Mental health week

This is mental health week. So many therapists and organisations are blogging about how to improve our mental health through therapy and many other forms of expert intervention. Yet the reality is that conditions in this country have declined significantly over the last decade for example,

“The UK has long had a poverty problem, with a decade of public service cuts pushing families across the country further into hardship. It means many will struggle to afford the food they need and be forced to rely on food banks. Some will find it difficult to pay for household bills, transport or internet connections.

The problem is not exclusive to unemployed people. In-work poverty hit a record high just before the pandemic, and a 2021 analysis by the Institute for Public Policy Research IPPR think tank found that London has an in-work poverty rate of 22 per cent – the highest in the country. The chances for households with two full-time workers of being pulled into poverty have more than doubled from 1.4 per cent to 3.9 per cent over the last two decades.” https://www.bigissue.com/news/social-justice/uk-poverty-the-facts-figures-and-effects/  https://www.ippr.org/news-and-media/press-releases/revealed-working-family-poverty-hits-record-high-fuelled-by-rising-housing-costs-and-childcare-challenges

The pandemic exacerbated the problem and speeded up the decline by changing so many work practices, the use of food banks has steadily increased. Government has systematically hollowed out public sector support for the population. Predatory capitalism which views competition as a good thing is increasingly pitting individuals, communities, companies and councils against each other in the name of an ideological canard.

Climate change, the increasing use of damaging fuel sources, fuel companies increasing profits, for example:

“BP’s highest quarterly earnings since 2008 were driven by “exceptional oil and gas trading”. TotalEnergies noted the “outperformance” of its oil trading activities and the “very good performance” of its gas and electricity dealers. At Shell, “higher trading and optimisation margins for gas and power, due to exceptional market environment”, resulted in the highest quarterly profit on record.” https://www.ft.com/content/0f125bca-ca3b-42f8-bbbb-3c83c6abf5db

illustrate how huge corporations are not only stripping the planet, heating the planet but are using populations around the world to grow their profits at the expense of the well-being of those they exploit.

As Douglas Rushkoff observes:

“Taking their cue from Elon Musk colonizing Mars, Peter Thiel reversing the aging process, or Sam Altman and Ray Kurzweil uploading their minds into supercomputers, they were preparing for a digital future that had a whole lot less to do with making the world a better place than it did with transcending the human condition altogether and insulating themselves from a very real and present danger of climate change, rising sea levels, mass migrations, global pandemics, nativist panic, and resource depletion. For them, the future of technology is really about just one thing: escape.” https://onezero.medium.com/survival-of-the-richest-9ef6cddd0cc1

The wealthy are not interested in the health of the majority. The wealthy are more interested in protecting themselves at the expense of the majority. This goes for mental health as well. Rushkoff goes on to describe a dystopian world where the mass of the population are passive recipients of technologies that are provided by the super wealthy elite. It is a dystopian matrix type world exploited to make money for the few out of the many.

Mental health is no exception. There is a vast industry of individuals and organisations providing therapy for individuals living in a toxic environment which is in large part creating their misery through lack of security, whether it be fuel, food, employment or housing.

Individual therapy cannot change this, talking about what happened to us cannot change this. Individual therapy is yet another neoliberal canard that enables the rich to become richer corporations and companies to make profits out of the misery of others.

It is time to recognise that if we really want to make a difference to mental health and well-being we have to change the environment not the individual. That’s not to say that the individual can’t benefit from education and support, but in order for those to be effective there needs to be an environment in which learning support and exploration are conducive to growth and development.

That is not going to happen in the current world where environments become increasingly toxic, increasingly uncertain. The misery that many people are experiencing is not because of their own failings because of the failings of greedy people who run governments and corporations for the benefit of themselves and a small number of others at the expense of the population.

There are many organisations now trying to develop co-operative ways of working, looking for sustainable ways of existing. There are many well-known people trying to put pressure upon the dinosaur that is hunter gatherer predatory capitalism. If we are to survive in any meaningful way as a human race, we have to learn some new words: cooperation, collaboration, communication, connection, etc. Not only do we have to bring these words to the forefront of our thinking, but we need to begin to practice them, learn what they really mean instead of just placing them in fancy documents as though that is sufficient to change the world. In short, we need a fourth cognitive revolution. Where, instead of thinking about problem, we need to start thinking about possibility. That is the paradigm shift when it comes to well-being.

Posted in economics, politics, Universal credit, Work | Tagged , , , , , , | Leave a comment

I Get Now… Woodsy

I get now,

more than ever,
how nobody saw it coming.
How could they?
I’m hiding now, behind a dozen or so tangled pieces of
“no, that’s not what it’s like”…
“no, that’s not what happens”…
“no, that’s not how it feels”…
“no, that’s not what this is about”…
and it feels right now like most of you can’t get to grips with just one.
Don’t tell me you want me to explain.  Because most of you barely want me to get halfway through the world’s longest, scariest sentence before you ride in with your gleaming sword and kill it stone dead –
without even stopping to see what it was.
If I was able to explain the gazillion things you can’t hear right now, I wouldn’t need the help I can’t ask you for.
But right now, I can barely breathe.
That’s why I can’t come to you.  Because sometimes, the thought of killing it all feels way less scary than hearing the screams of all those things we’re torturing by letting me carry on.
You don’t get that – because you think you know.
That’s why nobody saw it coming.
Posted in mental health professionals, poetry, poetry of the disenfranchised, trauma | Leave a comment

Money and Finance – the false gods of neo- liberalism economies.

Whether you look at jobs, homes, power, food, education or any other aspect that impact daily on people’s lives the reality is that insecurity and uncertainty are the demons that rule our lives. People want security, meaning and purpose in their lives. Most do not want vast riches, they want a future, a sense of direction for themselves and their children.

We can argue over current economic policy from the right or the left as much as we want but there is a fundamental problem. World leaders now believe that the world runs on money not people. The Tories want to stimulate the economy by giving more money to the rich. The Labour Party and the left-wing want to give more money to the poor to stimulate the economy. Neither policy is going to work and is literally just tinkering around the edge of the biggest existential crisis the human species has ever faced. What’s more, it’s self-inflicted.

Ever since the dawn of consciousness (whatever that is) the human race has approached its existence in a problem focused way. By this I mean that we pay attention to the problem in a linear fashion rather than considering what a solution would look like. For example, in this current situation everybody is trying to avoid a recession. This is a fantasy of economics, of the financial sector, made by the financial sector to richify the financial sector. It is a concept created to scare the person in the street into believing that interest rate rises, austerity, rewarding the rich are all necessary in order to help the world recover from the financial crisis. The God of the economy is growth, unachievable, impossible growth on a planet of finite resources. It is a short-term fix that will make a long-term problem even worse. From a psychological point of view, it is cultural hegemony.

Others talk of productivity, creating jobs, increasing investment in deprived areas, Liverpool is currently a good example of this. There has been much criticism of the public sector for being lacklustre in attracting business from outside. Indeed, many unfavourable comparisons have recently been made with Manchester who, it has been suggested, merely needs to flutter its eyelids to obtain inward investment currently.

While we continue with these “boom and bust” economics little will change regardless of who is in power. The fundamental change has to be in the way that we think as a species. This is a gargantuan task, but many are already beginning to think about what a sustainable future would look like, what a circular economy would look like, what a world in which security, a sense of future and a sense of purpose would look like. A world in which hope is not a distant concept but part of everyday life.

Investing in the financial sector, quantitative easing, increasing the wealth of the rich are all behaviours that will bring about destruction, war, pitting neighbour against neighbour and the rape of the planet for raw materials to drive growth.

It is time that some of the more enlightened thinkers began to consider the possibility of an economic system which returns to the idea of money as a means of exchange not a market in its own right. The bizarre thing is that the wealthiest people on the planet by and large do not do work but buy and sell money in some form. This is a bizarre concept. Bankers bonuses being the greatest and best example of this. Banks are some of the largest organisations on the planet, yet they produce nothing, add little or nothing to the quality-of-life of the person in the street and are generally cost upon the economy. It is not difficult to see why interest rates rise, the cost of mortgages rise, the price of food is inflated because at the end of the day it is the rich that benefit from all of these policy moves. It is the person in the street that pays for it. Furthermore, it is the most sophisticated example of a hunter gatherer economy. Finance and its product, money, are to be hoovered up, sequestered and handed out at a cost to others that requires growth in order for it to be repaid with interest.

