HOLD THE FRONT PAGE MENTAL HEALTH AND THE MEDIA - ISSUE 74 / SUMMER 2020 - UKCP
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ISSUE 74 / SUMMER 2020 I SS N 251 6 -71 62 (O N LI N E)
HOLD THE FRONT PAGE
MENTAL HEALTH AND THE MEDIA
THE MAGAZINE FOR MEMBERS OF THE UK COUNCIL FOR PSYCHOTHER APY
Welcome
New
Interview / Susie Orbach
The magazine of the
UK Council for Psychotherapy
Editorial address: UK Council for
Psychotherapy, America House,
I S S U E 74 / S U M M E R 2020
2 America Square, London EC3N 2LU
Published by: James Pembroke Media,
90 Walcot Street, Bath BA1 5BG
Editor: Anna Scott, editor@ukcp.org.uk
P
Issue 74 consulting editors:
Sarah Jackson, Sarah Niblock,
Martin Pollecoff, Sandra Scott roduction of this issue of
Head of design: Simon Goddard New Psychotherapist – which
Senior project manager: focuses on the relationship between
Marianne Rawlins, marianne.rawlins
@jamespembrokemedia.co.uk
the media and mental health – was
Advertising: Harvey Falshaw, harvey. already well underway when the
falshaw@jamespembrokemedia.co.uk, Covid-19 pandemic unfolded in the UK.
020 3198 3092 The speed with which society has locked
Subscriptions: New Psychotherapist
down has been rapid, leaving us with little
is free to members of the UKCP. Non
members can view the magazine at time to respond on these pages. However,
psychotherapy.org.uk/join/the- as well as being an enormous public health,
psychotherapist ANNA SCOTT economic, political and societal event, the
Anna Scott has been a journalist and coronavirus crisis is a massive media event.
editor for 20 years, writing about health, The nightly announcements from the
education and management issues. government and the scientific and medical
She also works part time with primary
communities, campaigns to volunteer
school-aged children, and has a keen
interest in psychotherapy, along with
for the NHS, online resources for home-
psychology, completing a Bachelor of schooling children, information on where
Science in Psychology in her spare time to get hold of groceries and other essential
supplies are, in the main, only possible with
DIVERSITY AND EQUALITIES STATEMENT
The UK Council for Psychotherapy (UKCP) promotes
access to the internet, TV, radio and print
an active engagement with difference and therefore media, in the absence of face-to-face contact with other humans every day.
seeks to provide a framework for the professions of
The relationship between the media and mental health has always been
psychotherapy and psychotherapeutic counselling 3
which allows competing and diverse ideas and complex and continues to be so during these unprecedented times. But while
perspectives on what it means to be human to
be considered, respected and valued. UKCP is we remain in the midst of this trauma, reflection and analysis should come –
committed to addressing issues of prejudice and as it does in therapy – further down the line.
discrimination in relation to the mental wellbeing,
political belief, gender and gender identity, sexual Even without the global pandemic, the ways in which mental health issues
preference or orientation, disability, marital or are portrayed and reported on within the media, and the impact of those
partnership status, race, nationality, ethnic origin,
heritage identity, religious or spiritual identity, age representations on our own mental health, is complicated. There has been
or socioeconomic class of individuals and groups. a shift from crude language that equates mental ill health with criminality
UKCP keeps its policies and procedures under review
in order to ensure that the realities of discrimination, towards more thoughtful representations, but there are still pockets of
exclusion, oppression and alienation that may form prejudice in relation to types of mental ill health, race and gender.
part of the experience of its members, as well as
of their clients, are addressed appropriately. UKCP This issue focuses on how the psychotherapeutic community can support
seeks to ensure that the practice of psychotherapy journalists writing about mental health to avoid stigma (page 14), the way
is utilised in the service of the celebration of human
difference and diversity, and that at no time is compassion fatigue is an increasing side effect of an omnipresent media (page
psychotherapy used as a means of coercion or
oppression of any group or individual.
20), how psychotherapists can help men to get mental health support that
acknowledges their gendered experience (page 26) and the ways in which the
EDITORIAL POLICY
New Psychotherapist is published for UKCP
misrepresentation of black, Asian and minority ethnic groups in traditional,
members, to keep them informed of developments online and social media contributes to poor mental health outcomes (page 30).
likely to impact on their practice and to provide
an opportunity to share information and views
Elsewhere in the magazine – and as many members are taking to video-
on professional practice and topical issues. The conferencing technology to work with clients during the pandemic – we hear
contents of New Psychotherapist are provided for
general information purposes and do not constitute from psychotherapist Monika Celebi (page 40), who uses video in therapy to
professional advice of any nature. While every effort help new parents and babies.
is made to ensure the content in New Psychotherapist
is accurate and true, on occasion there may be We hope you enjoy the issue and take care.
mistakes and readers are advised not to rely on its
content. The editor and UKCP accept no responsibility
Get in contact
or liability for any loss which may arise from reliance Share your views and ideas on our
on the information contained in New Psychotherapist. profession and this magazine:
From time to time, New Psychotherapist may
publish articles of a controversial nature. The views editor@ukcp.org.uk
expressed are those of the author and not of the ANNA SCOTT UKCouncilForPsychotherapy
editor or of UKCP.
Editor
ADVERTISING POLICY twitter.com/UKCP_Updates
Advertisements are the responsibility of
the advertiser and do not constitute UKCP’s
psychotherapy.org.uk
endorsement of the advertiser, its products or instagram.com/psychotherapiesuk
services. The editor reserves the right to reject or
cancel advertisements without notice. Display ads:
for a current advertising pack and rate card, please
contact Harvey Falshaw on 020 3198 3092 or email
harvey.falshaw@jamespembrokemedia.co.uk New Psychotherapist / Summer 2020
Contents I S S U E 74 / S U M M E R 2020
40 Therapy for
new parents
14
The risks of stereotyping
mental health issues in the media
On the Cover
This issue, we explore the effects of
the media on mental health and the
issues that therapists need to address
REGULARS FEATURES
5
06 Bulletin 14 The Big Report
Research and member news to Challenging and changing portrayals
keep you informed of mental health issues in the media
10 Reviews and feedback 20 Caring too much?
Recommended books and podcasts, Psychotherapy’s role in helping people
and members’ feedback who feel overwhelmed by bad news
48 Spotlight 26 Rising to the challenge
Pamela Windham Stewart on Exploring why fewer men than Join today!
working with mothers in prisons women seek mental health support UKCP membership is a
recognised quality standard – being
50 On Screen 30 Public shaming able to use the UKCP members’ logo
will demonstrate the calibre of your
Split’s portrayal of psychotherapy How stigma against the BAME
training and practice to potential
and dissociative identity disorder community affects mental health
clients and employers and among
colleagues within the profession.
