Promoting
Emotional
Maturity.
Proceedings of the
Sixth Annual conference
of the
The James Nayler Foundation
York, March 2004
Published by the James Nayler
Foundation
all proceeds from
sales of this book will go to the James Nayler Foundation
Preface
We were delighted to welcome about 300 participants
to our Sixth Annual Conference, held for the third time in York, in the
beautiful surroundings of the Central Methodist Church.
With this publication, we now have six complete
proceedings of our annual conferences. These continue to form an increasingly useful and
vital record of innovative development in this area. They add to the record not only of the thinking of key
experts from the UK, but also the thoughts and experiences of those who have
suffered from Personality Disorders.
We are grateful to all who participated, thus
helping the positive development of the Foundation.
Sue Johnson
Sue
Johnson: Welcome to the Conference & The Foundation 3
Dr Sami
Timimi ‘Emotional Maturity In An
Individualist Free Market Culture.’ 4
Dr
Felicity de Zulueta ‘The Impact Of Trauma On Emotional Maturity’ 8
Introduction
to Tony by Bob Johnson.......................................... 16
Question
from the floor:......................................................................... 16
Introduction
to the videoed interview with Karl................ 22
Further
questions from the floor................................................... 22
A very warm welcome to the Sixth Annual James Nayler
Foundation Conference.
We really are a very interesting and varied collection of
people here today. Participants have come from all over the country –
from Scotland, Cornwall, the Channel Islands and even Holland. There also is a
really big variety of people from different professions and all walks of life.
So it’s going to be an exciting day.
I would just like to say a few words about The James
Nayler Foundation
and how it actually came to be.
Seven years ago the BBC commissioned a documentary on Bob Johnson’s work
at Parkhurst Prison. This showed some of his work with men in prison who were
talking very honestly about their lives and about their recovery and their
crimes. The Home Secretary of the day – it was then Michael Howard
– chose to take the BBC and Bob to the High Court to try and get this
programme stopped. It seemed to him, I think, that the fact that prisoners are
human and really can change, is an Official Secret. This was the grounds anyway
for trying to get it stopped under the Official Secrets Act. And I think, if anything,
actually the climate and culture of our country has now gone even further along
that repressive road.
This attempt actually failed and the resulting publicity
meant that a lot of people sent in money and letters of support. The programme
was also shown widely overseas and some royalties accrued. These royalties were
put into the start of the James Nayler Foundation, a charity.
The name James Nayler is taken in honour of a seventeenth century Quaker
who was able to say, as he lay dying from the many beatings and persecutions he
had received, that “There is a spirit that delights to do no evil. It takes its
kingdom by entreaty and not by contention”. This forms the guiding values, the principles and the
philosophy behind the James Nayler Foundation.
We are utterly convinced that every single person is born lovable,
sociable and non-violent and are also totally convinced that truth, trust and consent are the vital ingredients for
restoring people to that state and for restoring their emotional health and
relieving emotional distress.
The Foundation is a very small organisation run entirely
by volunteers. Our money comes from individual donations, Quaker Meetings and
increasingly from the sale of Bob’s book. This year we were able to reprint it,
and it is actually forming a course book for the University of Michigan. So,
there seems to be an increasing demand for the sort of things the Foundation is
saying and it was set up to get across.
We have got various plans for the future. One of the plans
is to get all our past speakers together and have a very interesting seminar
with them all, which we will film and distribute.
We have had some wonderful speakers in the past. They are
all in the proceedings. We have had Dr James Gilligan who was (and I think
still is) Director of The Centre for the Study of Violence at Harvard
University; Dr Sandy Bloom who set up a very innovative psychiatric facility,
working at how to help people suffering from traumatic abuse, in Philadelphia;
Tim Newell who is the former Governor of Grendon Psychiatric Prison; Edward
Fitzgerald, a leading human rights QC; and many others. So, we think this
actually would be quite an exciting thing to do and we hope to push forward
with that this year. Anyway, that’s just given a bit of a flavour of what we
are about. I think we are in for a very exciting day and we have some wonderful
speakers.
I will pass over to Bob who will
introduce Sami Timimi.
Bob Johnson
I am really very pleased to welcome Dr Sami Timimi. I met
him first at a meeting of the Critical Psychiatric Network. I then read his
book which is on display. Unfortunately his publisher was a bit on the slow
side and didn’t send any copies for sale, but there is a display copy for you
to look at.
I am really looking forward to what he has to say. –
Sami.
Dr Sami
Timimi, Consultant Child & Adolescent Psychiatrist in
Lincolnshire. Having grown up in Iraq and come to live in England as a
teenager, his experience of growing up in two very different cultures has had a
lasting influence on his thinking.
His first book 'Pathological Child Psychiatry and the Medicalization of
Childhood' (2002) sets out the critical stance he has in relation to mainstream
practice in his profession.
Thank you very much Bob and thank you very much for
inviting me to speak today.
I am going to try and explore aspects of current Western
culture, because I think that there are a lot of, in many ways quite
paradoxical problems that confront us in the West. For example, we know that we
are richer than we have ever been. Standards of living are higher than they
have ever been. Yet, recurrent surveys of people’s perceived ideas of their
needs suggest that more and more people are feeling that they don’t have what
they need. It seems that the richer we get the higher the percentage of people
who are unsatisfied.
If we look at children, we see that there has been, over
the past few decades, a growth in what might broadly be termed psychosocial
problems – suicide, bullying, violence, drug abuse. This amongst a
generation who are again perceived as having been given the best of everything.
So, how do we understand what is happening here? How is it
that in a time of plenty our mental health seems to be deteriorating?
I don’t think there is any easy or straightforward answer
to these questions. This presentation is really an exploration at the level of
a generalisation, because, when we talk about culture and when we talk about
social things, inevitably we are talking about generalisations.
This is a quote from a colleague of mine who has been
working in the UK for the past five years as a paediatrician. She came from
Kurdish Iraq. (Iraq also is the country of my origin.) In a way, I think, what
she says (this is just in the course of a conversation, or one of the
conversations, we had) pretty much sums up everything I am going to say.
She says, “I was working as a paediatrician in the North
of Iraq for eighteen years and, despite all that we have been through –
the war, the gassing, the oppression by Saddam’s regime – I swear to you,
the children I used to see in my clinics in Iraq were so much happier than the
children I see here in the UK. I have always known about ADHD” – (Have
you heard of that? I presume most of you have heard of Attention Deficit
Hyperactivity Disorder, a diagnosis which has reached epidemic proportions in
the West.) – “but I only ever made the diagnosis once in the eighteen
years I was working in Iraq, even though I saw far more children on a daily
basis than I do here. We really felt like we belonged to our family. I remember
often having to look after younger children or helping my mum with the
housework. But I wanted to do it. I liked doing it. It made me feel useful and
wanted.”
First of all I want to talk about culture – and by the word culture I mean broadly a set of values, a
set of beliefs, a set of practices which a social group shares and which guides
its members through their life. Culture is, if you like, the big background
framework that organises our understanding of our beliefs of who we are, of
what life is about and so on. It’s the thing that gives meaning to a lot of
what we do.
So, when it comes to childhood, whilst the biological
immaturity of children is a fact of biology, there is very little else that we
can say is factual. This has been
one of the problems I have had (I am a psychiatrist by the way) with much of the
theorising that goes on in my profession. It continues to assume universals,
– that we know what a normal childhood is, that we know what the normal
stages of childhood are – when in actual fact it is describing a
particular cultural framework. As I say, the only given I think we can take for
granted is that children are biologically immature. This means therefore that
different social practices of different cultures will produce different
versions of childhood.
I can give you examples from lots of anthropological
studies. One in particular springs to mind:
A group of children from middle class American parents in
Boston were compared to a similar group from a tribe in Kenya, called the
Goosey tribe. It was basically done on observations. What they discovered was
that, right from the start of life, these two sets of children were
experiencing very, very different childhoods. For example, in the middle class
Bostonian families, there was lots of face to face contact, lots of what may be
called ‘conversations’. You look and the baby babbles and the mother (it nearly
always was the mother) would start a kind of stimulating conversation. Whereas
in the Goosey tribe the infants spent most of their time in a kind of dreamy
state on their mothers’ backs, while they went to the fields working.
What was very interesting, if we are thinking in terms of
meaning, was that not only was the experience of childhood different but so,
too, was the meaning that was given to child rearing practices.
At the end of the study, which went on for about two
years, they did something very interesting: They told the American parents
about the practices of the Goosey parents and the Goosey parents about the
practices of the American parents. Both were shocked, absolutely shocked!
The American parents could not believe that the Goosey
dealt with their children in that way. They felt that their practice was
lacking stimulation. How can you love your child, if you don’t show lots of
eye-to-eye contact? They felt the Goosey’s child rearing habits were really
very bad for children.
The Goosey parents were absolutely shocked. For Goosey
parents the first thing is giving comfort, children have to be comforted. So,
when a baby is crying, how could they not give that? How could they let a baby
cry? How could they put a baby in a separate bed?
So, what we consider to be desirable practices can be very
different from culture to culture. As we grow up, we absorb these values, we
absorb these ideas. You come to acquire, at least in part, some of the idea of
who you are and what your beliefs are from the values, beliefs and practices
that you have grown up with. If you look at this even more broadly, you will
see that the sorts of things which are thought to be desirable make sense in
terms of what your culture deems to be the important way of organising life.
For example, according to the American model life is
organised by the fact that you have to be independent. You have to be very
cognitive, very verbal and so on. Their way of rearing children makes sense in
the light of those ideals.
Within the Goosey culture we find a completely different
set of ideals. There children need to grow up and be aware of their
environment. They need to be aware of their social group and they need to be
able to survive in times when there is very little etc. etc. All that shapes
what is deemed to be desirable.
In a similar way, the idea of what is emotional
maturity is
culturally conditioned. What you think of as being an emotionally mature person
is going to be very different for the American middle class families in Boston
from what it is going to be for the Goosey tribe.
What I want to do is to explore a little bit not just the
different meanings we give but also the way in which different cultures are
going to actually give you a different experience and how that affects our
sense of ourselves and our emotional health. More broadly, I want to explore a
little the values which are important in a Western culture.
The first thing I want to look at is the idea of
freedom - which
is very prominent - and how that links into the economy of free markets.
Freedom appeals to the desire to rid oneself of authority. For a
free market to function properly you need a system of values to sustain it.
This then means that the pursuit of your own personal goals has to take a more
important position than social responsibility, because social responsibility
gets in the way of the profit motive. It gets in the way of competition. So,
the philosophy that underpins the free market, which is very central to the
success of capitalism, contains those attributes which then become part of the
value system.
This means that, at least to some extent, we have to
reject the idea of dependency. You see that in the way we talk about things.
Take for example the idea that, if you have a welfare state you’ve got a nanny
state – a sexual female who is keeping you in the nursery- and that you
have to get away from that, so that, freed from dependency, you can pursue your
own goals. Freed from ideas of social responsibility you can pursue self-gratification.
This pursuit of self-gratification has become an important
part of Western culture. In such an environment there is a level at which (and
again this is a generalisation) other people become objects against which you
either have to compete or which you can manipulate to your advantage, because
it’s all about looking after number one. Let’s face it, we often hear people
talking about “I’ve got to look after number one, you know. I need to be free
to do what I want.” etc. etc. That then becomes a very important part of the
value system. In such an environment the individual can flourish, but at the
same time the individual is atomised, because dependency is seen as a bad
thing. Since it’s all about individuals, individuals are more likely to become,
if you like, alienated.
Another interesting aspect is the way in which the free
market principle has sunk down to culture and has surfaced as ‘fun morality’.
Fun morality, the pursuit of pleasure, leads to diminishing returns. Have a
think about that one! The more you can do things for personal pleasure, the
more things you do for personal pleasure, the more difficult it becomes to get
really excited about things. I wonder whether the whole flourishing of the drug
culture has something to do with that. You have to go further to get your
kicks.
So, with market values and individualism, other people are
objects to some degree. You can see this in the ways we interact in our lives.
We have, for example, sales people. How often do we know, how often can we be
sure - as there is all this psychology about how to sell things - that we are
having a genuine exchange with people? How much of that does also enter one’s
personal life?
There is something fundamental about this, as it creates
an opposition between mankind and nature. Nature is something to be controlled,
in this system, not something with which we need to find a way of living
harmoniously. Nature, just like people, is there to be controlled. We have to
harness nature – and that includes our own nature. The world we live in
has to be harnessed, has to be under our control for our benefit.
This penetrates all aspects of social life. How much can you disengage if
you’re selling cars and are trying to convince somebody that this is the best
car since sliced bread? How much of that way of thinking and operating actually
goes into social life more broadly?
Dependence, when it does happen, is more likely to be
transferred onto experts now. Parenting, – there’s a good example. Can you trust
these days what your grandparents said, what their parents said, and what the
community as a whole believes? Not really. You have to go to an expert. It’s
the experts who know about parenting. It’s the experts who will tell you what is the right
thing to do, what a normal childhood is, etc. etc.
So, that brings me on to a related aspect, which is the
consumer culture.
How does that affect us? How does it affect the way we think and the way we
feel?
A capitalist economy needs mass consumption. That’s what
drives the economy. For mass consumption to work people need to be convinced
that they don’t have enough, that they need more. How does that affect us?
Well, one way it does, I think, is that it means that we
always think in the future. We don’t exist in the present any more, because we
have to accumulate, we have to get more. We are always planning for the next
thing but are never quite reaching it. So there is a constant sense of
dissatisfaction.
One of the things, I think, that causes is this cult of
self-examination. Just as neighbours are examining the whiteness of their
sheets, whether they use Persil or Daz, so you are constantly examining your
own inadequacies, because the consumer culture has to convince you that your
life is not adequate until you have got this and got that. This is not the same
as contemplative introspection.
So you feel that this sense of dissatisfaction could be
with your body, could be with your appearance, could be with what you have,
could be with your achievements. You are constantly getting the message that
you are not good enough. You have to plan for the next thing. You have to go
higher. You have to get better. Often these dissatisfactions are projected onto
material goods. So that maintains the economy of course.
Part of the need to develop new markets means that we are
constantly gripped by, what some people call, this growth fetish. There has to
be more. Whether it’s more knowledge, whether it’s more goods, whether it’s a
bigger economy or a bigger car, it’s a growth fetish.
