At home on their own

This was originally published in 2006

This is a story that is funny in hindsight but wasn’t at all funny when it happened.

When we were living in New Zealand, Hannah and Sam (then aged 13 and 11) were happy enough, going to school and enjoying the Kiwi way of life. They attended drama lessons at a local community centre, and one evening came home with a flyer from a TV company asking for volunteers for a new TV show.

If only we’d thrown the accursed thing out! But no, that would have been too sensible for a proud dad like me!

We thought it might be exciting and educational for the kids to be involved in a TV programme and I contacted the company to find out more. I was told that the show was about the children redecorating parts of the house in fun themes. This sounded like it could be interesting. I remembered seeing some such programme where the family ended up with some great improvements to their house, so said sure, we were interested.

Our house was a pretty spectacular timber building with lots of balconies located in the Lynfield/Blockhouse Bay area of Auckland, overlooking the Manakau Harbour. We all loved it.


Inside, it had been carefully decorated (by the previous owners) with neutral colours that were used throughout the house. We had what in New Zealand was known as a ‘Rumpus Room’ and this large, mainly pine-clad room was used by the children as a space to muck around, use their computer or watch TV.

Downstairs was a spacious open plan living area that incorporated our kitchen and dining table. This area was the hub of the house, and Donna and I really liked this space.


Not long after the phone calls and email contact with the TV company, we were visited by a very pleasant researcher, who spoke to Donna and I and the children. She wanted the children to generate some ideas for redecorating parts of the house. Donna and I told her we were happy for them to do use the rumpus room, their bedrooms and outside, but under no circumstances do anything to the living area. The ideas that the children came up with were supposed to be kept from Donna and I but the children told us that they had planned a space theme for the rumpus room and a tropical beach theme for outside.

The TV company were evidently taken with the children and our house and before too long came to do some initial filming, where they interviewed us all, and then Donna and I and the children separately. We got to meet the presenter, the interior designer, the producer and director, and of course the cameraman and sound man. They all seemed great people, friendly and interested in us as a family. The presenter talked to the children about their ideas and they all seemed very excited about the prospect of making their ideas come to life.

A few weeks later, the weekend arrived. Donna and I were to be whisked off to a luxury hotel for the weekend, whilst the children got to work with the team. The first indication that things weren’t quite right was when Sam locked himself in a cupboard not long after the team arrived. I spent quite a while trying to persuade him to come out, but he was adamant that he did not want to be involved. I thought he had cold feet and tried harder to convince him that it would be a lot of fun for him. Sam said ‘They aren’t going to do what we planned’ but I didn’t register his concern or distress. I thought he was just being awkward. How wrong I was.

Donna and I were filmed saying goodbye to the children, and then getting into the luxury car provided by the TV company, to be driven off to the hotel. Within seconds, however, the car stopped and we were asked to drive ourselves in our car to the hotel. We were somewhat perplexed by this, but went along with the request. We drove into Auckland, and checked in at the hotel, and spent much of the day wandering around the city. We had been asked to be at the hotel for 6pm for more filming and duly waited in our room, when the director arrived with a small video camera. We were filmed watching two snips of video showing what looked like our kitchen being painted with a dark blue and some sand being tipped somewhere. Donna and I were quite concerned at this point, but didn’t say much. Later we phoned the house and spoke to Bharti, our friend who was looking after the children. Bharti sounded concerned. She told us that Sam wasn’t feeling too well (he had a cold) but both of the children were really worried about what was happening to the house and how we’d react.

The next day, we were asked to be ready to return home at six in the evening. During the day the luxury car arrived and we were filmed both getting in and out of it. After editing, it really did look as though we had been driven to and from the hotel by the TV company. We set off to be back home for six, but received a phone call asking us to be there by seven instead, so Donna and I hung around our local supermarket, feeling more and more apprehensive. When we finally arrived home, we were asked to go straight to the garage and wait there. We waited in the garage for two hours. Much of the equipment the crew had used in our garage was covered in black cloth, but I could see polystyrene packing from what looked like a kitchen appliance poking out from behind some cloth. The smell of paint was very strong.

Finally, the team were ready to film the reveal. We were asked to keep our eyes closed and led up the back stairs to the rumpus room. Upon opening our eyes, we discovered a bizarre scene of a spaceship, floating spaceman and smoke. The presenter was evidently quite excited by this spectacle and crowed about how marvellous it all was. I wasn’t too impressed, but thought that seeing as it was the rumpus room, there was no harm done.

Next we were led into our bedroom, where I was asked to lie on the bed and pretend to snore. I was immediately drenched by a jet of water from a small pipe that had been tacked to the door frame, and this jet continued to squirt haphazardly despite the fact that I had leapt off the bed. I watched the bed slowly becoming drenched with a heavy heart.

Following this discomfiture, Donna and I were led through the upper floor of the house and down the stairs to our living area. It sounded ominously hollow as we made our way down the stairs with our eyes shut.

The final reveal was presumably the highlight of the evening – at least as far as the team was concerned. What we saw was unbelievable. Our kitchen and dining area had been turned into an undersea world, complete with a mural of a killer whale on the wall, a boat built around the work surface and around two tons of sand deposited on the dining area floor. To cap it all, a rusty 'treasure chest’ sat on top of the sand to complete the effect.


The presenter by this time was squealing with pleasure, but Donna and I were stony faced and unable to say much. We were really angry. The director, realising how upset we were, made some comment about how these programmes affect real people, but the producer curtly told her to do her job of directing and shut up.

The team promptly packed up and left. That was it, as far as they were concerned.

They had left the house virtually uninhabitable. Sam became really distressed at this point, and his anguish was punctuated by the house fire alarm suddenly going off. A smoke machine had been accidentally left on in the rumpus room for over an hour. I was devastated. It was one in the morning, my son was in tears, we couldn’t even make a coffee and I was due to present a key lecture at nine in the morning. To cap it all, the bed was soaking wet.

Whilst we were naive in letting this happen, the situation revealed that 'reality TV' has its dark side. All of us were misled by the team, but the extent to which the children were manipulated only became evident in the following days. Not only had their wishes been disregarded, but they had also been put in a position where they were directed to do things that they knew would upset their parents and were actually directed in what to say on camera too.

The contract I had signed (under the mistaken assumption the TV company were decent people) was watertight. If I took any action against them or made any public mention of our experience, I would be held responsible for any losses if the programme was not transmitted - up to NZ$100,000. I had never felt so angry, nor so impotent.