36 Interview psychotherapy.org.uk/join
TV producer Richard McKerrow on
the media’s role in starting national
Get in contact
conversations around therapy Share your views and ideas on our
profession and this magazine:
40 Video interaction editor@ukcp.org.uk
Guidance on using technology to
UKCouncilForPsychotherapy
provide therapy to new parents
twitter.com/UKCP_Updates
44 Interview psychotherapy.org.uk
Martin Pollecoff on UKCP’s priorities instagram.com/
as he starts a new term as its psychotherapiesuk
elected Chair
30
Improving representation of the BAME
community in the mental health sphere New Psychotherapist / Summer 2020
Bulletin
I S S U E 74 / S U M M E R 2020
News, CPD, reviews and member updates – here’s what’s
happening in the profession now
MENTAL HEALTH SERVICES
BAME groups experience higher
use of Mental Health Act
CQC report highlights
need for change
T he proportion of black or black
British people detained under
the Mental Health Act in 2018-2019
was over four times higher than
for white British people, the Care
Quality Commission has found.
There were 306.8 detentions per
100,000 of the black population,
compared with 72.9 per 100,000 of
6
the white population, according to
the report, Monitoring the Mental
Health Act in 2018/2019.
Community treatment orders
(CTOs) also continued to be
higher for the black or black
British population – 53.8 uses per Discrimination affects BAME people’s
100,000 people, compared with trust in mental health services
6.3 uses per 100,000 of the white
British population. or prejudice in assessments prejudice, oppression and racism
The report suggested that or, at a basic level, that mental impact BAME people’s trust in the
structural or institutional racism health services are not accessible, mental health services, which are
within health services and wider welcoming or responsive to people perceived as being designed and
society could cause this inequality. from BME groups,’ it read. delivered by white people.
‘For example, it may be that people Dr Kevin Cleary, deputy chief ‘Being racially different comes
from BME groups face stereotyping inspector for mental health and with many other aspects of
community services at the CQC, said differences – social injustice,
that the use of the MHA continues poverty, intra-community tensions
to rise and the overrepresentation regarding sexuality, religion,
of some black and minority ethnic personal freedom, and specific
Get in contact (BAME) groups is a particular cause family norms,’ he added. ‘And then
Let us know what you think of your
for concern. ‘More needs to be add racial discrimination into the
redesigned member magazine:
done nationally to address issues mix and you can only expect a very
editor@ukcp.org.uk
of inequality, but providers also disturbed and complex relationship
UKCouncilForPsychotherapy have a responsibility to oversee between a BAME client and white
twitter.com/UKCP_Updates how the MHA is working, including mental health service.’
psychotherapy.org.uk any impacts on human rights and
equality issues.’ Our feature on page 30 examines
instagram.com/
psychotherapiesuk Psychotherapist Faisal Mahmood the impact of the stigmatisation of
said that racial discrimination, BAME groups on mental health
New Psychotherapist / Summer 2020
Bulletin
Life through a lens
What can we do to change the portrayals
of mental health in the media?
Pages 14
RESEARCH Karen refugees on the
PTSD
Thai-Myanmar border
THERAPY FOR CHILD EARTHQUAKE
SURVIVORS BENEFITED
REFUGEES FROM PSYCHOTHERAPY
OFFERED AS PART
Children who survived a 1988 earthquake
OF PRIMARY CARE in Armenia and received psychotherapy
soon after have experienced health
A study has demonstrated for
the first time the impact of
psychotherapy in primary care for
benefits into adulthood, a longitudinal
study has found.
The long-term study at UCLA in the US
refugees with depression. is one of the first to follow survivors of a
Working in partnership with two natural disaster who experienced PTSD
primary care clinics in Minnesota, more than five years after the event.
researchers from the Center for Researchers evaluated 164 survivors
Victims of Torture (CVT), provided psychotherapy and demonstrated a who were 12 to 14 years old in 1990,
one group of Karen refugees robust recovery from depression. about a year and a half after the
from Myanmar with a year of ‘Several of my patients who earthquake. Of that group, 94 lived in
intensive psychotherapy and case received the embedded case the city of Gumri, which experienced
management combined with their management and psychotherapy substantial destruction and thousands
usual primary care from the clinics, services were completely of deaths. The other 70 lived in Spitak,
and another group with only transformed,’ said one of the where the damage was far more severe
primary care. study’s authors and family and there was a higher rate of death.
The study, published in BMC doctor, Jim Letts. ‘I saw their A few weeks after the initial
7
Family Practice, found that depression and PTSD symptoms assessment, mental health workers
adult Karen refugees who had improve dramatically and very provided trauma- and grief-focused
fled extreme violence, war and meaningful improvements in their psychotherapy in some schools in
torture, benefited from intensive social functioning.’ Gumri, but not in others because of a
shortage of trained medical staff.
STUDY ‘We were comparing two devastated
cities that had different levels of post-
‘UNDERSTAND’ DON’T ‘CORRECT’ earthquake adversities,’ said Dr Armen
PERCEPTIONS IN SCHIZOPHRENIA Goenjian, the study’s lead author.
Researchers interviewed survivors
C linicians must
develop a better
understanding of
their thoughts do not
belong to them.
Instead of suggesting
how patients can lead a
fulfilling life with their
symptoms. Key to this is
five and 25 years after the earthquake.
