Fear

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Posts exploring how fear shapes our public policies and everyday choices.

How not to judge families sitting beside you in the cafe

How not to judge families sitting beside you in the cafe

I spend most of my time these days thinking about how we, as a society, get information to parents about infant brain development.  ‘Brain development’ isn’t the right terminology, though.  The English language doesn’t have a word for what I mean.  I mean something more like the intersection of brain and body, self-awareness and self-regulation, anxiety and comfort, and the way that relationships underlie the development of all these systems.  That’s the most crucial point for parents to understand: relationships matter.

Our Western society does not begin to comprehend the importance of relationships for children’s development.  Our modern way of life damages our children – and ourselves – in ways we don’t realise.  It happens without our intending or being aware of it.  It happens because we are increasingly cut off from one another and from ourselves, even from our own bodies.  We end up surviving, rather than thriving.

Let me tell a story to illustrate what I mean.

I was sitting in a café last week, watching a family who had come in to have a meal.  Mum pushed the baby in his buggy, about 18 months old, over to a table.  Dad, Mum, and Big Sister put down their bags and coats.  The three of them went over to the counter to choose drinks and food, leaving the baby parked beside the table. 

The baby immediately got agitated, wriggling and holding out his hands toward them, scrunching his face, and protesting very quietly.  They didn’t notice, though, because their backs were to him, while they read the menu at the counter.  Plus, they will have believed him to be safe, strapped into his stroller and parked near their things at the table.

As minutes passed, the baby’s arm movements and face got more frantic.  His cries did not get louder, though; they stayed consistent and pleading, in their rhythm and tone.  I found myself getting agitated.  His family couldn’t see or hear him.  He needed help to get their attention. 

So I tried a technique that sometimes helps solve things, when a baby is in need and parents are distracted.  I like it because the parents don’t feel offended or blamed.  I simply said to the baby, in an empathic voice loud enough for his parents to hear, “Oh, are you feeling lonely?  Are you missing your Mummy over there?  She’ll be back in a minute.” 

My brief interjection helped Mum to turn around and realise her baby was needing her.  She smiled at me as she came back to the table, and I smiled back at her.  As she neared their table, the baby’s arms quit waving so frantically, and he relaxed a tiny bit, although his arms remained up in the air, as if he was hoping to be picked up.

That made sense to me.  He’d been missing her, far across the room in this unfamiliar place, so stress hormones like cortisol would have been rising.  His brain and body would instinctively have been craving a cuddle, since the reassurance would have brought the cortisol levels down.  Oxytocin would have been boosted too, by her touch, and that would have relaxed him even more.

However, a cuddle is not what happened.  Instead, Mum reached for the handle of the stroller, and moved it back and forth, trying to comfort him by the swaying of the buggy.  I knew that wouldn’t work fully for him, because the swaying of your buggy isn’t the same as the warmth of your mum’s hug.  But I didn’t know how to help the baby this time.  No parent wants an interfering busybody of a stranger telling them how to care for their own child. 

But the baby was still distressed.  His low-level cries of protest continued; his face scrunched; his head hung down in a kind of defeat.  Mum continued to ‘rock’ the stroller with one hand, leaving her other hand free to adjust the coats.  She was now focused on making space at the table, and so she wasn’t looking at his face any longer.  He had neither her gaze nor her touch to draw on for comfort. 

Watching all this, I found myself thinking that her physical closeness would be helping him feel somewhat safer.  The cortisol in his system should at least be levelling off, rather than rising higher.  His overall state wouldn’t change rapidly, though.  Cortisol stays in your system for at least 20 minutes – which is why reassuring touch in this situation is so helpful.  Cuddles kick-start the decrease.

Very soon, Dad and Big Sister came over to the table, having made their choices.  I wondered if the baby might now get a cuddle, or even a hand-hold, since there were more hands available.  This seemed hopeful, because his distress hadn’t ceased.  He was still quietly moaning and looking at the ground.

Let me pause in the midst of my storytelling.  Before I go on, I want to consider what might be happening for you, Dear Reader.  If I am telling this story vividly enough and compassionately enough, then maybe you will be feeling something of the anxiety I was feeling for that baby.

If he can’t get the comforting attention he needs from his family, then he has a problem.  At only 18 months old, his brain is still too immature to fully comfort himself when he is distressed, so he has to look to an outside source for that comfort.  Right there, in that café, in that very ordinary moment, he is learning lessons about where comfort comes from.  It isn’t from his family.

Perhaps, in order to cope with your anxiety for the baby, you might be feeling frustrated with the parents.  Why aren’t they giving him the attention he needs?  That reaction of frustration or exasperation or even anger makes sense to me, because these emotions signal that a situation we are witnessing requires some sort of action.  The trouble is that these emotions easily lead to judgement, and judgement is everywhere these days when it comes to parenting.  Modern parents live with the constant anxiety of being judged harshly.

Consider, for instance, what recently happened to political correspondent Robert Kelly, when was he “interrupted” by his two young children while giving a live television interview to the BBC from his office at home.  His spontaneous response, along with that of his panicked wife (or perhaps nanny – the internet can’t decide), solicited all sorts of criticism from observers.  Commentators on social media began arguing with each other over what response would have been most appropriate, and even the couple’s use of a baby walker was criticised.  My own response was to wonder how I would have reacted as a parent, handling such an unexpected, personally exposing situation, being broadcast live on international television.

So, returning to my story, what happens if we counter any rising sense of judgement with curiosity?  What happens if we wonder what was going on in that moment that kept this little boy’s parents from noticing his distress?  Were public places uncomfortable for them? Had they had to walk a long way in the cold?

What happens if we expand our curiosity even further and wonder what might have happened for them within the last hour or earlier in the day or within their general family interactions?  Had they just had an argument or come from a difficult doctor’s appointment?  Was Mum suffering postnatal depression?  Were they on the edge of divorce?  Did they believe that electronic devices help young children to learn?

