Online Support Group for People Isolated by the Coronavirus (Covid19)

 

Momentum “The World Transformed” Policy Lab on Capitalism and Mental Health – Saturday 21st Sept 3.00-5.30 in Brighton

 

Nicola Saunders and Paul Atkinson are organising an event at Momentum’s The World Transformed on Capitalism and Mental Health on Saturday 21st September at 3.00 – 5.30 pm in Brighton. Jacqui Dillon and Malcolm Philips are joining us to introduce the meeting.

The focus of the event is to gather together from the people at the meeting concrete proposals for radical alternative policies on mental health for the next Labour Manifesto. This will be part of Momentum’s Policy Lab programme through which an alternative manifesto will be presented by John McDonnell and others to the LP manifesto discussion.

Our aim is to quickly identify together the main policy areas and spend as much time as possible in smaller groups discussing and formulating policy proposals for each area. It really matters then that we manage to attract as wide a range of experience and opinion on transforming mental health policy.

The online Momentum flyer for the event lists five “speakers”. This is a bit misleading. In fact, Nicola will chair;  Malcolm, Jacqui and Paul will kick things off with very brief talking points around the kind of issues we face in the mental health arena; Jon Ashworth, shadow Minister for Health, will say something brief at the end of the session.

As far as possible, the meeting will belong to the people who come along. So please come if you can. Get tickets here. And please circulate the invite to anyone who might be interested.

Warm greetings from Paul and Nicola
Contact  paulwilliamatkinson@gmail.com

Letter from #MillionsMissing Campaign – May 12th 2018 (ME Awareness Day)

Dear Free Psychotherapy Network,

I was very interested in the article on your website calling on therapists not to collude with harmful back-to-work therapies and pyscho-compulsion.

You may not know, but the model for these therapies have been forced upon a group of patients with a physical disease for decades.  The rooted of the BPS model go back to the PACE trial on people with ME. This trial was part funded by the DWP and set out to prove that instead of the neurological condition described by the WHO it was a combination of deconditioning, fear of activity and false illness beliefs.  The ‘success’ of this trial has long been disputed by patients but is only now coming under scientific scrutiny.

PACE has been used to ‘prove’ that CBT and graded exercise are an effective way to return people to health.  Unfortunately, even trivial exercise such as having a shower has a catastrophic effect on ME sufferers, leaving them bed bound and in pain.  Some never regain the level of functioning they had before treatment.  However, they are told that it their fault for not trying hard enough or not challenging their false illness beliefs.  Parents are accused of perpetuating their child’s illness and there are a high level of accusations of FII against mothers.

The PACE trial has been thoroughly debunked but it’s influence continues and has contributed to the appearance of scientific evidence for IAPT. https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-018-0218-3

ME sufferers have been the ‘canary in the coal mine’ for many years, protesting without being heard.  The BPS lobby has been able to stigmatise a whole group of patients as ‘militant activists’ and akin to the animal rights lobby in the level of danger they present to scientists.

However, in the only legal arena that these accusations have been examined they were found to be ‘grossly excessive’.

http://informationrights.decisions.tribunals.gov.uk/DBFiles/Decision/i1854/Queen%20Mary%20University%20of%20London%20EA-2015-0269%20(12-8-16).PDF

This harm has been compounded by the blocking of any research that doesn’t fit the BPS view.  Any protests are met with contempt and the accusation that people with ME are afraid of being seen to have mental health problems.  It is a perfect Catch 22.  If you don’t protest then you are assumed to agree that ME is a mental health issue.  If you do protest then it proves that you have a mental health problem but are in denial.  In reality, sufferers are only asking for effective treatment for their primary biomedical problem.  They welcome counselling to help them accept the limitations that this long term illness has forced upon them.  ME sufferers are in the same position that people with MS were before the discovery of a bio marker when it was considered to be hysterical paralysis.

Things are now changing around the world.  In the USA the NIH has found insufficient evidence for CBT and GET http://www.meassociation.org.uk/2016/08/us-federal-agency-downgrades-its-advice-on-cbt-and-get-occupy-m-e-website-16-august-2016/ The Dutch have recently done the same https://www.meaction.net/2018/03/23/dutch-health-council-downgrades-get-for-me-cfs/

NICE are reviewing the UK guidelines but have refused to remove them until the end of the process, which will take at least 2 years.  In that time many more patients will experience iatrogenic harm.

MEAction are holding a series of demonstrations across the UK on May 12 to draw attention to the #MillionsMissing from their own lives.  We are asking therapists to stand with ME patients in asking NICE to stop GET now, rather than wait for the 2 year period to expire.

I am organising the London MillionsMissing protest and reaching out beyond the ME community to ask for allies.  https://www.facebook.com/millionsmissinglondon2018/

Sincerely,

Denise Spreag

http://www.virology.ws/2015/10/21/trial-by-error-i/

https://www.unrest.film/

http://stonebird.co.uk/new/index.htm

Demo at New Savoy Conference 21st March 2018

The Alliance for Counselling and Psychotherapy has organised a demo at the New Savoy conference again this year. Please circulate the flyer linked here to your networks and come along yourself if you can make it. It’s an early start at South Kensington.



Some context:
• The hierarchy of IAPT and psychological services in the NHS who gather at these conferences continue to offer liberal mouthings about DWP welfare reform policies, WCA and PIP, sanctions, coercion around Work and Health. But they’ve actually taken no real action to boycott DWP/Health collaboration, despite all the developments re judicial reviews, UN condemnations, the recent Parl Committee report, and the UC debacle.
In his intro to the conference, in the programme link above, Jeremy Clarke (NS chair) says:
 “The second issue is the running sore of welfare benefit reform, and its negative impact on mental health, that undermines whatever benefit we make to population wellbeing. Have we reached a consensus now for how we can turn the tide? The BBC’s Mark Easton will find out”
• The overall theme is depression; there are sessions on the crisis in the IAPT workforce, latest staff survey, impact of targets; session on Work and Health Unit; Wessely’s review of human rights and compulsory treatment; session on Employee Assistant Programmes (often run by people like Maximus); familiar faces in the list of speakers.
The scam of IAPT as a service in local communities. IAPT has a massive evidence base, tons of statistics for every CCG in England including “recovery” rates; ethnicity stats; deprivation stats; etc etc No-one really analyses the figures. For IAPT, it seems just collecting the stats is their claim to being evidence based and therefore their claim for funding from the Government. In fact, their stats reveal a shockingly failing provision.
For example, out of over 1,350,000 referrals a year, 85% either never enter any kind of therapy, or never finish a course of treatment, or don’t “move to recovery” (as IAPT jargon has it). In my CCG (Tower Hamlets) only 6.6% of referrals to IAPT “recovered” and among the Bangladeshi community who make up over 30% on TH population only 3% “recovered”. Paul Farmer’s Taskforce target for % of population who “need IAPT therapy” is 15%, rising to 25% by 2021. In TH about 2% of the pop were referred/referred themselves to IAPT, of whom as I say 6.6% “recovered”.
IAPT will be a major part of the propaganda around the NHS reorganisation now in progress, via the STPs and the ACOs they are developing (link here for more info on this). STP management have “the mental health crisis” high on their agenda – certainly their PR agenda – and selling more provision for IAPT services will be a major plank of the campaign. See Hunt on this role for IAPT here.
IAPT is rarely taken to task as a service that is massively failing communities all over England. This is true in the Labour Party as much as anywhere else. This has to stop. It is a propaganda service for neoliberal capitalism and its dissemination of psychological scapegoating and coercion across society.
Hope to see some of you on the 21st,
Paul Atkinson
New Savoy 2018 jpeg