They found that people from Gumri
who received psychotherapy had much
the lived experience one theory is right and acknowledging that what greater improvements in both their
of people with the others aren’t, the we consider to be “real” is depression and PTSD symptoms.
schizophrenia in order researchers argue that likely to be different for
to help patients live with the different approaches the clinician and patient.’
their condition, rather should be drawn Psychotherapist Mary
than try to correct together to inform Ann Coyne, a specialist
their perceptions, a clinical practice. in schizophrenia,
study suggests. ‘Clinical intervention said understanding,
Researchers at frequently focuses on phenomenologically,
the University of correcting the patient’s the world of a client
Birmingham assessed perceptions,’ said Dr experiencing psychotic
theories of how the sense Clara Humpston, co-lead process, is an authentic,
of self is constructed author of the study, empathic, non-directive
by schizophrenia Thinking, believing and intention which
patients, how they hallucinating self in ‘engenders trust with
might experience self- schizophrenia. ‘Instead, the therapist that can be ABOVE: Children who received therapy after the
disturbance and feel that clinicians might focus on validating and healing’. disaster experienced benefits into adulthood
New Psychotherapist / Summer 2020
Member News
I S S U E 74 / S U M M E R 2020
EQUALITY
HIPC forms
working group to
improve diversity
and inclusion
Plans to become more
From left: George Dewey, Sue
accountable and responsive Milner, Jessie Emilion, Syed
to less-privileged voices Azmatullah and Grant Denkinson
O ur profession helps some clients
more than others, writes Grant
Denkinson. When those people whose
UCKP’s Humanistic and Integrative
Psychotherapy College (HIPC) –
Sue Milner, Grant Denkinson, Syed
Next, we plan to make contact with
more groups for therapists who share
particular characteristics, such as race,
voices are least listened to in society, Azmatullah, Jessie Emilion and faith, disability, class or sexuality, and
who are most oppressed or who have George Dewey – have formed a also groups and individuals who would
one or more ‘protected’ characteristic, working group to address the issue. have something to say about how
have the confidence and courage to talk We surveyed all the training therapists have acted towards people
to us, they tell us that psychotherapists institutions in our college about like them who are deprivileged.
help the more privileged more than equality, diversity and inclusion, We aim to become more accountable
8
the less privileged. asking how potential students are and responsive, to learn from the good
Psychotherapy is often considered a attracted through training, practice work already done which amplifies
white, middle-class profession. Even and assessment, who is responsible for oppressed voices, centres the concerns
accessing the training and managing teaching diversity and oppression, and of people afforded less privilege, names
the costs is more of a challenge to how students and staff are protected, systematic wrongs such as racism and
members from some parts of society supported, challenged and compensated recognises intersectional issues.
than others. Some people training in the institution. We also asked how We not only bring our
or practising psychotherapy and much time is dedicated to EDI and how own experiences but also the
counselling are from parts of society it is integrated into theory and practice. collective, societal, historical and
with less power and often find We’ve collated responses and intergenerational, which for some of
themselves in a minority, trying reported back to the training us is steeped with inequality.
to learn, work and live with higher institutions with the hope of forming Ultimately, we would like future
levels of difficulty than others. a starting point for consideration and therapists and their clients to have a
As a result, five members of the change, perhaps in collaboration. better experience.
BELOW: Bluestone Fitness is
offering onsite therapy sessions
THERAPY SERVICE HELPS Chris Lewis and Andrea Headington
set up the service providing subsidised
HEALTH CLUB WIN AWARD therapy for members of Bluestone
Subsidised onsite counsellors Fitness in the East Midlands in 2018 and
have completed just over 100 sessions
offered to gym-goers with 17 clients.
Bluestone Fitness won the National
A talking therapy service set up in
a private health club by a UKCP
and BACP member is cited as one of the
Fitness award for National Gym of the
Year, with the judge saying: ‘Their final
winning formula is their attention to counsellors work onsite. This is the
reasons the club won a National Gym of mental health through creating Bluestone boldest move on mental health within a
the Year award. Counselling Trust where two registered fitness centre I have seen so far.’
New Psychotherapist / Summer 2020
Reviews
Psychotherapists review new and recent work in their own fields,
and recommend essential additions to your bookshelves
This too shall pass: Stories of change,
crisis and hopeful beginnings
J ulia Samuel courageously uses her
book as a platform to bring forth
Samuel separates the book
into chapters: family,
her lived experience of transitioning to relationships, love, work,
change. She brings her experiences to the health and identity. This
reader’s attention early on in the book, clearly allows the reader to
which allows them to understand that make sense of her way of Details
this is not just a book about her clients, it thinking in relation to stages Reviewed by Aviva Keren Barnett,
is also about herself. of life and the transitions that existential psychotherapist, clinical
In this book Samuel illustrates her are within. supervisor and international lecturer
ability as a psychotherapist to face She stresses the importance Author Julia Samuel
‘uncomfortable truths’, as she puts it, for us the reader to see how Publisher Penguin
with her clients. Samuel urges the reader different people have navigated Price £14.99
to ‘accept the pain of change’ in order to difficult times and that through ISBN 9780241348864
move through it onto better times. She her therapy with these people
wrote this book with the sole intention she acknowledges that ‘talking
10
of examining the reason why people feel and being heard’ have helped.
ill-equipped to deal with change. She I highly recommend this
uses case examples of her clients who go book for trainee
through the transition of different life psychotherapists to read
stages such as emerging into adulthood before starting their work with
from university, settling down and clients, as it importantly
having children, entering menopause illustrates the different life
and retirement. events that could occur.