And what happens if I search for the words that help this story to prompt curiosity in readers, rather than judgement or anger or blame?  Here are a set of ordinary parents, busy and tired and distracted by the tasks of modern life.  They probably have no idea how scared babies can get, parked far away across the café in a stroller, or that cuddles have a biological impact on a child’s brain.

In that case, how would it be helpful to them if I were to get frustrated about something they did unintentionally?  My curiosity will be more helpful than my frustration could ever be.

And, as it turns out, curiosity is going to be incredibly important for all of us, if we are to reach the end of this story in a compassionate place.  Because it’s about to get worse.

The whole family is now at the table, with Dad sitting next to the baby.  Mum and Big Sister are across the table, stretching out, having taken off the last of their coats.  The baby, though, is still strapped into his stroller, unable to stretch out or shift his posture.  His low level protest cries haven’t stopped, either.  His head is still hanging down, moving slowly back and forth in a restless fashion.

Dad must have noticed though, because he moves to offer the baby a kind of comfort.  He reaches into a bag and brings out a phone.  He hits a couple of buttons, and hands it to the baby.  It must be playing a video.

Sure enough, the baby’s whimpering stops, his head comes up, and his hands cease moving as they grasp the phone.  His agitation fades almost immediately.  He is intensely focused on the display on that phone.

I imagine that the father thinks he has comforted his child.  Outwardly, he does appear calmer and happier. 

As I watch the child’s fierce concentration, though, I think of the dopamine being sparked in his brain.  Dopamine is the hormone of novelty.  We human beings crave it.  It’s the feel good factor.  Dopamine is what gets triggered when we fall in love.  Our brains and bodies yearn for it.  We get addicted to it.

I knew I was watching a father comfort his son’s distress by fostering a biological addiction to technology.

And I knew the father didn’t know that. 

And I knew that when the father would eventually try to take the phone away, the spike in the baby’s disappointment and distress was likely to cause a terrible, wailing conflict – which would further distress everyone in the family. 

And I had no way to explain any of this to them.

Dear Reader, how am I doing? In telling this story, I am trying my best to turn you into a watcher, rather than a reader.  I am trying to have you sit with me in the midst of that café, trying to decide what you would do, how you would feel, what you would think.  I am aiming for that because, of course, we sit down next to ordinary families every day, whenever we walk into cafés.

How do we help ordinary families to understand what science is discovering about children’s development?  How do we help tired parents feel more curious about their baby’s emotional needs?  How do we help them to connect the dots, so that they realise their responses hold long-term, biological consequences for their children?  If this little boy’s brain becomes addicted to the dopamine hit his father’s phone is supplying, the parents will soon have major ‘behavioural issues’ on their hands.  And their little boy will suffer.

The points I am making are not novel ones.  They are part of the reasoning underpinning recommendations by the American Academy of Paediatrics that children under 2 years of age should never view screens alone.  Other organisations have used language shifts to emphasise the biological impacts, arguing that early technology use should be regarded not as an ‘educational’ or ‘cultural’ issue, but as a ‘medical’ one. The author Mary Aiken dedicates several chapters in her new book, The Cyber Effect, to exploring what is happening across our society as children encounter a mismatch between their basic physiological needs and their parents’ technology habits.

I found myself thinking about all this guidance as I watched the final stage of this family’s interactions.  The story doesn’t end happily.

With the baby now (apparently) settled and engaged with the phone, Dad again reached into a bag.  I realised he was taking out his son’s lunch, probably because there was a gap of time available before his own order arrived.  He could feed his son before eating himself.

And that’s what Dad proceeded to do.  He fed his son, spoonful after spoonful of packaged food going into his mouth — while his little boy never took his hands off the phone or his eyes off the display.

The baby didn’t protest.  He didn’t shake his head or refuse.  He passively accepted each spoonful of food the father delivered to his mouth.  His father looked relieved it was going so smoothly.

I knew, though, that this experience meant the baby was not engaged at all with his own body.  He wasn’t developing a conscious awareness of hunger or how to take care of feelings of hunger.  He wasn’t consciously learning about feeling ‘full’ or about ‘relief’ or about ‘companions’.  What he was learning was that you solve uncomfortable feelings with technology. 

The more the baby’s brain experiences that solution, the more the child will be out of touch with his own body.  His internal teddy bear (to use the language I frequently use) will be weaker, less able to comfort him from internal, self-regulatory sources.  He will become more dependent on external sources of comfort, turning to solutions like videos or games or drugs or alcohol or food.  It sounds extreme, to knit these outcomes together, but it is exactly what the research on addiction is teaching us.

I knew I was watching a father nurture an addictive personality within his infant son.  I also knew he had no idea that’s what he was doing.

As I stood to leave the café, 15 minutes later, the rest of the family’s meal was being delivered by the waitress.  Dad could relax.  His son was fed and was engaged in an activity.  He could have his own lunch in peace.

I have no idea what havoc may have descended when it was time for Dad to take the phone away.

That family has clearly stayed with me.  A week on, I’m still thinking about them – and now I’m writing about them, telling their story to a wider world, in the most compassionate way I know.

My hope is that their story, unknown even to themselves, might help other parents feel more curious about what’s going on in their children’s brains and bodies.  And I hope it might help those of us trying to support families, to feel more curious about the unknown struggles going on in parents’ lives.

Curiosity is always more powerful than judgement.

Can attachment needs help explain Trump’s narcissism?

Can attachment needs help explain Trump’s narcissism?

With Donald Trump’s inauguration upon us in a few days’ time, I find myself thinking of Vice President Biden’s comments earlier this month: “Grow up Donald.  Time to be an adult. You’re president.”

That is not going to happen.

Why not?  That is the question that I hear being asked repeatedly:  Why is it that Donald Trump keeps behaving in this aggressive, belligerent, exaggerated manner, especially since he has already won the election?

Trump Press ConferenceThe response to this week’s press conference echoes that sentiment.  Reactions from reporters and citizens alike included statements such as: “Donald Trump is not what he seems”; “The emperor’s new clothes”; “Makes me worried about the future”; “The dark side of Donald Trump’s insatiable need to be liked.”  One particularly extraordinary insight came from reports by Politico and Vox: Trump planted paid staffers at the press conference to clap, giving him not only support but also the “instant gratification” reminiscent of his rallies.