Now, if you maintain such a value system which is based
around the needs of the individual, psychologically, sooner or later, it’s
going to lead to a sense of guilt. This will happen at an individual level. But
I am thinking of it at a slightly more subtle level, at the cultural level.
There is a sense of guilt within the culture. Somewhere along the line we know
that this way of operating, of putting number one first, is not right, that we
have a social responsibility as well.
So how does our culture deal with that? Well it deals with it in the same
way actual individuals deal with it - or in a similar way - which is: We
project. We try and get rid of something we don’t like about ourselves and say,
“It’s not us, it’s that person.” or “It’s them.” So, what we have is the
development of the blame culture. We
are always blaming other groups and, on a cultural level, we choose scapegoats.
Whether they be Muslims, single parents or actually in a lot of cases these
days – children, they are ruining society.
The groups which are most likely picked for scapegoating
are going to be the traditionally different ones - along class, race, culture,
gender. We are in a very mother-blaming society. Mothers still have to carry
most of the burden for child care and they can only get it wrong. If things go
OK with their children, well, that’s because things turned out naturally, not
because of the hard work a mother put in, you know. And there is the issue of
age at both ends of the spectrum. Old people are a burden and young people are
a burden and, as this dynamic takes hold, you will find it in institutions,
too. So, what we often have is, we attempt to hold on to this idea that our
culture is doing things wrong. We have these knee jerk policies. For example,
we have a horrendous high profile paedophile case soon followed by a knee jerk
policy, or a knee jerk policy triggered by increasing numbers of asylum
seekers.
All of this reflects an inability to tolerate risk and
anxiety, because that contains guilt in it somewhere. Institutions then begin
to reflect this as well. You can see this in the way in which institutions
develop more policies and more procedures. And these appear in institutions
that essentially have a human social role function.
You find it in teaching, for example. My mum is a teacher.
She left the profession some years ago, because it was just becoming too
managerial. Policies, procedures, league tables, inspections – yet
teaching is there to fulfil a human social function. There always are going to
be good teachers and bad teachers.
You can see it in my profession, too - rating scales,
questionnaires, if you measure it, we know it. If we give it a number, that’s
it, we understand it. But I see my job as a human social job. It’s about
contact with people. Now though I have all these procedures and policies.
I think it’s against this backdrop that what I call the child
abuse industry
grew up, and this is not the same as saying that in a civilised society we
don’t need very good child protection and child welfare organisation. But there
is something paradoxical about a society that, as far as I can see, hates
children and at the same time appears to have the most developed and advanced
child abuse procedures. So I think it’s worth uncovering a little bit about
that, because I think that this is part of the guilt response.
Child abuse was apparently ‘discovered’ in the late 70’s
by doctors. Well, actually, child abuse has been known for a long time. Social
workers were dealing with it long before that. Yet, once a more powerful
profession took over and started talking about it, suddenly it was
‘discovered’.
Just a few weeks ago – (and it’s interesting how
that connects with the whole idea of how things become more technical, how in
this sort of blame culture these human social functions become more
technicalised) - just a few weeks ago I heard a professor talking about all the
recent, I guess, scandals - about some leading doctors who were, on poor
evidence, suggesting that mothers had abused their children - a point with
which I agree to some extent. But what was interesting was the language he was
using. He was talking about how difficult it is to ‘diagnose’ child abuse. I
didn’t know child abuse was a medical condition that you ‘diagnose’. There
again, this is about the technicalisation of things.
It’s interesting how the child abuse industry developed
with publications and conferences and more. Certainly in America, in the
eighties, they started producing all these rating scales, for when people came
into hospital, to see if there may be child abuse going on. The backdrop to all
this (this again fits in with the idea that this may be a response to feeling
guilty at a cultural level) was the right-wing monetary policy. The very
right-wing monetary policies of the eighties and nineties, and whom did they
hit the hardest? Children and families - not just within our countries, our
Western countries, but globally! The International Monetary Fund, the World
Bank, they were telling countries to cut down on their welfare programme. You
know, we were causing massive suffering to children and families, and at the
same time we were championing ourselves as being very good on child abuse and
child protection.
In that context, of course, we can find the scapegoating
business again. The plight of the poor was viewed as self-inflicted. ‘Get on
your bike’, said Norman Tebitt. ‘It’s your fault! Go and find yourself work!’
We were creating an underclass. The gap was getting bigger and bigger –
but it was their
fault.
That view also makes it easier to turn a blind eye to what
I think is, in terms of scale, a much bigger problem, when it comes to child
abuse, and that is neglect.
There were some figures that I read recently regarding the
time parents spend with their children. They are from North America, in the
early eighties. The average that parents spent with their children was 30 hours
per week. This, I think, is shocking enough actually. The average by the
mid-nineties was 17 hours. Children were left alone. They had to bring
themselves up, a lot of the time. It’s not that they were left with extended
family. - You have that film ‘Home Alone’. If you watch that film you can see
it. I mean, yes, it was funny and enjoyable, but there were a lot of references
within it to how children are a pain in the neck and get in the way and how it
was quite easy to forget a child in that way. - Of course this is a problem as
much, if not more, amongst middle and upper class parents.
So, what happens then, as this kind of ‘home alone generation’
grows up?
Well, something that has been happening is that the
boundary between childhood and adulthood has been disappearing. Children have
withdrawn into their own culture, which the markets exploit - they exploit
their boredom, their desire for stimulation and the fact that their parents
(some of them) would quite happily give out the money rather than spend the
time. The cultural rituals that mark off stages in childhood have been
disappearing. I can’t think of many, unless maybe you go to the Boy Scouts or
things like that. I can’t think of many rituals that are left to mark a
transition, unlike in other cultures. Instead children have very good access to
what should be considered adult material, whether it’s over the internet or
just through a daily programmes that they watch on the media. So they take part
in sports leagues that are the same miniature versions of the ones that adults
take part in. The clothes - how the clothes have changed! What about the music
they listen to and the words within the songs? They are very adult you know.
They are idols.
In this unhappy isolation children respond to the markets
pushed to adultify them. At the same time adults are being childified. You’ve
got models walking down the catwalk that are made to look like they were
children. You have the whole self-gratification culture, the fun morality.
Then there is another quite disturbing aspect. It is this
‘culture is almost holier than thou attitude’ about our ability to have really
good child protection functions in place.
What about the way consumer culture eroticises childhood
with advertising?
There are some interesting studies done on the beauty
pageants in America, just looking at the way things have changed from when they
first started in the seventies - when the children in the beauty pageants wore
clothes appropriate for children, which would now be thought of as childish,
and sung songs and did things that you’d expect children to do - to the
mid-nineties when they had become extremely competitive. There is money
involved. The things that were scoring points in the nineties were how
suggestively somebody walked across the stage. The clothes had changed. They
were wearing a sexually attractive style of clothes. – And what about the
music industry?
How much of our culture that kind of goes ‘shock!’ and
‘horror!’ about paedophilia, how much is it eroticising children?
In that context I don’t think it is that much of a
surprise to see what some psychoanalysts or psychiatrists might call
narcissistic self-love type disorders. For, this culture is about
self-gratification and about perfectionism. It is about feeling that you can’t
be different without feeling inadequate in some way. And if you are different,
you have to exaggerate it somehow to feel adequate.
So, we have all these disorders increasing as are the
armies of professionals sent to deal with them - like me and Bob. So also the
therapeutic concepts used amongst these armies of professional, they reflect
our culture. Not surprising really. The ways and the direction in which they
are going are technical, cognitive, control orientated and pathologising. So
that creates more consumers for the professionals but also for the allied
industries which cash in on our sense of inadequacy, like the drug companies.
The drug companies are the second biggest industry in the
world. (You know which the first is of course.) They are making huge profits.
Their biggest growth areas are such drugs as anti-depressants. They are now
trying to cash in within the Third World by convincing the developing world
that depression is one of the biggest enemies of our health. – It’s
interesting how language changes you know. I watch programmes and listen to the
way people talk generally. People talk about ‘suffering from depression’. They
don’t say “I feel unhappy”. They talk about ‘suffering from depression’.
So, children are socialised into this value system. They
are expected to show independence from an early age, whether that’s through
sleeping on your own in your own bed or in an education system that prizes your
ability not need spoon-feeding and to do things on your own. Naturally, as this
is a culture of competitiveness, competitiveness happens from an early age. And
there is something about the way we see children that has become very polarised
as a result. You often see children and childhood in the media painted in just
two different ways: one, as ‘the victim’ (either due to bad genes or due to bad
parents), and the other, as ‘the problem’ (because children are dangerous, since
they are running riot and so causing all these problems).
It seems very hard to see children in a much more ordinary
way.
Of course, as childhood is the ultimate state of
dependence in a system that’s all about independence and self-gratification, we
shouldn’t be surprised that parents leave, that families break up. Children get
in the way. If you have a little one dependent on you, you can’t go and pursue
your own needs.
I also want to mention a little bit about gender
dynamics here,
because this is another area where I think the developing world is wrongly
stereotyped.
A lot of the developing world, including where I grew up
in Iraq, is stereotyped as being oppressive to women and oppressive to
children. I think that this is partly true. The developing world has a lot of
cultures that are very patriarchal, and that’s not on, but at the same time
there is no culture more masculine than the West. I think that there is a
slight distinction between ‘being patriarchal’ and the value system ‘being
masculine’ as a opposed to ‘being feminine’ in nature. I will see if I can
explain that a little bit.
The most powerful social group in the West undoubtedly, in
gender terms, is men. If you look at it in terms of pure wealth, the top fifth
in terms of the world’s richest own 96% (or something like that) of the world’s
wealth. Of the top fifth the majority are men. Positions of power are occupied
by men, if you look at parliaments. If you look at companies, if you look at
directors, if you look at the movers and shakers in the therapy world (even
though in the therapy world there are so many women working) it’s the men who
occupy the positions of power. It’s the men who’ve developed all the major
therapies (or most of them). There’s this concept of ‘hegemonic masculinity’,
which some of you might have come across. It means the vision of what it is to
be a man. This doesn’t mean that all men are like that, but it means that, as
you grow up as a boy and a man, this is the value system that you are comparing
yourself to. This is what you are told or what you absorbed. Not so much told
as absorbed through the various messages within the culture, this is what it is
to be a man - physical strength, adventurousness, emotional neutrality,
certainty, controlled assertiveness, discipline, objectivity, reason, etc., you
can’t show emotion.
- In Iraq, where I grew up, you greeted your friends and
your relatives with a hug and with a kiss, with physical affection. If I’d
showed any physical affection like that when I came to school here, you know
what would have happened. -
That value system is absorbed so the pursuit of
self-gratification becomes absorbed as a principle. A Sociologist labelled this
‘the fighting, fucking and football culture’.
In education, if you couldn’t get the reason bit and
didn’t do well in a competitive system of winners and losers, it was a very
painful position to be in. One of the ways out for many boys who were in the
loser position was to identify with a hyper-masculine image, to be tough.
- I came here when I was fourteen, to a comprehensive
school. Apart from some racism what really surprised me was the bullying. It
was not something that I had come across - physical bullying and the machoness
and the passing around of pornographic magazines to show you know where men ...
-
There are a lot of sociological studies which show that it
is the losers in the education system that most turn to this value system. In
that sense, for them, education becomes feminised. It’s something that girls
do, not us blokes. That’s the way they keep hold of their sense of self-esteem.
‘Self-esteem’ is an interesting word as well. It’s a
concept I had never heard of when I grew up in Iraq. I’m sure there is a word
for it in Arabic, but I don’t know what it is. It seems to me again something
very much about the Western ideology of the self and the focus on the self and
the idea of self-esteem rather than connection.
I have only got a little bit of time left, so I am going
to rush through my last few points.
This is an interesting one. In the commodity culture even
having a child becomes commodified. So, for some people, you don’t feel
complete until you have had a child. In a situation where having children is
commodified girls are more rewarding, because they will give you back a lot
more. So, I think, boys growing up have really quite a painful childhood. They
are alienated, can’t express their emotions, are distanced, are in families
that have no time for them and are in a culture that has no time for them
either. Instead of trying to develop a nurturing response to this, the response
has been the institutional response, one of masculine science. What has
happened is that we are labelling boys with all sorts of disorders and are
giving them the equivalent of cocaine and amphetamines to control their
behaviour. It’s extraordinary, absolutely extraordinary!
In the United States (we are talking about 1996) 6% of
boys were on these drugs, and the figure is likely to be higher now. In surveys
of some areas we are talking about a third of boys being on these drugs –
amazing!
Then there is ‘globalisation’. What happens for example,
as now in the post cold war era, is that the West feels quite triumphant. So
it’s been busy imposing its value system worldwide.
Although the one good thing about ‘globalisation’ is that
it introduces the concept of diversity. We can’t dismiss other lifestyles that easily any
more, because we are now exposed to ideas from around the world.
I was going to talk (again in broad generalisation) a
little bit about comparing these Western value systems to an Eastern philosophy
and value system, where you are talking about a more community orientated, more
about a harmony with your environment and more a spiritually orientated way of
looking at the world. Infancy is much longer, but responsibilities come at an
earlier age. It is very welcoming to children. Children are seen as needed and
wanted.
So, just a few quotes, just to give you a flavour of that
- we should do well to remember that in terms of loving care and family support
their children (meaning children in developing countries) may be receiving far
more than our children. Material conditions of living are so transformed that
we may well be living on another planet. But that does not mean we do not have
much to learn about child rearing from developing countries. A child in India
is hardly ever alone. Babies are carried around by their mothers. It is a
common sight to see a girl, even as young a six, with a younger bother.
Children play with other children much more than they do with objects. A
regular bedtime virtually unknown, they tend to play or listen to the older
members of the family until they drop off to sleep - the younger ones probably
in their mother’s lap. Children learn to respect their parents, because they
see them showing respect to their parents. And this is just a quote from a shop
owner: “Here we are in Western culture. In India there is respect for elders
and family, and relationships are honoured. So you would call somebody your brother
in India and they would look after you. But over here? – No! They would
turn round and say ‘I don’t think of you in that way at all’, meaning ‘who
wants to be your brother?’ I miss those relationships and respect.”
Growing up in Iraq (again I don’t want to put rose-tinted
glasses on, because there is a lot wrong, but) the way we talk about people is
in relationship terms. So, my mother was called by my relatives ‘Mother of
Hassam’, which was my older brother. When somebody becomes a friend of the family,
they become an ‘uncle’ and we call them ‘Uncle’ - somebody you know. So, it’s
much more in relationship terms and not individual terms.