New Savoy 2018.pdf

New Savoy Protest against psycho-compulsion of MH claimants – 15th March 2017

scan9

“We have endured year after year of austerity with cuts to our services and benefits and jobs, whilst the already far too rich are coining it in. Britain is the site of gross and unacceptable levels of inequality, and it keeps getting worse. Nothing that comes from the mouths of this government can be trusted, as they continually say one thing whilst doing the complete opposite. We are faced with crises in every sphere of the services that we need including education, social care, prisons, mental health services, housing, zero hours contracts and the health service. All are being undermined and destroyed whilst the corporate media mainly ignores the hell that has been created for so many, or distracts us with endless propaganda campaigns designed to get us turning in on one another whilst the corporations steal away everything that our grandparents struggled to achieve.”

Roy Bard  MWA zine#2

Details of the protest here

Read the Mental Wealth Alliance zine for the protest here


Can FPN find a place in community networks?

Without real practical connections becoming alive and sparking between people in communities, then politics dies.This is George Monbiot’s thesis. Monbiot – activist, researcher and writer – has been laying out his vision of a reborn politics based on a thick web of interconnected grass roots and community activities.

Given the state of so many shattered communities, today’s politics can easily become all about argument and policy. It gets to seem dry, thinned out and irrelevant to most people. Live connected communities are essential if politics is to become vital and relevant to most people.

Over the last 20 years, the winds of globalisation have ripped through many communities and towns, atomising us, breaking down real connectivity between people. Recently it has become public knowledge just how many people are living such lonely isolated lives, that they may not speak to another person in a whole week. George Monbiot has written in the Guardian (8th Feb 2017 ):

“It is in the powder of shattered communities that anti-politics swirls, raising towering dust-devils of demagoguery and extremism. These tornadoes threaten to tear down whatever social structures still stand. When people are atomised and afraid, they feel driven to defend their own interests against other people’s. In other words, they are pushed away from intrinsic values such as empathy, connectedness and kindness, and towards extrinsic values such as power, fame and status.”

We need to restore community life in all its many varieties as a solution and response to the many crises we face. George Monbiot argues for creating thick networks – ” projects that develop a dense participatory culture ” – and he cites the example of Rotterdam in Holland where one estimate suggests there are now 1, 300 civic projects in the city. In the same article, Monbiot also looks at Todmorden in Yorkshire.

The question that I want to ask is this – is this movement that is participatory grass roots network the sort of movement that FPN should be linking up to, and contributing to? If Yes, then how do we start to do that?

Andy Metcalf

February 2017

 

United against welfare cuts and welfare reform: report from the lobby of the British Psychological Society conference, 18th January 2017

The challenge to the government’s draconian welfare reforms are gathering momentum, and as part of this campaigners from across Merseyside and even as far afield as London gathered outside the annual BPS Clinical Psychology Conference at the Hilton Hotel, Liverpool on Wednesday 18th January. The British Psychological Society (BPS) is the professional body for UK psychologists and has been working with the government on aspects of its welfare reform programme.

Service users/survivors, mental health workers and clinicians from a range of groups including Psychologists Against Austerity (PAA), Mental Health Resistance Network, Disabled People Against Cuts, Social Work Action Network (SWAN) as well as trade unionists arrived bright and early at the venue to share our concerns with conference attendees. There is strong evidence of the detrimental impact of welfare reform on claimants with mental health needs so we are calling on the BPS to withdraw from all work with the Department of Work & Pensions (DWP) and join us in demanding the government end their harmful welfare reform programme.

liv1

Campaigners from a number of groups united to send a powerful message to the BPS leadership

As a result of our lobby, delegates informed us that welfare reform had become a major discussion point for attendees inside. Then as a result of this pressure a call came through to inform us that Peter Kinderman, president of the BPS, had invited us to address the conference the following day to explain our position and present our demands.

The next morning a group of campaigners representing the breadth of our alliance –service-users/survivors, a carer, and activists from North West Psychologists Against Austerity, Mental Health Resistance Network and SWAN – spoke to 300 psychologists at the first session of the conference. The group shared a strong message about the effects of welfare reform and called on the BPS to withdraw from all collaboration with the Department of Work & Pensions. In his response BPS president Peter Kinderman accepted some of our arguments but maintained that the BPS needs to continue to work with the DWP to get its perspectives heard. We reject this argument. We believe continued BPS involvement only lends credibility to the government, and BPS withdrawal would send a strong message about clinicians’ and service users’ concerns. We will continue to call for an end to all collaboration between the BPS and DWP.

liv2

Campaigners are invited onstage to address 300 psychologists at the BPS Conference

The DWP is an unethical body that is damaging the lives of claimants with mental health needs.

The statistics and evidence on the harmful impact of welfare reform are clear:

  • 20,000 people with mental health difficulties had their benefits sanctioned in 2015
  • Following Work Capability Reassessment, there is a greater risk of suicides, self-reported mental health problems, and antidepressant prescribing (Barr et al, 2015)
  • 2,380 people died shortly after being declared able to work between 2011 and 2014
  • Government & corporate collaborators are imposing psychological explanations for unemployment, together with mandatory activities intended to modify beliefs, attitude, disposition, or personality – this is being called psychocompulsion (Friedli & Stearn, 2015)
  • The United Nations “is deeply concerned about the various changes in the entitlements to, & cuts in, social benefits introduced by the Welfare Reform Act 2012 & the Welfare Reform & Work Act 2016”. The UN has called on the Government to: “Review the entitlement conditions & reverse the cuts in social security benefits introduced by” these Acts

However we believe that this action and the growing campaigns around the country are starting to make a difference on this issue. A number of clinical psychologists attending the conference told us that the lobby and ensuing discussions would help to strengthen their voices within the BPS to make the case against the organisation’s involvement with the DWP.

We believe that when service users/survivors, psychologists and other mental health workers come together we are stronger. We will keep building alliances to pressure the BPS to withdraw from involvement with the DWP and to bring an end to the government’s wider programme of welfare cuts, reforms and psychocompulsion. If you would like to get involved please email us on mhwelfarereform2016@gmail.com.