And what about the most recent video by Keith Olbermann, host of the political webshow The Resistance?  In it, Olbermann asks calmly: “What is wrong with this man?”

Narcissism.  That’s the explanation to which a wide range of commentators have now turned, as a way of making sense of Trump’s behaviour.  These include, for a start, Tony SchwartzMichael Moore, Dan McAdams, Daniel WagnerNigel Barber, Alistair Campbell and Henry Alford.  These commentators aren’t talking the ordinary, self-absorbed narcissism that haunts modern life.  They are pointing toward full blown Narcissistic Personality Disorder.

It’s a perfectly plausible claim.  Recent studies have shown that narcissism and psychopathy are more common within the general population than is generally realised.  And amongst which group of people is Narcissistic Personality Disorder particularly common?  CEOs in the corporate world.  Several books on the link have been published, such as Snakes in Suits (2007) and The Good Psychopath’s Guide to Success (2014).  The esteemed business publication Forbes ran an article in 2013 under the title ‘The Disturbing Link Between Psychopathy and Leadership’.

However, there are many people who have never heard of Narcissistic Personality Disorder. They have no idea what it is or how it arises from unmet attachment needs.  So they continue to find Trump’s behaviour baffling.

I thought a piece on this topic to be timely, since Trump is about to be inaugurated into one of the most powerful positions in the world.  Our globe is a scarier place when it is impossible for citizens to predict or interpret a leader’s behaviour.  Fear isn’t good for us.

I’m not partisan in writing this piece.  I hope it will be of help to Trump supporters and detractors alike.  We all need to think more about the ripple effects of mental functioning.  If Donald Trump does have this serious personality disorder, then the two camps have something terribly important in common: the motivation for his actions is not caring for the American people, but is always about his own ego.

What’s Trump said now?

Let’s start with a few reminders of Trump’s recent behaviour.

  • Trump continues to engage in explosive Twitter tirades, often tweeting late at night or early morning.
  • On 13 January, he used the phrase “sleazebag political operatives” in a flurry of angry tweets.
  • TwitterOn 11 January, he referred to himself in third person during a press conference so disjointed that media descriptions have included “a train wreck” and “frequently disingenuous and ugly but compelling.”
  • On 11 January, he used Twitter to accuse the US intelligence services of functioning like those in Nazi Germany.
  • On 9 January, he called Meryl Streep one of the “most overrated actresses in Hollywood”, following her speech criticising his bullying behaviour.
  • On 9 January, the media mogul Rupert Murdoch gained a place on Trump’s list of “great guys”, because “Murdoch likes me much better as a very successful candidate than he ever did as a very successful developer!”
  • On 9 January, Trump told the New York Times that all the dress shops in Washington DC had sold out in eager anticipation of his inauguration – which turned out to be a bit of an overstatement when checked by reporters.
  • RatingsOn 6 January, he referred to himself in a tweet as a “ratings machine”, pointing out that his ratings as host of the television show The Apprentice had “swamped” the first season ratings gained by its new host, Arnold Schwarzenegger.
  • On 4 January, Trump claimed that sales of 16-year-old Jackie Evancho’s albums had “skyrocketed” after her announcement that she would sing at his inauguration ceremony, although an analysis showed that the spike is better explained by the fact her Christmas album was on sale during December.

Members of the public who aren’t yet on Twitter might be wondering on how earth brief social media statements, only 140 characters in length, can matter in the real world.  Yet they absolutely do.  First, we know for sure they come from Trump, not from some political committee who has crafted them on his behalf.  They thus provide first-rate insights into his character.  Second, it is this very personal use of Twitter that his supporters love.  They feel the tweets give them a direct link to him, which would never be possible via the ‘biased media’.

But how does one explain these acts that are not presidential, comments that are so often eccentric and extreme?  We start by realising that, if viewed through the lens of Narcissistic Personality Disorder, their content and tone aren’t unusual.  They are entirely predictable, especially for a man now living outside his natural comfort zone.  Trump has much less control of his world as a politician than he did as a businessman.

What is Narcissistic Personality Disorder?

Most articles discussing Narcissistic Personality Disorder start with a description of its symptoms.  As summarised by Preston Ni, author of the book How to Successfully Handle Narcissists, ten key signs are:

  1. Grandiose personality
  2. Charmer
  3. Rule breaker
  4. Incites negative emotions, especially through tantrums
  5. False image projection
  6. Conversation hoarder
  7. Conversation interrupter
  8. Sense of entitlement
  9. Boundary violator
  10. Manipulates others by using them as an extension of the self

These descriptors give you a chance to decide whether you think they fit Trump’s behaviour.  You can make a judgment as to whether you think it is possible he might have a diagnosable mental disorder, included within the clinical manual DSM-IV and attributable to somewhere between 1% and 6% of the US population.  Amongst corporate leaders, it is believed to be four times that rate.

NarcissismI use the world ‘possible’ above because it is technically impossible to know Trump’s mental health status without examination by a psychiatrist.  The fact that no clinical professional has been given a chance to interview him is one of the reasons we haven’t heard more about Narcissistic Personality Disorder over this election period.  All psychiatrists are prevented by the 1973 ‘Goldwater Rule’ from diagnosing celebrities whom they have not actually examined.  Bodies like the American Psychiatric Association and the UK’s Royal College of Psychiatrists require that their members abide by it, due to the inaccuracy inherently at risk in ‘armchair diagnoses’.

Critics, though, argue that the stakes with Trump are now too high.  What if the President of the United States is pathologically mentally unfit?  Their worry is reasonable, because when it comes to Narcissistic Personality Disorder, the people who end up suffering most are not narcissists themselves.  Instead, it is the people affected by their behaviour.  That would be us, ordinary citizens in countries across the world.