PODCASTS WE’RE LISTENING TO
THE RICHARD the media and how it feeds the moral Resistance will only generate Details
NICHOLLS PODCAST: panic through generating fear. fear and anger. The bottom line is Reviewed by Sunita Rani,
EPISODE 175: ANXIETY Though Nicholls stresses that that there are many things out of our trainee psychotherapist
OF THE UNKNOWN negativity bias is an inbuilt human control, but we can voice our opinions Creator Richard Nicholls
response we need to keep us safe, in a respectful manner, then let them Address Richardnicholls.net
We are in times of uncertainty like he does offer advice on how we can go. The very opposite of the Brexit
never before. With Brexit looming, begin to face the growing problem of process over the past four years.
psychotherapist Nicholls discusses anxiety. ‘I’ll deal with it, it’ll be alright’ Perhaps the ‘anxiety of the
Brexit uncertainty to illustrate his is chanted almost like a mantra. unknown’ is a modern phenomenon,
point in this podcast. He emphasises Nicholls states that life changes a way we have come to survive these
the lack of control we truly have over and we have to have faith we will be challenging times. I applaud Nicholls
our lives and that maybe Brexit has OK. As humans we love familiarity but for offering sane advice that we may
heightened our awareness of this. have to take risks to make life better. not like: own our processes and take
He highlights the exploitative role of They may not always pay off. responsibility.
New Psychotherapist / Summer 2020Reviews
The State of Disbelief: A story
of death, love and forgetting
F ive years ago, Juliet Rosenfeld,
then aged 46, a mother of two and
a psychotherapist, lost her husband,
of grief into mourning. She
questions whether grief can be
a process the bereaved can work
aged 52, to lung cancer. This book gives through, suggesting there is no
a poignant account of her experience of agency in grief, only that it has
bereavement and the effect of the loss of to be endured.
Details her husband on her mind, underpinned The book offers a moving
Reviewed by Tatum White, by the theoretical framework of her portrayal of how hard it can be to
psychotherapist psychoanalytical training. talk with loved ones about death.
Author Juliet Rosenfeld Rosenfeld distinguishes the two very It is also very much a book about
Publisher Short Books different states that grief and mourning life, love, hope and resilience
Price £12.99 entail. In her grief, Rosenfeld turns to and what it means to be human.
ISBN 9781780723792 Freud’s Mourning and Melancholia, to Accessible and insightful, it will
help her make sense of her feelings; be useful for anyone who has
the trauma of loss that occurs at the faced loss. For those recently
moment of death and afterwards, what bereaved it may offer consolation
she refers to as grief, and the evolution that grief can be survived.
11
How Psychotherapy Helps Us
Understand Sexual Relationships:
Insights from the Consulting Room
B y being willing to go where others
may fear to tread, Cherry Potter
has written a valuable book about
approach to her clients’ stories
ensures we always see the
human behind their complex,
how psychotherapy can help us to often destructive choices
understand the often deeply complex around sexual relationships.
world of sexual relationships. Potter doesn’t sugar-coat her
Unsurprisingly, the spirit of Freud case studies and it seems Details
permeates, but Potter’s invocation of only right that the range of Reviewed by Nick Campion,
his theories is measured and critical, outcomes she describes reflects trainee psychotherapist
using them as a jumping-off point the reality of working in this Author Cherry Potter
rather than adhering strictly to some challenging arena. Publisher Routledge
of his arguably arcane beliefs. Other The only mild criticism I could Price £16.99
theorists to feature include Melanie make of this book is that it ISBN 9780367177812
Klein, Ronald Fairbairn and John appears to be trying to address
Bowlby. The author sets the theoretical such a wide range of audiences.
context first, then focuses mainly on I wanted deeper exploration of
clients’ stories which she unpicks, the theory and obvious expertise
applying the aforementioned theory. that underpins Potter’s work. A
Potter’s easy writing style makes this weightier tome for therapists and
a very readable book despite its weighty trainees would be an important
subject matter, and her compassionate addition to the canon.
New Psychotherapist / Summer 2020Reviews
Have your say
Tell us what you think
of this issue. Email
editor@ukcp.org.uk
Supervision for Mental Health Care
I was very eager to get on with this
small but mighty publication from
the Foundation of Mental Health
developments in the history
of clinical supervision
within health care and its
Practice series. As a supervisor in functions. What brings life
training I was interested in how to this text are the figures
colleagues from other than systemic presenting working models,
approaches discuss and educate on the exercises and reflective
supervision within mental health care. activities, as well as
Both Paul Cassedy and Maureen examples from practice,
Details
Anderson manage to co-author a small appearing throughout the Reviewed by Kinga Sylwestrzak,
compendium on clinical supervision whole publication. It gets systemic and family psychotherapist
which will be suitable for student and more interesting with and systemic supervisor in training
newly qualified practitioners, but also as reading. Author Paul Cassedy and
a refresher for more senior and This book can be read Maureen Anderson
experienced staff who engage in front to back, or just by Publisher Routledge
supervision as supervisees or picking a chapter for the Price £24.99
supervisors. specific interest covered, ISBN 9781352007558
Although this book is predominantly without losing coherence or
addressed to supervisees, which would feeling fragmented or
12
be my only critical point since it’s not confused. The authors
indicated in the title, as an emerging clearly talk from experience,
supervisor I still found this book useful. supporting supervisees to
The content of the book is clearly take the most out of the
structured and addresses essential professional and personal
issues related to clinical supervision. developmental opportunities
The first three chapters ‘warm up’ the clinical supervision can
reader and introduce significant bring forth to them.
PODCASTS WE’RE LISTENING TO
WHERE SHOULD WE format allows listeners to hear details their problems. In Perel’s words: ‘I want Details
BEGIN? WITH ESTHER of others’ love lives without feeling [people] to leave with a different story, Reviewed by Kirsten
PEREL distastefully voyeuristic. as that is what breeds hope.’ Bickford, psychodynamic
Each episode consists of an The breadth of characters provide therapist
Infidelity, trauma, sexual compatibility unscripted session, recorded with a flashes of recognition and self- Creator Esther Perel
– or lack of it. Such issues present day- real couple in Perel’s psychotherapy reflection, which make for a rewarding Address estherperel.com/
to-day dilemmas in the therapy room; practice, edited from three hours listening experience. How does Perel podcast
it is Esther Perel’s unique approach to 45 minutes. Perel is alert to get around the confidentiality clause?
to dissecting them which has brought deeply held fears that can cramp The volunteers all responded to a call-
her global recognition. Perel was a communication, as the complexities of out for couples who wanted therapy,
best-selling author and polished public modern relationships wrangle beneath the trade-off being that their session
speaker before her foray into the thinly veiled disfunctionality. Her style would be recorded for the podcast,
podcasting world: Where Should We is creative, intuitive and, at times, light though names and some identifying
Begin? is now in its third series. The hearted, as she guides couples through characteristics have been removed.