Dialogue doesn't work where there is no will to engage

Dialogue requires listening to other points of view. It involves collaboration and the commitment of all parties involved to be prepared to suspend their own assumptions and to listen genuinely to different perspectives. It means a commitment to trying to understand why people might hold very different opinions.

From my perspective, Jeremy Corbyn has consistently tried to be dialogical. It could have been one of his greatest strengths but has sadly proved to be a fatal flaw, given the current political context.

The UK political system is adversarial  - based on one side scoring points over the other and trying to win an argument and persuade through arguments. It is not dialogical or collaborative.

Part of the UK context also includes newspapers that are primarily owned by a wealthy elite who have a vested interest in retaining and maximising the wealth of the owners. Interestingly, in the recent election, Liverpool, where ’The Sun’ (owned by Rupert Murdoch) is shunned, overwhelmingly voted Labour. The predominantly right-wing media has shaped popular perceptions of Corbyn as weak, a terrorist sympathiser and not to be trusted.

Dialogue works. It works in peace processes. It works in therapy. It helps heal divisions. But only where there is a will to engage.

Corbyn’s has attempted to be dialogical and collaborative both within the Labour Party (which, to be fair, has lots of divisions within it) and in his broader approach. His attempt to be inclusive led to the perception of him not dealing with the issue of antisemitism within the Labour Party. His appreciation that the UK has been divided over Brexit again has led to his even-handed position appearing to ‘sit on the fence’, leading to the perception of him being weak and undecided.

The UK is not yet ready for Corbyn’s style of leadership – unlike some Nordic countries, where his politics would seem reasonable, and certainly not extreme.

We now face at least five years of what may prove to be a repressive right-wing government that will do more to look after the wealthy than the poor, increase inequality and possibly lead us dangerously towards intolerance.

The Labour Party must find a way forward, in the face of a biased media an adversarial parliament and voting system that is weighed heavily against it. It may be even more unbalanced going forward, so progress for the party will not be an easy task.

Retirement deferred by 11 years.

In another world, I would be retiring this month.  As it is, I still have to work another 11 years and 1 month.

I started paying into the NHS pension scheme in 1983. From 1988 I had ‘mental health officer’ status, which meant I could retire at 55 and have every year over 20 years’ service ‘doubled’. When I moved into education in 1992 I shifted to what is known as special class status, which meant still being able to retire at 55, but without the doubling of years. This also makes provision for up to five years break in service before losing special class status

Maybe this would have compensated for the sarcoidosis I acquired after working with TB patients as a student nurse in 1982 or the chronic back pain I have that is almost certainly as a result of poor lifting technique taught in the 1980’s further exacerbated by being regularly called to other wards to help lift very heavy patients.

In 1996, the NHS College of Health I worked for was integrated into a University.  When I transferred from the NHS pension scheme to the University Superannuation Scheme (USS) I was informed that all my NHS pension benefits, including my special class status, would be preserved by the USS and the terms of appointment deemed me to have had continuous service from 1st September 1983.

I had a break in service to work abroad (two years and eight months) from December 2000 until September 2003, when I then joined another University.

When I telephoned USS to enquire about my status early in 2011, I was informed on the telephone that although I had lost my MHO status, I still had Special Class status and would be able to retire at 55. However, in 2012 when I enquired again, I received written confirmation that I had lost all these benefits.

I returned to the NHS in 2013, to work as a therapist. Stupidly, I transferred my USS pension back into the NHS scheme and because of austerity measures, I now find that my retirement date is in 2026 and I no longer will receive a lump sum. If I’d left my funds with the USS, perhaps I might have had something at 60.

I guess this a salutary lesson in being careful with your pension planning and taking advice before career changes and development, but it speaks of the inherent unfairness in today’s financial climate, too.

I've been putting money into my pension all this time, but discover it isn't really my money if the government needs to subsidise the bankers.

Polar Opposites

The natural world is devoid of opposites. There is no ‘good’ or ‘bad’ in nature. Opposites are constructions of human consciousness.

Conscious purpose is selective, and leads inevitably to decisions that do not take into account the totality of systems involved.  We want the best outcome for as little cost and effort as possible and things that hinder us are ‘bad’ and things that help are ‘good’.

Most conscious purpose is well-intended, for example, to cure disease. The use of antibiotics has benefited many people, but the systemic costs of not fully understanding the implications of the wide scale use of these drugs are only now beginning to be felt.

Even the conscious purposes of being ‘wealthy’ or ‘powerful’ are usually well intended, after all, who doesn't want security and comfort for themselves and their loved ones? But the wider consequences of this thinking are dangerous and have resulted in millennia of wars, environmental damage and inequality. Naturally, once someone has power and wealth, they need to protect these assets, and therefore more power and wealth is required and so on.

This polarisation of wealth and power has ultimately led to a small number of people with unimaginable wealth and power who profit from conflict, disease and the resources required for human life. Of course, their wealth and power insulates these well-intentioned (from their perspective) folk from much disease and conflict.

As with any conscious purpose, factors that hinder wealth or power are ‘bad’ and factors that help are ‘good’.  The next step is to polarise further; from ‘us’ to ‘them’, and ‘bad’ quickly becomes ‘evil’, ‘stupid’ or ‘sub-human’. Racial and religious differences become intensified, problems associated with poverty are blamed on the victims and critics are insulted or silenced.

I am increasingly despairing at the widespread hatred and suffering in the human world and the damage we are doing to the very environment we depend upon. This crisis isn't a matter of learning from the past, but of changing the way we think, but so much vested interest is in keeping this particular status quo, because it is profitable to those with wealth and power. This addiction threatens us all.

My solution is to keep trying to do good; to make little differences and simply hope that maybe they will add up and make a real difference. But it's an uphill struggle.

Dishonesty in making peace

The Treaty of Versailles reneged on the terms of the Armistice. This dishonesty in making peace directly led to the second world war and indirectly to many conflicts following it, with the loss of millions of lives. Dishonesty in making peace is a dangerous precedent. 

No matter how abhorrent the crimes of John Downey and other criminals who were given what appears to be an amnesty (notwithstanding that these agreements may have been made in less than transparent circumstances), to renege on these agreements is treading on very thin ice.

Lean methodologies, KPIs and the NHS: A recipe for trouble?

The concept of lean originated from Toyota and is founded on a model of continuous product and process improvement and the elimination of non-value added activities. The value adding activities are simply only those things the customer is willing to pay for; everything else is waste, and should be eliminated, simplified, reduced, or integrated.

One of the significant aspects of lean is that of key performance indicators (KPI). The KPIs by which a plant/facility or organisation are judged will often be driving behaviour, because the KPIs themselves assume a particular approach to the work being done.