If we are to survive as a species our form of investment has to change. We need to invest in our people, our communities, our connections and communication. We need to invest in cooperation and collaboration rather than conflict and competition. We need a wholesale change in our behaviour as sentient beings that can no longer be driven by a measure of success that is purely monetary in its outward appearance. Money is a concept, nothing more. It’s acquisition and its bedfellow, power, have become the overriding goals of a small number of individuals who see nothing of the consequences of their actions. The rest of us merely go along with it as we see no alternative.

It is time to consider sustainable alternatives, investment in social economies, in people, in communities in a future in which our children can be secure, fruitful, creative and above all thriving rather than surviving.

The obsession with money, the financial world and economics is a behaviour that is toxic to everything upon this planet. Continuing with the current economic global situation and playing with the levers of interest rates, quantitative easing, is going to have about as much effect as shuffling the deck chairs on the Titanic.

No party has the guts or the foresight to come out with a plan for the next 40 or 50 years that creates a vision of sustainability and security for the population. A plan to be worked towards, taking small and foreseeable steps towards a very low growth but sustainable and circular economy that no longer requires feeding with raw materials, low-paid workers, poor quality working conditions and hours but instead provides motivation and connection that enable people to be creative within a secure environment where each person can think about possibility instead of simply about problem.

This requires a fundamental change in leadership away from the pathological personalities that are currently gaining hold again across the globe because they seem to show decisive leadership and look like powerful leaders. History tells us that these people ultimately fail at great cost to the populations that they controlled. Leadership in the 21st century and beyond that is that of enablement, cooperation and collaboration. Not the paranoid fear of being displaced or replaced, being ousted from power. Current leadership needs constant growth. Sustainable leadership will recognise the qualities and abilities of those around them and develop and grow communities. They will not suppress them as is the current mode of leadership.

Posted in economics, future history, meritocracy, politics, Work | Tagged , , , , | 2 Comments

The argument against empathy in psychotherapy

Empathy: helpful or toxic?

Empathy is one of those thorny subjects that people have very polarised positions about. However, exploring the research in some detail makes it very clear that there is actually very little known for certain about the nature of empathy and at the same time a great deal of research has taken place over the last 20 or 30 years. One thing has become abundantly clear that some types of empathy, particularly emotional empathy, is very damaging.

For example, Schloßberger (2019) suggests that,  “The interior life of others is characterized by the fact that it is completely inaccessible. In order to really know what the other feels, we would have to get rid of her otherness—which, of course, makes separate individuals out of us—we would indeed have to become one and the same person”. In order to truly empathise with a person would need to become that person, an act that would be impossible. The belief that we can ever understand what it is like to another is an idea that is bound for failure, ultimately creating inaccurate opinions and images that distort reality and potentially very dangerous.

When we consider empathy in the context of any role, we need to be very clear about what we are talking about as the evidence for compassion as an action rather than empathy as a passive feeling is far stronger and a good deal more useful.

The exploration of empathy can be traced right back to Adam Smith. In his Theory of Moral Sentiments Smith writes,

“As we have no immediate experience of what other men feel, we can form no idea of the manner in which they are affected, but by conceiving what we ourselves should feel in the like situation. […]. It is the impressions of our own senses only, not those of his, which our imaginations copy. By the imagination (my italics) we place ourselves in his situation, we conceive ourselves enduring all the same torments, we enter as it were into his body, and become in some measure the same person with him, and thence form some idea of his sensations, and even feel something which, though weaker in degree, is not altogether unlike them. (Smith 1817, p. 2).”

Singer & Klimecki (2014) make a similar point and draw in a fresh idea that helps to identify the difficulties of empathy when they observe,

 Empathy makes it possible to resonate with others’ positive and negative feelings alike — we can thus feel happy when we vicariously share the joy of others and we can share the experience of suffering when we empathize with someone in pain. Importantly, in empathy one feels with someone, but one does not confuse oneself with the other (my italics); that is, one still knows that the emotion one resonates with is the emotion of another. If this self–other distinction is not present, we speak of emotion contagion.

Flasbeck, V. Gonzalez-Liencres, C. Brüne, M. (2018) go on to point out that,

 “Empathy” is a multifaceted construct of emotional experiences and behavioural responses based on these experiences that arise as a consequence of perceiving another individual’s emotional state. Accordingly, there is no generally accepted definition of what empathy actually is. A relatively broad conceptualization describes empathy as the ability to feel and to understand (my italics) what another individual feels and understands. This is thought to occur through a process involving the semi-automatic copying or mirroring of another’s emotional state, which induces a similar (my italics) emotional state in the observer, referred to as emotional empathy.”

Paul Bloom (2016) describes empathy in the following way in his Book Against Empathy : The Case for Rational Compassion,

“[E]mpathy distorts our moral judgments in pretty much the same way that prejudice does. Empathy is limited as well in that it focuses on specific individuals. Its spotlight nature renders it innumerate and myopic: It doesn’t resonate properly to the effects of our actions on groups of people, and it is insensitive to statistical data and estimated costs and benefits.”

Bloom goes on to make a very powerful argument for compassion with the use of an everyday example. He talks about the way that we, as parents, treat our children; he says,

“Any good parent, for instance often has to make a child do something, or stop doing something, in a way that causes the child immediate unhappiness but it’s better for him or her in the future: do your homework, eat your vegetables, go to bed at a reasonable hour, sit still for this vaccination, go to the dentist. Making children suffer temporarily for their own good is made possible by love, intelligence, and compassion, but yet again it can be impeded by empathy.”

In order to start my own exposition on this matter I want to consider a phrase that I use a great deal in my own work. I frequently work with teams and organisations where there are many people at different levels in the same organisation attending a training session. Some of them such as senior managers or chief executives have to take a much more strategic or helicopter view of what their organisation is doing. Then there are others who are working in a more operational way who are attending to day to day tasks who don’t necessarily see the bigger picture. It is rare that either have a full understanding of what is going on across the company unless it is very small in size. As a result, I begin by asking them all to think about the following phrase: zoom in and zoom out.

When we zoom in we are looking at the detail, the everyday activities of employees, the structure of the company in terms of documents that create its shape, its processes and the form of its everyday activities. We are taking an interest in individuals and their activities within the organisation. Frequently we are hearing descriptions of their experience of the organisation and we may well “empathise” with their view.

When we zoom out we are taking a helicopter view which is much more strategic, puts the organisation in the context of its environment both commercial and social, it helps us to look at the overall shape of an organisation and helps us to look at the way its processes impact upon the individual employee, the directors and senior managers, the organisation as a whole and its impact within its environment. We are much less likely to consider the role of the individual and their particular difficulties within the organisation but rather to focus on the greater need of the greater number within that organisation as well as considering the benefits that the organisation can bring to its customers and the wider environment in which it exists. Arguably, managing the strategic view which will benefit the majority may well disadvantage the individual but is the more compassionate and sustainable viewpoint.

Furthermore, any perspective on an issue is necessarily only one person’s perspective. When we zoom in we look at a particular issue through the lens of our own experience, that experience introduces bias. Paul bloom makes the point above that empathy focuses us upon that particular issue and excludes the wider environment. He makes the point very clearly that empathy is both myopic and innumerate as it excludes the bigger picture.

We see this conflict very clearly between the bigger picture and the narrow picture when a therapist sits down in front of a client all their attention is focused upon that client. By and large all the information the therapist receives comes from the client themselves. This may be regarding as zooming in and the therapist would consider themselves to be in an empathic role in relation to their client.

Yet the organisation and the context in which that therapy takes place is not considering the interface between the client and therapist but is interested in the statistics from all its therapists that are related to process and outcome and determine the organisation’s viability and future. This could be regarded as zooming out. Again, the gathering of statistics to identify and create a bigger picture could be regarded has a more compassionate role rather than an empathic one as zooming out is considering the bigger picture and the greatest good for the greatest number.

Arguably the therapist is being empathic in the room while the wider organisation is being rationally compassionate. Bloom (2016) considers this when he makes the observation, “empathy doesn’t resonate properly to the effects of our actions on groups of people, and it is insensitive to statistical data and estimated costs and benefits”.

