the time he seemed very concerned about the wellbeing of the child. The receptionist took me aside to mention that he spoke to his wife “like a dog” in the waiting room, but turned on the charm in the presence of clinicians. I didn’t even make a note in the file. I only remembered the comment 6 months later when the social worker said to a case conference that just prior to proceedings to move the child to the residence of these grandparents, the mother had disclosed childhood sexual abuse from her father, along with sadistic punishments like having her hands held against the hot oven door if she didn’t do as she was told quickly enough. This had then been corroborated by another family member, and her records showed the school had reported the burns to her hands. The child was placed in foster care instead.

I remember how stupid I felt. The clues were right there in front of me. The child was vulnerable to abuse, and the developmental delay and unusual behaviour with no sign of organic cause showed that something was going wrong in their life. But it was too easy to attribute it all to the ‘bad’ parents and not the ‘good’ grandparents, falling into the polarised thinking of the family, despite normally having more nuanced formulations. The mother’s story didn’t match the grandparents, and her lifestyle didn’t fit with their descriptions of her upbringing, but she had been branded an unreliable reporter. So why did someone from such a happy middle class home get into such a mess? The answer was given to me on a plate – she had fallen into a bad crowd as a teenager, and ended up drinking and in a destructive relationship – so I didn’t look at other contributory factors. It wasn’t my job to pry, I was just doing a developmental assessment of the child. Yet I know that severely troubled adults have rarely had idyllic childhoods, and have often experienced multiple adverse childhood events, and that attachment styles are often carried through the generations. Likewise I know that trying to charm professionals can be a warning sign, but nonetheless numerous small compliments on your insight, empathy and skill as a clinician can flatter your ego without being so excessive as to raise a red flag. And the receptionist’s comments were given outside of the clinic room, and whilst I didn’t have the file open to take notes. Plus she wasn’t a clinician and may not have heard the full context of the comment, so the team didn’t give it much credence.

Thankfully, the disclosure came in time to protect the child from being placed with someone with a history of abusing children, but it wasn’t thanks to my skill as a clinician. Sure, I was quite early in my career and still quite naive, but I suspect most clinicians think we have uniquely sensitive radar to pick up on abuse and abusers. Sadly, we don’t. Whilst we might not rely on the stereotypes that the public are fed, of dirty old men in trench coats exposing themselves at the park, or strangers trying to tempt children into their car with sweets or puppies, I do think we have some internal stereotypes. The abusers that are easily caught are often socially gauche, lower in intellectual ability and/or socioeconomic status, and we tend to think of men who are unsuccessful in adult relationships and are prolific and opportunistic in their offending, but abusers are a highly heterogeneous group. Few have overt mental health problems, some may appear to be morally upstanding citizens, some are female, they come from all walks of life, cultures and religions, they may have functional adult relationships, and most are known to the child. about a quarter of perpetrators are under the age of 18. The majority of abusers have a single victim or a small number within their immediate network. A tiny minority with a primary inclination towards children are prolific abusers like Savile, but the damage is so wide ranging and the cases more newsworthy and memorable, which is why people are more aware of them. So there is no clear alarm bell, apart from the inappropriate interest in or behaviour towards children itself, the presence of child pornography, or sexualised behaviour or disclosures from the child.

In hindsight, it is easy to recognise signs you may have missed, and if you know there is a history of sexual offences against children certain behaviours show in a different light. And I have learnt to be both more observant and more wary. Those flirtatious comments to the receptionist, or the attempts to find common ground with or flatter the assessing clinician stand out, just like the cringe-inducing examples of Savile’s behaviour we saw in the edited highlights from the rushes that Theroux had of his time with Savile. We can only hope that we learn from experience and aren’t so easily fooled next time.

*all case details have been suitably anonymised

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 would never use them again. I therefore recommend that 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 we gave up on it and rented rooms elsewhere the office was never made confidential (even by something as simple as opaque sticky-back-plastic on the glass) 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. They threatened to lock in my notes and materials, and sent threatening letters and emails about unpaid bills, despite the fact that no money was ever due and they had failed to live up to the contract we agreed of the work to be completed before any rent was due.

Over time the lack of access to a suitable office became a critical issue for the company, and as this coincided with me moving to a different area of the UK I was forced to conclude it was no longer viable for my business to continue to work in Milton Keynes and I had 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, became noisy on social media 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 was subject to a sophisticated robbery and fraud scam) and I am far from alone in having negative experiences (check their twitter feed and google for reviews). However, although I might be stubborn I try not to hold grudges and at least it has a happy ending now. Hopefully I will never have to deal with them again.

Update: They continued to try to chase “unpaid rent” for several months after we left, despite me referring them back to their own decision that nothing was due. They even referred the matter to a debt collection agency. However, Suzanne Jackson did eventually resolve this, and as of Feb 2017, I think this whole episode has been closed.

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.