Mental Wealth Alliance response to the psy professional bodies’ statement on benefit sanctions and mental health 30/11/16

From:

Mental Wealth Alliance[1]

 Mental Health Resistance Network; Disabled People Against Cuts; Recovery in the Bin; Boycott Workfare; The Survivors Trust; Alliance for Counselling and Psychotherapy; College of Psychoanalysts; Psychotherapists and Counsellors for Social Responsibility; Psychologists Against Austerity; Free Psychotherapy Network; Psychotherapists and Counsellors Union; Social Work Action Network (Mental Health Charter); National Unemployed Workers Combine; Merseyside County Association of Trades Union Councils; Scottish Unemployed Workers’ Network; Critical Mental Health Nurses’ Network; National Health Action Party.

To:

British Association for Behavioural and Cognitive Psychotherapies

British Association for Counselling and Psychotherapy

British Psychoanalytic Council

British Psychological Society

United Kingdom Council for Psychotherapy

30th January 2017

MWA response to the psy professional bodies’ statement on benefit sanctions and mental health  30th November 2016

We welcome the call from the psychological therapy bodies for the government to suspend the use of sanctions by the DWP subject to the outcomes of an independent review of its welfare policies and their potential damage to the mental health of benefit claimants. Given the accumulation of evidence over many years of the material and psychological suffering inflicted on benefit claimants by workfare-based conditionality[2], it has been frankly shocking that the professional bodies directly concerned with the mental health of the nation have preferred to welcome and participate in workfare policies rather than publicly and vociferously dissociate themselves.

The timing of the statement is given to be the recent report on sanctions by the National Audit Office. Welcome as its report is, the NAO’s perspective on government policy is primarily monetary, not one of health, ethics and social justice. Its “vision is to help the nation spend wisely”.  The choice of this timing represents realpolitik on the part of the professional bodies no doubt, as perhaps is the intention of the conditional statement: “The sanctions process may be detrimental to people’s mental health and wellbeing”. But surely as psychotherapists and counsellors we can do better to represent the overwhelming evidence of personal suffering on such a scale than point to poor returns on expenditure and an ambivalent proposal that sanctions may be detrimental to people’s mental health.

Sanctions are only one dimension, albeit at the sharp end, of a welfare regime based on the political assertion that people need to be coerced off benefits and “nudged” into work. The psychological pressure of WCA and PIP assessments, job search rules, work programmes on “good employee” behaviours and the regular cuts to welfare benefits generally are part and parcel of the psycho-compulsion of the DWP benefits regime.[3]

We dispute the government’s premise that work is a therapeutic priority for people suffering from mental health difficulties. The marshalling of evidence for this modern-day workhouse mentality lacks both substance and integrity. Work has become the ideological mantra for neoliberal welfare policies.

Obviously where people want to work and where employment possibilities exist that will support and nourish people’s mental health, then encouragement, training and professional support should be available. But why is there no acknowledgement of the hundreds of thousands of claimants with mental health difficulties who cannot work, whether they want to or not?[4] Where is the evidence that people with mental health difficulties are actually benefiting from what is now two decades of workfare conditionality in the UK? Where is the evidence that in our current labour market decent jobs exist that will nourish people’s mental health? And where is the evidence that psychological therapy for benefit claimants with long-term mental health disabilities succeeds in supporting them into decent jobs they want, can survive and maintain?

When the professional bodies say, “an estimated 86-90% of people with mental health conditions that are not in employment want to work”, they are supporting the proposition that getting into work is an overwhelmingly important and efficacious goal for this group of benefit claimants. It is not clear where this figure comes from and what it means.

A similar figure is quoted by The Royal College of Psychiatrists’ report on Mental Health and Work (2013)[5], making use of a Sheffield study by J. Secker and others (2001)[6]. In fact, Secker finds that of their sample of 149 unemployed service users, when asked if they were interested in work of any kind – including voluntary and supported work –  “around half (47%) responded positively, and almost the same proportion (43%) had a tentative interest. Only 15 people (10%) had no interest in work”. At the same time, only 25% of respondents saw full-time employment as a long-term goal. 71% said that their preferred vocational assistance would be “help for mental health/keep current service”.[7]

This study does not translate into “86-90% of people with mental health conditions that are not in employment want to work”.[8] What it points to is the complex texture of attitudes, desires and fears around waged work that are the common experience of service users, alongside the harsh realities of the current labour market, the socio-economic environment generally, and the dire state of mental health services of all kinds more particularly.[9]

From our point of view, the professional bodies’ statement is a step in the right direction. It is a step that must now be followed through with active political pressure on the DWP and the Dept of Health to suspend sanctions and set up an independent review of their use, including the damage they inflict on people’s mental health.  Parliament has already called for such a review.[10]

But more than this, the remit of such a review should include all aspects of conditionality in a benefits system that deploy psycho-compulsion through mandatory rules or through the more subtle imposition of behavioural norms which aim to override the claimant’s voice.

We again suggest that the psy professional bodies would benefit by widening their own conversations to include service users and the rank and file of their membership. They would also win more credibility as organisations with ethical and social values independent of the government’s policies of dismantlement of social security and the welfare state if they were willing to make transparent their currently private conversations with DWP.


[1] Mental Wealth Alliance (MWA), formerly the Mental Wealth Foundation, is a broad, inclusive coalition of professional, grassroots, academic and survivor campaigns and movements. We bear collective witness and support collective action in response to the destructive impact of the new paradigm in health, social care, welfare and employment. We oppose the individualisation and medicalisation of the social, political and material causes of hardship and distress, which are increasing as a result of austerity cuts to services and welfare and the unjust shift of responsibility onto people on low incomes and welfare benefits. Our recent conference focused on Welfare Reforms and Mental Health, Resisting the Impact of Sanctions, Assessments and Psychological Coercion.

[2] Parliamentary committees, the national press, endless reports from charities, service user organisations, people with disabilities, claimants unions and workfare campaigners have been reporting the physical and psychological damage of ‘welfare reform’ and its tragic outcomes for a decade.

[3] On psycho-compulsion and the benefits system see Friedli and Stearn http://mh.bmj.com/content/41/1/40.full and https://vimeo.com/157125824

[4] In February 2015 over a million people claiming ESA under a MH diagnosis were in either the Support Group or WRAG. Over 70% of new applicants for ESA are found unfit for work

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/470545/3307-2015.pdf

[5] https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212266/hwwb-mental-health-and-work.pdf p.17

[6] Secker, J., Grove, B. & Seebohm, P. (2001) Challenging barriers to employment, training and education for mental health service users. The service users’ perspective. London: Institute for Applied Health & Social Policy, King’s College London.