In the quotes that I used at the beginning of the essay there has been a deliberate introduction of a number of ideas about what empathy and compassion are and are not. In order to explore this a little bit further it would be useful to highlight those concepts and then deal with them in order.

Empathy as a passive feeling

Most researchers working on empathy tend to differentiate between two different types emotional empathy and cognitive empathy. The most common description that encompasses both types of empathy is along the lines of, “the act of coming to experience the world as you think someone else does” Bloom (2016).

Emotional empathy tends to be that immediate automatic response that may be to somebody in pain, either physical or psychological, where our own bodies react in some way as a result of seeing the pain of another, for example, seeing somebody stung by a wasp or a bee and feeling a similar though much milder response from our own body. A good example of how emotional empathy can be very unhelpful present time is that of the migrants entering the United Kingdom. Depending on your perspective one can feel considerable empathy for the migrants who struggled across continents to try to get here and identify with their pain and difficulties. Or one can identify with those who say we already have difficulties managing our own population’s needs who should be looked after first before we tend to the needs of aliens.

However you look at this situation our emotional empathy causes us to side with one group or the other regardless of the reality of the situation. As Bloom says, emotional empathy creates a spotlight upon an individual or small group of individuals to the exclusion of others.

Douglas Murray in his book, The Madness of Crowds: gender race and identity, illustrates this beautifully with the following anecdote,

“Christakis tried to explain his view that even if two people do not share exactly the same life experiences, exactly the same skin colour or gender, they can still understand each other. It didn’t work. At one point he smiled and was berated by students for smiling. ‘I am sick looking at you,’ shouted one young Yale woman. A tall black male student strode forward to instruct Christakis: ‘Look at me. Look. At. Me. Do you understand: you and I are not the same person. We’re humans, great – glad we understand that. But your experiences will never connect to mine.’”

There is something of an irony in this passage for me as it is not Christakis who was failing to show empathy, as he was trying very hard to be empathic. The irony is that the student with whom he was trying to be empathic clearly had no empathy for Christakis situation. This particular situation continued to escalate until Christakis was forced to resign from his post at Yale and his wife had to do the same. What made it even worse was that Christakis was a man who had fought for social justice all his life. This was the product of an attempt at empathy.

Empathy is not about action but about identification. The person displaying empathy is simply trying and believing that they are identifying with the person for whom they are expressing it. It does not imply change or action and as can be seen from the example above can then mire both in a set of emotions that are both negative and unhelpful.

Empathy as requiring imagination not objective evidence

Adam Smith uses the word imagination in his description of empathy at the beginning of this essay. Imagination seems to be a characteristic unique to human beings and has enabled us to achieve much but in the context of empathy imagination immediately begins to fail us. When we use our imagination we draw upon our own experiences, our own understandings of the world. If we use that imagination to try to imagine what it feels like to be another person, we are simply imposing our experiences and our understandings upon the world of the other. It is incredibly unlikely that they are going to match. Therefore, when we say that we understand how another person is feeling, first of all we cannot possibly know that; secondly it is highly unlikely that we are experiencing the same feelings as the person that we claim we are empathising with. This creates an immediate opportunity for miscommunication and the assumption of understanding leads to greater misunderstandings and miscommunication as a conversation or relationship progresses.

In therapy there is a famous phrase, “the rupture of the therapeutic relationship”, in my opinion this rupture occurs more often because of empathy, and assumption of understanding and a resulting failure to listen, than for any other reason. The therapist ceases to collect evidence, observe their client and proceeds based upon their own understanding of the situation rather than that of the client. That observation leads neatly to my next two points.

Empathy having the potential to conflate self and other and emotional contagion, the potential to assume that we can understand and experience the distress of others directly.

We can never understand or experience distress of others directly. We feel what we feel, we do not feel what the other feels. Our experiences and understanding of the world mediate our understanding of another. We interpret everything through our own experiences. We cannot be objective. Psychology as a profession attempts to be a science but every experiment, every process of gathering data in the social sciences is a question of interpretation. From random controlled trials to the psychologist in the therapy room there is a degree of interpretation of evidence, it cannot be otherwise. That interpretation is carried out by a human being or a group of human beings. It is a consensus rather than an objective fact. We may have become more sophisticated in our interpretations but Freud had it right, we do nothing more than interpret the words and behaviour of those that we are examining and working with.

Cognitive Empathy

Many psychologists would say that they do not use emotional empathy but that their approach is cognitive and intellectual. Bloom makes the point in relation to this, “cognitive empathy is overrated as a force for good. After all, the ability to accurately read the desires and motivations of others is a hallmark of a successful psychopath and can be used for cruelty and exploitation.”

I guess many psychologists would say that they would want to use it as a force for good, but my response to that is that we are then into a whole new argument around morals and ethics and what is “good”. Is it good for the individual? Is it good for the family or the context in which the individual or individuals are situated? Is it good for the psychologist? Is it good for the state? The phrase “force for good” is immediately fraught with dilemmas of many different kinds. Furthermore, it is entirely tied up with perspective. These are all aspects of empathy that infer judgements have to be made by the empathiser in order to “understand” what the person is feeling.

Empathy as part of theory of mind.

Epley and Waytz repeatedly write in their frequently cited survey chapter on “Mind perception” in The Handbook of Social Psychology(2010):

“Others’ mental states are unobservable and inherently invisible and it is precisely because people lack direct information about others’ mental states that they must base their inferences on whatever information about others that they do, in fact, have access to. They must make a leap from the observable behavior to the unobservable mental states, a leap employing either simulation or theoretical inference.”

“Moreover, enhanced theory of mind by no means would be expected to always translate into prosocialbehavior. Some data suggest that enhanced theory of mind can translate into manipulative, gain-seeking behavior as well, for example, in effect, bullying (Sutton, Smith, & Swettenham, 1999). Some findings suggest it could be associated with oversensitive behaviour later in life, for example, in the transition to peer relations at primary school (Dunn, 1995). From this perspective, of course, the expected relation between adult theory of mind and adult social skills and interaction would have the same features; “mature” theory-of-mind understanding is only “sometimes necessary, never sufficient” to guide social-communicative interactions, both prosocial and antisocial interactions.”

To demonstrate theory of mind, one has to be able to represent cognitive and affective mental states, attribute these mental states to self and other, and deploy these mental states in a manner that allows one to correctly understand and predict behaviour (Abu-Akel and Shamay-Tsoory, 2011, Hillis, 2014).

There are a number of phrases that I would like to draw out of the statements above that illustrate just how dangerous these ideas of empathy and theory of mind really are:

“Leap from the observable behaviour to the unobservable mental states, a leap employing either simulation or theoretical inference.”

“mature” theory-of-mind understanding is only “sometimes necessary, never sufficient” to guide social-communicative interactions, both prosocial and antisocial interactions.”

These statements illustrate the level of assumption that we make when we empathise or use our own theory of mind to guess what is going on in the minds of another. It is not safe nor is it scientific and it is time that the promotion and promoted use of these as a skill of the psychologist, the leader or the therapist should be seriously questioned.

To try to illustrate how difficult it is to identify the “theory of mind” of another, I have provided a story that illustrates just how different perceptions of given situations can be.

Two little boys

Sometimes it is helpful to understand “theory of mind” by considering the lives of two small boys. One boy was born to a mother who was addicted to heroin. He was conceived at a drug fuelled party. The poor woman didn’t realise that she was pregnant until she was 16 weeks into her pregnancy. The child was born in the neonatal unit and had to be weaned off heroin, as his mother had continued with her habit throughout the pregnancy. She eventually took him home and no more was heard of either of them for 18 months.

One night when he was about 18 months old, he was found walking down the street at midnight in a soiled nappy. Social services were called and the boy was taken into care immediately. He was placed with foster parents but his behaviour was so poor that they couldn’t cope with him. He was then placed with specialist foster carers who are used to dealing with difficult behaviours, but they couldn’t manage him either.

Eventually he finishes up in a local authority children’s home, aged about five years old. For the next five years he has cared for inconsistently. His carers have different rules at different times, he has been shouted at, physically abused, bribed and possibly even sexually abused during this time. In his short life he has learned that he cannot trust adults; that they will meet their own needs before they meet his; that they will use him to meet their own needs as well.