As a research scientist who works with the public, my job is to help make sense of scientific insights on attachment, connection and human relationships.  My aim in doing that is to reduce suffering. I think we deserve access to ideas and information that can assist us in interpreting unsettling behaviour from the next President of the United States of America.  We need to reduce the fear and anxiety floating in the world.

So here’s how I think it is easiest to make sense of Trump’s behaviour: understand what’s driving it.  The answer is: human attachment needs.  At a fundamental level, Trump is no different from the rest of us. Here are two reasons why.

Why Trump is no different from the rest of us

1. We’re all driven by attachment needs.

BelongingLove. Belonging.  Emotional safety.  Human beings have a craving for these things.  They lie at the core of the attachment system.  When I say ‘core’, I really mean that.  These are biological needs.

All mammals seek connection, but it is especially intense for humans.  Our large skulls cause our offspring to be born extra-early, extra-vulnerable and ultra-dependent.  It is our biological attachment system that keeps us alive as babies and that frames our relationships as adults.  When our attachment system is placed under threat, our brains and bodies panic, because we move toward overwhelm.  When the overwhelm gets too intense, it starts to feel like we’re at risk of dying.  Our sense of self is tied up with the unconscious strategies we use to manage occasions on which panic rises.

People with Narcissistic Personality Disorder live with a lot of unconscious panic. Their sense of self is fragile, as a consequence of emotional injuries they suffered early in life.  Their way of coping with that panic is to develop a false self that they can present to the world.  The more grandiose and exalted, the better.  That idealised self-image, projected to the world, keeps them from feeling the overwhelming emotional wounds that gave birth to the inauthentic self in the first place.  As the author Preston Ni puts it, deep down, pathological narcissists feel like the ‘ugly duckling’.  They worry they aren’t good enough, but they don’t want anyone, including themselves, to know it.  A lot of unconscious psychological energy has to go into keeping up the front.  Phew! It’s exhausting just describing it!

So, at a deep human level, the rest of us are just like Donald Trump, and vice versa.  We all want to be loved.

2. We’re all seeking a sense of safety.  Control gives us that safety.

Heather Munro 11We all seek emotional safety.  That’s the aim of our attachment system.  It is always on the look-out for relationship threats that can be spotted on the horizon.  That monitoring is crucial to us as babies, because our immature stress management system renders us totally dependent on summoning people to rescue us from overwhelm.  Overwhelm is frequent in babies’ lives; it rears its head hundreds of times a day.  And it’s not fun.  Remember: once it gets intense, overwhelm feels like impending death.

We gain a sense of safety through having enough control over our environment and other people.  We are our best selves when we feel in control.  If the threat risk has dropped, there is no need to stay on high-alert.  Control = emotional safety = relief = relaxation.

You can see that pattern in Trump’s behaviour.  When he’s at home at his Mar-a-Lago resort in Florida, he is described as relaxed and calm.  At his 2016 New Year’s Eve party, held there, Trump was described by the New York Times as “comfortable in his own skin”.  He was reported by attendees as “holding court” at the party: “totally at ease, very positive, very gregarious”.  Sure, he’s at home.  He’s in control.  He can be his charming best self.

It makes sense that he began his term as President Elect, as reported by journalists Maggie Haberman and Ashley Parker, concerned about how frequently his new job will allow him to get home to New York and Florida.  It makes sense that he is keen to host foreign dignitaries in his Washington DC hotel, rather than in the customary lodgings for Presidential visitors, Blair House.

His Cabinet picks?  He has chosen people he feels safe with.  They may not all be the best people for the job, but, hey, they feel trustworthy to him.  That’s emphasised by his tweet on 13 January, in which he said: “I want Cabinet nominees…to be themselves and express their own thoughts, not mine!”  Why does he need to articulate a quality that should come automatically as part of the job description for a Cabinet post?

Integrating family members into his political activities, despite the conflicts that risks?  Yes, his family members make him feel safe.  Rude to reporters at a press conference?  Well, since he doesn’t generally like the media and he doesn’t know what questions reporters are going to ask him, it can’t feel a safe environment for him, can it?  That would easily send his self-regulatory system into overdrive.   Reluctant even to travel in the Presidential plane, Air Force One?  Okay, his suggestion that he hire out his private jet to the government for his Presidential travel would indeed make him money, but I reckon that what’s more pertinent is a feeling of familiarity and relief when travelling inside his own personal plane.

Donald Trump is no different from the rest of us.  He is seeking a sense of emotional safety.  And, if he has Narcissistic Personality Disorder, then that internal sense of safety is fragile.  A person inevitably exerts more control over their external environment when they can’t find a sense of control internally.

US CongressThe problem for Trump is that he about to be President of the United States.  That role risks putting him constantly outside of his comfort zone.  He cannot control Congress; he cannot control the press; he cannot control other countries; he cannot control what his critics say of him.  All of that uncertainty would easily keep him on constant high-alert.  That would explain why he so often hits out on Twitter and in interviews.  Punching someone – whether with your words or your fists — is a way of exerting control.  All bullies instinctively get that.

Moreover, they feel better after punching.  Lashing out is a tonic.  Their cortisol levels drop once they’ve discharged all their pent up anxiety.

The problem for us ordinary people is that a leader who feels constantly threatened becomes even more erratic, more authoritarian, more dependent on intimidation and tantrums as a stress management strategy.  That is a serious problem for the globe.

In understanding Trump, we better understand ourselves

Ha haI predict there will be a number of people who won’t thank me for this article.  Essentially, I’m saying that there is a rational explanation for Trump’s eccentricities.  The extremity of what he says and does has driven many of us to our own extreme positions.  It is easy to stay holed up in 1) derisively laughing at him or 2) protectively defending him or 3) terrified by his capacity to blow up the world.

As Inauguration Week begins, I’m unlikely to win a popularity contest with either liberals or conservatives by saying that Trump’s dangerously quirky bullying can be explained logically.  Indeed, the people I risk becoming most popular with are the trolls.