[7] Ibid, pp. 397-399

[8] Compare a DWP survey of disabled working age benefit claimants in 2013. 56% of 1,349 respondents agreed that they wanted to work. Only 15% agreed that they were currently able to work. Only 23% agreed that having a job would be beneficial for their health. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/224543/ihr_16_v2.pdf

[9] For example, some of this complexity is flagged by Blank, Harries and Reynolds (2012) The meaning and experience of work in the context of severe and enduring mental health problems: An interpretative phenomenological analysis Work: 47 45(3)    “Stigma, the disclosure of a mental health problem and the symptoms of the mental health problem are frequently described, as well as feelings of hopelessness, seeing recovery as uncertain, and feeling a lack of encouragement from services. Difficulties in accessing occupational health services, having a disjointed work history, lack of work experience, age, lack of motivation and fears about competency, as well as the social benefits system and caring commitments, are also experienced as barriers to accessing employment for people with mental health problems.”

[10] https://www.parliament.uk/business/committees/committees-a-z/commons-select/work-and-pensions-committee/news/benefit-sanctions-report

 

Mental health activists, workfare campaigners and therapists protest against work cure therapy for benefit claimants with mental health disabilities

  It’s time for the psy professional bodies to stop colluding with the DWP 

Join the protest against the professional bodies supporting work cure therapy for benefit claimants with mental health disabilities

Tuesday 5th July at 9 am at the New Savoy Conference

Hallam Conference Centre, 44 Hallam Street, London W1W 6JJ

Central London @ Great Portland Street tube (Map here)

See the conference programme here


For a decade or more, the Government has been deploying psychotherapy to get people with mental health difficulties off benefits, back to work and mapped into the neoliberal labour market. Since 2010, austerity policies of welfare reform – punitive Work Capability Assessments, benefit cuts, workfare, sanctioning – have intensified government strategies of psycho-compulsion and work cure for welfare claimants. IAPT therapists are being co-located in Jobcentres, DWP mental health advisers and employment coaches in GP surgeriesfood banksschools and libraries.

The big five national organisations representing the professions of counselling, psychotherapy and clinical psychology* have welcomed these policies and the state funding of back-to-work therapy.

As members of the New Savoy Partnership, they have been major players in The New Savoy Conference, an annual jamboree and market stall for state therapies in the NHS. The NSC frequently stages opening addresses by DWP and Health ministers to assert the close relationship between the professional bodies, MH charities and Government mental health and work-cure policies and funding. Hundreds of mental health workers accredited by the psy professional bodies have been hired by the DWP to provide “support into work”. These are jobs that are experienced as deeply unethical by many of the professionals being steered into this kind of work.

In March this year, the Mental Wealth Foundation (see below) wrote to the five professional organisations challenging their support of the government’s use of psychological therapies to put pressure on people with mental health disabilities to get into work. You can read the exchange of letters between us and the professional bodies here.

So far, all but one of these organisations are refusing to speak to us and continue to argue that they have had private reassurances from the DWP that “work cure” therapy will not be mandatory for claimants, and will not involve setting entry into employment as a therapeutic outcome. This claim defies the reality of the DWP’s record of punitive and coercive policies of workfare, Work Capability Assessment and sanctioning and its growing determination through its Work and Health initiatives to prioritise work as the therapy of choice for long-term mental health disability.

British Association for Behavioural and Cognitive Psychotherapies; British Association for Counselling and Psychotherapy; British Psychoanalytic Council; British Psychological Society; United Kingdom Council for Psychotherapy

Come and join the protest against work cure therapy for benefit claimants with mental health disabilities. All welcome. Gather at 9am on Tuesday 5th July outside the Hallam Conference Centre, 44 Hallam Street, London W1W 6JJ. For more info contact eventsatfpn@yahoo.com


The Mental Wealth Foundation (MWF) is a broad, inclusive coalition of professional, grassroots, academic and survivor campaigns and movements. We bear collective witness and support collective action in response to the destructive impact of the new paradigm in health, social care, welfare and employment. We oppose the individualisation and medicalisation of the social, political and material causes of hardship and distress, which are increasing as a result of austerity cuts to services and welfare and the unjust shift of responsibility onto people on low incomes and welfare benefits. Our recent conference focused on Welfare Reforms and Mental Health, Resisting the Impact of Sanctions, Assessments and Psychological Coercion.

Currently, seventeen organisations are gathered under the MWF umbrella: Mental Health Resistance Network; Disabled People Against Cuts; Recovery in the Bin; Boycott Workfare; The Survivors Trust; Alliance for Counselling and Psychotherapy; College of Psychoanalysts; Psychotherapists and Counsellors for Social Responsibility; Psychologists Against Austerity; Free Psychotherapy Network; Psychotherapists and Counsellors Union; Critical Mental Health Nurses’ Network; Social Work Action Network (Mental Health Charter); National Unemployed Workers Combine; Merseyside County Association of Trades Union Councils; Scottish Unemployed Workers’ Network; National Health Action Party

Manchester Conference Saturday 21st May 2016

Mind the Gap: Free Psychotherapy in an Unjust World

Sat, May 21, 2016 at 11:00 AM

Friends Meeting House, – 6 Mount St, , Manchester M2 5NS, United Kingdom – View Map

A conference organised by the Free Psychotherapy Network

The state of our emotional and psychological lives is as fundamental as our material standard of living – our incomes, our physical health, our working conditions, our education and housing. Yet we live in a society whose dominant political and cultural messages over-emphasize money, profit, property and consumption. At the same time, the quality of our emotional lives and relationships with our families, friends, co-workers, neighbours and wider communities is undervalued.

This conference is an opportunity to explore and develop sustainable networks of psychological support which are community led. The aim is to create a collaborative space for therapists, service users, survivors, claimants’ unions and community groups to explore our experience, our needs and desires together. We have much to learn from each other!

The day will be workshop based. Workshop themes may include: sick individual or sick society?; peer led groups – what works, what doesn’t; the experience of FPN so far – free work and working free of funding and institutional restraints; minding the gap between the ‘professional’ and the ‘client’ – exploring the power relationship between therapists and clients; building the relationship between FPN and community groups; developing FPN local groups.

If you would like to suggest or run a workshop, please email: eventsatfpn@yahoo.com – add your suggestions here

The conference is free. All welcome.

If you would like help with travel costs we may be able to help, email: paulwilliamatkinson@gmail.com

 

The venue is wheelchair accessible.

Book a free place via Eventbrite here

 


Open letter to therapy’s professional bodies on the psychocompulsion of welfare claimants – from the Mental Wealth Foundation

_______________________________________________________________

 

Mental Wealth Foundation is a broad, inclusive coalition of professional, grassroots, academic and survivor campaigns and movements. We bear collective witness and support collective action in response to the destructive impact of the new paradigm in health, social care, welfare and employment. We oppose the individualisation and medicalisation of the social, political and material causes of hardship and distress, which are increasing as a result of austerity cuts to services and welfare and the unjust shift of responsibility onto people on low incomes and welfare benefits. Our recent conference focused on Welfare Reforms and Mental Health, Resisting the Impact of Sanctions, Assessments and Psychological Coercion.