The other young man is of a similar age, about 10 and comes from a family where the mother is a GP, the father is a barrister. He has two other siblings and a wide range of aunts and uncles from both sides of the family. He frequently goes and stays with extended family and his cousins. He knows he is a small boy and that adults will look after him and that that care is consistent.

They are both sitting on a park bench eating their lunch, a man a dirty raincoat comes up to them and offers each of the boys a sweet from a paper bag. The gesture from the man to each boy is exactly the same. The young man from the children’s home is likely to be suspicious, he makes an assumption that the man is likely to want something in return for the sweet as this is his experience. He is likely to retreat and possibly even be hostile.

The young man from the conventional family is much less likely to be suspicious, though his parents may well have told him about stranger danger, and although unlikely to take the sweet is far less likely to assume that there is a sinister motive for the giftgiving and is likely to refuse politely.

The point of this story is that it is not the gesture of the man in the raincoat that is significant, but rather the experience that each boy has so far had in their lives that determines the outcome of the encounter. However, notwithstanding that it is the past that is influencing the present, the behaviour of both boys can only be changed in the present and it is about learning to change the schema through anticipating a preferred future and rehearsing the behaviours that are appropriate to that future.

The process of the creation of imagery using “empathy” or “theory of mind” to identify what is in the mind of another is fraught with a myriad of difficulties, yet empathy is considered to be one of the cornerstones of psychological therapies.

I have merely scratched the surface of thousands of papers, books of which at the last count there were over 2000 books with empathy in the title and many more discussing it besides. Empathy has been seen as the mainstay of psychological therapies, I argue, like Bloom and many others, that this reliance upon empathy in human communication is not only fraught with error but prevents exploration of situations; reduces the ability of the helper to help their clients make progress as it gets in the way; creates misunderstanding; blinds people to the bigger picture and should be seriously discouraged and thus replaced by compassion.

Compassion

I would be surprised if any psychologists have not heard of Prof Paul Gilbert, the compassion foundation, and compassion focused therapy. While I am not an adherent of this particular approach, I prefer something even less complex, Prof Gilbert has done a huge service to psychology by advocating for compassion rather than empathy.

Stevens & Benjamin (2018) describe compassion as being conceived as:

“A feeling of concern for another person’s suffering which is accompanied by the motivation to help. By consequence, it is associated with approach and prosocial motivation. There appears to be considerable consensus as to a definition of Compassion. Compassion is a sensitivity to the suffering of another and a desire to alleviate that suffering.”

“So commonplace is this trait of compassion that scholars have considered it to be “an emergent, phenotypic property of our minds” and of critical species survival value (Gilbert, 2005). Genetically, it may find its development in enhanced species propagation through (1) its preservation of the welfare of vulnerable offspring, (2) increased perceived desirability in mate selection, and (3) the protective consequences of nonkin cooperative relationships.” (Stevens & Benjamin 2018)

Stevens & Benjamin (2018) go on to say that compassion,

“Differs from empathy in that empathy is the general vicarious experiencing or sharing of another person’s emotional state, not just their suffering. Empathy lacks the motivational component of compassion (to help), and compassion can involve emotions other than those of the observed.”

Compassion as an action, an activity rather than a state of mind.

Gilbert (2009) suggests that describing compassion as an action, “takes us to the heart of compassionate behaviour because it isn’t just about acting in kind, warm and friendly ways. It’s also about protecting ourselves and others from our own destructive desires and actions; it’s about being assertive, tolerating discomfort and developing courage.”

Compassion as an act aimed at alleviating suffering.

Most effective acts of assistance are based upon compassion not empathy. As seen in the quotes above from people who have researched the subject for years empathy is passive and difficult to describe, while compassion is far more easily define as a behaviour or action, it requires effort, a sense of purpose and direction.

Compassion is the act of recognising someone’s distress or pain and wishing to do something about it to alleviate their suffering. This may be at an individual level, a group, community or even larger such as a nation. It considers the collective good and not just a focus upon an individual. Compassion considers consequences of actions, not just feelings in the moment like empathy.

Compassion is prosocial and developmental, seeking possibility and change for the better; an alleviation of suffering rather than just the recognition of it and alleged identification with it.

A display of compassion is far more easily identified than an act of empathy and its impact is far easier to measure.

Finally I wish to bring in the concept of affordance as this illustrates the chaotic and harmful nature of empathy while emphasising the practical utility of compassion.

Affordance Theory

Affordance Theory as defined by J.J.Gibson, states that one perceives the world not only in terms of object shapes and spacial relations but also as object action possibilities (affordances) – one’s perception of an object implies the action associated with it. Gibson states that affordances exist naturally in the environment and are instantly perceived by the viewer requiring no sensory processing. (https://cs.brown.edu/courses/cs137/readings/Gibson-AFF.pdf)

It might be worth while using a short anecdote to illustrate the theory of affordances. (Offered to me by Dr Mark McKergow as a personal communication)

Imagine if you will, three people walking through a forest. One is a biologist, one is an entymologist and the third a carpenter. Each is observing the environment through their own experience. The biologist may see the foliage, animals and soil as an interactive symbiotic world in which each organism acts upon all the others in some way that maintains a balance that allows all to exist. The entomologist sees the insects and recognises their specific traits and characteristics that allows them to survive in the environment. The carpenter sees the trees as the potential for furniture or building materials (even as a carpenter there are many subgroups who would see the materials in different ways for different purposes depending upon whether they build houses or make furniture).

Each of these three people will see something different in the environment. Their experience and training has taught them to notice different aspects of the environment in which they are immersed. While there may be one overlap of knowledge it will be limited and in no way compensate for differences in the perspectives of the three people. Arguably empathy is limited by the knowledge of empathiser who cannot understand the perspective of the other any more than the biologist, entomologist or carpenter can truly understand each other’s perspective. What makes this worse is that this is part of unconscious bias as the empathiser cannot compensate for that which they do not know or understand.

A person practicing compassion on the other hand would be curious about the role of the other, asking questions, attempting to discover how they might help the sufferer, learning what action might be helpful, what would make a difference and improve the lot of the sufferer. A compassionate interaction would also look at consequences of actions.

in order to have any kind of empathy or even theory of mind about another we have to know that other well we cannot make assumptions based upon our own understandings of the world and assume that they are similar to the person that we are observing.

In conclusion I stand with researchers like Bloom and stake my claim that I am against empathy.

References:

Bloom, P. (2016) Against Empathy : The Case for Rational Compassion, Bodley Head, London.

Gallagher, S The Case Against Theory of Mind DOI:10.1093/oso/9780198846345.003.0005

Flasbeck, V. Gonzalez-Liencres, C. Brüne, M. (2018), The Brain That Feels Into Others: Toward a Neuroscience of Empathy found in: The Neuroscience of Empathy, Compassion, and Self-compassion, Edited by Larry Stevens & C. Chad Woodruff Elsevier London.

Gibson J. J. (1979) https://cs.brown.edu/courses/cs137/readings/Gibson-AFF.pdf

Gilbert, P. (Ed.). (2005). Compassion: Conceptualisations, research, and use in psychotherapy (1st

ed.). London: Routledge.

Gilbert, P. (2009),THE COMPASSIONATE MIND A New Approach to Life’s Challenges, Constable, London.

Murray, D. (2019) The Madness of Crowds: gender race and identity, Bloomsbury Continuum, London.

Schloßberger, (2019), Beyond Empathy: Compassion and the Reality of Others, Published online: 9 May 2019 https://doi.org/10.1007/s11245-019-09636-7

Singer, T. Klimecki, O. (2014) Empathy and compassion, Current Biology, VOLUME 24, ISSUE 18, PR875-R878, SEPTEMBER 22, https://doi.org/10.1016/j.cub.2014.06.054https://www.cell.com/current-biology/fulltext/S0960-9822(14)00770-2

Smith A (1817) The theory of moral sentiments [1759], vol 1. Kluwer, Boston found in Matthias

Stevens, L. Benjamin, J. (2018) The Brain that Longs to care for Others: The Current Neuroscience of Compassion. Found in The Neuroscience of Empathy, Compassion, and Self-compassion, Edited by Larry Stevens & C. Chad Woodruff Elsevier London.