Important Note:  Seeking to understand behaviour is not the same thing as saying that behaviour is okay.  It is not okay to lie, to demean people, to rage and sulk, to obfuscate and gaslight.  Seeking to understand behaviour is simply a starting place for devising solutions to problems.  Finding effective solutions is always impossible unless understanding is your starting place.  And you can’t reach understanding without curiosity.  So yes, I am encouraging us to be genuinely curious about the origins of Trump’s behaviour. 

Why publish an article that carries risk, when I could just as easily have chosen to another of my pieces on the healing power of laughter?  The answer is that my main aim isn’t actually helping us to better understand the enigma of Trump.  My main aim is helping us to better understand ourselves. 

AmericaAmerica got itself (and the rest of the world) into this situation, where they have elected a man who may be seriously mentally disturbed, because too many people felt unheard.  The misery of poverty and anxiety about uncertain futures went unsolved by their politicians.  It is in times of fear that we look to someone else to save us.  As I have written about before during this election, our own attachment needs place us at most risk when we feel most vulnerable.  It is at times of vulnerability that we are most likely to be tricked by people who tell us they will be our saviour, that they will be the one to make our lives great again.  All they have to do is make us feel heard.

The best way to make sure you aren’t being conned is to get better at listening to your own vulnerabilities.  Along the way, you also get better at listening to others’ vulnerabilities.  That compassion is invaluable because…if we are to heal ourselves from the division that Trump’s election has created, we will need to get very very good at listening to each other.

Stories of loss move us to action

Stories of loss move us to action

This week, Nicola Sturgeon, First Minister of Scotland, made a ground-breaking statement.  No, it wasn’t about political independence.  It was about the political prominence of LOVE.

SNP Conference Care Review AnnouncementIn front of 3000 conference delegates, she said:

“My view is simple: every young person deserves to be LOVED.  So let’s come together and make this commitment: to LOVE our most vulnerable children and give them the childhood they deserve.  That’s what inclusion means in practice.” 

She then promised a “root and branch review” of the Care System.  Essentially, she wants to understand how LOVE got lost from the Care System, and how we recover it.  She wants to know how, despite the efforts of so many dedicated people, being raised in the Care System leads to statistics like these:

  • 50% of children in the care system go on to suffer mental health problems.
  • Half the adult prison population were in care as children.
  • Children in care are 20 times more likely to be dead by the age of 25 than those not in care.

At a personal level, the part of her speech that most struck me were two short sentences:

“Recently I have been spending time with young people who have grown up in care.  Their stories have moved me deeply.”

So it wasn’t the statistics that most moved the First Minister, chilling as they are.  It was real life stories of loss.

I have discovered in my work how powerful stories are.  They are perhaps the best vehicle we have for moving others to a place of action.

I want, therefore, to use this article to tell another story, one that has been lost from our national consciousness.  I want to tell the story of a 3-year-old who went into hospital for a tonsillectomy in 1965.  Her parents’ loss, now long forgotten, played a crucial role in changing hospital practice.  Every parent today who takes a child to hospital benefits unknowingly from that couple’s story of pain and courage.

Why re-tell that story now?  One answer is that, if Nicola Sturgeon’s vision can be realised, then children in the Care System of the future will benefit from the determination that’s being shown now by the young people of Who Cares Scotland.  At their invitation, Nicola has committed to hearing 1000 of their stories over the next two years.  STV’s recent haunting documentary enabled us to share in five of those stories, including that of Laura Beveridge, who gave a deeply moving TED Talk in Glasgow in 2016.

ARCHIE Foundation LogoA second reason for reflecting on the history of children’s hospitals is that, on 3rd November, I’m going to embark on a wee risk myself.  I’m taking to the stage, as they say, with an entertaining show called TEDDY BEARS RULE.  It’s designed to give the public a light-hearted take on the science of attachment.

The evening is being held in support of The ARCHIE Foundation’s campaign for a new children’s hospital in Tayside.  It’s an apt partnership.  The study of attachment began in earnest in children’s hospitals of the 1950s.  ARCHIE’s work in hospitals today emphasises the importance of relationships, of emotional safety, of LOVE, for children’s healing.  Even their logo conveys that message, with their lovable little mascot firmly gripping his cuddly toy.

But it wasn’t always the case that hospitals recognised the importance of relationships.  That’s the point of my story of a child’s deadly tonsillectomy.

We begin in the early 1950s.  The war is over and the National Health Service has been established.  Thank goodness on both counts.  All parents can now obtain medical treatment for their children, whether in moments of crisis, like broken legs and bad asthma attacks, or for scheduled operations, like hernias and eye corrections.

One aspect of the care, though, is that much separation between parents and children will need to be endured.

Children's hospitals 1950sStandard practice for the 1950s was that parents were allowed to visit their children once a week, usually for one hour.  It didn’t matter the age of the child: 2 years or 3 years or 10 years.  Restricted visiting was simply the norm.  Besides, trips on public transportation could be cumbersome, there were typically other children at home who needed to be cared for, and husbands needed someone to make their tea.  (I am not joking.)  In some hospitals, the restrictions were even more severe.  In St Thomas’ hospital, children went one month before being allowed a visit, although their parents were permitted to observe them sleeping.  In London Hospital, children under 3 years old went without seeing their parents at all.  Parents could, if they wished, view them through partitions.

If this historic account leaves you a bit stunned, good.  I want us to be stunned that, not all that long ago, our society took for granted rules that sound unimaginable to our ears today.

If you are looking for someone to blame, don’t.  The system was filled with dedicated, hard-working people who simply did what was regarded as normal.  Curiosity will get us a lot further than blame.

If you are an adult who was once a child in hospital in the 1950s (or 1960s or 1970s), and you can remember desperately wondering where your parents were: THANK YOU.  Thank you for your strength then and your strength now, reading this article.  I know there are very many such adults living in the UK today.  Frequently you spontaneously raise your hands in my training events and share your stories of loss.  Thank you.

James RobertsonBack to my story.  A growing number of professionals and parents were concerned about this practice of restricted visiting.  Amongst these were the psychologists John Bowlby, Anna Freud, and especially James Robertson.  The data they were collecting led to the establishment of what would come to be known as ‘attachment theory’.  But the 1950s were still early days in the study of attachment and emotional trauma.