In the NHS, KPIs are used to examine and compare performance across NHS organisations. These indicators focus on areas such as length of stay, costs per episode of patient care and number of staff employed. Many assess efficiency within the service, whilst others examine clinical performance. The intention is to define a service and judge its effectiveness and KPIs also provide benchmarks to implement incentives and sanctions in an effort to improve overall quality. However, there is little or no evidence of what sorts of incentives and sanctions actually work to drive up quality.

For example, a Child and Adolescent Mental Health Service (CAMHS) that has approximately 100 referrals per month, has KPIs that define service levels with regard to how referrals are managed. Urgent cases need to be seen within 24 hours, with a follow up within a week. Another KPI is that young people who require assessment but are not urgent will be seen for a routine assessment within three weeks of the referral being made. There are also limits imposed regarding the number of cases not appropriate for specialised CAMHS who can be signposted to other services, for example local authority family support.

In terms of sanctions, if a young person is not seen within that period, the service will be penalised with a reduction in funding of £30,000. In a team that is already undergoing budget cuts and staff losses, it is hardly surprising that meeting KPIs dominates the management of the team, and leads to an emphasis on getting though as many assessments as possible. The downside of this emphasis is less attention being paid to the actual interventions and therapies provided for young people and their families; caring for desperately troubled young people has become simply a matter of meeting targets.

It is important to recognise that these KPIs were established by the commissioners of the service, and agreed by the senior managers of the service, none of whom have any clinical experience of working within CAMHS. This process also provides an insight into a significant flaw in the artificial ‘internal market’ of the NHS; those specifying and agreeing services may have little knowledge of the service and often do not consult with the practitioners.  

Another KPI specifies a DNA (did not attend for appointment) rate of 10%, so not only is the practitioner's time wasted at a cost to the service, but the service is punished by financial sanctions if the DNA rate goes over 10%.

One of my concerns with the lean culture is that it pays little attention to the wider impacts an organisation can have on the context in which it operates. For example, by ordering parts’ just in time’ from external suppliers, the external suppliers are bearing the costs of uncertain revenue streams and fluctuating demands, which may tempt them to cut costs in other ways; perhaps by employing staff on fixed term or temporary contracts – thus shifting uncertainty down to the workers themselves.

Other criticisms of lean are that lean practitioners may easily focus too much on the tools and methodologies, and fail to focus on the philosophy and culture of lean, or that management decides what solution to use without understanding the true problem and without consulting shop floor personnel. As a result lean implementations often look good to the manager but fail to improve the situation.

Whilst many hold up Toyota as an exemplar for lean working, it might be borne in mind that earlier in February, Toyota announced it is recalling 1.9 million of its Prius hybrids, 30,790 of which are UK-registered, because of a computer problem that could cause the vehicle to stop. This follows a series of recalls over many years as listed below:

Sep 26, 2007 – US: 55,000 Camry and ES 350 cars in "all-weather" floor mat recall

Nov 02, 2009 – US: 3.8 million Toyota and Lexus vehicles again recalled due to floor mat problem, this time for all driver's side mats.

Nov 26, 2009 – US: floor mat recall amended to include brake override and increased to 4.2 million vehicles.

Jan 21, 2010 – US: 2.3 million Toyota vehicles recalled due to faulty accelerator pedals[ (of those, 2.1 million already involved in floor mat recall).

Jan 27, 2010 – US: 1.1 million Toyotas added to amended floor mat recall.

Jan 29, 2010 – Europe, China: 1.8 million Toyotas added to faulty accelerator pedal recall.

Feb 08, 2010 – Worldwide: 436,000 hybrid vehicles in brake recall following 200 reports of Prius brake glitches.

Feb 08, 2010 – US: 7,300 MY 2010 Camry vehicles recalled over potential brake tube problems.

Feb 12, 2010 – US: 8,000 MY 2010 4WD Tacoma pick-up trucks recalled over concerns about possible defective front drive shafts.

Apr 16, 2010 – US: 600,000 MY 1998–2010 Sienna minivans for possible corrosion of spare tire carrier cable.

Apr 19, 2010 – World: 21,000 MY 2010 Toyota Land Cruiser Prado and 13,000 Lexus GX 460 SUV's recalled to reprogram the stability control system.

Apr 28, 2010 – US: 50,000 MY 2003 Toyota Sequoia recalled to reprogram the stability control system.

May 21, 2010 – Japan: 4,509, US: 7,000 MY 2010 LS for steering system software update.

July 5, 2010 – World: 270,000 Crown and Lexus models for valve springs with potential production issue.

July 29, 2010 – US: 412,000 Avalons and LX 470s for replacement of steering column components.

August 28, 2010 – US & Canada: approximately 1.13 million Corolla and Corolla Matrix vehicles produced between 2005 and 2008 for Engine Control Modules (ECM) that may have been improperly manufactured.

February 22, 2011 – US: Toyota recalls an additional 2.17 million vehicles for gas pedals that become trapped on floor hardware.

Russell Brand’s Revolution: A call for systemic thinking?

Russell Brand’s idiosyncratic but perceptive call for revolution is welcome.  I welcome it because it is one of the most public articulations of the need for us to think differently about our relationships to each other and with the planet.

Brand was invited to edit an issue of the New Statesman  and he outlined some of his ideas in a recent interview with Jeremy Paxman:

  
Not voting, from Brand’s perspective makes sense; voting to change the system maintains the system.  However, Brand’s revolution is not one of apathy, nor is it a revolution of bloodshed and uprising. It is a revolution in how we think.

This revolution has been slowly gaining momentum since Gregory Bateson outlined what he called a ‘cybernetic epistemology’; a way of thinking in terms of relationship, of recognising patterns, a way of thinking that also requires humility and an appreciation of the sacred.

 “What pattern connects the crab to the lobster and the orchid to the primrose and all four of them to me? And me to you?” he asks us to consider at the outset in Mind and Nature (p. 8).

This focus on both the content and relationship aspects of all messages invites us to think about pattern also in human relationships and how we create patterns that we live and that define us. And it is becoming vital that we heed and respond to this need.

Bateson warned us in his essay Form, Substance and Difference (in Steps to an Ecology of Mind, 1972):

“If you put God outside and set him vis-a-vis his creation and if you have the idea that you are created in his image, you will logically and naturally see yourself as outside and against the things around you. And as you arrogate all mind to yourself, you will see the world around you as mindless and therefore not entitled to moral or ethical consideration. The environment will seem to be yours to exploit. Your survival unit will be you and your folks or co-specifics against the environment of other social units, other races and the brutes and vegetables.