________________________________________________________________

 

Date                21 March 2016

From:

Mental Wealth Foundation

Mental Health Resistance Network

Disabled People Against Cuts

Recovery in the Bin

Boycott Workfare

The Survivors Trust

Alliance for Counselling and Psychotherapy

College of Psychoanalysts

Psychotherapists and Counsellors for Social Responsibility

Psychologists Against Austerity

Critical Mental Health Nurses’ Network

Free Psychotherapy Network

Psychotherapists and Counsellors Union

Social Work Action Network (Mental Health Charter)

National Unemployed Workers Combine

Merseyside County Association of Trades Union Councils

Scottish Unemployed Workers’ Network

 

To:

British Association for Behavioural and Cognitive Psychotherapies

British Association for Counselling and Psychotherapy

British Psychoanalytic Council

British Psychological Society

United Kingdom Council for Psychotherapy

 

 

Professional bodies scrutinise Government therapists in job centresplans

 We write in response to your joint public statement of 7 March 2016 outlining the outcome of your meetings with the Government’s new Joint Health and Work Unit and your scrutiny of the Government’s plans to place therapists in job centres [1].

There is no indication that any consultation has taken place with members of your organisations with knowledge of these matters nor with service users, clients and their representative organisations. This lack of consultation and opportunity for wider reflection has contributed to your organisations departing from your own ethical structures and frameworks, and being seen as agents of harmful government policy [2]. It is by now generally accepted that the consequences of the DWP and government policy in this area are far reaching for physically and mentally disabled people on social security benefits. Inexplicably your organisations’ scrutiny of government plans has failed to recognise this.

The joining of Government Health and Work Departments is not helpful, and current DWP policy intended to reduce the socio-economic causes of mental illness to the one simple fact of unemployment is clinically and intellectually ridiculous. The resulting policy promoting work as cure, which your organisations are now supporting, is offensive and dangerous. It is wrong for therapy organisations to buy into the unthinking praise for ‘work’ that often forms part of the rhetoric of governments.

While for some clients improving employment prospects may be an objective, for many others this is not the case and may be profoundly damaging. Indeed, for some people, their mental health problems may have begun because of work e.g. through experiences of bullying in the workplace. This one size fits all approach is simplistic. Premature return to work can result in loss of confidence and relapses affecting future ability to get back to work. This can also lead to prolonged periods without benefits and no income [3].

You state that plans must be aimed at improving mental health and wellbeing rather than as a means of getting people back to work. These are not the aims and objectives being expressed by the people who are implementing the programme right now, involving targeting ‘hard to help’ clients who are likely to be people with enduring physical or mental health difficulties. For example in the Islington pilot project Councillor Richard Watts has stated, “We think there is much more that health services can do to promote the idea of employment for people with health conditions.” In the Islington CCG Commissioners’ report in November calling for employment services in GP surgeries to reach ‘hard to help’ claimants, they state that, “to improve the system we need to…maximise the contribution of all local services to boost employment, making it a priority for health, housing, social care and training. We need to open up how we talk to people about employment, including asking healthcare professionals to have conversations about work with patients, as part of their recovery. We need to give professionals the information and tools to help them to do this.” [4]. For all clients, establishing a trusting relationship is the first priority, involving respecting their current needs, perspectives and autonomy.

Jobs advertised on the BACP website in November 2015 have the explicit aim of getting clients back to work and engaging with employment services e.g. “your role will include: producing tailored health action plans for each client, focusing on improving their health and moving them closer to work…generate health and wellbeing referrals to ensure continued engagement with employment advisers” [5]. Similarly G4S advertise jobs for BABCP accredited CBT practitioners with job roles including: “Targeted on the level, number and effectiveness of interventions in re-engaging Customers and Customer progression into work” [6].

We respectfully submit that information about these jobs was known to all of your organisations when you issued your joint statement. This inconsistency is seriously misleading.

We are glad that you oppose conditionality, coercion and sanctions. Clearly such punitive measures have no place in the therapeutic relationship. We fail to share your reassurance from the government that these measures will not be pursued against clients. DWP have repeatedly claimed that sanctions are a last resort and only happen in a tiny minority of cases. The reality is that millions of people have been sanctioned. In the twelve months to September 2015 alone, over 350,000 ESA and JSA claimants were sanctioned [7]. In the Employment Support Allowance Work Related Activity Group the majority of sanctions were of people who have been placed in the group specifically because they are experiencing mental health issues and research shows that benefit sanctions on people with mental health problems has increased by 600% [8].

It is not possible to consider this issue without considering the context of sanctions, cuts and persecution which is endemic in the current system. You fail to acknowledge that attending this proposed therapy may not be explicitly linked to conditions/sanctions but will feel so for many of its prospective clients who are on benefits. There is a structural power imbalance between job centre employees and those on benefits. With their income under threat, those on benefits will be especially susceptible to cues, suggestibility and positive reinforcement when attending job centres. Many on benefits have experienced oppressive power relations for much of their lives. Saying no in relation to an apparent free choice in this context is hugely difficult, especially when saying no has uncertain consequences [9] .

Attempts to coerce people into work are detrimental not only to their health but to their safety and, in many cases, present a risk to life. The extreme fear and distress caused by the current welfare reforms, including changes in disability benefits and the new Work Capability Assessments, is widely reported including instances that have led to suicide [10]. Therapy alongside this coercive system breaches the ethical principle of non-maleficence.

You state that there must be choice as to location of therapy. There is a clear danger in putting DWP representatives into GP surgeries, community centres and food banks that are seen as safe havens for people on low incomes and benefits. The presence of DWP compromises this. DWP/Maximus workers in the GP surgery, with access to medical records, will serve as a deterrent to people visiting their family doctor. The model currently in use in Islington allows Remploy/Maximus workers to access and write into GP records; this jeopardises any commitment to client privacy and confidentiality [11].

The choice of method of therapy is an illusion and therapists of all modalities are subject to the stresses of an unjust target driven culture [12]. We are concerned that under-qualified and inexperienced staff, such as job centre coaches, will be in a position to make referrals to Health and Work programs. This is exacerbated by the fact that referrals are likely to be to IAPT workers, many of whom themselves lack in-depth training and experience of severe mental health issues. Inappropriate referrals are increasingly likely in a target-driven culture.

We are not reassured that the feasibility trials planned by the government will contribute to knowledge and understanding and are not reassured by your echoing what government is saying. Instead you and government must listen to the voices of survivors who describe the reality of government plans on their lives and are fighting for services with a vision of humanity beyond work [13].

It is clear from your public statement that you have failed to critically examine and scrutinise the ongoing activities of the Government Joint Work and Health Unit. We call on you to cease your engagement with this unit and instead hold a national stakeholder event which is guaranteed to involve the participation of representative organisations for service users and therapists with direct knowledge of the area, as well as professional bodies like yours. There should be no government involvement in such an event. From it, a representative group can be selected that will adequately represent the views of service users and therapists to the appropriate government departments as well as to the opposition.