New Psychotherapist / Summer 2020Feedback
We want to hear your stories, news and views, so please get in touch
ACEs and women in prison The origins
of the ACEs
T hank you for highlighting
the huge importance of
Adverse Childhood Experiences.
prison is the greatest indicator of
a child going to prison themselves.
There is much to think about but
movement
For more than 20 years I have
run weekly therapy groups for
pregnant women as well as
the saddest part is that the highly
expensive prison system costs so
much money that should be put
I wanted to thank New
Psychotherapist for the
excellent special ACEs issue.
mothers with their babies in in at the beginning of a child’s life Perhaps I could point out that
prisons called Born Inside. This – not years down the road when the term ‘Adverse Childhood
well-established and respected they go to prison owing to Adverse Experiences’ was actually coined
intervention is not funded by the Childhood Experiences. by John Bowlby in around 1981.
prison system but by the Maria Pamela Windham Stewart, In ‘The origins of attachment
Montessori Institute. psychotherapist. theory’ from A Secure Base (1988),
Being pregnant in prison can For more, see Spotlight, p48 Bowlby wrote: ‘Thus adverse
be a great motivator for psychic childhood experiences have
change. Prison can provide a effects of at least two kinds.
unique opportunity to work with First, they make the individual
women often way beyond the ‘Being pregnant more vulnerable to later adverse
reach of therapy in the community. experiences. Second they make it
Over the years we have noticed in prison can be more likely that he or she will meet
13
the high impact of having a parent a great motivator with further such experiences.
in prison on the current prison Whereas the earlier adverse
population. Indeed, research
for psychic experiences are likely to be wholly
indicates that having a parent in change’ independent of the agency of the
individual concerned, the later ones
are likely to be the consequences
of his or her own actions, actions
that spring from those disturbances
of personality to which the earlier
experiences have given rise.’
In his revealing final interview
in early 1990, John Bowlby honestly
admits and regrets his ignorance of
child abuse: ‘I was totally unaware
of physical abuse until 1960. I was
really unaware of sexual abuse
until about 10 or 15 years ago.’ Had
Bowlby lived a few years longer he
would have seen that the novel
ACEs Movement was founded on
the recognition of the link between
childhood sexual abuse and the
tendency to obesity. I don’t think he
would have been surprised.
I think it is important to own the
British part of the ACEs story.
Simon Partridge,
co-chair, London ACEs Hub,
‘The challenge of adversity’, New Psychotherapist, Spring 2020, looked at ACEs simonpartridge846@btinternet.com
New Psychotherapist / Summer 2020The Big Report Mental health stigma
TRIAL BY MEDIA
DESPITE SOME CLAIMS TO GREATER SENSITIVITY AROUND MENTAL
HEALTH ISSUES, MUCH POPULAR REPORTING STILL CONFLATES MENTAL
ILLNESS WITH CRIMINALITY, WRITES RADHIKA HOLMSTRÖM
‘N
HS trust fined after nurse are complex. ‘Those in contact with ‘Mind over Matter’, a collaboration which
killed by mental patient’ (The the [system] come predominantly from examines the way that the UK print media
Times, 5 May 2005). ‘1,200 communities that are badly affected by reports mental illness. Three years ago,
killed by mental patients’ (The Sun, 5 health inequalities. For example they in 2017, it found that for the first time
14
April 2016). ‘Paranoid schizophrenic present with higher levels of need with since the study started in 2008 there
who killed three had been arrested respect to mental health, substance were significantly more anti-stigmatising
for attacking farmer just days before, misuse and blood-borne viruses,’ says articles (50%) than stigmatising (35%)
it emerges’ (Telegraph, 2 December the charity and agency Revolving Doors, articles in its sample of articles on mental
2019). ‘Mentally ill patients killed 96 which seeks to break the cycle of mental illness from 27 local and national UK
in London over eight years, say trusts’ ill-health, drug and alcohol abuse, crime, newspapers, on two randomly selected
(BBC, 8 October 2013). homelessness and domestic violence. days of each month during 20164.
In reality, people with mental health There is a far higher proportion of mental A more rigorous study the same year
issues are much more likely to be the health problems in the prison population came to similar conclusions. Marian Chen
victims of crime than people in the than in the general one3. But it goes and Steven Lawrie of the University of
general population: for example, 45% of without saying that it’s wrong to assume Edinburgh looked at nearly 1,000 articles
people with a serious mental illness were from this that mental illness = criminality on mental and physical health, taken from
the victims of crime over a 12-month – and that the headlines above are far nine UK newspapers surveyed over a four-
period, according to mental health charity from the whole story, or even, in many week period – repeating a survey they did
Mind’s 2013 At risk yet dismissed report1. cases, the accurate story. 15 years before using the same methods.
The campaigning coalition Time to Change Why are popular print and broadcast Out of the 200 articles on mental health,
is even more robust, stating that ‘the media reports so different from this over half were ‘negative in tone’ and 18.5%
majority of violent crimes and homicides reality? And what is psychotherapy’s suggested an association with violence.
are committed by people who do not have role in working with journalists to shift However, importantly, patients with
mental health problems’; that ‘the statistics reporting of mental health issues away mental health problems were quoted
data do not support the sensationalised from stigmatising and conflating with directly in nearly a quarter of these stories
media coverage about the danger that criminality towards more accurate, (22.5%, as opposed to 19.7% of people with
people with mental health problems responsible and solutions-focused physical health issues) and the stories also
present to the community’; and that journalism? discussed treatment and/or rehabilitation.
‘contrary to popular belief, the incidence The authors concluded that, ‘Mental health
of homicide committed by people with THE LANGUAGE in print media remains tainted by themes
Illustrations: Dave Bain
mental health problems has stayed at a It’s fair to say that the landscape is of violence [but] some improvement in
fairly constant level since the 1990s’2. changing. Time to Change and the reporting in recent years is evident, in
The connections between mental Institute of Psychiatry, Psychology & particular by providing a voice for people
health and the criminal justice system Neuroscience, King’s College London, run with mental illness’5.