 

 

 

 

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Medicalising the end of lockdown will make it worse.

As the pandemic is beginning to lift, I can almost hear psychiatric and psychological services getting themselves into gear with disorders, diagnosis, problems and other negative approaches to the distress that people will begin to express as they come out of the restrictions.

I think it is time to remind those professionals who see this as an opportunity to display their expertise in analysis and description of what is wrong that folk who are distressed as a result of this pandemic are not disordered. They are responding a normal and understandable way to a frightening and unpredictable situation.

For the last 50 years predatory capitalism has told people that their lives are safe and predictable if only they bought a pension, work hard and obeyed the rules of the state.

The pandemic, as I pointed out in a post in April last year, has utterly destroyed the image of an economy that is strong and stable. Indeed, events of the last 15 months have shown just how predatory the wealthy can be at the expense of the poor.

I have no illusions that the distress of people who have lost their jobs, their health, family members and the sense of future will now be commodified by another group of professionals who will seek to peddle complex and difficult therapies to cure their ailments.

The reality is that the distress that people feel is related to the environment that has now been created by the predatory capitalism of the few at the cost of the many. Individual ‘treatments’ for a disorder that is not situated within the individual will be largely ineffective potentially even more damaging as a result of the greed of the elite.

There are many small community efforts springing up, not only in this country but all over the world, which are bringing people together to support each other and help to reduce the toxicity of the economic climate. If government had half a brain and wants to stay in power, it would be seeking to support those activities, bring people together, not seeking to get everybody back to work to make money again. If we are to survive into the future then we have to think about cooperation, collaboration and abandon the idea of a hunter gatherer competition to restart the world.

Posted in corona virus, economics, mental health professionals, meritocracy, politics, psychology. | Leave a comment

Digitisation: winners and losers.

Let me set out my stall to begin with, I’m a technophile and an early adopter. I love technology and the benefits it brings. But, that’s not to say that I assume everyone benefits from technology in the same ways that I do, that would be absurd! Every new innovation has its winners and its losers.

When human beings moved from a nomadic lifestyle 11,000 years ago to become urban dwellers, the increase in numbers living in close proximity brought the advantages of feeding, leisure and support through community. It also initially brought a lower life expectancy, poor hygiene and increased levels of disease. Then the move from city states to states and nations brought a myriad of complexities and conflicts, but it also brought greater cooperation and opportunity for a wider exploration of human abilities and talents. The Industrial Revolution brought the marvel of mass produced goods, many of those goods now within the grasp of many more people, not just the elite.

Again, it also brought poor hygiene, increased levels of disease, overcrowding and crime as people moved from the countryside into the cities and the cities grew ever larger. Each of these transitions produced their own problems as well as their own solutions, but those in power were often reluctant to initiate change. Perhaps the best example is John Snow in London in 1856 when he took the handle off the pump to prevent the spread of cholera. It was another 10 years before his peers and the medical profession as a whole accepted that foul water was the problem.

Then came the so called “fourth Industrial Revolution” which has brought huge innovation in the last 30 years. Innovations that my father and many of his generation could never have conceived of. Who would have thought that the mobile telephone (of which I had the ‘brick’ form very early on) that gave us such freedom could morph into something so ubiquitous and fundamental to modern life that it has become a tool of everyday use? For example, a median of 76% across 18 advanced economies surveyed have smartphones, compared with a median of only 45% in emerging economies. https://www.pewresearch.org/global/2019/02/05/smartphone-ownership-is-growing-rapidly-around-the-world-but-not-always-equally/

The transition that we are currently going through, the outcome of which has been the subject of hundreds of articles, both apocalyptic and utopian, is creating the same kind of disruption as the transitions that I noted earlier. This time however it is a much more subtle transition, perhaps it seems more subtle because we are in the middle of it; or perhaps it seems more subtle because for many of us it is a huge advantage to our lives both at work and at leisure.

Even so, like all major shifts in human behaviour, it has brought its own problems. These problems are not just social but also challenging for the scientist too. Let me begin with the social challenges, I observed that on average 76% of the world’s population is now connected to the Internet in some way, conversely, 34% of the world is not. That 34% is being left behind or perhaps they don’t want to keep up.

There are moral and ethical issues around assuming that everybody on the planet wants to have the next technological innovation immediately. Or perhaps those people are unable to take advantage of the technology because their literacy is low or non-existent, perhaps they have not been so fortunate to be able to access digital technology and be able to develop an income, whether through working for an organisation or being sufficiently entrepreneurial to work for themselves and develop an income stream that way; or perhaps they have some kind of developmental difficulty; a physical disability; suffered some kind of physical trauma which has entirely disrupted their lives (one area of my activity as a clinician); or perhaps they have suffered some kind of psychological abuse (short or long-term) that has impacted upon their ability to trust others and compete on equal terms with the rest of us.

We are also seeing the digitisation and automation of factories and many other forms of production, computer-aided design (CAD) computer-aided manufacture (CAM), for example. We are also seeing the automation of many traditional white-collar activities, to name a couple: accountancy through software programs like QuickBooks, the law through will writing and other algorithm driven legal processes, estate agency and, of course, online retail shopping whose exemplar is Amazon. Those people without access to the Internet are immediately disadvantaged in the current employment market. This huge leap in communication ability saves time and effort, the advantages in automated production produces opportunity for cheaper goods and greater profits. Those without access to these advantages are again disenfranchised. At the beginning of December 2020 a website called ITProPortal produced a shocking headline: AI could generate more revenue than human workers by the end of the decade, this headline gives a clear steer to the direction of travel for business of all types. Money not people is the overriding principle. Though it does suggest that such a direction of travel will produce upskilling of workers, but only those who are already at a reasonable level of literacy and education. https://www.itproportal.com/search/?searchTerm=generate+more+revenue+than+human

However, there is something far more important that we are just at the beginning of that is going to disenfranchise many in those groups of people that I outlined above in a far greater way. The Covid-19 pandemic has sped up the process that the fourth Industrial Revolution has made possible. For the first time in 300 years, we have realised that we no longer need to live in cities to be close to where we work. The pandemic has also made people long for a piece of green grass or garden of their own for privacy. The company Airbnb has now become one of the largest flotations of any company in the history of global stock markets at somewhere in the region of £31 billion. https://www.standard.co.uk/business/technology-media/airbnb-ipo-booking-shares-marriott-hilton-b209244.html The reason for this is simple, those that can are now looking at long-term leases and purchases in rural areas. As this new global trend grows, rural settings will become more intensively populated but without the office blocks that city dwelling has previously brought. We are already seeing leisure activities, drive-in movies, plays and shows brought to local halls and cinemas that have been in the doldrums for years. https://www.artscouncil.org.uk/coming-pub-near-you  There are new delivery companies springing up all the time to be able to manage the new demand for online shopping as more and more people spend all day sitting in front of their computer screens and on their phones, whether it is for work or leisure. The film industry is already evolving to capture a larger audience by including streaming and last Christmas at least one company produced a film that was put on the Internet the same day it was put out in the cinemas. Communications programmes like Zoom are attracting the interest of the arts as a new medium: https://dcmetrotheaterarts.com/2020/12/11/using-zoom-in-a-new-way-to-create-theater-that-transforms-how-we-see/?fbclid=IwAR0Pbso0A4RxbTqLl1j8RYlrApJ7twT4S7_XAQeG41cV80xkuv6WYMOevFI

Digitisation has enabled this diaspora, it is, as yet, only in its infancy but as it gathers pace the cities will become hollowed out because opportunity will follow the wealth that can afford to move. “Network provider Openreach (BT) has announced that 227 new UK locations – 250,000 premises – are being added to the roll-out phase of their 1Gbps capable Fibre-to-the-Premises (FTTP) broadband ISP technology, which this time appears to focus on some of the “harder to reach” villages, market towns and rural areas”. https://www.ispreview.co.uk/index.php/2020/01/openreach-add-227-rural-uk-areas-to-fttp-broadband-rollout.html Already some large corporations are ending their leases on city blocks as they realise the benefits of having their staff work from home. https://www.economist.com/leaders/2020/09/12/is-the-office-finished https://www.raconteur.net/workplace/future-office-remote/

Yet there is little consideration for those who cannot take advantage of these amazing innovations. As cities decay, and we have already seen this beginning to happen long before Covid and the pandemic, properties will be repurposed, if they are lucky, if they are not, they will become derelict. https://www.forbes.com/sites/tiffanychu/2020/10/01/covid-19-is-not-the-death-of-the-cityits-the-rise-of-the-neighborhood-center/?sh=97ded0424919 If cities are not repurposed, as Tiffany Chu suggests, cities will become the dwelling places of the poor and disadvantaged where there will be few services, despite this being the place where they are most needed. Furthermore, any services that do survive are likely to charge insurmountable sums of money because there is nowhere else to go, further separating the poor and the wealthy. Power and influence will become increasingly networked and the advantages of close proximity to each other for powerbrokers will diminish.