Robertson found that when he tried to talk about his data, it proved too threatening for medical staff to listen to.  They could not believe that their normal hospital practices could lead to lasting emotional damage.  They felt offended, their professional integrity impugned.  What Robertson was calling ‘emotional deterioration’, they simply saw as ‘settling’.  Once a child stopped crying, they regarded the behavioural problem as having been solved.

In fact, that was part of the reason for restricting parents’ visits.  When parents arrived, they not only brought ‘germs’, but also started off the children’s crying bouts again.  How were a few nurses to handle a whole ward of crying children, once their parents had departed?  Better to keep the parents away.

So James Robertson tried new steps in his campaign.  In 1952, he made a narrated film called A Two Year Old Goes to Hospital, in which he showed viewers what ‘emotional deterioration’ in a toddler looks like.  Did it help?  No.  The medical profession’s reaction was so intensely negative that he had to stop screening the film for a while.

Robertson integrated his efforts with those of others who were concerned.  They wrote letters, published papers, penned editorials, gave lectures, created opportunities for distraught parents to tell their stories. By 1959, the debate had grown so heated that a formal review was commissioned by the Ministry of Health, chaired by Sir Harry Platt, President of the Royal College of Surgeons.  His report called unreservedly for more humane care for children in hospital.  Guess what changed?  Very little.

So Robertson turned to the press.  He wrote a series of articles for the newspapers, inviting parents to send him letters about their experiences.  He collected together hundreds of them, which he published in a book called Hospitals and Children: A Parent’s Eye View.  One particularly harrowing story was told by a mother who re-mortgaged her house in order to pay for private treatment so that she would not have to be separated from her son while he recuperated from an eye operation.  In 1961, Robertson convinced the BBC to broadcast a television series on the “cruelty” of hospital care, which featured parents’ letters and segments from the several films he had by now made.  What changed?  Not much.

Do you know what finally finally finally proved to be the tipping point, after nearly two decades of concerted effort?  A story of loss.  A little girl, 3 years old, went into hospital for an ordinary tonsillectomy, and ended up crying herself to death. Literally.

It was 1965.  In line with usual practice, her parents were allowed to spend an hour with her on the day of admission but were thereafter prevented from seeing her.  They were informed, though, that their child had come round from the operation, as she was crying continuously.  The mother begged repeatedly to see her but was denied permission.  Three days after admission, her little girl was dead, having bled to death, surrounded only by strangers called hospital staff.  In a heart-wrenching letter, the mother wrote that she “could not help thinking that the continual crying caused the bleeding” and that she believed “her presence would have stopped the crying.”

Student nurses in 1950sIt’s a shocking story.  I want us to be shocked.  And I want us to be curious.  How is it possible that well-meaning staff could have failed to realise the importance of LOVE for reassuring a scared child?  How could their lack of understanding be so complete that she ended up drowning in her own blood?

If you think the way I’ve told this story sounds too extreme, that’s okay.  You can read the story for yourself, retold in the 2009 paper written by Dutch researchers Frank van der Horst and Rene van der Veer (pg 135).  The case was much discussed at the time, in the press, in the medical journals and by the Ministry of Health.  Whilst some leading medical professionals supported the mother’s view that her presence would have calmed and saved her child, others subtly blamed the mother for the death, suggesting that she had failed to adequately prepare her 3-year-old for the experience of being in hospital.

Blame.  It is such an easy option for us human beings.

The only light to emerge from this terrible story of loss is that it helped the tide to finally turn.  The Ministry of Health took a harder line on hospital visiting practices.  By 1970, restrictions had come to be regarded as unnecessary and unsuitable for young children.  It had taken two decades of campaigning.  Things still weren’t perfect.  But the tide had turned.  LOVE was being permitted to flourish in hospital wards.

Why am I telling that story in such detail now?  Two reasons.Teddy Bears Rule Poster

First, when I stand up on stage on 3rd November in Dundee, in aid of The ARCHIE Foundation’s campaign for cutting-edge hospital facilities, I want the evening to be entertaining, full of fun and laughter.  I won’t be telling this heart-breaking story.  But I wanted to put it on record, so that, as we walk into that auditorium, we fully appreciate the significance of ARCHIE’s attention to relationships.  ARCHIE gets it, and they are working to help ensure that others get it.  The money we raise that evening will help them continue that work.

Connection.  Laughter.  LOVE.  It is way too easy for us to take these basics for granted.

Second, Nicola Sturgeon’s speech about the Care System has filled many people in Scotland with hope.  Tears were shed as she announced her root and branch review.  I believe Nicola’s intention, and I have no doubt that the determined young people of Who Cares Scotland will hold her to account.  They have claimed their own stories of loss.  They have used their stories to drive long-needed change.

However, even hefty reviews do not automatically lead to action.  My history of hospital care reminds us of that reality.

I do not want to wait two decades to achieve the vision Nicola Sturgeon set out this week.  If our children in care are to experience the LOVE she seeks for them, and the LOVE they deserve, then it needs more than policy change.  It needs culture change.

That part is up to us.  We don’t have to wait for a governmental review.  We can start today.  We start with kindness and curiosity.  We listen to stories of loss.

When we fail to be shocked

When we fail to be shocked

Omran DaqneeshIn August, I wrote a piece urging us not to buy into the language of ‘shock’ when it is used to describe images of children caught up in war.  I was trying to help us fight the dangerous pull of sentimentality, when our human emotions easily cloud our ability to look upon harsh realities.

What do we think war looks like, I asked?  Of course it looks like children dazed and covered in blood.  There is nothing shocking about that image of Omran Daqneesh.  He is a child caught up in terrible war.  Yes, the image is haunting, awful, gut-wrenching.  But it is not shocking.  It is depressingly predictable.