New Psychotherapist / Summer 202015
Report / Mental health stigma
THE REPORTERS’ REALITY
Most journalists have no training in mental health
issues, or how to report them, before they’re
confronted with a story they need to cover. ‘Mental
health doesn’t tend to be part of a course even when
it’s taught formally,’ says Andy Cottom, UKCP vice
chair, who worked in TV news and documentaries
before becoming a psychotherapist. ‘I’ve taught and
I’ve been an external examiner, but I’ve never seen
it considered as a separate element,’ says Rosalind
Coward, Emeritus Professor of Journalism at
Roehampton University. ‘Some students have touched
on the subject, but it’s something that ought to be more
integrated formally into courses, because it’s a huge
issue.’
What they are trained in is wanting a story: and
a story that’s coherent, that is either news or has
a newsy ‘hook’. ‘Programmes are curated: there’s a
choice over what is used and what is left out,’ Cottom
explains. ‘News very rarely gives the opportunity for
nuance. At the end of the day, it’s to get ratings.’ Gavin
Rees, who is the director of the Dart Centre Europe,
puts it equally bluntly: ‘Certain things sell and there’s
likely to be a focus on negative things because that
news is urgent.’ The reason why the pressure from
many organisations to get ‘good news stories’ across is
16
so likely to fail is because without a striking new hook,
good news stories mostly come across as well meaning
but irrelevant.
Psychotherapist and former journalist Mark Brayne a traumatised background. This intelligent, educated
was director of the Dart Centre Europe between 2002 colleague absolutely could not get that these boys
and 2008, and set up the BBC’s project of Journalism were not inherently evil. It’s not the responsibility of
and Trauma in 2002, following his own experience the media alone. It’s a kind of collective unconscious.
of distress as a journalist. He was working at the BBC There is a fundamental shared understanding about
World Service in 1993 when three-year-old James the terms of reference for how we approach anything,
Bulger was murdered by two 10-year-olds, Robert from the murder of a little boy to climate change. To
Thomson and Jon Venables. ‘You couldn’t sell a understand it, human beings get caught up in a kind
headline saying “the story is very complex”. At editorial of “spell”, a shared understanding of how the world
meetings, stories feed into the need for “othering”. The works, and are impervious to presenting a story in its
media reflects the society we live in, too. I remember true complexity.’
trying to help a colleague understand that the boys
who’d committed the murder would have come from FROM JUDGEMENT TO CLICKS
What’s more, the context for all media reporting has
changed dramatically since the Bulger story (see feature,
page 20). ‘The concept of online news judgement, that
is held by journalists, is completely overtaken and
overruled by the audience, which acts as gatekeeper
‘News very rarely through clicks,’ says UKCP chief executive Sarah
Niblock. Psychotherapist John-Paul Davies takes a step
gives the opportunity back to look at how this interacts with consumers’
demands: ‘The reports feed an appetite which is
for nuance. At the unhelpful, and by feeding that we become more
end of the day, it’s angry. We are safety-seeking, we’re always scanning
the environment. Our human nature has shaped that
to get ratings’ kind of media. Mainstream media are competing with
websites that can show videos that are incredibly
New Psychotherapist / Summer 2020Report / Mental health stigma
‘General reporting is
oversimplifying some
very complex issues
and that creates a real
dilemma in how mental
health is explored’
reporting, and there is of course considerable space for
improving, but it’s not fair to say that coverage across
the board is unreliable.’
MENTAL HEALTH IN MANY GUISES
And as Rees says, and as the studies from Time to
Change and the University of Edinburgh attest, the
scare stories aren’t the only ones. ‘We tend to lump the
media into one big box when we are living in times
when there are limitless media forms. In the reporting
of crime, there persists the repeated suggestion
of causal connections between mental health and
offending, but there’s also the exponential growth of
17
first-person pieces by royalty, footballers and other
VIPs,’ Niblock points out. Davies makes a distinction
between magazines/journals and news media. ‘I
graphic and frightening. They’re businesses.’ regularly contribute to Healthy for Men. They’re very
In that context, there is even less room for interested, but they’re more interested in things like
nuance: and more pressure to link mental health and depression and anxiety.’
criminality. ‘General reporting is oversimplifying ‘Some of the ways in which mental health is
some very complex issues and that creates a real represented mean that it is becoming slightly difficult
dilemma in how mental health is explored,’ says to work out what it’s about,’ says Coward. ‘There are
psychotherapist and lecturer at the University of so many young influencers and celebrities, almost
Exeter, Hannah Sherbersky. ‘There’s a tendency to rushing to declare themselves to have mental health
say someone is mentally ill rather than thinking in a issues, but there’s a curious disconnection; you don’t
different way,’ Cottom adds. ‘People are criminal for feel that understanding has come on much. It’s
very understandable reasons but we explain it away probably helped raise awareness of eating disorders,
by saying they are ill, rather than struggling. We like for instance, but it doesn’t seem to be making a major
putting things in pigeon holes.’ difference in how society as a whole is responding.’