If this is your estimate of your relation to nature and you have an advanced technology, your likelihood of survival will be that of a snowball in hell. You will die either of the toxic by-products of your own hate, or, simply, of over-population and overgrazing. The raw materials of the world are finite.

If I am right, the whole of our thinking about what we are and what other people are has got to be restructured. This is not funny, and I do not know how long we have to do it in. If we continue to operate on the premises that were fashionable in the pre-cybernetic era, and which were especially underlined and strengthened during the Industrial Revolution, which seemed to validate the Darwinian unit of survival, we may have twenty or thirty years before the logical reductio ad absurdum of our old positions destroy us.


Nobody knows how long we have, under the present system, before some disaster strikes us, more serious than the destruction of any group of nations. The most important task today is, perhaps,  to learn to think in the new way”.

Unfortunately, there are the few who will not want to hear Bateson’s warning and challenge, for they have a vested interest in this status quo that in reality is a slow decline into more inequality and destruction.

Brand’s revolution is to reject this status quo in which the very few profit, and the price for this profit is paid by people who are starving, killed in conflict and sick.

Yes, we can reject this system by not voting. We can reject it by becoming critically aware of the propaganda spewed out of the mainstream media that services the needs of the few.

But this revolution is not just about rejection of an old, unfair and destructive system. It is about accepting others, about sharing ideas, engaging in dialogue, and re-evaluating our relationships.

Blaming the vulnerable

A 'terrorist' with Asperger’s, an abused mother with alcoholism who kept the corpse of her child that died of starvation for 2 years in a squalid home, a murderer who was not being treated for his mental illness....all symptoms of a 'broken society'; a society broken by a lack of resources for mental health and social care, a society where the vulnerable are castigated and the people who work at the front end are blamed for what are systemic failures. The Conservative conference tagline ‘for hardworking people’ and Cameron’s closing remark "Together we'll build a land of opportunity for all” are just empty sound-bites to keep the faithful happy while all the while, the rich carry on getting richer and richer. I am beginning to despair. How many people are suffering right now? How more people and children have to die before we see some real change?

Addiction to power

When only the 1% are left, there will be no more profit. They will own a barren world created by their addiction to power.

Inequality

In the UK, the public sector is continually being squeezed with demands to improve performance.

Performance is measured by achievement of targets. A focus on ticking boxes rather than thinking about patient's needs led to the appalling Mid Staffs situation.

Why did this happen?  Because ticking boxes keeps the commissioners of services happy.

Who are these commissioners? Believe it or not they are also NHS employees, but they are the purchasers in the ludicrous ‘internal market’ that is the ‘modern, efficient’ NHS.

Why an internal market? Because politicians and ideologues did not like doctors deciding what was best for their patients.

Recent evidence published in the Lancet indicates that health in the UK is lagging behind other countries. The response from Jeremy Hunt (the UK Minister for Health) is "For too long we have been lagging behind and I want the reformed health system to take up this challenge and turn this shocking underperformance around."

Translated: ‘We need more boxes to tick’

He wants more people to go for regular health checks to spot diseases earlier and he is calling better joining up of NHS services so that patients don't get lost in the system.

Well, no shit, Sherlock.

He also says that many deaths happen because the NHS is not good enough at preventing people getting sick or because treatment does not rival that seen elsewhere in Europe.

So let’s blame the NHS, shall we, Jeremy? It makes a change from blaming the population, I guess.

Here is something to think about.

The health of the population in the UK is contextual.

People eat crap food full of corn fructose, starch and horse meat because food producers manufacture cheap, crap food to keep the prices down.

Lots of people in the UK are poor and have little choice but to buy cheap food sourced by supermarkets (who incidentally screw producers to keep costs down – after all, supermarkets are ultimately about profits and dividends)

People drink and smoke too much too. That could be because lots of people in the UK are unhappy.

The context of health (and other issues like crime and education) in this country is that, like in the US, around 40% of the wealth is owned by less than 1% of the population.

We all know politicians lie or are ‘economical with the truth’ and that many politicians represent the interests of the elite.

But the even bigger lie is that politics makes any difference. Even having the vote makes little difference as far as the gap between rich and poor is concerned; nothing has changed in hundreds of years.

Mainstream politics is a sideshow, a diversion from the reality of inequality in our society, and it is this inequality that needs to be addressed.

Anything else is just a distraction, like taking an aspirin to treat a cancer.

Porn: The banality of evil in the 21st century.

Nine men have been jailed in Rochdale for their part in the grooming and sexual exploitation of five females aged between 13 and 15. One of these young women was forced to have sex with twenty men in one night.

I suspect that if these young women had been aged 18 to 20, the story would not have made headlines.

Hannah Arendt wrote about the banality of evil; how ordinary people could be involved in committing atrocities because they accepted the premises of the state, and assumed that their actions were, therefore, normal.  There seems to be a greater likelihood that acts that could be considered evil are more likely to be committed when a group is involved, as in Rochdale or in Abu Ghraib. Perhaps peers encourage each other, and people who ordinarily would not commit evil feel able to, or pressured to do so. The peer group normalises such behaviour.

Pierre Bourdieu wrote about the learned, fundamental, deep-founded, unconscious beliefs, and values, taken as self-evident universals, that inform our behaviour which he describes as 'Doxa', and suggests that this knowledge emerges from and reinforces another concept, the 'Habitus'. Habitus could broadly be taken to mean the internalised assumptions that arise from living in a particular culture.

I remember seeing Passolini’s film ‘Salò’ and being horrified by the increasing degradation and torture that was perpetrated on the victims of the men of power.

The film ended with two young soldiers, both of whom had collaborated in all of the prior atrocities, dancing a waltz together. The banality of evil captured.

Now this film is pretty much freely available for anyone to see; yet when I saw Salò in the late 1970’s it could only be shown with a Home Office licence. And this leads to a wider point.  The current ease of access to a film like Salò is hardly surprising in the context of the massive amount of pornography that is freely available.

Pornography represents another dimension of the banality of evil. Much pornography involves the degradation of women, be it anal penetration, double penetration, ‘air-tighting’ (where mouth, vagina and anus are simultaneously penetrated) or the insertion of objects that painfully stretch the vagina or anus. Oral sex typically involves deep, painful penetration, and the male usually ejaculates over the woman’s face. Some porn (bukkake) involves multiple men ejaculating over a woman’s face, another type of humiliation.

Imagery of this type is creating a habitus not only for those who access it, but for the partners of those who access it. Assumptions that this type of degradation and violence is normal lead to men expecting that sex will be like this and women internalising negative views of themselves as sexual objects. All the while, billions of dollars are made (typically by men) who profit from the sex industry.