And just a few things to think about for us as
professionals:
I think we need to think about the value system that we
carry with us, when we go into our work. I think we need to understand that
what we do doesn’t just affect the children we work with, it affects the local
culture. - If I start prescribing medication to lots of children, teachers are
going to be saying, ‘Oh, he behaves a bit like that, and I’m going to send him
there’. You are going to have an effect on local culture.
To incorporate diversity means that there are lots of ways
of looking for strengths and positives. . . .
[unfortunately the tape runs out at this point]
Dr Felicity
de Zulueta - Consultant
Psychiatrist In Psychotherapy and
head of the Traumatic
Stress Service in the Maudsley Hospital, London. She is an Honorary Senior
Clinical Lecturer in Traumatic Studies at the Institute of Psychiatry. Author of From Pain to Violence, the Traumatic Roots of
Destructiveness (1993).
Hello and I am delighted to be in York. I haven’t been
here for ages. And to be a guest
of my dear friend Bob Johnson (whom I met many years back) to share some
thoughts with you.
I am going to talk to you about ‘personality disorders’, a
dreadful label they stick on people, whose behaviour they cannot explain. Since
these people don’t behave nicely, their behaviour is thought to originate ‘all
in the genes’. And the response often is – ‘Let’s lock them all up.’ Dangerous, severely personality disordered people are
now locked up before they have done any harm, perhaps for having evil thoughts.
. . Appalling situation really!
The work I do is actually based on Attachment research.
So, what we want to understand is that these people (people with personality
disorder) are people who experience things differently. They cope with things
with difficulty and have problems relating to other people. So, how come?
The work that I am going to rely on is attachment work.
You will have heard of Bowlby. He was an extraordinary man who came and looked
at animal behaviour and saw how much we shared with animals. He recognised the
importance of the way in which children need to attach to parents and how we
need others to survive, to live and to enjoy life. Despite all the research,
despite the huge importance of his work he is still very little known.
I, too, wasn’t trained in attachment work as a
psychiatrist nor as a psychotherapist. It was through writing my book that I
discovered how important it was. -
The reason for this lies in what Sami has already said: We live in a
society, where the value of the individual is paramount and where the
importance of our relationships and the way we relate to one another is not
really considered to be significant. Yet it’s the only way we live. The denial
of that is really one of the problems that we face.
Attachment behaviour you can see in animals, as when a
little baby lamb on the hill rushes to mum when frightened. Our very young
children can’t run. They are stuck where they are, but they howl. Later they do
run. That is behaviour that seeks safety given by a care giver. It is induced
by fear, and this is very important.
Now, Bob has probably told you about the study of the
monkeys who were separated in infancy from their mothers. It looked at how that
affected their development and their behaviour. They found that the longer the
separation from the mother and the earlier it happened the worse were the
results. Those monkeys would
interact in a very abnormal way. They couldn’t form relationships; therefore
they couldn’t actually have sex. So some mums were artificially fertilised to
see how they would behave as mums.
The results were disastrous. The mums would be seen biting
the fingers of their babies, crunching their heads and showing appallingly
abusive behaviour. There was such damage to their capacity to attach and to
nurture their little ones. They were very selfish. They were scratching and
biting themselves, banging themselves and tearing themselves apart. Also, very
importantly, normally animals know whom to go for. You don’t go and attack the
big monkey in the tribe. You keep well away. Abused ones, however, could not
distinguish one from the other. So, they would go for the huge ones and get a
very raw deal naturally.
Here are some of the findings that show how important this
behaviour is. It’s the system within our minds and bodies.
The areas in the brain that are involved here, where
attachment happens to be processed, are mostly within the right hemisphere. An
area of particular importance is this one, in the front of our heads. It is
called the supra orbital on top of the orbital area. One of the interesting
hormones involved is an opiate - we are actually all producing endogenous
opiates, in fact we are all opiate addicts really. When we get on with one
another and we have that nice feeling of tuning into somebody, we release those
opiates into our blood stream. When we are separated from one another and we
really feel very restless our opiate levels go down. This is of importance in
terms of the work I will bring up later.
Now, when human babies are born they are probably born too
early. The reason for that is that in order to stand upright we mothers have to
produce them early. Otherwise we wouldn’t be able to stand upright. Hence there
is a limit as to how long they can stay inside. So, they don’t just come out
with great difficulty but they also can’t regulate their hormonal systems. They
can’t gratify themselves very well at all. They are unable to feed themselves
and they are very dependent both physically and psychologically. We say ‘care
givers’ - to be politically correct (Because it’s not always mums. It may be
dad. It may be somebody else, who will act as ‘care giver’.), but I will lapse
into ‘mum’ from time to time - we
‘care givers’ respond by feeding, caressing, talking and giving not just food
but a whole huge amount of interaction.
You may have read Daniel Stern and seen videos done by
him. They show this extraordinary dance between mother and child, where the
mother playfully makes a face and the baby responds and there is a sound that
goes with it and there is movement and so on. These extraordinary little
patterns of interaction are what map out the way the child’s brain will
develop, because, when we are born our brains are like (to put it a bit
crudely) semi-programmed computers. During the first two years of life, there
are a whole lot of programmes waiting to be stimulated into action. The care
giver is the one who will enable these things to develop, so that we can relate
to one another and can feel things. However, if this doesn’t happen you
actually have destruction happening in the brain and consequently the child may
have difficulties in holding her own. Therefore stimulation is essential, once
an infant is out of the uterus.
We also are born unable to regulate and modulate our responses
to stress. When stressed we release cortisone. Little babies, however, release
far too much of that at first. Yet, the mother will modulate the baby’s
responses with her own. So the cortisone system is regulated at a physiological
level, which has its consequences in terms of what happens in the brain and so
also on a psychological level. That is why interactions with the care giver lay
down templates for future interactions between this little individual and
his/her future attachments, for example, to a wife, children, a partner etc. In
a sense such interaction patterns are actually internally represented. The
words we use are working models. It is rather similar to what you have heard
about object relations. It’s the same kind of concept but in a different
language. A child’s template, once it has been established, will be based on
how the mother and father have responded to him/her when s/he was in need of
attachment.
Fortunately, the majority of children have what we call
‘secure attachment’. In other words, they have an inner representation of their
parents responding when they are in need. Who exactly is a care giver does not
matter hugely to these children, because they have a secure sense of ‘when I’m
in trouble somebody’s there for me’. They can take changes on board, because
they have a sense of security, which means that they are confident. They are
also capable of empathising with other children and capable of forming good
attachments. This is very important.
As you know, I work with traumatised people and so find
that good attachment is actually a defence against traumatisation in later
life. This is a very important
concept which has been developed quite recently.
The other important concept is what is now often called
‘reflective functioning’.
It is best explained like this: If you have experienced an
occasion when you have been in the mind of another, for example your mother or
your father, you then internalise this. You take on board yourself that
capacity of having the mind of another in yourself. So you acquire the capacity
to think about people in terms of ‘What does it feel like to be John?’ - ‘What
does it feel like to be mum?’
Now, if your parent were unable, for various reasons, to
even think about, ‘What does it matter to John my little one what I do or what
I say or how I behave?’ then that function may not develop.
But, and this is the important thing, you are going to
find out that attachment theories are rather deterministic in the sense that
attachments are said to become replicated down generations. Yet reflective
functioning can be given to you by a teacher, by a social worker, by a nurse or
by a doctor.
A little kid can come from a dreadful home background with
a lot of abuse and violence. But there is a teacher in the class who notices
something and who begins to treat that child as if s/he knows what it’s like to
feel the misery that this child is receiving. That showing of empathy may well
form the basis of an attachment which then will protect this child in future.
That’s where we can all play a part.
Now, insecure attachment happens when an infant hasn’t
been able to incorporate in his/her mind a representation of a grown-up parent
figure that is responsive in times of need. So, instead, that child develops a
traumatic attachment to try and make sure that s/he gets what s/he needs. The
basis for this is, as Bob keeps emphasising, survival. If you haven’t got a
parent to attach to, you die. Therefore you have to find ways of surviving.
There are three different types of detachment behaviour in
children that can be measured and by the age of one are already fully
developed.
A test they do to find out which group an infant belongs
to is to separate mother and infant. First the mother leaves the room. Then,
after a while, the mother comes back into the room. They watch the infant’s
response.
Infants from the first group get terribly, terribly upset
when mum leaves and don’t settle down for ages. When mum comes back (and she
would not be an abusive parent, just an inconsistent one. You know, the sort
who wants to do her cleaning and her washing, so that the kid really has to
raise the temperature to get the attention s/he needs.).
The avoidance type is much more worrying. They are the
ones who, when mother goes out, don’t seem very bothered. They act as though
her leaving doesn’t really matter. But if you measure their heart rate, it has
actually increased. They, in fact, are stressed out. When the parent returns,
they sort of ignore her as if to say ‘Who cares whether you are here or not. I
can do without you.’ But, as they get closer to the mother, they avoid eye
contact, because they have already learnt that, if they go to mum with a need,
mum rejects them. So they get as close as possible and at the same time make sure
that they don’t invite that rejection. This really is the first defence
behaviour that you can observe in an infant.
We are going to call the next group a capital D, because
these are our future personality disorders. These infants basically show a complete
muddle of responses. They are disorganised in their responses. When their
parent comes into the room, some leap into a corner in terror, some shake, some
actually freeze, some go rushing towards the mother and then under the chair,
some curl up in a little ball. It’s actually very distressing to watch these
responses.
The freeze response is very important. What we are seeing
with these kids is that they are showing what we call in adulthood
post-traumatic stress disorder. They have been terrorised by their parents, who
themselves may not always be abusers, as they themselves may be suffering from
trauma. - One mother, for instance, whom we have in our unit (we have many
refugees and women who have been raped) sees in the eyes of her child the
rapist that raped her. So, when that child wants a response, s/he receives not
that of loving care but of that terror and fear. So, you can imagine how that
affects the brain of a little kid – ‘every time I need my mother she is
actually not available, as she is terrified, she is in another place’. So
trauma here is mother being in another place.
Others, of course, are on the receiving end of attacks, of
abuse, of violence, of threats and that leaves them traumatised.
In such a child, the whole attachment system, which we
biologically need, can’t function. Running towards a mum who is about to clout
you won’t help you survive. Neither can you choose to run away instead, because
that way you wouldn’t survive either. So, as the child needs mum so badly the
only response left is the third one, the freeze response.
Also, the reflective function is clearly not there for
these children, because their parents haven’t got them in their mind at all.
So, fight for life is out of the question. Instead the freeze response springs
into action. This is another animal response that we have inherited, one we
have all seen in films, when the lion comes and there is a little Bambi and its
mother. The little Bambi realises, ‘there is no way I can get to mum, so I’d
better freeze and hope to God that I am not noticed’. It’s not conscious and a
brain chemical is released that stops it from crying.
It’s interesting. For, in our trauma patients their speech
area shuts down when they get their freeze responses. So, we humans still have
it full blown in the same way.
Little children in this situation of no solution also show
the freeze response. So you get some odd psychological results which all come
from them needing to maintain their attachment to their parent.
Say, you keep on having dreadful memories of mum coming to
call you and of you feeling that you are about to be exterminated. As a result
you never dare go to her, even when perhaps she is a little more available. But
we all need our needs to be gratified, so we split off. We cut the awful
experiences of ‘me and her in a bad place’ out of our minds. Hence people with
personality disorders will often have an idealised picture of their parents -
‘whom I love’ or ‘my mother was very nice to me’. But when you ask them to give
an example, they will tell you, ‘oh well, my memory is not very good’.
Then, when you take them on for treatment or you get
otherwise involved with them, you can find yourself in a place where you don’t
want to be. Either you are the victim of people who are doing to you what they
had done to them. Or they experience you as though you are the one who
victimises them. That is an idea
that you will meet again and again. You know it well, this belief. These kids
in grown up shapes will tell you that they are bad - and ‘don’t you try and
tell me that I’m not bad!’ So you do some nice piece of work with them and you
think you have had a good session and the next day they are in out-patients
with an overdose.
They insist on their badness, because, ‘if you are bad,
you are in charge.’ So it becomes, ‘I’m bad, I’m in charge, I’m in control and
I’m not a helpless victim’
There is hope. ‘If one day I get it right and I’m really
nice, mummy will give me what I want. So I hold onto that belief like hell.’
It is a huge turning point, when a person with borderline
personality disorder actually abandons that defence and faces the grief of
realising that there is no parent around. - Bob gets there very quickly sometimes. – ‘There isn’t a parent around to
give me what I want. I’m not bad, I’m a bit of both – a depressive
position.’
Now, the psycho-biology of neglect shows us what’s
happening in the minds and the brains of such people. Their right hemisphere is
affected and the channels of development, all these neurones, are not properly
stimulated. So, there is actual destruction in some places and over-activation
in others. As a result they cannot exercise emotional modulation. They either
go too far into misery or too far into excitement.
That modulation of feelings is acquired through
mother-infant interaction, but these kids haven’t had that. So, people we call borderline
pre-school for
want of a better term are people who cannot modulate feelings. They just get
carried away from one extreme to another. Hence they use drugs and alcohol and
their relationships have an addictive character, are a way of getting some
respite from these extremes. We call that self-medication.
The other emotion to bear in mind with these individuals
is an enormous sense of shame. They often have been humiliated beyond belief,
made to feel that they are complete shits, made to feel they are nobody - shit,
rubbish, crap. Such people therefore are extremely sensitive to any experiences
with any of you which actually bring out that shame. So you lose them in
therapy very soon. Unfortunately, though, this also is one of the most common
triggers of violet behaviour. One of the reasons so many people commit violent
crimes is that somebody has made them feel that unbearable feeling of not being
there. Then look at those
prisoners who say ‘I prefer being bad to not being there at all’.
Studies also have found that in these people the area in
the brain, which is the memory area, is often smaller, which indicates perhaps
that too much of what are stress hormones have shrivelled it up.
Another study which followed up little disorganised
one-year-olds up to when they were nineteen showed very clearly that these
babies were the ones who later became people with so-called borderline
personality disorder and Dissociative disorders of a different type. So, there
is a whole spectrum which arises from those early experiences which results in
abnormal behavioural responses later.