However, several practitioners point out that not all ‘There doesn’t seem to be much distinction between
conditions are stigmatised. ‘It tends to be psychosis PMT, long-term can’t-get-out-of-bed and schizophrenia,’
and schizophrenia, and I think it’s because we’re more adds Cottom. ‘If they come under the broad construct
fearful,’ Cottom says. ‘If people believe someone could of mental health they’re going to mean different things
harm others, that’s frightening and if in newspapers to every reader. And then learning disabilities, ADHD,
those conditions get attached to criminal behaviour, autism and Alzheimer’s are added in too – which
that’ll increase the link.’ And Rees, in fact, is ‘not sure encourages a medical symptom-diagnosis-cure that
it’s automatically true. Certainly there is irresponsible isn’t what psychotherapy is about.’
reporting out there; but there is a broader issue to do Some practitioners also feel that the coverage
with how the public see those kind of stories, and the influences clients or potential clients, either positively
cultural archetypes they react to. It’s useful to make or negatively. On the one hand, Cottom feels it puts off
a distinction between news and lengthier feature men, in particular. ‘The sort of men who are struggling
writing which has the opportunity to go into the with emotions rarely talk about them, and mix up
context. There are cases of sloppy and mendacious shame/anger/fear/hurt – it’s rarely verbalised. If the
New Psychotherapist / Summer 2020References and reading
(1) mind.org.uk/media/642011/At-risk-
yet-dismissed-report.pdf
(2) time-to-change.org.uk/media-
centre/responsible-reporting/violence-
mental-health-problems
(3) prisonreformtrust.org.uk/
WhatWeDo/Projectsresearch/
Mentalhealth
(4) time-to-change.org.uk/news/
first-time-print-media-reporting-mental-
health-significantly-more-balanced-
and-responsible-more
(5) ncbi.nlm.nih.gov/pmc/articles/
PMC5709678/
others. If the question is how can people
who are psychotherapists reach out to
people in the media to share their own
and their clients’ experiences, that has
to be through a dialogue that is based
on curiosity and mutual respect. There’s
a public communication part to this
that operates at a higher policy level,
in which it’s useful for people who’re
representing professional organisations
18
to speak the language of stakeholder
language that is being used, especially There’s also a role, she feels, for UKCP and policy implementation, but that’s
in broadcasting, says there is something and individual psychotherapists to speak only one way that psychotherapists and
wrong with them they aren’t going to up. ‘It behoves organisations like ours psychiatrists get to speak to society. It’s
talk about their fears.’ On the other hand, to better inform and support journalism worth remembering that many people in
Davies feels it can be a positive. ‘I don’t schools and editors.’ On an individual the media have social and professional
think anxiety is stigmatised. And coverage level, she suggests people ‘call out bad contact with psychotherapists and that
of depression is helpful, in fact, because it practice’ where they see it. ‘Psychotherapy many psychotherapists have friends or
means the type of clients I see are more has such a rich vocabulary and discourse family who work in the media. And there’s
likely to be brought to therapy.’ in what it is to be human. Write in, where also the challenge of taking professional
you feel you can and wish to do so.’ Davies language out of its silo, and using it in a
PROFESSIONAL INTERVENTION takes an even more direct approach. ‘I do way that’s easily understandable to others.’
How can psychotherapists – individually, wish newspaper coverage of conditions Finally, several people point out that
collectively and as a discipline – intervene would always include a comment from the journalists themselves are far from
and, in particular, break the association professionals. It’s been a wonderful thing immune to mental health issues. ‘Given
between mental health issues and crime? for me to combine the client work with that it likely affects one in four in their
There are still big areas to explore, Niblock being able to comment in magazines and own newsroom, it’s important that
believes. ‘Obviously there are a number of newspapers, and there’s certainly a big newsroom managers are ensuring their
questions we might now be asking about appetite in magazines.’ teams have access to CPD and expert
the frustration and confusion the public He adds: ‘There should be sufficient knowledge in this area,’ says Niblock. It
has with the media. There’s an urgent funding for research and investment in may or may not enable them to correct
need for research into effects of the use experts to support journalism trainers the stigma that persists, but it might
of media on our mental wellbeing. Stories to better educate the next generation of also lead them to a direct experience of
like the death of Caroline Flack have been reporters on mental health.’ psychotherapy, and all that the discipline
interesting because there have been so Rees, again, takes a nuanced view. can offer them.
many questions, particularly pointing the ‘I think being a psychotherapist gives
finger at the press. Whether it’s the case or one a useful viewpoint but not a uniquely What do you think?
not that the media have a direct impact on privileged one. It’s a danger for anyone, Share your thoughts and
mental health, there certainly needs to be a including journalists, to assume that their opinions by emailing:
deeper conversation.’ professional perspective transcends all editor@ukcp.org.uk
New Psychotherapist / Summer 2020The Big Report Compassion fatigue
20
C A R I NG
T O O M UC H ?
HOW DOES THE ENDLESS IMPACT OF ‘BAD NEWS’
AFFECT PEOPLE AND HOW CAN PSYCHOTHERAPISTS
INTERVENE IN THIS? BY RADHIKA HOLMSTRÖMReport / Compassion fatigue
W hen you’re sent off to a
war zone, you don’t know
what is going to happen
to you and how you may
react,’ says UKCP vice
chair, psychotherapist and
former broadcast journalist
Andy Cottom. ‘You have to
maintain your professional eye and also maintain
your humanity; you have to protect yourself
against the stench of rotting corpses. You do that
eco-anxiety experienced following images and news
about climate change. Borne out of the conference,
speaker, journalist and activist Emma Marris (see
box, overleaf ) wrote an article in the New York Times
entitled, ‘How to stop freaking out and tackle climate
change’, which looked at the effects – along with a five-
step plan to deal with the stress brought on by news
reports regarding climate change.
LABELS AND SYNDROMES
‘Negative thoughts are particularly tenacious, and
by becoming to a certain extent automata. The big the next thoughts people reach for are likely to be
problem is when you come back to the world and negative, so the risk is that people find themselves
that is where psychotherapy can help you recognise tipping into a spiral, with all sorts of unexpected
that your “compassion fatigue” is the defence.’ consequences for themselves,’ says Gavin Rees,
Cottom’s experience is one that many people who is the director of the Dart Centre Europe. Rees
21
working in areas affected by conflict or famine will does, however, question terming this ‘disaster’ or
recognise. It’s also an experience that healthcare ‘compassion’ fatigue. ‘It’s clear that negative material
professionals and others caring for those acutely ill has an impact, and material that makes people
with Covid-19 are going through. Compassion fatigue feel threatened is likely to contract their sense of
(sometimes known as disaster fatigue) was defined by agency and hope in an alternative reality, but I’m
psychologist Charles Figley as ‘a state of exhaustion not sure it is a syndrome. One of the dangers of
and dysfunction, biologically, physiologically and working in psychotherapy is tipping arresting labels
emotionally, as a result of prolonged exposure into syndromes, as if they have a concrete medical
to compassion stress’. It affects journalists (the existence; and also, the different related concepts all
Dart Center for Journalism & Trauma was set up come from distinctly different places but often get
specifically to tackle this), aid workers, doctors, swapped around as if they’re the same thing.’
interpreters… the list goes on. But what about the He adds: ‘People who operate with compassion-
people who are also consuming that news, either focused methodologies in trauma treatment often
through the now 24-hour news media or through
social media? How does the constant saturation of
images showing the details of cruelty and/or disasters ‘There are
affect the people who read and/or see them?