We need to change the way we think ; the way we think about relationships and gender, and challenge this habitus that reinforces stereotypes and limits the possibilities for intimacy.

References

Arendt, H. (1963). Eichmann in Jerusalem: A report on the banality of evil. New York: Penguin

Bourdieu, P. (1990). The logic of practice. Stanford, CA: Stanford University Press. 

Further information:


www.antipornography.org/

http://www.object.org.uk/

Functional medicine: A systems approach to medicine

Mark Hyman, MD has dedicated his career to identifying and addressing the root causes of chronic illness through a groundbreaking whole-systems medicine approach known as Functional Medicine

Individualism and Collectivism: Schismogenesis and #occupywallstreet

Most social systems require a balance between symmetrical and complementary relationships or patterns.

A symmetrical pattern is characterised by ‘tit for tat’.  You hit me, I’ll hit you back. Obviously, this pattern has its uses, but unchecked would lead to the destruction of one of the parties in the relationship, and thus end the relationship too.

A complementary relationship is characterised, crudely, by a sadist and masochist, where the behaviour of one party complements that of the other. Again, this type of relationship can be useful, but unchecked, this pattern can lead to destruction as the sadist becomes increasingly sadistic and the masochist becomes increasingly masochistic.

Gregory Bateson (1972) referred to these runaway patterns that lead to destruction as ‘schismogenesis’ and argued that most relationships need to have a balance between complementarity and symmetry patterns. This balance could be thought of as a form of homeostasis. For example if a relationship is tending towards more ‘tit for tat’ (symmetrical) patterns, for example both partners becoming more violent, if one party becomes submissive (complementary), this would disrupt the runaway pattern and lead to a balance. Of course this new complementary pattern will, in time, need to be balanced by more symmetrical behaviour and so on.

In an earlier post (I seem to have deleted by accident) I wrote about how privileging personal gain over co-operation can ultimately become self-defeating, and I wonder if there are parallels in the current political context where we might think of balancing patterns of behaviour on a societal level.

Short term, personal gain seems to be the raison d'être of the individualist culture; characterised by politicians whose policies are influenced by terms of office, popularity and benefitting themselves and where corporations are motivated by keeping profits up and shareholders happy. It has become increasingly evident with recent revelations regarding News International and the scandal involving Liam Fox and his friend Adam Werritty that politics and corporate desires are intimately connected, adding more weight to suspicions that there is small elite of people who conspire to serve their own needs.

The benefits of this culture are of course, competition (although sometimes this is faux), comparatively cheap prices and a reasonable standard of living for many people (in the developed world).

The downside to this type of culture is that the addiction to short term gains for the few is leading to future consequences that are self-defeating and destructive.

Cheap, unhealthy processed food has led to phenomenal numbers of people becoming obese, and diabetes is likely to be a massive burden on future health care services.

The environment is exploited without regard to the long term consequences of pollution and deforestation. The fact that global corporations sponsor climate change deniers is significant. Their addiction to short term profits over-rides any responsibility for future generations.  Automobile manufacturers and oil companies have a vested interest in lobbying governments to keep citizens dependant on cars rather than other forms of mass transit.

The developed world’s addiction to oil is almost certainly the reason for US intervention in the Middle East, with countless dead and injured. The concept of transgenerational trauma (Shevlin & McGuigan, 2003) indicates that relatives of people affected by trauma, including those born after traumatic events, have symptoms of post traumatic stress. This does not bode well for the future health of states so significantly impacted upon by conflict.  A dominant narrative of the developed world’s rapacity is likely to feed the emergence of more dissent and violence from poorer states.

A balance is required to counter what I believe is a runaway pattern of individualism, where a more collectivist, long term approach might privilege and prioritise differently, considering more closely the long term ethical and environmental consequences of behaviour. I hope that the #occupywallstreet movement is the beginning of this counter-balance. It is, so far, a peaceful and determined protest and it is to be hoped that it remains so.

I’d like to close with these words from Gregory Bateson’s daughter, Nora; words which I believe offer a wider understanding of the situation:

“When you peel back all of the lovely accomplishments of the great revolutionaries what do you find? At the center there is this: They did the impossible. They risked everything, and changed the unchangeable. Occupy Wall St...This is the exhale we have been waiting for. This movement is the release of all we have held back, and all we have deferred: the fatal complications of poverty, ecological disaster, and political injustice against. Until now, we have been betting away our futures to keep this monster from tipping over; we have been covering for it, nursing it, convincing ourselves we were even proud of it. Like children of abusive alcoholic parents-- we have been silenced for so long. Finally the unsayable is being said, giving the unmovable boulders of this illusion of subservience to economic structures an opportunity to crumble. We were as my father said, “double binded” by the loop of needing the corporate body to both employ us and then relieve us of our earnings for what we thought was survival, but is actually destroying our real survival in our environment and with each other. Now, the thing that has kept us rapt and bound is grotesque: oozing greed, eating its young, poisoning us, the earth and even itself. If we can remember, that these structures are constructs of our imagination, not forged in nature, we can begin to re-imagine the system. Ideas... are what we are working with, and they can grow, change, evolve. We can live better, but first, we occupy. Don’t be distracted by the deeds of the change-makers, the “what” in what they changed, really, the key is THAT they did not wrap themselves in the practicalities of reason. Of course it’s impossible, that is why we have to do it.”  Nora Bateson

 Shevlin, M. & McGuigan, K. (2003) The long-term psychological impact of Bloody Sunday on families of the victims as measured by The Revised Impact of Event Scale.

British Journal of Clinical Psychology, 42: 4, 427–432.

Fixing a 'broken society'

 

“Something is profoundly wrong with the way we live today. For 30 years we have made a virtue out of the pursuit of material self-interest: indeed, this very pursuit now constitutes whatever remains of our sense of collective purpose”. Tony Judt; Ill fares the Land

Salvador Minuchin, the originator of structural family therapy, considered that, in order to function healthily, a family needs structures, boundaries and rules.

Within the wider family system, sub-systems work together, and complement each others roles.  The boundaries of a subsystem are the rules defining who participates, and how. For example, the boundary of a parental subsystem is defined when a parent tells an older child, “You are not your brother’s parent. If he is watching something on TV he shouldn’t, tell me and I will take care of it”.

For proper family functioning, the boundaries of subsystems must be clear and defined well enough to allow subsystem members to carry out their functions without undue interference, but they must allow contact between the members of the subsystem and others.