People who develop PTSD are those whose stress response is
abnormal, hence the idea that they may be people who experienced some failure
of attachment in earlier life. It’s the combination of the two, the state of
helplessness reminiscent from childhood and what later happens to the adult,
which helps to bring out the disorder.
Something else we have discovered is that there are people
who hurt themselves with cigarettes or cut themselves or bully or eat too much
because that releases opiates into their blood stream. So they get a high. We
look at these people and we ask, ‘but how can you do this?’ and they look at
you and they say, ‘well, you know, I feel better for a while’. So, for some
this is a way of feeling, because they are so numb through disassociation and
foe others it’s a way of having a high.
The interesting thing about the attachment stuff is that
unfortunately 75% of mums are likely to transmit to their children the
attachments they had themselves. So, it is important, also with already
pregnant mums, to try and do some work before the arrival of the kids (and that
they have been doing).
Also, all of this has huge implications in terms of
genetics, because this factor is never taken into account in genetic studies of
schizophrenia, personality disorder and so on. There is a great researcher in
this field. When I asked him if he’d ever thought about environmental factors
he got very angry. I have never seen anybody get so angry by a question. He
went apoplexy. The whole room looked at me as if I had said something
absolutely criminal. He said, ‘We are doing this study at the moment to prove
that they’re not relevant’. So I said, ‘Oh, can I have the reference?’ ‘Oh it’s
not being published’ was the answer.
Yet the attachment factor is hugely important for
psychiatry. For, if you don’t understand where these kids you are treating come
from, you’re not going to deal with them in an effective way.
Also, it’s quite interesting here that studies show that
women are more likely to do this disassociation. In other words, they have a
capacity to reduce their response by cutting off, by numbing themselves, when
for instance they are exposed to a traumatic event. They will respond with a
mild tachycardia and they’ll keep the symptoms, they’ll feel them inside as
depression etc. etc..
Males are more likely to display the fight and flight response
when exposed to fearful experiences. It is very interesting that in some
adolescent boys the heart rate normalises over time and that some recorded a
soothing feeling when they began stalking a potential victim. This goes with an adult study, which shows
that certain criminals who commit violent offences have an unusually low heart
rate.
So, why I’m bringing that up? Because the lovely thing
about attachment behaviour research is that we are dealing here with the mind
in relation to the body - no more of this dualism of ‘the brain and the body
each are two separate entities’. That is very helpful when we treat people now.
It lets us think that via the body we can approach the mind or that via the
mind we can approach the body. So, there are more ways to get to someone than
we think.
Basically, this is my conclusion, that for as long as our
profession (and that’s my profession) colludes with the populist agenda of
labelling these people evil, we only confirm what these individuals feel anyway
about themselves. We fail to understand, let alone treat and prevent, the
causes of violence in our society.
And I’d just like to say that in England, where we have
this kind of hatred of children which Sami brought up, we have one of the
highest (apart from the US) rates of death in little children. We lose two a
week in this country. In Sweden,
where, twenty years ago, they
pursued the ‘stop spanking campaign’ with an educational programme, they get
upset when they have one child a year die. That’s how bad we are. Also, we lose
two women a week through attacks by husbands or partners. We are a very violent
society and yet we don’t really want to confront it. We get worried about
paedophiles, but what is going on at home?
Something else quite interesting we heard the other day.
They have decided to do profiles of serial killers. So they are going to put a
lot of money into some fancy research to do with the ‘what is a serial killer?’
profile, because they hope to find a way of stopping serial killers. Yet, one of
the top experts in the Police Force said, ‘Why don’t you look at domestic
violence? It’s happening all the time. It is far more serious!’ - but no
interest, an absolute blank!
Just one point that I realise I have left out: The
attachment can be different in relation to each care giver. It can vary from
the mother to father. So, the final outcome will represent the balance of power
between these two attachments. For instance, you can have a secure attachment
in relation to your mum and insecure one in relation to your father and so on.
So don’t believe it all happens in just one way.
So these are some of the thoughts I wanted to share with
you today.
Bob Johnson
Felicity is wonderful, quite astonishing. But what struck me so forcibly
was that, if you take away the stereotypes, the prejudices, the teaching that
is drummed into you and actually look at what’s in front of you, then you
eventually are going to see the same thing.
What Felicity is describing is that she has moved,
following the publication of her book, to attachment, and I have moved to
exactly the same sort of outlook, as I’ll show you. I mean, I keep hearing my
talk given before I get on to do it, which is wonderful. This is the reality.
The other thing that I am going to say before we break for
10 minutes is cultural. We live in an extremely impoverished culture. We live
in a culture, which has very serious flaws and is not looking at those flaws.
From what we have heard about the children and the violence, they are not
looking at the remedies. There are remedies. Just take a point that Sami
mentioned. There has been globalisation of child poverty as a matter of
strategy. This is what you do now. What are you doing? You are impoverishing
the future. You are reducing the support and with that the mental health and
social health of the future. The infants are growing up in an over-worked,
rejecting context. What are they going to do, when they have the power?
So it’s now five to twelve. We will meet again at five
past - at least I shall. Please join us!
Dr
Bob Johnson Consultant Psychiatrist. Co-founder of the James Nayler Foundation. Formerly at Parkhurst Prison, he
specialises in the treatment of severe Personality Disorders. Author of
‘Emotional Health’
[introductory remarks on the difficulties which innovators
face – these are lost from the tape unfortunately]
. . . . . Babbage was an early computer pioneer in the
1850’s and he had a wonderful paragraph - which I can't quote entirely - but he
said something like, ‘Introduce a new idea to an Englishman and he’ll start
shredding it.’
I want to go back to 1796. (It's a funny sort of backward
innovation.) There is a book here, ‘Mad in America’ by Robert Whittaker
[Perseus Press]. He reviews much of what we have heard about this morning. You
have to have a very strong stomach to read it, particularly if you have the
psychiatrist in your job description. I reviewed it for the New Scientist in
one of my fifteen minutes/ fourteen minutes of fame. I said that everyone
should read this and that psychiatrists should read at least the preface every
year and report back to everyone else what they are doing about it.
Because what you heard this morning has had dire
consequences on psychiatry. But
what he does say is that in 1796 the local Quaker community, which happens to
be in York, founded The Retreat and that they accepted into The Retreat all
manner of mental disease. Then he produces figures to show that the success
rate of treatment there has never been equalled. I’ll repeat that: All
treatments given today, including the fancy drugs, which he goes through in
some gruesome detail, have never bettered what was done in 1796 and possibly
for some 50 years thereafter - before the rather malign medical influence came
in. And all went downhill.
1963 – I’ve put there because I was trained in
psychiatry in that year. I was trained in what was called a ‘Therapeutic
Community’. In view of what we have heard this morning, this is a somewhat
dangerous thing to say. We had ward meetings. The cleaners attended the ward
meeting and the porters attended. The Therapeutic Community was a Community
that was Therapeutic. That was in 1963.
In 1952 this slim volume [holding up the book] was
produced by the American Psychiatric Association. It's called ‘The Diagnostic
and Statistical Manual of Mental Disorders’ [First Edition], and it's very
slim. It says, “Take into
account the social factors”.
This volume [holding up another book] is the fourth edition of the same
book. It's called, ‘The Diagnostic and Statistical Manual of Mental Disorders
[Fourth Edition]’. And
it's a load of crap. It's says, “Ignore entirely social factors. Ignore entirely
what's happened to the individual”.
Unfortunately that is what the profession in relying on at the moment.
Oh, 2053 is down there, [looking at the slide projected on
the screen] because – I am quite confident – I am hopeful that in
fifty years time, what we are talking about today and what I am going to show
you and what is perfectly obvious to anybody who hasn’t been trained otherwise,
will be the norm. People
will say, “Well, it's ridiculous what they did in the early 21st
century - giving out these drugs, giving out these chemical straight jackets,
giving out all these ridiculous regimes. What they should have done was listen
to Sami, hear what happened to the children, listen to what was known about
attachment. We are putting it right now and we are curing people.”
Sadly, by 2075, they will have forgotten all that and will
have gone back again – but we’ll leave that.
There I am. Those are all my qualifications. Despite all
the qualifications, do they listen to me? No!
The title of this conference today is ‘Promoting Emotional
Maturity’. Now here’s the
revolution. Are you ready? I
don’t see it as that. I see it as Promoting Sanity. Sanity for me is emotional maturity and, conversely, all
insanity is emotional immaturity. No wonder I don’t get anywhere! All mental
illness is emotional immaturity – unless you have been taught fancy thick
volume stuff. This is far too revolutionary! Get off the scale! Promoting
emotional security.
The secret is, as Sami was saying, that human beings don’t
know how to bring themselves up. They don’t know how to. They don’t know how to
speak English. They don’t know how to speak. They don’t know how relate. They
don’t know how to cognate. They don’t know how to socialise. They need to be
taught!
So, what I do - and I employ everything that’s available
to me: joking, joshing and so on - I find a way of encouraging them to grow up.
Now, if you go to a 6ft 3 murderer and say, “Come on, grow up you oaf!”, then
you are not going to have such a successful approach. But if you can persuade
such people and treat them as if they were adults, which they are –
respect them, have a humble approach to them – then they have the
evidence and they have the information which you are facilitating or not,
depending on their consent.
They just don’t believe it. You heard it this morning.
There are situations where they don’t know what to do. They just feel that
there is no option for them. Growing up doesn’t apply to them. All these other
people seem to be milling about, but what they are doing – ‘We don’t
know.’ and ‘It's not for us.’
These are the facts. They are stuck in a child/infant
emotional strategy. It's not that they want to, but nobody has ever convinced
them. And they don’t need to be convinced of anything other than that they are
an adult, and need to become emotionally mature.
You can call it what you like: emotional education,
maturation therapy, etc. Be courteous. These people are adults. They are not
children. They want you to treat them as children. They want you to mother
them. They want you to wipe their nose and all the other stuff. Yet, all I am
talking about is what the best teachers do. The best teacher doesn’t say, ‘This
is what's the matter with you.’ They say, ‘You want to learn about this?’ and
they lead their pupil through.
People ask, ‘How do you do it? How do you do it so
fast?’ I do it in this
way, because, after getting rid of all my old training, I now know for an
absolute certainty that the person in front of me doesn’t want to be the way they
are. I know that they can grow up,
because they are adults. The only thing, which fools the psychiatric profession
absolutely and why this book [ the DSM-IV] is so thick and so valueless, is
that every individual is different. Why should this be a surprise? Every
childhood is different. Some mothers do this, some have siblings, some have
parents, some don’t have parents, some are English, and some are Arabic.
Whoops! They are all different. Why shouldn’t they be different? Each individual is learning what the
world is like from the bottom up.
Here are some provocative statements: ‘All Crime is
infantile.’ or ‘All Crime is revenge.’ ‘Prison is governmental and public
cruelty.’ ‘Acts of evil are acts of infantilism.’
You have to have the utter conviction it’s going to work.
The revolution is that no-one wants to be insane or immature. The revolution
really is that these people don’t need to be as they are – but they have become their own worst
enemy. They raise barriers to progress.
If you can facilitate, persuade and evoke emotional
maturity, you get non-violence. You get self-confidence. You get civilized
individuals. So, we have quite a
long way to go in this country.
Just to put it in a concrete metaphor: Everybody can swim,
if they have been taught. Everybody initially is terrified of the water.
Drowning takes 4 minutes. How long have you got? But, if you are taught supportively and encouragingly,
then you can swim. Exactly the same happens in all other areas of human
learning.
Parkhurst prison taught me that we are born lovable, sociable and non-violent. Now, a lot of people persuade
you otherwise. A lot of people try and persuade you otherwise, for their own
selves. Yet that’s the fact, and, if I am going to set about to change these
people, then that’s the notion of sanity I’m aiming for. I’ll just whip through these slides,
because I’ve shown them before, but they are so critical.
We all start very small. – I didn’t need to say
that. Here is Ethan. I love Ethan.
He was born, as you see, on the 19th December, 1999, and there he is
20 seconds old. He is screeching, because he doesn’t like where he’s arrived.
Here he is 17 minutes old, and what his father has done, which is most unusual
for fathers ? He’s
picked him up. Ethan focuses on his face. The father sticks his tongue out at
Ethan. Ethan concentrates very hard and sticks his tongue out back. Seventeen
minutes old! Now, how many of us
talk to our infants? Sadly, I
didn’t. I was in this trans-generational thing, all handed down from my
parents, my grandparents. So, I didn’t do it, but, if I had it to do again, I
would do it. That’s what people need to be taught. People need to be taught how
to grow up. Maybe they need to be taught how to say ‘hello’ to children.
We heard some really tragic views this morning. Yet here
is the proof. All infants require a sound parental attachment. Where it's
robust, as we heard, trauma can be processed successfully – where it's
not, you are in for trouble.
Now this monkey: I’m going to show you - there he is - the
monkey. What the monkey does is to bite itself, when the photographer
approaches. Now, that is a Harlow
monkey and it was brought up in partial isolation. We know precisely why that
monkey bites himself. Why
then are we so surprised when human beings show similar behaviour? Why don’t we find out? Why don’t we
ask? Why don’t we look?
These monkeys defend themselves very aggressively. That’s what people do in prison.
That’s what I was dealing with. The reason was the same.
When you say, “Look, you don’t have to do this any more,
you are out of the nursery nightmare”, once they believe you, they stop doing
it.
Well, there’s my lovely phrase, ‘Parenting keeps infants
alive and adults insane.’ This is why I’m not popular with the psychiatric
establishment, but do I care anymore?
Now Truth, Trust and Consent: I go into the definitions of
that in this book. [Holds up a copy of Emotional Health].
Truth is the correlation between what you think is out there
and what's actually out there. The more precise your view of the world - it
will always have some imperfections - the more truthful it will be.
Trust is absolutely critical. You are not going to tell anybody
anything, if they are going to hit you, or they are going to destroy you. Trust
needs to be developed, it needs to be taught, and it needs to be learned. I
approach every customer whom I see on the basis that it is my job to prove that
I’m trustworthy.
And Consent, well, you expect people to change. You can't force
people to change. You can't get inside somebody’s head and say, “That needs to
change!” A person changes him/herself – or it doesn’t happen.
We are actually live in a democracy, which is meant to be
based on consent. Consent is the pillar of mental stability and of social stability.