Those of us who aren’t key workers are in the midst fears that good
of experiencing this alongside the massive changes
to our daily lives in the lockdown. Guidance from the
content is being
NHS suggests reducing our intake of news and social drowned out by
media to avoid the anxiety and depression wrought
by absorbing unrelenting stories of daily death tolls, disinformation
plunging stock markets, and pressure on the NHS,
during the Covid-19 pandemic.1 This is likely difficult
and marketing-
at the moment when so many of us are relying on based products’
these sources to clarify information in a rapidly
changing situation.
UKCP’s recent conference, ‘Sleepwalking into the
Anthropocene’, highlighted the growing problem of
New Psychotherapist / Summer 2020Report / Compassion fatigue
have reservations about compassion fatigue, because their way convince yourself you can’t get that deeply involved because
of looking at it is that compassion isn’t something you run out you have to protect yourself. I’ve always wondered about the
of: people are more likely to get into difficulties because of fatigue in that it has required us to do something deadening
insufficient compassion, not a surfeit of it.’ to ourselves, in order to protect ourselves. That, for me, is the
Whatever the terminology, others do feel it can be a useful damaging thing.’
framework. ‘I see a lot of anxiety,’ says psychotherapist John-
Paul Davies. ‘I am curious: is it compassion we get tired of, or MEDIA PLAYERS
feeling angry and frightened? Feeling sad all the time is also Media reporting has also changed since the days of Hillsborough
about empathy. Caring about others and the world is a sign of or the Zeebrugge ferry disaster. In those days it was still a matter
being psychologically healthy, though while we’re doing that we of a daily paper and regular news updates on the radio and TV.
can’t enjoy our present moment. But where do we draw the line Today it is literally non-stop: every newspaper is online, in addition
between the distress of billions, in our waking day? I can also see to the news websites and – very importantly – social media. ‘After
why people get frightened and cut off. I don’t think the threat the Grenfell fire, I read a lot about the young woman who was an
part of us distinguishes between what we can control and what artist, and what happened to her in the course of the evening. Most
we can get worried about while living the rest of our lives as well. I of those details weren’t picked up from the normal reporting but
think that’s where the fatigue comes from.’ more people were telling her story outside the media,’ Coward says.
Professor Rosalind Coward, who has a longstanding track Indeed, there is now a huge overlap between ‘real’, professional
record as an academic and journalist, adds: ‘I think people can be reportage, phone video footage taken by passers-by and tweets;
genuinely traumatised by media coverage of disasters. Part of the journalism students are in fact taught to look at Twitter feeds
time we can keep a distance and understand what is happening, as a tool for news-gathering, and online coverage frequently
and reassemble ourselves, but some disasters really get to us. incorporates non-professional social media. At the same time,
I always think people have a “defining disaster”. For me, it was social media constantly circulates articles tailored to each
Hillsborough. I remember being traumatised by the coverage, consumer’s interests, both through the outputs’ own analytics and
of seeing people squashed up and clearly asphyxiated. If you through users sharing stories. ‘Most of us are walking around with
allowed yourself to identify and empathise and find out about “micro post-traumatic syndrome” (as Jamie Wheal terms it), caused
22
those people, you can be traumatised. And if that happens quite by the amount of information we encounter,’ says psychotherapist
a few times in a row, in order just to survive you have to distance Catherine Knibbs. ‘I see difficulties in clients aged up to their
yourself, do something about your empathy. You’re constantly seventies, who’re experiencing anxiety because they see so much
seeing things that actually are traumatic, and you have to negative news and don’t know how to change their settings.’
The growth of social media, and of what is termed ‘citizen’ (non-
professional) journalism, has been paralleled by a collapse in local
journalism. A few decades ago, each main area in the UK had
at least one local paper, often staffed by highly experienced and
knowledgeable journalists who knew their ‘patch’ intimately and
were part of the local community themselves. Today, many of those
papers have shut; between 2005 and 2018 nearly 250 titles closed
Climate change down2. At least one study has pointed to a ‘democracy deficit’ and
a drop in community engagement as a result3. Cottom agrees: ‘I
EMMA MARRIS ON THE ROLE do think local papers used to bind us together. Journalism at its
OF PSYCHOTHERAPISTS best makes us feel part of a human world and local papers used
to be full of good news as well, about how the local school was
‘I’ve been thinking solve climate change doing things and so on. These days all we get are celebrities.’
about this a lot. I think themselves – will be ‘What’s different now to when I worked on news desks or
psychotherapists can help helpful. So many people trained journalists is that online news brands dominate,’ points
clients reorient away from judge themselves out UKCP chief executive Sarah Niblock, who trained and worked
their personal feelings of constantly for the as a journalist for years. ‘Their news values are different to those
guilt, fear and grief to find ecological sins and I think of print. They’re determined by clicks. Old-school judgment is
groups to become active this is extremely counter- now secondary to audience hits, and we are now reading the
with. Indeed, in that productive. Those clients media in a world where branding, target audience and emotion
sense, collective groups didn’t design the system are driving the news judgement and the values of the coverage –
are a form of therapy. within which they live whether this is of climate change or a terrorist’s actions. Emotion
‘I do think setting and they should be able is the main criterion for selecting a story: because it is universal
before clients the facts to forgive themselves if and affects all regardless of socio-economic background,
of the matter – that they have to live in it to purchasing preferences, age, gender and so on. It’s a win-win
they are never going to participate in the world.’ way of getting hits which helps attract advertising revenue.
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