References

  1. http://www.bacp.co.uk/media/index.php?newsId=3906
  1. https://www.opendemocracy.net/ournhs/dr-lynne-friedli-robert-stern/why-we-re-opposed-to-jobs-on-prescription
  1. https://www.morningstaronline.co.uk/a-a3e3-Joblessness-branded-a-mental-illness#.VuKWT4SFDzI
  1. http://www.islingtonccg.nhs.uk/Downloads/CCG/BoardPapers/20151111/4.3%20Health%20and%20Employment%20Programme.pdf

5          ‘Mental Health Advisor – Job Details’ Retrieved from http://www.bacp.co.uk/jobs/jobs.php November 21st, 2015. Available athttps://www.dropbox.com/s/a6p9mod1jb08dne/Mental%20Health%20Advisor%20-%20Job%20Details.docx?dl=0

6          http://careers.g4s.com/jobs/Cognitive-Behavioural-Therapist_58526/6 crisis

  1. https://www.gov.uk/government/statistics/jobseekers-allowance-and-employment-and-support-allowance-sanctions-decisions-made-to-september-2015
  1. http://www.independent.co.uk/news/uk/politics/benefit-sanctions-against-people-with-mental-health-problems-up-by-600-per-cent-a6731971.html
  1. For a fuller discussion of these issues, see http://mh.bmj.com/content/41/1/40.full
  1. http://jech.bmj.com/content/early/2015/10/26/jech-2015-206209.full
  1. Para 4.3 http://democracy.islington.gov.uk/documents/s6740/Health%20and%20work%20-%20HWB%20update%20Jan%202016%20final.pdf

http://www.pulsetoday.co.uk/home/finance-and-practice-life-news/gps-told-to-inform-patients-dwp-will-obtain-their-fit-note-records/20030820.article.

See also http://files-eu.clickdimensions.com/hscicgovuk-amnje/files/emed3dpnlettertogppracticesv1.0.pdf?_cldee=Y29yYWwuam9uZXNAbmhzLm5ldA%3d%3d&urlid=0

  1. http://www.theguardian.com/healthcare-network/2016/feb/17/were-not-surprised-half-our-psychologist-colleagues-are-depressed

 

  1. http://recoveryinthebin.org/2016/03/10/welfare-reforms-and-mental-health-resisting-sanctions-assessments-and-psychological-coercion-by-denise-mckenna-mental-health-resistance-network-mhrn/

The Christmas Ogress

We would visit the old river valley again,

Seam of silver below black mountains,

our dream of a time

when people lived simply,

at peace with the landscape,

walking and working there.

In the dark of winter, in the festival of light,

Even the old women wore crowns

Flaming like flowers. .

At night, at dusk when the light fails and the fire is low.

we long to travel there.

Yuletide stripped of our disappointment, our city sophistication.

And yet… if the stories are true,

There lives also Gryla, rarely seen.

Screaming down from her cave

above the icy mists.

 

Flying high out of the smoke and fire,

Flying high over the lava fields,

Comes Gryla, in the shape of an eagle,

From her eyrie in the mountains

She strikes down to the little towns in the river valley

Consumed with a hunger she knows not, assuaged by nothing except…

 

Scolded, the children stand by the fire,

round eyed at the tale,

Slap still stinging on their bare legs.

 

Gryla, Gryla, Gryla

Oh then comes Gryla

Gorging on their innocent delicacy.

 

Wikipedia tells us that Grýla was not directly linked to Christmas until the 17th century and that her name may mean “threat” or “threatening”. In the folktales, Gryla can detect children who are misbehaving year-round and at Christmas time, she comes down from the mountains to search nearby towns and devour naughty children for whom she has an insatiable appetite. The legends comment that there is never a shortage of food for Gryla.

My route to Gryla, whom I did not know before, was a thought-journey to the North – via Radio 3 Northern Lights themed programmes which also took  me to Tanya Tagaq’s extraordinary voice and the soundtrack to Nanook of the North, which brilliantly evoked the strangeness and vastness of the inuit landscape.

But also to another soundtrack – composed by Valgeir Sigurdsson – called Draumalandith.  Written post the Icelandic financial collapse, it is a critical and creative response to a sense that everything was going wrong in modern society.  In the sleeve notes to the CD, Andri Snaer Magnason writes:

“The book Dreamland was written during a time in Icelandic society when dissidents gained power in the fields of privatisation, energy and foreign affairs.  The revolution was a quiet one, a ‘peaceful’ one, and many considered it to be sensible and furthermore, inevitable.  …. When the world at large seemed to be moving towards new technology, new methods of communication and generally a more environmentally friendly mentality, the Icelandic government decided to invite companies and corporations of questionable reputation to come to Iceland, to take advantage of – and eventually destroy – manyh of the country’s most valuable resources.”

“Flying over the Fljotsdalur waterfalls that are no longer there, a solitary viola is our guide, and we can sense the threat…. We fly over the sand pyramids on Vatnajokull, in the direction of an area that is to be destroyed because of a short-term gold rush.  The shrill brass tones resonate and contrast with the heavy, impenetrable silence. “

The first track  – which I like so much – is called Grylukvaedi.  I found a website that gave the Icelandic lyrics and used Google to translate them – with some very obvious failures to give acceptable English translations. The poem I am in the process of making is not a translation, therefore, but takes off from a very faulty translation, further very faultily interpreted by me, also, I am sure, before taking me off into my own thoughts.   Partly about the wholesale destructiveness of humanity, it is also particularly about its manifestation not just in our wars and corporate ravishing of the land and its peoples, but also in what we are doing to perpetuate that when we frighten children with tales of being eaten by ogres if they don’t behave.  A story that became attached to Yule, that precursor of Christmas. Our own modern version is that ‘Santa’ won’t bring any presents to naughty children  (and many European Yule stories are anything but stories of generosity and love). And yet we  maintain a perhaps idealised – fantasy-nostalgia of a simpler, more ‘natural’ past where people were happier – a Christmastime of family jollity and togetherness.  But life was and is harsh for many if not most, and people were harsh in how they faced it, and taught, beforce, their children that harshness.

So to my mind, there was always Gryla, in even the most paradisal of imagined worlds. We conjure those ideal worlds – our Edens from which we know we have banished ourselves – as flowers of light in our darkness, desperately fragile, falteringly hopeful. Ever to be treasured and sheltered from the icy blasts.

And perhaps I am saying that Gryla is always part of us and part of what we are and what we fear – the ravening, destructive part of ourselves that pitilessly (but rationalised as necessary) brings childish innocence to an end.  And in the music I heard our sorrow for our own part in destroying it, and our sorrow for its part in our own loss. Hardest of all to think about is the satisfaction we feel – Gryla’s lust in her cruelty;   something that we do not easily allow ourselves to know – hence the ‘it’s for your own good’ excuses we make. Fracking is good for our economy, for example.