Yet coercion is the name of the game today. Market forces, fines, parental
fines, all this coercion doesn’t work. Two centuries ago they had a phrase ‘You
can lead a horse to the water, but you can't make it drink’. Well, why has that changed? What's
different? Everyone is born lovable, sociably and non-violent. And, if you don’t believe that,
you should find out, because I’m suggesting that’s the case.
This is Parkhurst Prison, and these are the drugs - the
tranquilisers - 3.5 kilograms per annum when I arrived and 150 grams per annum
when I left, due to Michael Howard closing the unit. These are the physical assaults –
disappeared! Now, what's
happened? No alarm bells for 3 years! Something has happened. ‘Oh no, it
hasn’t. You can't say things like that! Rubbish! Get lost!’
And yet they are spending (and I must say a little bit on
this, because it really gets my goat), they are spending £270 million on
building what they call ‘DSPD Units’. They can't get the staff, because people
don’t like working with people who are incurable. They can't get the clients.
So, they frog-march them in. –
I’d better stop.
This is an extract from a transcript that I am going to
show you. This is Lenny and he
describes on the video how he has difficulty in turning to his mother (role
play) and say, ‘Hello mother, I am an adult’. Now, the truth of the matter is
that Lenny is an adult. The further truth is that he cannot say this. So you
have a conflict, you have a conflict in what Lenny perceives and what Lenny is
able to tell himself.
And because of the relationship I have built up with Lenny
by that point - which is about two months into my time at Parkhurst - we are
able to laugh about it. Then I say, “Can you tell her that?” and he says, “Well
I could try, I could try”. So, off he goes, “Hello Ma, I’m an adult” and I say
“Do you believe that?” and he says, “Partly”.
He’s not going to say that, if he is frightened of me. If
he is in a macho situation he is not going to even go there. But he is being
honest when he says ‘partly’.
What does that mean? Part of him is right to say ‘this is the truth of the
matter’. So, my task very clearly is to say, “It's not frightening, try it
again!” - Like I said - cajoling, joshing, and joking – it’s to see and
confront the truth.
This is a clip from Tony. On the right hand side you’ve
got what he was like before I started talking back at him. He said, “Can you listen to me?”
So I said, “Fine, I can listen to you.” and for half an hour he described
mal-attachment. He described how, at the age of six weeks, he was given away by
his mother and how, up to the age of twelve, he went through children’s homes,
sex abuse, emotional abuse, physical abuse. Then, at the age of twelve, his
mother reclaimed him and took him to live with her in Newcastle in a one-roomed
flat. There he slept on the sofa, because she had a boyfriend at the time. And
he was bedwetting. So that wasn’t a very satisfactory situation.
That was in the same half hour basically. I suggest to him
that now, at the age of forty-two, he doesn’t need a mother. Nobody had
suggested that. We have the ‘yearning’, as he calls it, or the attachment. The
solution to his problems was to try and find a reliable mother. But I say, “No
it isn’t! How about looking after yourself? How about being forty-two? How
about being an adult? How about growing up?” - I use that phrase. It's a
difficult phrase to handle, but that’s what I mean. - Then he suddenly says,
“What do you mean ‘the problem’ –
the problem has gone.”
Well, you have to see the video and judge it for yourself.
Now, this is Hattie and she’s very miserable. She’s very
depressed. She’s very weepy and at one point I suggest that I get some Kleenex
tissues and she says, “No, no! They are not wet tears, they are not real
tears!” And then I persuades her to verbalise, “Yes, I miss my Mum.” which
eventually she does. Then I say, “Why? What do you need from her?” I’m bringing
it into the today. I’m saying, ‘you’re telling me you miss your mum. You are
obviously very distressed about it.’ (Her mother died some twenty years before)
and I want to know what it's about. I am trying to get her to say this.
Well mum could do this, do that – but she’s dead. -
Whoops, whoops, whoops gets some attention there. - Then later, on the right
hand side of the screen, she manages to say for the first time, I believe, in
her life that ‘my mum is dead’. Because what the child does is to deny. The
child says, “This isn’t happening to me.” Shuts down! I found that, if you get the person to say it, they
may go - mumble, mumble, mumble - “No, no! Sorry, I couldn’t hear you. What was
it?” But it's ‘MY MUM IS DEAD’. Again it's the truth, the painful truth,
difficult to come to. It’s not easy to persuade the individual to face it, but
that’s the objective.
Here’s Steph. Now Steph is a thirty-year-old, who suffered
for 5 years from heroin addiction. (Since the NHS won’t refer patients to me, I
see them through solicitors, who are interested in results – happily for
me.) So I sit her down and we start talking. I want to know about her
attachment and I want to know about her emotional maturity and I want to know
– if she’s grown up. So I ask about her memories of her parents, and she
suddenly burst into tears, which cheers me up a great deal, because I then know
that that’s the area we need to be talking about. That’s the area into which we
need to get some daylight.
She says, “They don’t understand me.” and I actually say -
and I hope it will show on the clip -, “I propose that you wean yourself off
your parents.” I used that phrase, because, as I get older I get bolder and I
cut the corners. Then, two weeks later, she feels much better. A great weight
was lifted off her shoulders.
So, let’s see if we can see some of this. We will go
straight to the video - with luck. So, we start with Lenny:
(Video of Lenny)
I just want to draw attention to two or three points. Again, it's just astonishing! I took
this video in 1991, thirteen years ago. Yet you heard from the previous two
speakers about the reasoning that’s going on out there.
When I invited Lenny to say to an empty chair, to his
mother, that he was an adult, he added something to the phrase. He says, “You
can't hit me anymore, Mother!” I didn’t say that, he did. And that made the
difference. It means that his psychic fear is figment fear, which is still in
his head. He got a remedy. For, there is no longer the hopeless fear that we
heard about. What our conversations have helped him do is to get confidence,
confidence to look at today’s reality, at what is the truth today, what is the
reality today. And look what he says: “If a doctor had taken an
interest...” This ‘doctor’
could be anybody.
Later this afternoon I’m going to shown you a film of
Karl. In Karl’s case it was two members of staff in the prison, who took an
interest. They insisted and they pushed themselves forward. They said, ‘Things
have to change!’
Lenny says – “If a doctor had taken an interest, say
when I was in my twenties, none of this would have happened.” - He would have
grown up emotionally. - Then he says, “You can't hit me, mother, I’m a grown
up!” - This is 1991! - “I am a grown-up.” - What does that mean? Well, what
that means is that he is protected. He can say, “Sit down mum, don’t get all
riled up!” - He has escaped from his nursery nightmare. He would never have
escaped from his nursery nightmare, if I hadn’t said to him, ‘You don’t need to
be there any longer. The world is not like your nursery nightmare has taught
you that it is. It's different. People can be friendly!’
So, now move to Hattie. I apologise, the emotions that
come out are pretty strong. So, brace yourselves.
(Video of Hattie)
One of the patients that I treated said, “What your
treatment really should be called is ‘detachment therapy’” and you can see
there that, with a lot of expertise, I am helping Hattie to detach herself.
And I must emphasise again: These are very fragile areas.
These are very crucial areas, vital areas for the individual concerned. I am
much more confident now than I was. So I go in where I wouldn’t recommend
people, who aren’t familiar with the area, to go in. But you can see what's
happening. It's almost as if she’s hanging on to this dead image, or image of
her mother. That’s her life-support system, which it should have been, and
she’s lost it. What I’m asking her to do, what I am inviting her to do is to
transfer her life-support system - it is as crucial as that - and again we hear
the phrase ‘grow up’. “I’m grown up.” she said, and then that wonderful phrase,
- what a thing language is - and I say, “You never need your mother again. Is
that true?” and she says, “Getting true.”
I’m not going to jump up and down and say, “Well !” I’m
going to say, ‘Fine, she knows what the truth is. She’s now moving. She wasn’t
before.’ - “I thought I’d got rid of my mum.” Well, she hadn’t got rid of her
mum. Her mum was still pulling strings. She could see the strings. She could
feel the pain.- And it is very painful.- But we had a strong enough bond and a
strong enough understanding and enough trust for her to consent. This was about
the sixth session and there have been lots of gaps in between. So, this didn’t
come out of the blue. It was built on a long period.
So, here is Tony.
(Video of Tony)
So, you can see why I enjoy my work. That smile! That’s a
change in personality. “I realised I didn’t need a mum.” Now, at the age of
forty-two, his life-support system is among his peers. At the age of six weeks,
in infancy, as we have heard his life support system is in ‘care givers’ - mum,
dad, whoever is around -, because human infants are born quadriplegic. They
can't move. They can move their face and they can move their tongue, but they
need parental support or adult support.
I just want to add there: It's not only mums. It's not
only dads. Parenting is a skill like any other. It needs to be taught, and,
unfortunately, my parents or your parents are not always ace at teaching it,
because they weren’t taught themselves. As I stress so much in my book, it's
not the parents today, it's the stressed, anxious, incompetent parents of
people’s infancy.
As you can see so clearly, there is a picture in Tony’s
mind of what he needs. It's perfectly true for an infant. It's the opposite of
what happens to be the truth for an adult, because, as he says, he put this
onto probation officers’ toes - not sure why their ‘toes’, but anyway - all
these different people’s toes, because they were competent and he was not. They
were the boss and he was not. If you suggest to him in a context in which he is
open and is trusting you and in which you are asking for his consent and not
thrusting it down his throat, he will say “I don’t need a mum.”
Now, nobody has ever said that to him
(a)
They didn’t know how important it was. They didn’t know about attachment and
how it was important to detach.
(b)
He had never sat in a situation long enough with somebody who was competent or
had expertise or confidence or whatever to say these things.
Now he knows and he will never burgle again. Beforehand
his life was one long string of petty burglaries, because, so he believed, the
world owed him compensation. But then he found he didn’t need that. Now then, this is Steph.
(Video of Steph)
I just want to draw out one or two points: (I am running
over but the Chairman is very indulgent.
I suggested that she criticize her parents. She’s never
met that before and then says, “Criticize?” It takes her aback. You don’t
criticize your life-support system. As Felicity describes, you don’t start
making rude remarks about your mother, when you desperately need your mother.
That’s still the infantile pattern that’s going on there. I gave her the
cognitive challenge that her, then, relationship with her parents is breaking
her heart. Does she want that? I gave her a choice.
I am showing you these clips, because the change is very
rapid in these particular people. When I was working in Parkhurst, it would
perhaps take two years to get anywhere near along these lines.
The other thing I want to say here is that, when I said to
her, “I want you to wean yourself off your parents” she said, “I know”. She knew. At what level did she know? Her
husband said, ‘I have been saying this for a long time.’ So, people had been
saying this – and it hadn’t gone in. She was saying that it hadn’t gone
in. It must have been a particular configuration of her expectation, her
trusting me, my confidence – which meant that in the particular slots, I
knew what to do.
So it went in. And you can see a change in her personality
from (a) to (b) - as I said, that’s why I enjoy my work. For she’s so
cheerful! And I have seen her
subsequently and she tells me that her relationship with her parents (you won’t
believe this) is better. She talks to them and they talk back. She suddenly
realised that they were very worried about her. They are obviously not terribly
articulate emotionally either but, when she goes to see them she sees two
individuals. She doesn’t see two enormous people, upon whose support her life
depends. - It doesn’t any more. - She goes to talk to them and they say, ‘Oh,
she’s interesting.’ They are interested and she is now talking to them. This,
though, now is an adult to adult. This is the detached relationship, in the
sense that it is not like the infantile attachment. This is a social
attachment, a social pattern, and it's where society should be aiming.
Thanks for your interest. Lunch till 2pm, and then we come back for a plenary.
Right, well, I’m very pleased to introduce you to Tony.
You have seen some clips of him and he has very bravely come along, and I’m
going to ask him some questions and then, later, you can ask him some
questions.
Bob: So,
what did you think of the video then?
Tony: I was shocked really, to see how low down in my life I had
got.
Bob: What’s
happened to you since?
Tony: I’m living at YACRO [a local probation-type hostel] at the
moment and I’m doing several courses and part-time work.
Bob: And what’s the difference, what made the
difference, what happened that changed things over?
Tony: The thing that changed things over was realising that the
mother thing I’d been looking for wasn’t in probation. It wasn’t in any form of
authority. It was all in my head.
And as soon as that was released then my mind and brain
was like opened up to all the help that anybody could give me.
And since I’ve known I didn’t need a mother I have
accepted all the help and it’s worked.
Bob: Why didn’t you know you didn’t need a mother?
Tony: Because nobody told me.
Bob: (I paid you five quid for that one!) I mean, it’s
just staggering, I mean, we were just sitting there, we were talking it over
and I just reacted in that way and told him - but nobody had told you that, had
they?
Tony: Never, it never even crossed my mind.
Bob: It’s the change over from attachment, to the life
support system without which you cannot survive, which was the maternal figment
as it turned out. And that’s true for an infant, that’s absolutely the reality
for an infant. And then you get to the age of 42 and it’s no longer the reality
and in fact it trips you up, doesn’t it?
Tony: Yeah, because once I’d found that out, the rapid speed of
improvement was, it was just so rapid. Everything just fell into place,
everything that should have happened in 42 years happened in a matter of weeks.
Everything just seemed normal.
Bob: Well, thank you very much Tony for coming up.
There may be questions we can ask you later if that’s alright.
Tony: Yeah, no probs.
Bob: We can take two or three questions. Here is the
microphone-man, sorry, not the microphone-man, a man with a microphone. Have we
any questions for Tony while he’s here? Hey she’s got a question, stand by!
I’d
like to say that, although you came to the realisation that you didn’t need
your mother and that you don’t need your mother for nurturing you now any more
- and that was a huge realisation for you - I wonder, whether in some way you
needed your mother to answer a lot of things for you. Didn’t you still have
that huge need within you to ask her things, to get reactions from her, an
understanding about why things had been?
Tony: I never like understood any of it in any case. So, to ask
mother would just have done no good at all. It just wouldn’t have any meaning,
because the things, the thing that was my problem was that I couldn’t accept
any other life apart from wanting a mother to cuddle me and love me. And
without that I couldn’t do anything. So to ask my mother, why she didn’t do
that, I just didn’t dare, I wasn’t bothered.
Question from the floor:
So in a way it was the acceptance of where you are and who
you are that was the huge opening up for you?