White-collar employees who might live in suburban areas will become increasingly isolated from their work colleagues physically and will have to develop and get used to new ways of communicating effectively through technology. Health services have already been developing digitised services, telemedicine, national data management and hundreds of thousands of online services. And this is just as true of private sector as it is of the public sector. They all seek to commodify their services as predatory capitalism demands that every service has a cost rather than a value. Mark Carney describes this very clearly in this year’s Reith lectures. https://www.bbc.co.uk/programmes/m000py8t

This may seem a rather dystopian view but, in much more quiet ways and far less headline grabbing ways are the millions of people who are quietly developing communities (village in the city for example, which is now spreading globally https://villageinthecity.net/ ), learning to communicate face-to-face in their immediate physical horizon, beginning to notice and take care of those less fortunate than themselves. Working away, often as volunteers, while carrying on their day job, connecting with others in their own country and much more widely across the globe as individuals with common interests discover each other and common goals.

Yet this ability to communicate still remains a double-edged sword as social media divides and rules with its clever algorithms and its ability to engage the human psyche. There is an organisation called the social dilemma (https://www.thesocialdilemma.com/) and I hope that many of you have seen the movie they made late last year about how those who created the massive social media platforms never intended their platforms to be used to promote lies and fake news, nor to encourage hate speech, bullying, misinformation, etc. Their intention was always good, human beings rarely do things with dubious intent. Folk get uncomfortable when I say this and then use the example of Donald Trump by suggesting his intentions are good! They are – for his constituency. He did not intend to deceive people, he really believes he is changing America for the better. (https://www.amazon.co.uk/Madness-Crowds-Gender-Race-Identity/dp/1472959957). People prefer the echo chamber of their own world and this is true just as much of the left as it is of the right in politics. The use of social media to manipulate is well known and the Facebook/Cambridge Analytica scandal is perhaps the best known example. (https://en.wikipedia.org/wiki/Facebook%E2%80%93Cambridge_Analytica_data_scandal )

The gathering of masses of data has also enabled deceit to take place in science as well as our social world. As ionadis points out, “There is increasing concern that most current published research findings are false”. The BPS published an article in September 2019 illustrating the lack of safety of some of the most famous research findings in psychology suggesting that “…given the public fascination with psychology, and the powerful influence of certain results, it is arguably in the public interest to summarise in one place a collection of some of the most famous findings that have proven tricky to repeat.” (https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.0020124 https://digest.bps.org.uk/2016/09/16/ten-famous-psychology-findings-that-its-been-difficult-to-replicate/ ). We have learned that over 40% of all psychological research is not safe. Data is used to prove what the researcher hopes is true, if the research doesn’t provide the answer, it is filed in the bottom drawer. A skilled enough statistician can make data say whatever they want it to by omitting or including certain criteria! I’m sure plenty of institutions do this (for example IAPT).

In terms of specific data on mental wellbeing, Wilkinson and Pickett (2014, Kindle Locations 960-965) observe that it may be that greater public spending on mental health services reduces the burden of mental health difficulties. However,

“A study was specifically designed to test this using data on over 35,000 people from 30 European countries. It found no support for explanations involving public spending, but did find support for what the author called the ‘psychosocial hypothesis’: more equal countries seemed to have better mental health at least partly because their populations are less anxious about status and are more involved in social networks that involve reciprocity, trust and co-operation”.

This observation would suggest that those countries who consider equality as an important aspect of policy making fare better than those who do not. Attempting to treat individuals one at a time for their lack of success, as the UK does currently, is clearly not a recipe for success – more a waste of taxpayers money and increases the sense of failure of those who are less fortunate. Furthermore, many services (as noted above) are becoming digitised which increases the disenfranchisement of those who cannot access them.

Yes, we are in a transition and what will come after that transition is not yet clear. One thing I am sure of it will not be a utopian world. Yet digitisation has the opportunity to bring many benefits particularly in terms of energy use, climate and planetary conservation, it brings the opportunity for people to communicate across the globe with people that they could never have hoped to have met previously. The sad thing is that currently digitisation, data gathering and psychological manipulation are the most common benefits for the few over the many. Every new innovation has to be monetised, has to bring a benefit in competition against its rivals.

The future of digitisation, of the World Wide Web, social media, data collection and communication in all its forms cannot be left in the hands of a few extremely powerful people to play out their power games at the expense not only of the disenfranchised and disadvantaged, who will be left behind altogether, but for many others whose naiveté of the system and gullibility related to things that they are told will also be ultimately left behind.

I said at the beginning that I am a technophile, I am. I love it but I’m now getting too old and crotchety to understand it so well, so perhaps my view is a little jaundiced, but I also see a huge opportunity for mankind to step up to its moral and ethical plate and begin to think how it can use these innovations for the good of itself, the other creatures on the planet and the planet itself. If we learn to cooperate, communicate effectively, clearly and honestly, use everything we have learned so far as engineers, psychologists and politicians to begin to think about how we can make a better world, a more sustainable world then we will begin to find ways to use this new wonderful technology in a way to improve ourselves and care for each other better. In 2016 I wrote an article called “Are we the guardians of the human psyche?” It is still on the British Psychological Society website and I would argue that everything I said there is even more relevant today.

While global politics continues to be based upon hunter gatherer principles, acquisition of wealth and power remain crucial to the survival of successful politicians. I believe that this produces a crop of particularly toxic individuals whose desire for power overwhelms any sense of purpose other than to gaining and retaining that power. The digital revolution, if used successfully, will sweep away the ability of the few to manipulate the many and take another small step towards a better and more secure future for every organism on this planet. If it is used as it is being used at the moment it will sweep away the many for the short-term advantage of the few. The few are a conniving bunch, they will devise a way to keep the many on the brink of survival, always swimming against the tide while they continue to cash in because the population is too tired, too ill or too weak to fight.

We need to act now as researchers, psychologists and citizens to try to prevent the worst excesses of the desire for power. We need to think about a world that is more sustainable and better for everyone, including those who are less fortunate than ourselves. The transition is already taking place and disruption is occurring. It is up to all of us as to what that new world looks like when the dust settles.

Steve Flatt and Laura Gregory 20/12/20

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Summer Holiday Hunger – Laura Gregory

Hunger pains like stabbing needles

Growling like a rabid dog

Stomach churning, acid burning

No one dare complain

Belly concave like an empty spoon

Ribs protruding trying to break free

From the deathly pale prison of flesh

While cold reaches in to take root

In bones too small to withstand it

Energy reserved for body to function

Can’t play, can’t laugh, can’t run

Tears run down a small gaunt face

As the last bell of the year rings shrill

Like nails on a chalkboard it grates

Sealing the fate of the ones trailing behind

With no one at the gate to run to

No school, no food on repeat in their heads

Dread creeps, fear stalks in the shadows at home

Empty fridge with its glaring light mocking

Cupboards are bare but for the cobwebs

Its only six weeks, not long at all

Six weeks

1008 hours

60480 minutes

3629000 seconds

To wait, to hope, to survive

Posted in free school meals, poetry, poetry of the disenfranchised, politics, trauma | Tagged , | 1 Comment

The race to the top results in fighting in the mud.

There are indications in the press, on social media and in the journals that the psychological professions see a great need for an increase in therapists and expert therapeutic intervention, particularly as a consequence of the pandemic. While there is some recognition that politics play a part in the health and well-being of our society the professional psychological and psychotherapeutic organisations appear to be playing largely lip service to the significance of community and political interventions. 