Haiti devastationMy theme was picked up by blogger Tim Dunwoody, writing about the devastation that has occurred in Haiti as a result of Hurricane Matthew.  He asked why the images were being described as ‘shocking’, given that Haiti is the poorest nation in the northern hemisphere.  He wondered whether those of us who don’t live in abject poverty subconsciously protect ourselves from acknowledging its reality by telling ourselves, in times of disaster, that we are shocked by what we see.  He challenges us to be real: “If we are honest with ourselves, surely we know that natural disasters always hit the poor the worst.  Do the images from Haiti really shock us?”

I found myself returning to this theme once again as I looked at another of the week’s news images.  This time, though, I wondered why we were not using the language of ‘shock’.

The answer is that we were, instead, using the language of ‘cute’.   Our laughter at all the cuteness kept us from seeing the possibility of a harsher reality: a child being objectified.

Trump holding up baby

On 10th October, US presidential candidate Donald Trump hosted one of his largest rallies yet.  Nearly 10,000 people gathered in Wilkes-Barre Pennsylvania to hear him speak with anger and vitriol about the current state of America and its leaders.  Approximately 45 minutes into the speech, he spotted a child dressed up to look just like him.  Lots of people had donned costumes for that rally, and the parents of this two-year-old toddler had joined in, dressing him up as a mini-Trump, complete with dark suit, red tie, voting badge and a full head of similarly combed-over hair.

When Donald spotted the child, sitting high on a set of shoulders in the crowd, he invited his security guards to bring him up onto stage.  The rapturous crowd loved it.

Crowd at Trump rally

“What’s your name?” Donald asked.

The child responded with one of the abilities common to all young children learning to talk.  He repeated the last word he heard: “Name!”  Some of the papers explicitly noted that repetitive pattern in their coverage of the story.

“Are you having a good time tonight?”

“Night!”

“Where’s your daddy, and your mommy?  Do you want to go back to them, or do you want to stay with Donald Trump?”

“Trump!”

The roar of approval was deafening.  You can hear that “beautiful moment” for yourself here:

It wasn’t just the crowds who loved it.  So did the media.  ABC News declared that ‘Mini-Trump Steals the Show.”  The Toronto Sun said ‘Mini-Trump upstaged Donald Trump’.  The Daily Mail charmingly called him the ‘Doppelganger Baby’.

So what’s wrong with any of that, you might ask?  It was funny.  The kid was cute.  Nobody got hurt.  The child didn’t even cry.  If you look closely, he was smiling.  His parents were there the whole time.  What is the problem?

My problem is that our collective response was to laugh indulgently as an angry demagogue used a child for his own political purposes.

It’s not surprising.  In fact, it’s a common strategy amongst demagogues.  When they smile at children, they seem more likable.  When they get us to laugh with them, we remember ourselves as having had a good time.

Stalin & Hitler propaganda posters

And if we’re having a good time, we’re more likely to overlook the ways in which a person is being used to manipulate us.  That person (in this case, a small person) has been objectified, used as a pawn in a bigger game.

We have become pawns too.  Donald played us all brilliantly: the crowd, the newspaper editors, those of us who looked at that photo and smiled.

Let me be very clear: I’m not particularly criticising him.  He was doing what all politicians do: kiss babies.  (The Atlantic published a lovely little piece in 2011 on why this “clichéd propaganda” works so effectively.) Donald was also doing what we might expect of a politically ambitious bully under severe threat:  he was seizing an opportunity to shift the public mood.  Three days previously, most folks around the world had been outraged by the way he had objectified women.  He vaporised some of that anger instantly by getting himself photographed being sweet to a cute kid.  It’s a brilliant strategy.

Politicians & babies

I am not in any way reproaching the child’s parents, either.  Loads of parents involve their children in political struggles, using their very youth as part of the political point being made.  The follow-up interviews (and even the pre-interviews) with Hunter Tirpak’s mother made clear that, as a strong Trump supporter, her aim was to bring positivity to a negative campaign.  She is absolutely free to dress her child up as Baby Trump if she wants.

Nuclear & abortion rallies

Rather, my critique is focused on us, the public.  Why were we so easily entranced?  Why did the language of ‘shock’ not appear in any of the papers?  Why was this story dripping in froth and fluff, rather than scrutiny?

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One answer is that Donald has offered us so many shocking moments during this campaign that we’ve become a bit inured to his antics.  And this moment did come just after the meltdown created by his comments about grabbing women by the pussy.  It is understandable that, in the face of such blatant objectification, we might miss the more subtle objectification involved in holding up a smiling child for public viewing.

So if you didn’t spot this interpretation, don’t feel bad.  Nobody else did either, as far as I can tell.  Donald is a very talented showman.  He’s better even than Derren Brown.

And if you disagree (perhaps vehemently) with my reading of Donald’s performance, that’s okay too.  Debate on the objectification of children would be terrific.  It would let us address my earlier question: “What’s wrong with any of this?”

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What’s wrong is that objectification is the first step on the journey to exploitation, xenophobia and abuse.  When we are astute enough to spot objectification, we stand a better chance of preventing things from getting worse.

One other event occurred in the British media this week that highlights how ‘worse’ it can get.  Louis Theroux produced a courageous television documentary exploring how he had failed to spot the sinister depths of his predatory friend, Jimmy Saville.  What signs had he overlooked 15 years ago?

The programme made for unsettling viewing – but not because we were watching a man trying to make sense of his own guilt and gullibility.  It was unsettling because Theroux was compelling viewers to ask themselves what they too had missed, as they laughed along with Saville, during all the scenes of smiling children.  He was trying to help a nation not to get lost in a cloud of guilt and shame, but to have the strength and curiosity to ask:  what signs did we miss?

Jimmy SavilleWell, objectification is a pretty good sign.

The creepy, crazy thing about objectification is that it doesn’t have to feel bad.  It can easily feel like entertainment.

Come to think of it, maybe objectification is at its most powerful when it comes wrapped in sentimentality.  Who could possibly question laughing at innocent cuteness?

stalin-hitler-black-white

 

There is nothing shocking about this image

There is nothing shocking about this image

There is nothing shocking about this photo.  It is totally predictable for a country at war.