Tony: Yeah.
Follow up question from the floor:
Rather than trying to pretend that you had some other
rights - to be somebody else or to have another life to have this perfect life
in a way that you wanted - it was accepting who you were and what you were?
Tony: Yeah that’s what happened.
Bob: I see the way you are going, and this is a
particularly interesting area to try and expand and to ask Tony about. The way
I see it is that it is a life-support system over here. And the solution to all
life’s problems is a wonderful mother, not the real mother, because she kept
disappearing, but the mother in the form of government or whatever: ‘Here. We
have done you wrong. You have had a lousy childhood. Here is a wonderful house.
Fill it with these things.’
So,
it was a life-support solution. And what happened to Tony was that I said,
“Just a minute. Have a think about this. Think about not having a mother, not
needing this yearning.” and that’s, well, what did you think of all that, what
happened?
Tony: Yeah, what happened all the time in my brain, anything I
related to had to come with like love and protection, which, obviously probation
and other authorities couldn’t give me that intense love. So my life was never
like, fulfilled.
It was never took to the limits where I got that love and
devotion. But, once I realised that I didn’t need that love and devotion,
because life can go on without it and I can give myself love and devotion and
devote my own life to myself, it just became clear that I didn’t need any
authorities really to rule my life.
Bob: He’s getting on, on his own, which is the crucial
factor there. And what’s interesting about your description there was, it comes
in a packet marked ‘love and protection’, like your mother should have given
you. Now, if it doesn’t come in that envelope or that big label round its neck,
it just doesn’t count, does it?
Tony: It’s just void.
Bob: Void?
Tony: Yeah, you just don’t have it.
From the floor:
Tony,
I would just like to know - you have talked about your relationships with
probation and authority, how have your friendships and more intimate
relationships changed for you now, as to how they were before?
Tony: With probation?
Floor No, your personal friendships or intimate relationships.
Tony: Right, umm, well, before I didn’t really have any friends,
because I wasn’t in a friendly-like environment. I have never been in an environment,
where I could say ‘you are my friend’, because like I’ve always been in
establishments and mixed with people of similar background to myself. So you
only have like acquaintances. But, since this has all happened, I have realised
that I have learned to accept friends as proper friends and not like use them
to get things what I want, to use them to give me love, but to use them just to
be a friend, just to be there.
So it’s a lot easier for me to meet people and become
friendly with them, instead of having a big barrier up and just trying to be
their friend just so that I could have the love that I didn’t have with a
mother.
Bob: Let me just add: Again it’s this envelope. This
packet is love and protection. If you didn’t offer that to Tony before, he was
not interested, because the only important thing in his life - which was true
when he was an infant - was that he needed some parental or maternal love and
protection. So, if you came along and said, “Hello, how are you doing?” he’d
say, ‘Yeah, but where’s the love and protection? You haven’t brought it. Well,
I’ll have to try somebody else.’ - is that right?
Tony: Yeah, like if I became friendly with somebody and I did
something wrong to them, which I usually would, because they were not
fulfilling what I wanted of them, so, I just like rejected them in the end. I’d
turn away from them or I’d do something to harm them, so they wouldn’t like me
any more. But now, when I see a friend, I just see them as a normal person. I
don’t see them as authoritative, or I don’t see that I need them, I just like
to be their friend and that’s it.
Another question from the Floor:
Hello
Tony. I really enjoyed this. It’s a lovely story and it’s so good to see you
and hear it. What I was really struck by in the video - of the first interview
with Bob, wasn’t it? – was, how quickly you came to realise that that’s
what you wanted. You wanted your mum. I have met many people who don’t actually
find it that easy to acknowledge. So I don’t know if there is anything you can
say about that. It was so fast and it’s made so much sense to you. Bang, bang!
That was it, and then you were there, which was wonderful.
Tony: Well like after 42 years of like institutions, at first, when
he first said it, I thought, ‘Yeah this is going to free me and I wanted to
believe it’. But in the back of my mind it was saying, ‘Well, nobody can cure
me this quickly, if 42 years of probation and social workers haven’t done
anything for me. Surely this man can’t just say this, and I’m cured!’ And then,
as time went on, I started to accept it.
And the more I accepted it, the more I accepted authority. And when I
started to listening to authority and Probation Officers and the YACRO workers,
the more I accepted them, the easier my life became. And I realised that all
the time it wasn’t their work that was rubbish towards me, curing me, it was
because I wasn’t accepting that work and I was pushing it away all the time.
But realising that I didn’t need a mother, I realised that I didn’t need them
in a way that I was looking for them before. And the only reason I need them
now is to just show me how to be an adult. So I find it easy to accept them,
and I look at them as a total different people, just normal people trying to
help me.
Bob: I’ll tell you, what Felicity wants to know
– what is the magic button
that I press. No, it’s absolutely
right, I mean, I don’t mean to disparage that, when I was asking Tony and when
I came up to the question - because we spoke for about half an hour about all
the problems and we came up to this.
I was actually quite anxious in a way, because, as you
say, if you put this question too forcefully to begin with. to some people -
well in Parkhurst, for example, there were three murderers that threatened to
kill me, because I suggested that their mothers weren’t quite so ideal.
And there was
something that had already been going on in Tony’s mind, as I mentioned. He had
asked to see a listener in Durham Prison. And the listener had already started
him thinking, by saying that the reason all these things happened to him was,
because he was pressing the self-destruct button. So there was something about
that, which was already growing in Tony’s mind.
But it’s the cognitive, it’s the emotional-cognitive, it’s
the little blueprint. And I say, “Well, what about not having a mother?” And to
some people that is horrific, because it’s you saying to the infant, “Well,
there is nobody there at all. You’re dead!” But to Tony, as the video shows, he
immediately cheers up. There is –
a weight goes off his head, as it did with Steph later. And then he
cemented it by thinking it through. It’s a blueprint that you can offer. I
can’t change him. He did the curing. I didn’t do the curing. He did the curing.
I was able to offer him a selection of things, one of which he took on,
straight to his heart as it were. And that’s what happened. But then it’s a
cognitive thing. You can say, “How old are you?”, and you can chivvy them and
so on. And the work happened in that hour, or half an hour, or whatever it was.
And then it’s thinking about it later, isn’t it? It’s turning it over in your
mind and testing it out. ‘What is this doctor saying? It sounds ridiculous!’
and so on. And then maybe he’s right. And then you start feeling better about
it and all the endorphins start coming out, or whatever you have got in there
– Felicity, I don’t know what you’ve got in there - they come out and you
feel, ‘Whoosh it’s not so bad maybe. I’ll do alright.’ What do you think?
Tony: Yeah, because like I’ll give you an instance. If I had a
problem and I went to see somebody in authority about it, I would listen to
them. But I would come out of the room still unsatisfied. But because I
accepted that I wasn’t going in that room to find out, to fulfil like a
replacement for a mother, I was solely going into that room to solve this
problem, that problem was getting solved and I was coming out the room happy. I
was coming out fulfilled, because I wasn’t going in there in the first place to
look for something that I know wasn’t going to happen. So, the more I accepted
it, the more things in my life got solved, and my life just became better and
better and it became easier and easier to accept.
Bob: You went into the conversation with me in the
interview, in the examination, looking for a solution. Now, the listener had
set you up for that, and probably the solicitor, too. What we had been working
with set you up for that. The other thing I must emphasise, I did not go in to
love and protect him. I went in as what I call an ‘emotional plumber’. I go in
there and say, “Change the boiler” – “I’m not changing the boiler.”
– “Well, then don’t change the boiler.” That’s it. And that’s absolutely
critical. Most of the medical training, and a lot of other professional training,
say, “Well, you’re the expert. You tell them what to do”. And you immediately
become parental. And you go in there and you are parental. And then they say
that ‘you’re not protecting me very much, probably don’t love me very much
either’. And you immediately attract antagonism. So, there are two factors
really, but it’s this: He went into the meeting looking for a solution, which
probably the Solicitor had – yep?
Tony: When I went, when I first went in to see Bob, I expected him
to say like ‘Yeah, you have had a hard life. Come here, I’ll love you’ or ‘I’ll
send you to somebody that will love you. I’ll send you to such and such’. You
know, I was looking for that love still. But had he done that, my life would
have just been the same today, as it was before, I went in there. Because
nobody can give me that parental – they have gone, I’ve never had it
–
Bob: You don’t need it.
Tony: - but I don’t need it. So I was cured by him being honest and
saying, ‘Look, you don’t need someone to hold you and love you. You don’t need
this. You need to grow up. You need to be a man.’ And that’s what happened.
Bob: What can you say! I mean, he’s even better than
the video, you’ve got to admit that! Steph isn’t here, is she? No, you’re not
Steph, I can tell. Where’s the microphone-man? Here he is. I don’t pay him
enough, that’s the problem!
From the floor:
I’m
just curious, right? I work with young offenders every day, right? And I was
just curious to ask you, at what point do you think in your life earlier, if
someone had come along like Bob, what age do you think you could have handled
that earlier?
Tony: I would say about at the age of 11 or 12. As soon as you start
realising that you need a parent. You need - a child in a normal family set-up,
parents will probably start talking to them. About the age of 15 even young as
14, like, these days, ‘Look it’s about time you started washing your own
clothes.’ Before then, you’ve got it all done for you. So, at that age then you
have to start realising that parents, they are nice but, hello, you don’t need
them. You can’t live your life on your parents.
Floor: That’s what I try to do with the young people I see. And I’ve
got to admit, it does work.
Tony: Good!
Bob: Thank you Tony, so much, and thanks for coming up!
We will now have a few words from Nada, won’t we Nada? She’s just settling down
you know, polishing her glasses, that sort of stuff.
Nada: I found it easier to write down to say what I wanted to say today,
the way I hear rather than the questions. So I shall read to you my thoughts.
Back in 1996 I was diagnosed by my GP as having shingles,
but my GP was able to see that behind my illness and sudden weight loss lies
something much more than the symptoms of my complaint. I was treated in a
hospital for my shingles and sent by my GP for urgent counselling at Charing
Cross Hospital. On my referral there I met Dr Zulueta and was subsequently
referred to Dr Johnson. I was reluctant to meet him, as I felt ashamed and lost
and did not want to open my Pandora’s box of problems, which, if I dared to
look inside it, would weaken me and kill me spiritually and physically.
I was desperate and scared with panic attacks that made me
feel I was going mad. Suicidal thoughts were overwhelming me, and I knew that I
needed help fast. Eventually I met Dr Johnson, who greeted me with a big smile
and handshake. The questions that followed in an almost blunt manner surprised
me, but he was friendly and open and I trusted him immediately. And, slowly,
with the support of James Nayler Foundation and Dr Johnson, I was able to
confront my past and cut the umbilical cord from my father. I discovered that
my emotions as a child do not apply to me today. I feel that the healing
process for me was as simple as that.
Today I have a new relationship between me and myself,
with a gradual increase in my feelings of self-worth. I read somewhere during
my quest to make sense of my life, that you are the sum total of choices you
make. I am glad now that I can make my own choices and enjoy being free and
independent. I have learnt that society and existing institutions just label
you and want to give you pills to heal a broken life. For me that dispassionate
approach just doesn’t work. How much better it would be to have an emotional
drop-in centre, where doctors and therapists would have a sympathetic insight
into your pain. We must guide and support those who can’t look after
themselves. I would hope and pray that the centres like a JNF Centre become
more common and the ideas and attitude of Dr Johnson become more widely
adopted.
Bob: Thank you Nada! I have to tell you a little story
about Nada. We had our first JNF conference down in London in 1999, and I
always wanted people, who had experienced going through the process, to come
and sit on the platform and, oh, I was very strongly advised that that was very
naughty, that you shouldn’t do this, and so on and so forth. And I can still
picture in my mind, I turned to the benches where Nada was sitting and said,
‘Would you come?’ and she felt a bit hot, like she did just then. But she came
and talked and really broke the ice. And it showed to me and the conference
that people are prepared, as Tony was, - now I would never have asked Tony or
previously Karl, who I’m going to show you a video clip of, unless I had Nada
there to show that this was a sensible thing to do. It was not a damaging thing
to do. In fact the people in that conference and since have said of Nada that
she is actually speaking from the heart and that really comes across. Thank you
Nada so much!
Nada: I have been treated for a long time for this fear of my dad and the
problems in Yugoslavia and losing eight of my family. All my life blew into my
face and I was treated by different psychiatrists in different hospitals, had
the shingles twice, close to death twice, violent, the whole lot. I had all
aspect of the suffering, but I have never met anybody, who is more
compassionate and somebody who is very human and caring like Dr Johnson. And in
my opinion the only way forward for us people, who are on the receiving end, is
respect and guidance from people like him. And I think Dr Johnson is the best
emotional plumber there is!
Bob: So, if you have got any leaks let me know! Thank
you. So now we’ll move to the next bit.
Sue: Our two wonderful speakers from this morning have
to leave at 3 o’clock. So I have been trying to compile all these very
interesting questions and we will have a question and answer session with Sami
and Felicity now. I think we will start with some simple neurological ones for
you, Felicity. – Has any research been done into whether the neurological
connections, which did not develop in traumatised infants, can develop later,
even in ones 50’s, 60’s and 70’s?
Felicity: Is
it irreversible, is the damage irreversible? Well there is no research to show
that can happen, but what I want people to realise is that the brain is an
enormously complex - what shall we call it – instrument. And what I think
Bob’s work does - I use, by the way, Bob’s techniques in my work in the
Maudsley of all places, complete. So, you know, it’s gaining ground. –
Anyway, there are many alternative pathways to get there, basically many roads
that lead to Rome. And I think that what we learn to do is, we learn to use the
bits of the brain, the pathways that are functional to bypass the defects.
I
will give you a very interesting example: My other interest is in languages.
And I found myself, when I was younger, interviewing a schizophrenic manic
depressive man, a very, very floridly psychotic English man. But he took the
phone like a child with me and started to talk to me in Spanish, because I
speak Spanish. And we looked at each other in complete amazement, because this
man was speaking perfectly coherently. So he did it again, and we looked at
each other again, and then, the third time, he did it. He said in Spanish,
“Doctor, isn’t this strange? When I talk to you in Spanish, I’m perfectly
normal and, when I talk to you in English, I’m completely bonkers.”