In addition to clarity of boundaries, most families can be conceived of as falling somewhere along a continuum of whose poles are the two extremes of diffuse boundaries and overly rigid boundaries. These two extremes of boundary functioning are typically called enmeshment and disengagement.

Members of enmeshed subsystems or families may be handicapped in that the heightened sense of belonging requires a major yielding of autonomy.  In contrast, members of disengaged subsystems or families may function autonomously but have a skewed sense of independence and lack feelings of loyalty and belonging and the capacity for interdependence and for requesting support when needed.

The clarity and range of boundaries within a family are useful parameters for the evaluation of family functioning, but is this the case in a broader society?

Where does a society begin and end?  What sort of boundaries delineate any given society and its sub-systems and are they permeable or rigid?

If our society was a family, my sense is that we have an extremely small subsystem that is very much disengaged from the remaining subsystems. The extreme level of disengagement, along with the disparity in size and wealth between this subsystem and the remaining societal sub-systems is toxic.

This toxicity leads to what David Cameron described as a 'broken society'; lack of social cohesion, poor health, increased dependency on drugs and alcohol and crime. In contrast, societies that have more equality seem to do better.Richard Wilkinson   a researcher in social inequalities in health and the social determinants of health in a 1997 paper published in the British Medical Journal suggested that “one reason why greater income equality is associated with better health seems to be that it tends to improve social cohesion and reduce the social divisions”.

He later went on to suggest that “the psychosocial effects of relative deprivation are unlikely to be confined to health… where death rates from accidents, violence, and alcohol related causes seem to be particularly closely related to wider income inequalities, the predominance of behavioural causes may reflect changes in social cohesion”.

From a structural therapy point of view, a family that has serious problems needs to be restructured. If we think at a societal level, this would involve changing the structure of the society, making it more functional by altering the existing hierarchy and interaction patterns.In a recent TED lecture, Wilkinson argues for a fairer, progressive tax system to address inequalities.

However, a more comprehensive solution to the problem of restructuring our society has been addressed by Tony Judt, who argued that the whittled-down Left squandered a huge opportunity to show the mainstream that new ways of seeing and thinking are desirable. In the aftermath of recent financial crises, it’s pretty much impossible to argue that financial markets properly regulate themselves.

Judt advocates a revival of the central values of American liberalism or European social democracy. He calls for the beneficent authority of a welfare state (in one form or another) to redress the excesses of unregulated market forces; a course that emphatically rejects both dogmatic socialism and unrestrained capitalism.

His version of social democracy (or, for Americans, liberalism) envisages a society less materialistic, less individualistic and more community-minded than the present one, based on an economy in which capitalism, while by no means abolished, is on the other hand firmly tamed and regulated.

In light of these great upward shifts of wealth, Judt (who died in 2010) felt that, at that time, no civic movement had gained mainstream influence. Perhaps the #occupy protests are the beginning of this very movement?

Judt. T. (2010). Ill fares the land. London; Penguin.

Minuchin, S. & Fishman, H. C. (2004). Family Therapy Techniques. Harvard: Harvard University Press

Wilkinson, R. G. (1997). Socioeconomic determinants of health: Health inequalities: relative or absolute material standards? BMJ 314: 591

Mong: Language, Ricky Gervais, Wittgenstein and Humpty Dumpty

'When I use a word,' Humpty Dumpty said in a rather scornful tone, 'it means just what I choose it to mean - neither more nor less.' - Lewis Carroll, Through the Looking-Glass

As Lewis Carroll wryly noted, words require a shared meaning rather than an idiosyncratic meaning chosen by the speaker.  Wittgenstein argued that definitions of words emerge from what he termed ‘forms of life’, roughly the culture and society in which they are used, although he might have observed that this emergence is a process; sometimes words have different resonances and meanings to different generations or groups within a broader culture. A recent example of this unfixed meaning of words was evident in the use of the word ‘mong’ by the comedian Ricky Gervais on twitter, which caused a polarised response in some media.

In popular, current usage, the word ‘mong’ refers to a state of being messed up, and ‘monged’ was often used as an equivalent term in the north West of the UK for being ‘stoned’ on cannabis. However, the word ‘mong’ derives from the term ‘Mongolism’ or, more accurately ‘Mongolian Idiocy’ used (formally) to describe people with Down’s syndrome up until 1961, and formally dropped by the World Health Organisation in 1965.

Having grown up with an older sister who, since the early 1960’s has been formally described and diagnosed as ‘mentally handicapped’, ‘autistic’ and ‘learning disabled’, I frequently had to endure my peers and strangers calling her ‘mongy’, ‘spaz’ or ‘retard’, or our family being stared at when my sister made some unusual (to others) gestures and movements when she was feeling happy. It was not pleasant, and was sometimes quite distressing, especially when I was very young.

Gervais’ casual use of the word ‘mong’ suggests that, in popular culture, language that is derogatory to people with learning disabilities is more acceptable (or can be used with less sensitivity) than words that are derogatory about race, or other differences.  Black people can protest about (or even appropriate) the offensive word ‘nigger’, Asians can do likewise with the offensive term ‘Paki'.  People with learning disabilities cannot protest as easily; in a sense they are more vulnerable, and make easier targets for bullies but we all have a responsibility to challenge derogatory and hate language, no matter who the target.

Gervais and his sidekick Stephen Merchant previously insulted the actress Victoria Wright who has cherubism, and they seem happy to push the limits of post modern, ironic comedy to teeter on the edge of being bullies rather than funny. Which is a shame. Whilst Gervais may not have meant to cause offence by using the term 'mong', how he positions his comedy in relation to disability and derogatory language in the future will be the acid test.

Robbing from the vulnerable

The above video is from recent events in London. It shows a young Malaysian being simultaneously helped and robbed by a group of youths. The video was shown on the BBC news and understandably provoked quite a lot of reaction.

I felt this is quite an interesting motif to reflect upon from a broader perspective, thinking about how what was perpetrated in the video above models behaviour at other levels of society; from politics, corporate business and finance, healthcare, education and of course, the media.

Most corporations want our money, usually in exchange for junk.

Junk food that is full of additives, junk equipment that has obsolescence built in, junk insurance that is full of small print to minimise pay-outs and junk clothes, with a limited life and manufactured by people living in poverty.

Meanwhile, on a larger stage, the same deceits continue...

Children blown to pieces by  cluster bombs as democracy is forced upon populaces.

Troops killed in the name of war on an abstract concept - terror - which is in reality serving the interests of oil companies.



The muggers in the above video are simply replicating what happens routinely to us all. That young man being mugged is you. He is all of us who are being robbed under the pretext of being helped.