And, on another plane, Gryla is imagined as a woman – the dark fears of woman as an elemental force of destruction – the perversity of eating her own children, consuming the future and its resources – that stalks the deepest imaginations of humans all over the world. Life giver and life destroyer.

 

 

Empathy Explores Beyond Limits – Peter Ryan

 

Death is like a cold, dark whirlpool, a wave of suffering, just waiting to wash us away
you who rest in comfort upon the shoreline, how can you know our state? (Hafiz)

I am a passionate about spreading the word, work and wonder of empathy. This passion is born out of years counselling studies and practice experiences. However, it is individuals from various social, economic and cultural backgrounds that have shown me just how far reaching the cosmic dimensions of empathy can be. Empathy penetrates the darkest corners of the human condition and sheds an understanding light of acceptance onto the chaos of existence.

It has a Ninja-like quality of daring at its heart. I named this quality a courageous sensitivity.

The effectiveness of my courageous sensitivity to engage traumatised individuals in the therapeutic process is evidenced in Extending the Empathy Zone Embrace[1].

I believe, the secret to exploring hurtful experiences locked within the inner terrain of human existence is down to one fundamental fact – empathy is a born survivor. It thrives in the unknown, vulnerable, emerging presence, keeping its edge sharp. Instinct is empathy’s whiskers, intuition its resonator. Empathy recognizeswelcomes and treasures the individuality, personhood, identity, spirit or soul of the other human being in all its shared and unique aspects[2]. That is why, when labouring with raw materials from a client’s subterranean world, it is essential external forces of influence, bias and control on a person are equally welcomed for empathic exploration. Not all psychological problems are caused by childhood experiences; not all emotional stress concerns individuals. The influence of history, geography, economics, philosophy and religion on individual responsibility is vastly underestimated[3]. A closed system of relating only condemns people once again to draw in the exhaled breath of oppression found in stuffy, compartmentalised environments. An empathic ecosystem liberates individuals by its refreshing, interconnecting atmosphere. Its breath-taking relationship is designed to blend in with its surroundings, not to be apart from it.

Empathic understanding…always leads directly into the psychic connection itself. Rational understanding is merely an aid to psychology, empathic understanding brings us to psychology itself. (Karl Jaspers)

There is still a lot of misconception about empathy. It’s often mistaken as a fluffy, “female” feeling to be used as a tissue for mopping up tears. Nothing could be more wrong. Empathy is always knowledge-based[4] drawing on both masculine and feminine qualities beating quite capably at its organic heart. Empathy’s unisexual soul is the bedrock of what it means to be a complex human being. And attempts by many high ranking professionals seeking to place a “cognition crown” on empathy’s majestic head are doomed to failure. This top-down approach heavily laden with logic and order will just not do. Parading empathy in ordered logic as the ideal state of mind not only betrays a deep wariness towards human unordered and often irrational feelings and emotions but also demonstrates a poor understanding of empathy’s true power. Viewing empathy through such a lens condemns it to exist in a restricted, incongruent and lifeless enclosure whose walls are fiercely guarded by seemingly superior reason. If this state of affairs continues to gain ground in the counselling realm, it will rip the heart out of empathic engagements. I am reminded of the late Indian history writer and teacher, Abraham Eraly, who said: Everything was efficient and well-ordered in the Indus cities, most remarkably so, but there was little scope for artistic flourishes or individual creativity in this bloodless, precision-engineered society.

 From the first moments of a therapeutic encounter with a client, I let empathy guide our way through the session. Empathy is felt and reasoned simultaneously. It is a quantum experience[5]. As the dynamics of our empathic connection develops and clients stop hugging the shoreline of familiarity then the spirit of adventure into understanding the waves of their suffering can begin. Empathy is the sail that keeps the vessel of healing afloat in the dark whirlpool. Therapy without empathy is not counselling. And counselling without empathy is not therapy. Empathy is not a ‘technique’ of responding to the client, but a way-of-being-in-relation to the client[6].

Empathy is extremely effective in alleviating shame – the underlying emotion of many disturbing feelings and behaviours. As beautifully expressed by five year shame researcher Dr Brené Brown: Shame is highly, highly correlated with addiction, depression, violence, aggression, bullying, suicide, eating disorders (…). Shame is an epidemic in our culture. Empathy is the antidote to shame[7].

In order to be vigilant against the creeping vine of shame and its ability to produce chock-off points, therapeutic engagement requires constant use of body awareness which is the gateway to keeping empathy fresh when dissolving shame. Empathy is not only a born survivor. It is the rescue service available in bringing isolated clients back from the brink of oblivion and into the fold of humanity. It is not for nothing that empathy represents the deepest expression of awe, and understandably is regarded as the most spiritual of human qualities[8].

I believe that finding answers to difficult issues is made easier when clients are fully supported by an empathic therapist who trusts in their capacity to transform. For empathy, in all senses of the word, involves an ongoing, ever-changing process of self-transformation[9]. This confidence in empathy and positive transformation has an evolutionary component embedded in my sense of trust.  For we humans are gifted with possessing the most highly sophisticated powerhouse of abilities on the planet – the nervous system with the most powerful brain known to us. This highly specialised system utilises and arranges interactions between humans and the world around us. It is regulated by the constant flow of information via sensing, instinct, intuition, visceral experiences, images and perception. Being open and non-judgemental to the plethora of ‘subterranean gifts’, generated by new experiences, is vital to keeping our powerhouse in pristine top-notch shape. Consequently, if the nervous system is used to distort or deny perceptions and experiences, and emotions and feelings that those persecutions and experiences could/would evoke, it becomes overstressed and starts failing, and with it the zest for real, authentic life.

For empathy to thrive it must feel the pulse of emotion. Emotion is the engine where the zest for life is created. Emotion is the true touch-stone in successful empathic communication and is the gateway to authentic living. Authenticity is to empathy what water is to life. The bridge linking empathy and authenticity is called unconditional acceptance. Empathy distilled from a non-judgemental openness draws forth the clear, clean waters of authenticity in an endless cycle of rebirth and sparkling purity. Accessing the life force of authenticity is dependent upon maintaining the quality of a non-judgemental presence. Empathy and unconditional acceptance enhance one another in promoting movement towards congruent living.

Thus the first step towards an empathic life and authentic living is to take a stand. That is, take ownership of what we are experiencing and by doing so calibrate our ability to evolve fully into the unfolding moment. In counselling, as in life, limits imposed on experiencing the integral stream of our internal information system keeps human potential locked in a flat-earth landscape.

We don’t always have to express verbally what we are feeling, but, as Carl Rogers phrased it, we must be open to making our feelings available to our awareness. We need to tune in and trust in our private unique frequencies and rhythms. By doing so we allow for a more confident space to bloom in which the fruits for an empathic life and authentic living can be enjoyed.

To be faithful to that which exists nowhere but in yourself — and thus make yourself indispensable.