So, then I did a review and I discovered that those who
learn a second language after puberty use different parts of the brain to the
ones we use when we mop languages up like a sponge, when we are little. And I
have been trying to get a research application, with very top people, to get
funded. But the horror of the
establishment at the thought that schizophrenia can be language-relative, is
such that we have not yet managed to get the funding. But this is an example
there, I think a nice example, of how different pathways can be used in the
brain to bypass wounded parts of the brain. And, I think, that’s what people
are doing when they are using body-connected therapies and other forms of
treatment.
Sami: Can I say something, because it’s relevant, although not
directly, to the question in terms of the brain, as you have been talking
about. One of the things that has been pretty well established now is called
patho-plasticity, which means that the brain adapts, and - like Felicity was
saying - that, when one part of the brain is damaged, another part of the brain
can take over that function. And that’s particularly during childhood. That’s
when the brain is most able to do that. But there have actually been a number
of interesting studies, which have - because nowadays they do all these fancy,
often meaningless, scans, which show which part of the brain is working when
you are doing what. Where the blood flow is going and so on. And there have been a number of
studies now, which have shown, for example, that, when people are presenting as
depressed and they are treated “successfully” with an anti-depressant or else
with psychotherapy - you know, without any medication – that the changes
that take place in brain imaging are the same. So, just a thought...
Bob: Can I just ask briefly on that, Felicity, the man
you talked of, was his Spanish learned before puberty or after?
Felicity: He
was a linguist, who taught young adults. We have lots of psychiatrists around
at the Royal Free, who decided to treat their schizophrenics, before I found
this out, by teaching them German. And they reported actually tremendously
positive results. And the man told me very clearly that, if he spoke French he
was free of all his symptoms for a while. And that was great. So, there is a
lot of interest in that.
Next question: (Unfortunately the
question was not picked up by the microphone.)
Felicity: If
it has more beneficial benign situation data, it can grow. I can’t be so
specific. I mean, there is a lovely example of the brain coping with defects.
Once a medical student, who had to pass his exams in surgery was told to do a
dissection of the cerebellum in a dead brain. And the young man came back to
his teacher and said, “There is no cerebellum.” And the guy said “Well, you’ve
failed your exam.” So, the young man said, “But at least come and show me,
where the cerebellum is.” - You know, it’s the little piece at the back of the
brain, which makes you do all the automatic movements, piano playing, bicycling
and all that. - They looked and there was no cerebellum. And, guess what? The
dead man’s job had been window cleaning, on top of staircases... His brain had
compensated and found alternative circuits to do the same thing. He had had no
problems. So, I think, that’s what is important, the plasticity of the brain.
So, a lot can be done.
Sue A number of questions around training:
Where can you get the training and the sorts of things we have been hearing
about this morning? What are cognitive behavioural therapy techniques? What
part does silence play in therapy? A group of questions there.
Sami: Well, I have done a number of trainings, and when I finally
finished my child psychiatry training and went out into my first job as a
consultant child psychiatrist, when I was working in east London, a part of
London where about 50% of the community were from ethnic minorities - some of
them migrants, some of them asylum seekers, some of them refugees - within
about a year I had kind of torn up all my training books and I had had to rethink
so many things. Fortunately I was already in the process of beginning to
rethink that.
I think that the training issue is a huge one, and I don’t
know where we should start, because the way I see it at the moment in my
profession, in child psychiatry, we are kind of in a theoretical vacuum. There
is no discussion going on with other disciplines. We don’t know what on earth
is happening in related fields, which are to do with human psycho-social life -
what’s happening in sociology, what’s been happening in philosophy, what’s been
happening in anthropology and various branches of psychology.
It’s an increasingly narrow view that’s being put forward.
And I think it’s a real problem, because, as I was saying, it’s those values
that you then take on into the work that you do that are going to affect the
way you approach your work. Because, if you approach your work, as I was meant
to, was trained to approach my work, - which was that I see children and
adolescents and that my task is to collect their symptoms - because we don’t
have signs, we don’t have physical signs, unlike the rest of medicine. I can’t
get out my stethoscope and listen to their chest. - then I was to pick up my book and work out what the diagnosis
is and then to make my treatment plan, with cognitive behaviour therapy which is quite a popular one.
And I am a bit rude about it, I have to say. I would say I
use it a lot, but, actually, to me it’s just common sense that’s kind of
wrapped in this pseudo-scientific language to make it seem like it’s something
special.
One of my interests, the more I have looked into what’s
going on in other fields, is actually learning about the more ancient
psychologies that are around, because Western culture is actually a very young
culture. And, as I was hinting in my presentation, it's actually very
infantile, but there are psychologies out there from Eastern psychologies, for
example, who’d been debating many of these issues for a long time and also have
quite sophisticated ideas about the unconscious, about inter-personal
relationships, about life etc. etc.
So, how we bring those perspectives into mainstream
thinking - and that doesn’t mean throwing away everything about mainstream
thinking - but how we can enrich it with the insights from other cultures is, I
think, one area which I await with some hope. One day, maybe by the year 2053,
we will see a much more enlightened approach to training, because training is a
big problem.
Bob: The question here is a bit more specific in a
sense. It says, “Where can I train as a therapist with the skills embodied in
the James Naylor Foundation?” One of the difficulties is, and Nada touched on
this, one of the personal decisions that I have taken fairly recently is, that
I have to cut down on my other work and develop more of the teaching modules,
using the videos. I am gradually mastering some of the technology, but the
videos to me carry so much weight. You can see them miserable and then you can
see them happy. And you can’t deny the fact that there is a change. And
hopefully I am going to work in this area, possibly working with Felicity, on
working out how to teach. –
A lot of people say, ‘Oh, it's your personality. It's
because you’re so cheerful. But I’m so cheerful, because people cheer up. And I
am a contradiction in terms: I am a happy psychiatrist. And I go in there and
people cheer up and they say, “Thank you!” and “I like talking to you.” And I
say, “Well, I like talking to you.” And it feeds on itself and you get more
confident. But the reason I’m so pleased about Tony is, that it was something I
said, it was a phrase, it was with confidence that I said, “Look, is there a
need for a mum?” And it's readjusting what you desperately want.
Everybody desperately wants to stay alive, that’s
perfectly understandable. But it changes. You desperately want to stay alive,
so as an infant you say, “Where’s mum, what's happening?” and, as an adult, the
roof falls down and you say, “Where’s mum?” NO! Roof falls down and you say, “Where’s the exit?” And there is
a difference. And because it becomes so loaded and because institutions hate
people like this, I am going to keep coming with that phrase. It's very
difficult, but, if you can get in there - and I am sure you can, providing you
haven’t been trained (Sami threw all his books away. Very wise! You could build
a nice bonfire with that one.) Well, Sami listed them all, what they see as
these problems. ‘The mentally ill’ are the problems; ‘the criminals’ are the
problems; ‘the truants’ are the problems... No! This is something where you can
get in and sort it out. So, hopefully, I shall get some modules out.
Felicity: I
am trying to get Bob to do some proper training and to do some proper research
to get his ideas on the map, because as you may have noticed, I made a very
scientific presentation. That goes down very well with the top professionals.
And the purpose is to influence through that pathway, so that people actually
can begin to think in a different way. And I think, that is very important and,
by the way, this book has saved many, many lives of my patients, because half
of my patients are refugees. And if it wasn’t for the DSM-IV Post Traumatic
Stress Disorder Criteria, which have allowed me to tell the Home Office, “If
you send this guy home then...” (and these are genuine, I mean, I know that
there are fakes and so on) But I see such ravaged, destroyed people that I am
very grateful that there is a body that we can use for our purposes.
I think what I try and do is to use the bits that can be
useful to me to get what I want and, for instance, the Borderline Personality
Disorder here, which is of course crap. But what I’ve done is, I’ve taken each
symptom and I have shown how actually it's a manifestation of attachment
damage. And you can take one after the other and it's very interesting. That’s
how I do it. It's a woman thing. Women bring things together, men like to be
off on their own. So conciliation is my thing.
Bob: I promise to work with Felicity. Alright?
Contributor from the floor:
On
training: There is in London a school of architecture, called The AA School of
Architecture. AA stands for Architecture Association, and that was set up in
the 19th century by a group of students, who were totally
dissatisfied with the architectural training they were offered in the
institutions. They just appointed the staff they thought appropriate. And they
are still going strong and are still regarded as a pretty radical set-up if not
maverick.
Sue: There are a few questions here in the diagnostic
categories. “Can we trust the diagnosis of Munchausen’s by proxy? What is
multiple personality disorder? and What's the best treatment for Borderline
Personality Disorder?”
Felicity: Well,
you know, what I’ve never understood is Munchausen’s by proxy. And I am so glad
to hear, it's going to be removed, because some poor man has misused it. I’m
sure my colleague knows more about it than I do.
With
the borderline one - I kept on saying, when I was using it for want of a better
term, (in America they call it complex PTSD, which recognised that PTSD and its
manifestations originates in childhood) the approach you’ve heard from Bob, his
approach mixed with attachment work, is probably the best. That’s kind of
challenging, because the so-called borderline phenomena are manifest in the
different parts the child is idealising. The abuser is being recreated, and the
idealised parent, the abusing parent, will become manifest together with the
yearning bit and the terror bit. So they are all in there. So, Bob actually is getting
there with his methods. But these people are difficult to engage sometimes,
because they have been made to feel that no-one can be trusted. So that’s that
one.
And
the disassociated identity disorder is for me an issue, because it is just the
further cutting-up of the sense of self, because of the person having had to
disassociate from so many experiences in life through the abuse. I kept on
telling you that the child will retain this attachment to the parent but at the
cost of disintegrating their mind into different bits, so that they can
survive. But I think the Americans and certain people in this country have gone
overboard in actually fuelling that by giving them names and indulging the
little ones in actually doing some most extraordinary work. I don’t do any of
that. I recognise the different bits and I say to the person, “I’m going to
work with the adult in you. What are you going to do about the bit of you
that’s going to try and destroy everything?” I do, and I suggest that “A bit of
you is trying to destroy you, because you want a mummy that will never come”?
That’s how we start the treatment plan and we work on that basis right from the
beginning. So, there are different approaches.
Sami: I have to admit that I’ve got a real problem here, which I’m
going to own up to: I’ve got a pathological hatred of labels, and I don’t find
any psychiatric label useful to me, whether it's Post Traumatic Stress Disorder
or any of them, sorry.
Felicity: Well
you would, if your life depended on it!
Sami: They are a construction at the end of the day. There is a
philosopher, and I can't say it as eloquently as he said it, but he said
something along these lines: One thing that we do with reality is, we create
categories in order to help us. However, once we see alternative category
membership for anything, our previously limited view of reality can change, and
we find it very hard to then go back to our previously more limited view of
reality. So we create categories more for our convenience rather than them
actually being a reflection of reality.
And
this is very true, where we don’t really have any physical things to measure.
Rather than them reflecting anything real - in a way it comes across in the
story of Tony. He was saying that once his previous view of reality and of the
way he categorised things changed, it opened up whole new doors to him. So, in
my practice now, I simply don’t diagnose. I don’t do assessments. I don’t do
treatment plans. My treatment starts the minute someone walks in the door. In
fact, it starts the moment I send the letter out for the appointment, in the
way I phrase the letter, in the way I’m creating a certain expectation.
Assessment is still happening if I’m seeing somebody a
year down the line compared to when I first saw them. I do use medication but
very, very occasionally. In fact, you know, I’m half time with the patient and
half the time in the community. And, over the last year, I know the number of
times that I have initiated a prescription, I can count them on the fingers of
one hand, because I know who they are and what they are and for how long they
were and all of them were temporary.
But I have also taken lots of people off medication. For
example, in my current community case load, I inherited over 30 people on
stimulants. I think there are only two still left on a stimulant, and I expect
they will be off it within a year as well. I listen to people’s stories, and I
am constantly searching for new ways of framing it. And one of my problems with
Post Traumatic Stress Disorder is not the minimising of the suffering but also
that it can and is in a way misused sometimes, this putting a frame of therapy
around something that is the same frame that develops the category.
In other words, you often have people who come from
communities with very different belief systems, who are being told, “This is
what's wrong with you, and this is the way it's treated.” And that includes
counselling therapies that actually might not sit comfortably with their belief
systems. So you then miss the resilience, the strength of the community, the
importance of helping them create connections with the people who can share
similar things and who can be supportive. I worked with a wonderful family
therapist who, like me, tore up her books when she finished her family therapy
training. She is black South African who’s worked with refugee communities in
Africa and in other countries, and she was also working in Europe. Her approach
was very hands on. She would take people out and go with them and get them to
show them, where they can take their kid swimming and how to negotiate the
Social Services office. She would get families together, you know, it's good
stuff.
Bob: I suppose I should say that Munchausen’s by proxy
- I am actually appearing as a legal expert for some unfortunate woman who’s
been accused of Munchausen’s by proxy - is a load of old cobblers in this
particular case. And I haven’t met others.
What
I would say about the trauma PTSD that there is one thing in that book [indicating
the DSM-IV] which the editors will allow, which has some relation to the
environment. So I will excuse it on that ground, and I have also used it in a
Court of Law, because it's nicely categorised and you have pigeon holes. You
have three of these, half a dozen of those and one of them, and you’re in. And
I mean, ‘why not, if you can do that?’
But, in fact, the whole of my view of mental disease, as I
have just explained this morning, is to do with trauma, which prevents you
moving from infantile survival to adulthood. And those are the only two
categories I will tolerate, because I’ve had psychotics who are completely out
of touch with reality in the morning and then, after a while, they become in
touch over lunchtime and then, by the afternoon, they are ‘manic depressive’
and then they become ‘split personality’. And you think, ‘Just a minute!’ What
their reaction is, well, we have to keep tying to track it down.
They’ve
got more and more of these butterflies stuck on all the boards and it's dreadful.
DID [Dissociative Identity Disorder] and Borderline Personality Disorder. But
they all are people who are extremely troubled. And I will not talk to Freda,
or whoever comes in - in fact I was in the middle of one particular
consultation that wasn’t going too well and she said “Penelope wouldn’t like to
hear that. Oh no, she wouldn’t!” So I said, “Well, I’m afraid we’d better stop
there.” “Oh no, why are we stropping?” “Well”, I said, “all I can do is ask
questions and the questions are upsetting you.” and she reintegrated. This indicates a defence against
an overwhelming terror, and I say that this situation is terrifying you, so
let’s take a pause, let’s come at it again, but I’m talking to one individual.