All the time, the rich get richer  -  last year, according to Mary Ridell writing in the Telegraph, the combined fortunes of the 1,000 richest people in Britain rose by 30 per cent to £333.5 billion.

News International and the myth of power

Lord Acton famously said that power corrupts, and absolute power corrupts absolutely. The English anthropologist and social scientist Gregory Bateson argued that power does not exist in relationship and that, in fact, it is a myth. He said, in Steps to an ecology of mind (1978) that

‘…the myth of power is, of course, a very powerful myth, and probably most people in this world more or less believe in it. It is a myth, which, if everybody believes in it, becomes to that extent self-validating. But it is still epistemological lunacy and leads inevitably to various sorts of disaster’.

Bateson’s view on power was critiqued at the time, particularly by other social scientists and therapists who felt that to deny power was to deny the experiences of abused people, particularly women. On the surface, this seemed a reasonable critique; what reasonable person could deny that an abuser has power over the abused? However, this critique misses the wider point of Bateson’s argument, which is that the conventional (erroneous) use of the term power is that of a metaphor drawn from the language of physics (along with terms like energy, force, impact and so on), which have no place in a biological, social world of information, context and meaning. Instead of thinking of power in human relationships, we would be better served by reflexive dialogue about the metaphor of power, and see ourselves as simply parts of a larger situation. For this to be necessary, both sides in a conflict would need to be proud and humble rather than arrogant.

The sort of disaster that Bateson alluded to, and that humanity is facing is, in part, linked to the self perpetuating pursuit of the myth of power. Hand in hand with the myth of power is the concept of profit. To be rich, in the conventional epistemology, is to be powerful, and therefore, to control resources is seen as an imperative by states that wish to maintain and increase power.

Noam Chomsky recently wrote (available here) ‘there is every reason to suppose that today's policy-makers basically adhere to the judgment of President Franklin Delano Roosevelt’s influential advisor A.A. Berle that control of the incomparable energy reserves of the Middle East would yield "substantial control of the world." And correspondingly, that loss of control would threaten the project of global dominance that was clearly articulated during World War II, and that has been sustained in the face of major changes in world order since that day’.


Later in this article Chomsky writes:

‘Systemic risk in the financial system can be remedied by the taxpayer, but no one will come to the rescue if the environment is destroyed. That it must be destroyed is close to an institutional imperative. Business leaders who are conducting propaganda campaigns to convince the population that anthropogenic global warming is a liberal hoax understand full well how grave is the threat, but they must maximize short-term profit and market share. If they don't, someone else will.

This vicious cycle could well turn out to be lethal. To see how grave the danger is, simply have a look at the new Congress in the U.S., propelled into power by business funding and propaganda. Almost all are climate deniers. They have already begun to cut funding for measures that might mitigate environmental catastrophe. Worse, some are true believers; for example, the new head of a subcommittee on the environment who explained that global warming cannot be a problem because God promised Noah that there will not be another flood’.

 In short, the pursuit of the myth of power with its attendant need to maintain profits and control resources has led to the loss of countless lives in the Middle East, active denial of the reality of global warming, and as I have indicated elsewhere, the abuse and misuse of ‘evidence’ in rushing through incompletely trialled medicines for the sake of short-term gain.

Relevant to the current situation with News International, Bateson (1978) also wrote

‘What is true is that the idea of power corrupts. Power corrupts most rapidly those who believe in it, and it is they who will want it most. Obviously, our democratic system tends to give power to those who hunger for it and gives every opportunity to those who don’t want power to avoid getting it. Not a very satisfactory arrangement if power corrupts those who believe in it and want it…Perhaps there is no such thing as unilateral power. After all, the man ‘in power’ depends on receiving information all the time from outside. He responds to that information just as much as he ’causes’ things to happen… it is an interaction, and not a lineal situation’.

 Clearly the Murdoch entertainment/propaganda machine has been intimately linked with, and and has been a mouthpiece for, the political/corporate elite who routinely have been committing crimes against humanity. The stone that has been lifted by the telephone hacking scandal has shed light on some worrying relationships between the elite and the media and sent all sorts of people scurrying for cover. Perhaps now is the time to challenge the world order typified by the pursuit of power by the elites.


Bateson discussed how Goebbels, the Nazi Minister for Propaganda, believed he was powerful and in control of the Nazi propaganda machine when in reality he was guided by informants (effectively Goebbels was dependent on feedback) and ultimately his belief in his control of the system ultimately led to its destruction. The arrogance and confidence of a mileau where the hacking of telephones and bribery of police was condoned (or even encouraged) would indicate that News International, like Goebbels, was lured into believing in its own 'power'.

Let us not fall into the same fallacious trap that power can be overcome with more power, but instead through humility, dialogue, persistence and by recognising our own part in this very dangerous situation.

References:

Bateson, G. (1978) Steps to an ecology of mind. London: Paladin.
Chomsky, N. (2011) Is the world too big to fail? The contours of global order. http://www.chomsky.info/articles/20110421.htm accessed 18th July 2011.

Wikileaks: Dominant and subjugated narratives

There seems to be international condemnation of Wikileaks. The founder, Julian Assange, is at the centre of intense media speculation and a hate campaign against him in, particularly in the US, following the leak of 250,000 US diplomatic cables.

It is clear that most governments, particularly those closely involved with the US, are acutely embarrassed by the leaks. The leaks reveal the duplicitous nature of many governments and the lies and deceptions that characterise governments’ relationships with each other and their own populaces.

Of course, the dominant story from any government is that they are as transparent as possible and that politicians are honest people trying to do the best for their countries.

But the populations of these counties are, to a greater or lesser degree, aware of a subjugated story; this is a story where corruption is rife in many parts of the world, including wherever we happen to live. This story is where politicians routinely lie.  This is the story of our leaders thinking of themselves, not the greater good. This is the story where business deals and politics are blurred, where giant corporations lurk behind decisions to send troops to war. This is the story of atrocities commited in the name of democracy and freedom.

Julian Assange and Wikileaks have thickened this alternative story, and at the same time, thinned the dominant narrative of ‘honest government’.

As the Wikileaks cables are being revealed, there has been a general cynicism evident regarding the process used by FIFA to select the host nations for the 2018 World Cup. Whilst this might be regarded as a joke, it nevertheless casts light on the dubious activities and horse-trading that seems commonplace in international relations.

It is going to be interesting to see how this pans out.  What will the implications be if Assange is silenced?  I think the context is rapidly changing; people are becoming surer of their cynicism of governments, and if Assange is arrested or murdered, this will only serve to thicken the subjugated story and cast even more doubt on the dominant story. It may even prove to be the tipping point and the stories will flip; and this will have serious consequences. People are going to demand something better.