(Andre Gide)

 

[1] http://uktherapyguide.com/blog/extending-the-empathy-zone-embrace/

[2] http://www.empathictherapy.org/What-Is-Empathic-Therapy-.html

[3] Clarkson P. The therapeutic relationship. London: Whurr publisher Ltd; 2009

[4] Joseph S. and Worsley R. Person-centred psychopathology. United Kingdom: PCCS Books Ltd; 2012

[5] Rifkin J. The empathic civilization. Cambridge: Polity Press;2010

[6] Mearns D. and Thorne B. Person-Centred counselling in action. London: SAGE Publications, London; 2008

[7] https://www.ted.com/talks/brene_brown_listening_to_shame?language=en

[8] Rifkin J. The empathic civilization. Cambridge: Polity Press;2010

[9] Cinramicol A & Ketcham K. The power of empathy. London: Piatkus publications;2000

Going clean, going legal and the personal responsibilities of the ‘productive’ citizen – Lena Theodoropoulou

Francis Alys Don't cross the bridge before you get to the river
Francis Alys Don’t cross the bridge before you get to the river

In theory

The coalition’s government [i] drug strategy for 2010-2015 is a clear, straight-forward document that describes their intentions and plans as well as the changes that actually took place in the UK drug recovery system during the past five years.

The document starts with a statement by the Home Secretary and her commitment to chase those involved in the drug trade; following that, she attempts to make an arbitrary link between drug use, organised crime and the security of UK borders. The inexistent in the real world, as described by the Home Secretary, distinction between drug users and drug traders is no news; the fact that it is mentioned though at the very beginning of the document makes it clear that for its instigators, addressing the connection between offending and drug activity (use or trade) is a priority for the ‘safety of the community’ and their strategy will evolve based on that conviction.

In the main body of the document it is mentioned that amongst the main targets of recovery is for individuals to cease offending, stop harming themselves and their communities and successfully contribute to society. Further on, it is stated that ‘key to successful delivery in a recovery orientated system is that all services are commissioned with best practice outcomes in mind’ that include: a reduction in crime and re-offending, sustained employment, the ability to access and sustain suitable accommodation, improved relationships with family members, partners and friends and the capacity to be an effective and caring parent. At the same time, the government calls the services to provide individualised, person-centred treatment and care plans tailored to the service-users’ needs. This is quite a paradox as, based on the guidelines above, it is obvious that the centre of attention is not the person that actually asks for help but the safety and wellbeing of the people and institutions around them. It is clearly stated that the services won’t be judged (and funded) on the premises of their therapeutic work, but on their ability to produce ‘good citizens’, meaning citizens that have a job, a house, are part of or in the process of forming a nuclear family, are good parents, do not offend etc. It is safe thus to conclude that individualised treatment only refers to the identification and correction of the ‘deviances’ in the service-users’ lives, rather than an effort to accompany them in the discovery of their own aspirations, plans and chosen way of being.

 

In Practice

As a support assistant at a residential detox and rehabilitation centre, I was invited to attend with the residents a group called GOALS, delivered by an external facilitator. The initials stand for ”Gaining Opportunities and Living Skills” and it is designed to teach the participants the ”Ten Keys of Success”. The facilitator introduces it as a course on how to become successful, delivered in a variety of settings, including companies that are interested in strengthening their employees’ motivation.

The GOALS group focuses on encouraging the participants to take responsibility for their own actions, acknowledge the fact that there is always a choice and learn how to leave the past behind them. The booklet of the course includes a variety of decontextualised catchy quotes coming from thinkers, philosophers and celebrities. Positive thinking and anger management become priority areas and the facilitator starts using examples on personal responsibility and the availability of choices. Among others, she uses the example of the UK’s age of criminal responsibility (the age of 10) and states that by that age people are able to tell the difference between right and wrong (and hence take responsibility and pay the consequences of their actions). The following example is about a man claiming that he had no other choice but to steal in order to feed his children. Once more, alternative options are presented to the group including food banks, or even looking for food in the garbage in order to avoid offending. And finally, when it comes to anger, the participants are advised to leave the past behind for their own good and learn how to forget and forgive.

Bit by bit and with one example after another, a value system is created, based on personal responsibility and the identification of legality with justice. It is also interesting that, although the examples used throughout the course didn’t mention directly drug/alcohol dependence, the connotation is obvious: obedience and legality equals a clean and happy life while disobedience and resistance equals social exclusion and relapse; and it is the enforcement of such equations that render the specific recovery model not just invalid but also unethical and dangerous. If there is a shared, universal feeling amongst people that have experienced drug addiction that would be guilt and shame. In addition to that, the route towards treatment is not an easy one. It usually involves lots of pain, disappointments and disillusionment as well as a feeling of defeat. All these conditions put the person that asks for help in a vulnerable, but also a very respectable position; manipulation though is definitely not the way to show respect. The government’s drug strategy pushes towards treatment that steps on peoples’ guilt and anger (in many cases the outcome of personal as well as social suffering) in order to create obedient, functional and productive citizens. Although the basic principles are quite similar in most treatment models, the reasoning behind them is completely different. Violence and offending for example constitute a ‘boundary’ in most treatment models around the world, not because it is ‘not right’ but because it reflects a lifestyle in many cases adopted during the times of addiction and bears negative connotations for the people in recovery. Additionally, linking offending, criminality and eventually drug dependence with resistance to social injustice and any behaviour that goes against the norms is again an effort to manipulate people during a very sensitive period of their life and takes us back to the initial point of this text that the government’s drug strategy is not about supporting the people that ask for help but about creating ‘safe communities’ and forcing social stability. Finally, playing the card of personal responsibility is an attempt to take the weight off the State’s back when it comes to social injustice and exclusion.

The subordination to a substance is the outcome of the original fear of a person to stand against the world with a clear mind; and this fear is not a choice but a result of the marginalisation since an early age of those that fail to fit in the prevailing social narratives and adapt to the rules of institutions. The failure there is not personal but systemic and has its roots in the imposition of social norms in a top-down fashion. The government’s approach to addiction creates a vicious circle that reproduces rules, restrictions and oppressions, even in the intimate and in theory free of all fear space of recovery.

All this is not to say that personal responsibility does not exist and does not play an important role in recovery. It does though alongside social and collective responsibility and does not only apply to the ex/drug users but to everyone else surrounding them, including drug workers, researchers, services, policy makers etc. Drug recovery is not (just) about being able to stay healthy, get a job and have babies. It is also an act of resistance, an escape from a pointless routine and a desire for freedom. Thus, addiction can only be treated in an environment that offers people the freedom to make their own choices, free of social expectations; free of the guilt of failure to reproduce stereotypes.

[i] This text is based on the previous government’s drug strategy, the outcomes of which are by now embedded in the practices of drug services. Although the new conservative government hasn’t yet published its drug strategy for the next five years, it is quite safe to say that they are expected to follow a similar agenda as they are the instigators of the current drug strategy anyway.