As Felicity says, I talk to the adult. I’m an adult - you are an adult. - “Oh
no, I’m a little girl” “No you are not. Well, you can be a little girl if you
want, but I am going to talk to the adult.” “I’m not going to try.” –
“Well, so let’s leave it.”
You have today’s reality. That’s the truth of the
situation. What is the truth of the situation? The truth is, you are 25. You
don’t need your nappy changing or whatever it's going to be.’
But
these areas are so fluid. There is nothing more powerful than the human mind.
It's so resilient! The stories that you hear: just decades of crushing, and yet
they are coming out, still there. They are still alive, thank you! [to Tony] You liked that
didn’t you?
Sue: It’s 3 o’clock and I’m afraid our wonderful
speakers have to depart for the London train.
Bob: Like Cinderella, the bell is going to go.
Sue: But you have given us such stimulation and, well,
there is such honesty and a humanity about how you talk, about your work, which
is just wonderful to hear. Thank you!!
Felicity: Thank
you for having us!
Sami: Thank you
very much!
Bob: The
book I’ve got here – ‘Mad in America’ [ISBN ] is written by a
journalist. He describes
psychiatric treatments from 1750 onwards. And as I said in my talk, 1796 was a wonderful
flowering (actually in this town) of a really enlightened non-medical
psychiatry, which has not been exceeded since.
The treatments, so called, that psychiatry have got up to
over the period is just mind bogglingly awful. Sami has just stunned me by describing
institutional hatred for children.
Here there is similar institutional hatred towards the mentally
ill. The process still
carries on today in form of ECT [Electro Shock Therapy] which damages the
brain. Indeed he has a chapter in
here on therapy by brain damage.
I mean its just berserk, its bananas and its just appalling. But that’s the background
to it.
What I want to do now is to introduce you to Karl. Now two years ago, Karl was
a prisoner in the Scottish system.
I was asked to go and do a report on him. I went to see him and found he had been extremely
violent, had done extremely violent crimes in the past. However, I did a report on him saying
he had done all the work that was needed to sort out the crimes and that he was
safe enough to be released.
The psychologists got very upset. They used what they call ‘the
Hare Psychopathy Scale’ which is a check list, based on the principle that
people never change. You are
born a psychopath. You stay a psychopath. And there is just the question of
finding out if you are a psychopath or not. So you check the boxes, and if you are still a psychopath
then that’s the end of it.
So here is a man who is totally sane, totally
straightforward, worked everything out – yet they were keeping him in on
that basis. He went through a
number of tribunals – and they all said ‘well the psychologists say you
are still among the 5% most dangerous prisoners in Scotland’. But he wasn’t.
Well, happily he found his way eventually to the higher
court in Scotland and he was eventually categorised down from category A
through to being released. Two
years ago he was in a category C prison [one up from an open prison], and
Governor said ‘Yes, you can come down to this conference [the JNF conference]
as long as you come with a prison officer’. So he came with a prison officer. When they presented themselves at the
door here – people got it the wrong way around! They thought the prison
officer was the one with the problem! Well maybe he was! Because Karl didn’t
have any problems with anything.
Now last year, he was in an open prison. But here the new governor said ‘No. No
chance, no way’. Even now when he
is actually out in the community, (he is in a probation hospital) and again
they say ‘absolutely no way’ [can you attend the conference]. So in honour to Karl, and also to
show you the educative nature of the situation, I intend to reshow the video of
his earlier talk at our conference. It’s just that he describes it so clearly
– much more clearly. I
have never treated this man – I facilitated his release – in effect
by going and checking whether he had passed the criteria for my model. And he does. And he describes so
clearly how he used violence to protect that part of his memory that he would
not, could not look at.
He actually says that violence was his friend.
It’s just so ignorant and cruel on the part of the Home
Office (and for what I call the Cruelty Justice System) that this sort of
evidence is totally ignored. If the powers that be, would listen to what Karl
has to say and what I am going to show you now, (assuming the technology does
what I tell it,) – he is just eloquent. He just says why he was violent. He opens by
describing his childhood. He
can remember his childhood up to age 8. But from 8 to 10, there is a gap. He has no idea what happened to
him in that time. And in
finding out what happened to him during that time, he was able to put things
together, so here we are.
Speak to me Karl .
(Video now being played).
Bob: So there are just one or two points I want to
emphasise from that. Right at the
beginning, he describes his memory of the terror and the smells and the sounds
are still in him at that time.
This must be 30 to 40 years before – but terror has frozen him at
that time. And taking on
from what Felicity said, that the healthy child turns to a reliable adult for
support when frightened, so they build up in their mind that nothing can be too
terrible or when it starts getting terrible, you seek a parent and you get
support. And this is the
problem.
Every child suffers from trauma. But it’s what happens immediately after that, that
matters. And basically, one
of the things I am doing is giving them support to re-evaluate the trauma. Indeed, that’s what happened in Karl’s
case. He says “I used
violence as a tool to kill the terror”.
And that’s exactly my experience in Parkhurst. That the violence is of value to the individual. So
you have to undo that value to remove the violence.
What fascinates me every time I hear that video, is the
conversation between the two therapists in the group. They say to Karl “why isn’t this working ?” Now how many therapists say that
for a start? How many
therapists would ask him? Then he says “Oh I’ll tell you why”. It doesn’t often happen but this
is consensual relationship, this is an informal supportive relationship. He says, “I know why it isn’t working,
– “its not working because I’m frozen”. “You say you’ll come here at 2 o’ clock. So from 1 o’clock I can’t stop my mind
from turning off. It
turns off. I can’t do
anything about it.”
So Karl also provides the remedy. And why does he provide
the remedy – because he wants to solve this problem. So he says “don’t tell me when
you are coming”. So they go
“whoops, we’re here”, and Karl
goes crack! Falls on the floor, headaches, vomiting, nose bleeds the lot. And you can work it out from
that.
In one sense the model is very simple – the trauma
needs addressing. The trauma needs processing. The trauma needs support, so that it goes. And you can see why it hasn’t
gone, and why it would never go, unless Karl had that particular configuration.
However when it’s gone – he says “I am completely cured”. It has completely
gone. I mean, he’s not going
to attack anybody now. He doesn’t
need the terror and violence.
He doesn’t need the violence to keep the terror away. And I am very sorry that we live
in such a cruel society that it has prevented him coming here today. That’s why I showed you him
– (a) he is very articulate as you can see and (b) because its outrageous
that the Cruelty Justice System has prevented him coming. Maybe we will see him next
year. Thank you.
Sue: I think we are all getting punch drunk with
experiences today. Anyway there
are some wonderful questions here.
Quite a lot of the answers to some of the questions were covered in some
of the answers that were given earlier. But I do have three questions here which I think are
of a more sort of general political sort. And I think it might be quite nice just to throw this
out to you, and give us some feedback on those and see what we as a conference
think about these questions.
So what I am actually proposing is that we have maybe a 20
minute – a 15 to 20 minute discussion on this. And I am reliably informed that there is more tea and
coffee through there. if people want tea and coffee. And possibly some biscuits left. I don’t know, not
many I don’t think.
And we will close about a quarter to 4. Does that sound reasonable? OK. I’ll read out the
three sorts of general questions:
The National Health Service document January 2003 called
‘Personality disorder no longer a diagnosis of exclusion’ is very far from
being a positive document.
Do we just recognise that at least the NHS is beginning to look in that
direction ? Or do we,
as a Foundation, demand more from the NHS,? What should we do about that one?
What statement can be made to government at this time of
the highest prison population of 75,000? In view of the insights of the James Naylor Foundation
that’s an interesting one, together with the possibility of concern being raised
by Michael Howard in his new role.
And the other question, really about corporate medicine
and the role of the drug
companies. Could corporate
medicine, for example the makers of anti-depressants, ever ensure that the work
described by today’s speakers could becomes mainstream? Are they the main and only real
threat? If yes, is the fact
that corporations are legal persons their Achilles heel ? Maybe we could sue corporations ? I think that’s what the
questioner is getting at.
So I’ll just throw those questions open to the floor. Have we got any comments?
Bob: Where’s microphone man – there he is, he’s
working very hard the sweat is coming out of his brow!
From the floor:
Out
of all the comments I could make, I think what I would just like to say,
working as a counsellor in a Health Centre where I have had 6 years of
experience – there are a number of men who go to their doctors saying
that they have got problems with anger and violence. It’s often the first port of call, I think, for men. I know that, because I am also
involved with a project that works with men, who have got a problem with
violence. So certainly in
the Health Centre where I am working, I know what would happen. Usually they would be given a
prescription and their problem and presenting symptoms would be seen as a
diagnosis. While your anger
and aggression is something that can be treated with medication and I think
probably that is happening all over the country as we speak.
But also I think that there are a lot of the men that I’ve
worked with over the last 2 or 3 years, most of them aren’t in the criminal
justice system because they manage not to be caught by the police or
prosecuted. And also most of them
have never even been to the doctor either. So I do know there are a lot of men out there who want some
help and support and they don’t know where to access it. And so, also in terms of training
– we shouldn’t always think we have to look to the experts all the time
to tell us what people need.
I think Sami said something interesting about listening to
people’s stories. It’s not
rocket science. What all of
us and perhaps each of us individuals here, have come here to do – this
is to think what can we all do as individuals. So it’s about time and caring and listening and
understanding. We don’t
actually need a lot more research, if any at all, around violence and abuse
because we know its out there. And if we listen to the stories, what we hear
over and over again is people’s childhood experiences. So we need to do a lot more
listening and a lot more preventative work with very young children in schools,
more educative all round. I
just wanted to say that really.
Bob: I think that’s very interesting indeed. Now what I would say is something
that Karl picked up, which was the last point he made – it wasn’t anybody
who was particularly highly trained [who helped him], it was these two
individuals, who were dedicated to him. And it really goes down to – that it’s sort of
almost a religious or an ideological position. Is the person in front of you a human being or are
they evil or born stupid or born dangerous or born demons or whatever it
is. Or can you be of value
to them by sitting and saying ‘look I want to talk to you in an adult
manner’. As you say, I’m
sure that’s right, a lot of the training is dysfunctional, it dysfunctions a
person.
From the floor:
One more thing about labels too, it’s a them and us
situation in terms of power often.
If we are in a position of a therapist or policeman or whatever we might
be, we are seen as the ones that if someone comes to us for help that we are
the one who might fix it.
But if we continue to put people in boxes other than us, and they are
different. Particularly I am
speaking as a woman here, its men, men have to not put other men in boxes
different to them in terms of their behaviour. And the sooner we can remove more labels and meet people as
individuals and equals to look at what it is about men and masculinity and male
behaviour and the way we socialise boys and young men.
From the floor:
I’d like to take up the question – what can we do as
ordinary people. But first I
would like to say that to me the defence against overwhelming terror describes
the reaction of the mental health system to the kind of discussions that are
going on here today. Also
following on the idea of, if we wanted training it has to be created from
somewhere. It has to exist. Can there be a complementary initiative
to what’s on offer ? In
Hereford, where we live, we are trying to set up a safe house as an alternative
to hospital, for people who in a mental health crisis. This is going forward with
a great deal of energy. So
can we not create both the complementary system and the training for people who
want to work within that system?
Bob: Absolutely. That’s a very good point. And I would point out the historical power of the
Retreat – because that’s how the Retreat started in 1796. There was a very strong Quaker presence
in York at that time and in Yorkshire in particular. One of the members of the Meeting,
one of the Quakers was taken into Bootham Park, would you believe. And of course it was well known
that once you are insane, you can’t feel heat or cold or damp, so it was quite
alright to chain them up in a damp dark cellar. So that’s what they did. And this unfortunate woman died there. The Quakers thought that
this is not quite the best sort of medical treatment really. So they bought The Retreat
which was then on the outskirts of York, established it almost as a country
home, as a home. And
the stories of what it was like you can read in a book on it published around
1840 by the grandson of the original founder. They went to all lengths to cope with the manic
people.
I would just like to mention a story out of here, which is
a similar thing. Lauren
Mosher who we might possibly try and invite here, was head of the Schizophrenia
Department in NIMH, Washington DC in 1970. [Sadly, by the time these proceedings were being
edited, it has just been announced that Loren died while in Berlin – so
that is an opportunity lost, unfortunately. ]
At that stage there was some very alarming research
published, showing that if you had schizophrenia in Nigeria, Columbia or India
then you were back at work within 3 years. But if you had schizophrenia in the West, you would be out
of work for decades. So he
thought – “Well, let’s find out if this is the case. Let’s have a look at how these
drugs work”. So he matched
10 young single schizophrenics put them in a special house or hostel. And he matched them against 10 in
the ordinary system. The
latter being treated up to the eyeballs with drugs.
And he staffed these special houses with solid, friendly
people but not medically trained.
And there is a wonderful story, of how one of the inmates of this hostel
said – “You know, the Martians are coming at 3 o’clock tomorrow morning
in Los Angeles airport”.
“Are they?” “Oh yes”.
So the staff said “Let’s go and see”. So they went.
And when 3 o’clock came along,
there were no Martians.
“Oh”, said the young man, “they must have got the time wrong”.
So what does it tell that individual? It tells the
individual that people are listening. That what he says matters. It’s by consent. And then gradually he comes out of it. What the result showed was
that it was 3 or 4 times better therapeutically. That this carefully matched controlled scientific etc.,
approach was better than the orthodox treatment.
So what do they [the Establishment] do ? They don’t say – “Yippee!
At last a treatment for schizophrenia that actually works”. What they actually said was “Very
unscientific. We are cutting
your funding. We are
changing your director”. And
that’s what happened to Loren Mosher.
But what he showed (again) was that treating the mentally
ill like human beings, is beneficially therapeutic. You expect a human being to be sociable, (though
violence is a different matter you have to wean them off the violence) but
there are steps you have to take. [ tape ends ]
[Editor’s note: Apologies are due to the incomplete
nature of some of the transcriptions – sadly the resources available this
year were not as prolific as last.
However, the editor takes the view that the material that can be
included amply compensates for that which has been inadvertently omitted.
Incidentally, some of the transcripts of the videos
shown appear in early printed proceedings, since Karl in particular, needs to
be re-shown every year until the punitive Criminal Justice System relents, and
allows him to resume normal, adult, civilised life.]