I want to consider some alternative possibilities to the threat of still more psychological therapy for individuals or small groups, I also want to consider some of the reasons why the professionals continue to maintain this professional, expert and rather individualistic role. 

One doesn’t need to look very far on social media to see the turf wars that are being fought between psychiatry and psychology and within both professions. These battles for the soul of the client, to my mind, are almost entirely pointless but are indicative of the meritocracy in which they are being conducted.  

There are a number of areas that I wish to cover, the common good, meritocracy, scaling/impact and commodification. I do not intend to provide all, or perhaps any of the answers, but to begin to ask questions about how each of these impinges on the nature of the delivery of services at the current time and try to get people to consider alternative interventions that may be worthwhile exploring and perhaps more effective.   

Improving Access to Psychological Therapies (IAPT) has now been running for more than a decade and has no doubt helped, probably, millions of people. After all, we know that somewhere between 10 and 20 million people have accessed the service during the time it has been in existence. However, while it may have made a difference to individual lives there is absolutely no evidence to suggest it has improved the well-being of the nation in anyway whatsoever.

Indeed, I would be surprised in the current climate if any individualistically based intervention would impact upon the current neoliberal political ideology that holds sway. Rather than focus upon the real or perceived shortcomings of the IAPT service I wish to take a more helicopter view all the difficulties we face as a nation and consider how we might be more effective as a body of knowledgeable individuals who for the most part wish to make a difference to the quality of life of those around us.

Some of the issues that I consider may not appear to be immediately relevant but please try to stick with the narrative and I will attempt to explain why I am considering them.

I think the place to start is with the idea of meritocracy. The evidence for the increase of inequality of income and opportunity over the last 40 years or so is unequivocal. It has been driven by a careful shift of emphasis by global politicians from the idea of sharing common goals, space and resources to the idea that we are each responsible for our own success. Michael Sandel (2020) puts it very well, 

“It encourages people to think of themselves as responsible for their fate, not as victims of forces beyond their control. But it also has a dark side. The more we view ourselves as self-made and self-sufficient, the less likely we are to care for the fate of those less fortunate than ourselves. If my success is my own doing, their failure must be their fault. This logic makes meritocracy corrosive of commonality.”

I can’t help looking at the race for qualifications and expertise within the psychological professions that provides clear water, academically speaking, between the therapist and their client. Indeed, I could argue that cognitive behaviour therapy is particularly responsible for this; how its language is inherently paternalistic, for example describing someone’s beliefs as irrational is profoundly disrespectful in today’s climate. Just to make the point, I consider that the degree of success attributed to this particular form of psychological intervention is overblown and often due to researcher allegiance and that proponents of the intervention have an ideological adherence to the model that is irrational. I have little doubt that there are those who are now bridling at my statement and would suggest that I am the irrational one!

Cognitive behaviour therapy was a product of an era, that era has now passed in much the same way as, for the vast majority of people, psychoanalysis is also past its sell by date. The human psyche is a constant and dynamic process, changing as the environment changes and in the 30 years since CBT became popular as a form of psychological therapy the world has changed considerably, economically, socially and spiritually. The idea that an expert therapist can understand the mind of the individual sat in front of them to the extent that they can make judgments as to whether their thoughts and beliefs are rational or otherwise has long since passed. I would also make the point that therapy is in a position to be able to prepare people for work and should be encouraging people back into work is a value judgement that is not part of the therapeutic process.

Wilkinson and Pickett (2014, Kindle Locations 960-965) observe that it may be that greater public spending on mental health services reduced the burden of mental health difficulties. However,

“A study was specifically designed to test this using data on over 35,000 people from 30 European countries. It found no support for explanations involving public spending, but did find support for what the author called the ‘psychosocial hypothesis’: more equal countries seemed to have better mental health at least partly because their populations are less anxious about status and are more involved in social networks that involve reciprocity, trust and co-operation. A similar study that sought to see if lower public expenditure contributed to the relationship between higher inequality and higher levels of violence reached the same negative conclusions”.

The development of an explicit meritocracy in the last few years has created huge inequality and has begun to explicitly blame those less fortunate for their misfortunes. This has been exploited by politicians in the West unmercifully. This meritocracy is clearly displayed in a single set of statistics from Kate Raworth (2017 Kindle Locations 869-872),

“Thanks to the scale of global income inequality, responsibility for global greenhouse gas emissions is highly skewed: the top 10% of emitters – think of them as the global carbonistas (The wealthy elite) living on every continent – generate around 45% of global emissions, while the bottom 50% of people contribute only 13%.”

I consider that this growth of meritocracy is actually part of what enabled Improving Access to Psychological Therapies to come into existence. It is based upon the expertise and idealism of the meritocratic professional. 

This brings me neatly to my second point which may not be immediately obvious. Over the centuries there has been a steady erosion of the entitlement of the common person to those things which have been held in common for all. It began in earnest with the enclosure acts in England and by 1844 a third of all the tillable land in England and Wales had been enclosed by private landlords. Hundreds of thousands of small farmers were reduced to beggary (Rocker, 1989). The coming of the industrial revolution produced overcrowding and reduced sanitary conditions for millions.

“The commons – a vehicle for meeting everyone’s basic needs in a roughly equitable way – is being annexed and disassembled to serve a global a market machine which treats nature as a brute commodity. Commoners become isolated individuals. Communities of commoners are splintered and reconstituted as armies of consumers and employees. The “unowned” resources of the commons are converted into the raw fodder for market production and sale (Bollier & Helfrich (eds) 2012).

This erosion of the Commons has continued to this day.  “Private control over living beings is now reaching into the deepest levels of people, plants and animals, i.e., their DNA. The same impulse to implant “code for control” is also being implemented deep inside the new digital commons” (Crosnier 2012 found in Bollier & Helfrich eds, Kindle Locations 4834-4836).

Crosnier goes on to say,

“Similarly, the commons of world scientific research may also be contaminated by fraud, which erodes collective confidence in the research while boosting the careers of deceitful researchers. Deceptions may at times lead the scientific community to pursue dead-end lines of research and ignore more promising research priorities”.

Crosnier also observes that, “the threats to the commons are also threats to communities, their existence and their ways of life. The dispersion of communities, generally due to violence, is the main form of attacks on the commons.” However, there are many more much more subtle attacks on communities through the commodification of services to communities.

Wilkinson and Pickett, Kindle Locations 470-471) make the point that,

“Over the last thirty or forty years, a large number of studies have shown that having a network of close friends, good relationships and involvement with others is extraordinarily beneficial to health”.

The determination of the psychological professionals to become the assessors, advisors, diagnosticians and treaters of misery is part of that disablement of people to manage their own difficulties and distress within their communities. If professionals really want to get on board with psychological distress, then they need to be part of and firmly embedded in their community and help people to recognise their inherent skills and develop those skills to help themselves and not treat the skills of the expert as a commodity to be sold into a community.

Russel (2020) reminds us that,

“The first invisible threat results from living in a culture of consumerism. In this kind of culture, the members believe that they can buy everything they need for a good life. The only thing they can’t buy is community, and community is the essential producer of a good life. He reveals the second threat as the world of professionalism. In that world, the message is “you will be better because I know better.” Cormac reminds us that a community is made up of people who know best how to create the future that will kindle a good life. The third threat Cormac makes visible is governments and institutions that claim they want to help. Their help most often creates a benign dependency” (Kindle Locations 136-142).

This quote provides more than just a nod to that aspect of meritocracy outlined above where professionals assume that they know better than the person living and working in a particular environment which frequently has never been experienced or is even understood  by the expert.

The final frontier Of the Commons is that of our minds, which are not very subtly being invaded by nudge units, psychologists and psychotherapists. One could argue that this invasion of the mind began with Descartes who disentangled mind from body and suggested that the body was simply deterministic matter and the mind was a rational principle detached and standing above that raw clay. In today’s world we know that body, emotions, mind and beliefs are intimately tied to one another in a daily dance where each has their turn at ascendancy while we struggle with the paradox of trying to be a human being.