Omran Daqneesh - AMC Photo 2Yet that is the wording chosen by the Guardian“Shocking image emerges of Syrian child.”

And by NPR News:  “A wounded child shocks the world.”

And by CBN News“Child’s shocking image becomes the face of Syria.”

And of course by the Daily Mail:  “Harrowing image shocks the world.”

Yes, the photo is distressing, but that’s not the same as shocking.  ‘Shocking’ implies we should somehow be surprised.  How can we be legitimately surprised?  Syria is at war.  This is what war looks like.

If we are genuinely shocked, either as a society or as individuals, that tells us more about ourselves than about this 5-year-old child.  Being ‘shocked’ says we are living in denial. What do we think war looks like?  What do we think the reported deaths of approximately 50,000 Syrian children have looked like?

The BBC News website has a page that shows those children’s names, each in turn.  You need to watch for 19 hours to view the complete list.

Omran Daqneesh - AMC Photo 3
Yes, the photo of Omran Daqneesh is distressing.  His blank face forces us to look upon the psychological trauma of war.  We are right to be distressed when we see such a “still, silent child”, as the NPR story put it.

The trouble for the human psyche is that distress is hard to feel.  We have to do one of two things in response to it:  1) move toward it or 2) move away from it.

If truth be told, most of us choose the second option.  We move away.  We turn over the page.  We shift our gaze.  We deny.  Turning away makes perfect sense when we can’t do anything useful.  To look distress in the face and stand helpless is deeply painful.

That’s why our psyche needs the tools of denial and repression.  They are coping mechanisms that serve a key psychological function. They save us from becoming overwhelmed.  They keep us from being stopped in our tracks with sadness and horror.  Denial and repression enable us to continue with our day.

However, saying we are ‘shocked’ takes us to a deeper, darker place.  It implies that we are somehow surprised that a child should be traumatised by war and bombing.  That is disingenuous.  There is no way we can be legitimately shocked that war should bring such consequences – and we know that.  In our gut, we know that.

Ultimately, then, these headlines are insulting.  They make a mockery of this child’s trauma, trauma that will haunt him his whole life.  The headlines encourage us to believe his distress is somehow surprising.  Every news editor who opted for the headline of “shocking” should feel ashamed of their choice.  It panders to sentimentality.  The power editors have to help us see the world more deeply has not been exercised.  I know that is entirely common for the modern day press.  It still doesn’t make it okay to use a child’s pain in this way.

Omran Daqneesh - AMC Photo 2The insult is made worse with statements like this one:   “Warning: this article contains images that readers may find distressing.”

Warning?  Why do readers need a warning about looking upon distress that is predictable?

Most of the adults reading the story of this child will never have known the sound or smell or gritty residue of a bomb.  They will never have known the death of their child or the terror of going to the market to be able to feed them.  Most of us will never ever have to know the horror of such things.  And yet we need a warning about a photo of them?  Are we meant to look away if we are too upset?  Five-year-old Omran Daqnessh is living inside that photo.

I acknowledge, though, that a very real problem remains.  How do we look at that photo and then get on with our day, filled hopefully with absolutely important acts like getting breakfast on the table for our own children, hugging them, taking them out later to play football or for ice cream, laughing with them in the car on our way there?  It is precisely that question that leads most of us to reach, unconsciously, for repression.  It is a tool to help us resolve this dilemma.

Repression is normal.  It is ordinary.  It is understandable.  Repression saves us from being overwhelmed by knowledge too painful to bear.  But just because repression is normal and ordinary and understandable doesn’t make it okay.  Or kind.

Omran Daqneesh - AMC Photo 2What would be kinder for this traumatised lad is to sit and stare at his photo.  We honour his distress when we find the courage to stop ourselves from turning over the page.  We strengthen our capacity not to be overwhelmed when we practise looking distress in the face and accepting it.

Children need adults who can do that.  Children need adults who are able to acknowledge their pain, to see it and sense it.  Children need adults who do not rely on turning away as a coping mechanism.  To feel safe, children need to know the adults around them will not desert them when they are struggling emotionally, with traumas big or small.

We may not be able to do anything at all that directly helps Omran Daqneesh, but we can use his presence on our front page to help us serve other children.  Something worthwhile then comes out of the terrible, stupid tragedy that has been inflicted upon him.

There is a power that comes from the strength to stand and look distress in the face: we are impelled to action.  So if you want ideas about what to do, here are some options:

  1. Donate money or time to a charity supporting Syria. The Guardian published a welcome article this week listing nine charities doing active work.  The fabulous organisation I Am Syria lists more.
  2. Write to your MP and ask why the UK government has so far resettled only 1602 Syrian people out of the 20,000 planned over the next five years.
  3. Donate money or time to a charity in your local area that supports children traumatised by circumstances such as domestic violence, bereavement, a parent with mental illness.
  4. Ask yourself why the prison population is filled with adults who were once children in the care system. All people who spent time in the care system have trauma in their history – or they wouldn’t have ended up in care.
  5. Next time you find yourself about to speak sharply to a child (usually for some bit of behavior you didn’t like) ask yourself if there is a gentler way you could convey your thoughts – because underneath all behavior is an emotional need, and it isn’t a need to be told off.
  6. Hug your child, knowing that lots of parents in Syria no longer can.  That includes Omran’s parents, because his older brother, Ali, was killed in the same bombing raid.  That terrible fact, though, was not reported with the same breadth as his younger brother’s photo.
  7. Put Omran’s photo on your refrigerator, so that you can practise looking into the face of distress without denial or overwhelm. When you’ve gotten good at it, replace his photo with the face of another Syrian child.  You can find a distressingly wide selection of them on the Aleppo Media Center’s Facebook page, here.

Omran Daqneesh and sisterThe comments of Dr. Zaher Sahloul, a medic from Chicago who volunteers in Aleppo, received widespread coverage this week when we said that the children of Syria no longer have need of our tears.  I agree.  Our sympathy mocks their pain if it does not lead to action.

Denial protects us adults, but it does absolutely nothing for children.