To then try to struggle with ‘new principles and new ideas’ of yet another supposed expert when we are distressed seems utterly bizarre to me.  But, more importantly, this is yet another invasion and a reduction of our common rights as a human being.

As (Kilty & Dej (2018) Put it so eloquently,

“Psycho-centrism refers to the dominant view that pathologies are intrinsic to the person, promoting a hyper-individualistic perspective at the expense of understanding social, political, economic, historical, and cultural forces that shape human experience. Psycho-centrism is itself a form of social injustice that promotes individual reformation rather than social and economic justice.”

Finally, there is an unwarranted assumption that research in human psychology provides final answers. it is common knowledge that psychological research is hard to replicate  (Amir & Sharon 1990, Galak, LeBoeuf, Nelson & Simmons 2012, Earp & Trafimow, 2015, Ingre & Nilsonne 2018), But what is even more uncertain is the idea that small scale research in one specially designed and controlled environment can be scaled up to national and international scale interventions that are going to be effective.

As McLean, Gargani & Lomofsky (2020) observe,

We don’t know what works, what might work depends on context, and context is complex. This is why research and innovation are critical. And why the common wisdom about scaling typically falls short. Unlike in the private sector, and as attractive as it may seem to donors and social enterprise, when it comes to development outcomes, faster, bigger and more is not necessarily better. Instead, we need to shift our focus toward achieving positive impact at optimal scale.”

Right at the beginning of this essay I observed that while IAPT has had impact for individuals across the decade of its existence it has had absolutely no impact upon the well-being of our society and despite being set up with trying to get people back to work in mind (Indeed, it was this premise that suggested the service would be cost neutral by returning people into work and that this was part of its political attraction) has palpably failed in this goal.

The argument is only just beginning about how we move forward post pandemic and, more importantly, when the primitive hunter-gatherer economy that we continue to rely upon finally breaks down entirely. There is considerable research (for example, Wilkinson and Pickett, Kate Raworth) suggesting alternative modes of existence for human beings but these alternatives are much less oriented towards the meritocratic winners and losers approach that we have at the moment and illustrate clearly the efficacy of community and cooperation instead of competition. This is not a plea for socialism or any other sort of ‘ISM’ it is a plea for people to start thinking about what kind of a world they would like their children and their children’s children to live in, rather than considering more and more ways of attempting to climb the greasy pole of meritocracy and expertise at the expense of others who have just as much right to live and have access to the commons as those blessed by being born into more fortunate circumstances.

References:

Amir, Y., & Sharon, I. (1990). Replication research: A “must” for the scientific advancement of psychology. Journal of Social Behavior and Personality, Special Issue, 5, 51-69.

Baker, M. (2015), Over half of psychology studies fail reproducibility test. https://www.nature.com/news/over-half-of-psychology-studies-fail-reproducibility-test-1.18248

Bollier, D. Helfrich, S. (eds) (2012) The Wealth of the Commons: A World Beyond Market and State (Kindle Location 22). Levellers Press. Kindle Edition.

Earp, B., Trafimow, D. (2015) Replication, falsification, and the crisis of confidence in social psychology. Frontiers in psychology 6, 621, 2015

Galak, J., LeBoeuf, R. A., Nelson, L. D., & Simmons, J. P. (2012). Correcting the Past: Failures to Replicate Psi. Journal of Personality and Social Psychology.

Ingre M, Nilsonne G. (2018) Estimating statistical power, posterior probability and publication bias of psychological research using the observed replication rate. R. Soc. Open sci. 5: 181190.http://dx.doi.org/10.1098/rsos.181190

Kilty, J. Dej, E, (eds.), (2018) Containing Madness, https://doi.org/10.1007/978-3-319-89749-3_2

McLean, R. Gargani, J.  Lomofsky, D., (2020), Scaling what works doesn’t work: we need to scale impact instead, September 7th. https://blogs.lse.ac.uk/impactofsocialsciences/2020/09/07/scaling-what-works-doesnt-work-we-need-to-scale-impact-instead/ 

Raworth, Kate. (2017) Doughnut Economics, Random House. Kindle Edition.

Rocker, R. (1989) Anarcho-syndicalism, Pluto Press 345 Archway Road, London N6 5AA.  https://libcom.org/files/Rocker%20-%20Anarcho-Syndicalism%20Theory%20and%20Practice.pdf

Russell, C. (2020) Rekindling Democracy: A Professional’s Guide to Working in Citizen Space, Kindle edition.

Sandel, Michael J. (2020) The Tyranny of Merit, Penguin Books Ltd. Kindle Edition.

Wilkinson, R. Pickett, K. (2014) The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone’s Wellbeing. Penguin Books Ltd. Kindle Edition.

Posted in mental health professionals, meritocracy, politics, psychology. | Tagged | Leave a comment

There is No Beauty – Laura Gregory

White hot rage

Burning, all consuming

As bright as a star, but there is no beauty.

Dangerous like a volcano erupting

Spewing its anger onto unsuspecting targets.

Innocents caught up in the wrath of its fire

Unable to escape the ferocity, the anger

Violence unspoken, building and building,

The pressure amounting to inevitable collapse.

The teenage me, broken, unwanted

Unrecognisable in the aftermath of the fire

A burnt-out husk with nothing left to give

An acrid, black stain on the floor

A product of hatred, of neglect

Like a once loved toy at the bottom of the box.

But, out of the ashes I rise

Like a phoenix reborn from destruction

The adult me, stronger for the chaos that came before

Cautious, resilient, hopeful

Yet so fragile, the scars still fresh

Angry red welts that linger like a jagged smile in a broken mirror

Distorting

Disfiguring

Numb to the faintest touch, the smallest glimmer of kindness

The result of the fire that burnt nerve endings away,

Preposterously fine strands, that allow one to feel

Gone

In a flash

Like a slap to the face

Shock and then

Nothing

Nothing at all

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Torturous Sea – Laura Gregory

I am lost in this torturous sea

A furious maelstrom of thoughts,

Swirling, thrashing, snarling

Trying to pull me under

Fighting for each and every breath

As the waves crash and the tides drag me

Ever further from solid ground

I look to the sky but find no solace

The clouds black and ominous press down

Their crushing weight ever present above me

Just as dangerous as the ocean I’m drifting in

The intensity of the storm ravages

My body, my mind, my soul

Energy saps, the will to survive waning

Acceptance of my fate to drown all alone

In the midst of this unforgiving beast

I let go of the breath I’ve been holding

The last of my hope ebbs away

I succumb to the will of the dark, cold water

Caressed by its grip, it steals my strength

The light in my eyes long since burned out

Just as the last of me slips under

There is a light, a voice in the dark

A hand reaches down and pulls at my clothes

Plucks me from the depths of despair

I am too far gone, no one can save me

The sea has made sure of that

But the voice is persistent, gentle, encouraging

Like the first rays of a new dawn

Breathing new hope, new life into my broken and battered being

The storm begins to calm, the sky, slowly brightens

No longer adrift in a sea of malaise

The shadow of land on the horizon, still out of reach

But no longer impossible to grasp

The helping hand guides me to safety

Plants my feet back on solid ground

Building a wall to keep the sea at bay

When the storm rises up with the intent to destroy

Now, I can feel the sun on my skin

Smell the salt on the air

See the sand at my feet

Hope is restored, strength is regained

The light in my eyes, reignited

One helping hand and a voice in the dark

Cut through the confusion, the hurt, the pain

To save me, a person, once lost to the sea

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Battle of Wills – Laura Gregory

Who am I?

I don’t know

Who can tell me?

Where can I turn?

I can’t trust my mind to tell me the truth

It tells me I’m disgusting

That I’m a failure

I don’t deserve to be here

I should die

Everyone would be better off

But I don’t want to

Not really

Do I?

The constant narrative of negativity

Relentless

Wearing me down

Breaking my spirit

Slowly

Surely

I try to rally, use coping mechanisms

But it uses them against me

Smoking is disgusting

Alcohol makes you needy

Chocolate will make you fatter

Twang of the elastic band

Not as satisfying as a blade

The release of pressure not quite the same

Who will be the victor?

Between my mind and me

Only time will tell

I feel that perhaps time is running out…

Posted in poetry, poetry of the disenfranchised, trauma | Leave a comment