Male and female brains, complexity and objectification

Recently I was teaching a group of MSc students about chaos and complexity theories and how they might be relevant to leading organisations. One of the things that struck me is that working with complex self adaptive systems requires a focus on relationships between the parts of the system rather than on the component parts themselves. Of course, to a systemic therapist, this is nothing new, but the implications for leadership and management in our economy are huge.

Unfortunately, the dominant ways of thinking (especially in the West) are reductionist and lineal, and while this is fine for dealing with and managing simple systems or problems, relational, systemic thinking is required for dealing with the complex, non-lineal systems that would include nations, corporations, services (such as the NHS), hospitals, or even small and medium enterprises.

Simon Baron-Cohen (who is a Professor of Psychology at Cambridge University and researches on the autistic spectrum) notes that people with ‘male brains’ tend to be good at what he calls ‘systemising’, which he describes as the drive to analyse and explore and extract the underlying rules that govern the behaviour of a system as well as the drive to construct systems. I would argue that this is very much thinking about systems, rather than thinking systemically and being able to include self within a given system. This ‘male’ type of thinking is characterised by more focus on detail, components and parts, rather than relationships.

While the male brain tends towards logic, and the female brain towards empathy, neither are actually exclusive to each gender; in fact most of us are somewhere in the continuum between both extremes. Of course, manifestations of the extremes of either might range from ‘mindblindness’ and autism on the male side to ‘logicblindness’ and attributing mind, thoughts and feelings to inanimate objects, on the female side.

The male brain focus fits in very much with the reductionist, lineal thinking associated with science since Descartes, and though this type of thought is useful, is may be less helpful when thinking about and managing complex systems. Generally, women tend to be more relationally orientated and empathic, which suggests that leading and managing complex adaptive systems might be more suited to women than men. To get more women into roles where they can use their skills in dealing with complex, relational issues will require a massive shift, and the effort required to get more women into leadership roles at all levels of society is not just about equality – it is a necessity.

William Hamilton, an evolutionary biologist said “People divide roughly, it seems to me, into two kinds, or rather a continuum is stretched between two extremes. There are people people, and things people.” It would seem that women are more likely to be ‘people people’, and men are more likely to be ‘things people’.

These same differences in thinking might also go some way to understanding why men are more likely to ‘objectify’ women. If ‘male brainedness’ is less relational and more about things, or objects, perhaps for some men, women are simply that – objects. I was staggered by the lifelike ‘love dolls’ manufactured in Japan, which seems to me to be an extreme and literal form of the objectification of women by men.

Evidence based medicine: Selective use of evidence and the role of drug companies

Recently I was talking to my daughter Hannah about the work she was doing for one of her modules. Although her degree is in Marine Biology, for some reason she was looking at National Institute for Clinical Excellence (NICE) guidelines, and how they work.

We had some interesting discussions about what evidence is accessed by NICE, about randomised controlled trials (RCT’s) and the consultation process. What emerged from her review confirmed my suspicions regarding the use of evidence, particularly by drug companies who have a vested interest in their products being recommended in guidelines.

In 2003, the Department of Health agency responsible for ensuring that medicines meet appropriate standards of safety and effectiveness (the Medicines and Healthcare products Regulatory Agency—MHRA), released data regarding the risks and benefits of newer antidepressants used to treat depression in children and young people.

The information published on the MHRA's website included both previously published and never before published data obtained directly from the manufacturers of the SSRIs ("selective serotonin reuptake inhibitors") and other newer atypical antidepressant drugs. These data were collected after earlier work had raised concerns about the safety of paroxetine (Seroxat) and venlafaxine (Efexor, Efexor XL) in children and young people with depression.

Based on their review of the data, the MHRA concluded that all of the newer antidepressant drugs, other than fluoxetine (Prozac), carried serious risks that outweighed any benefits. The MHRA, therefore gave warning of the potential that these drugs could increase the risk of suicide-related behaviour (rather than decreasing it—as would be expected of an antidepressant) when using these drugs in the treatment of depression in childhood and adolescence.

The National Collaborating Centre for Mental Health (NCCMH) had been commissioned by NICE to produce national guidelines for the whole of the NHS on the treatment of depression in children and young people. NCCMH is an evidence-based guideline development unit jointly run by the Royal College of Psychiatrists and the British Psychological Society and funded by NICE.

However, the NCCMH only had access to published data, so, when the MHRA verdict on the SSRIs became public, it became evident that the MHRA had access to information about a total of 11 trials, of which the NCCMH had only seen 5.

Because of the inconsistency between the MHRA's findings and the published literature, several members of the NCCMH committee (Whittington et. al. 2004), decided to compare and contrast the published data with the unpublished data. This work was designed as an experiment to test out what the difference might (or might not) be if, in producing a guideline, the committee had access to the unpublished as well as the published literature.

They concluded that the published evidence was more favourable than the unpublished evidence, and most importantly that it was only when all evidence was examined that it was clear that the risks (particularly the increased risk of suicidal behaviour and thinking) outweighed the benefits.

They also found evidence to suggest that at least one of the drug companies who had undertaken trials of an SSRI in the treatment of childhood and adolescent depression had withheld publication of trial data on the grounds that it contained evidence that the drug was unlikely to be effective in treating depression in this age group.

A UK psychiatrist, David Healy, has been raising similar concerns for a while. He has general concerns about influence of pharmaceutical companies and the way that they don't mention the problems in the way that academics are expected to do so. He has evidence of one paper being written by a pharmaceutical company, but where academics appear to be the main authors. He has a particular concern about this influence on bipolar disorders, particularly since NICE guidelines quote one of the articles in which very young children are given the diagnosis of bipolar disorder and prescribed medication as part of a 'trial'.
You can access one of Healy’s papers here: http://www.furiousseasons.com/documents/healybp.pdf

In June this year, the New York Times published an article identifying that a world-renowned Harvard child psychiatrist, Dr. Joseph Biederman, whose work has helped ‘fuel an explosion in the use of powerful antipsychotic medicines in children’ earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.

In my earlier article about Champix I didn’t mention that the manufacturers did not trial the drug with patients who have a history of mental health problems at all, and the drug was released on evidence that was derived from an ungeneralisable sample of the population.

Drug companies can afford to fund trials into their newly developed products. They may, as seen above, be selective in the evidence that they see fit to publish. The vast resources to fund for research into other therapies, for example talking therapies, are simply not available. Funding this type of research is down to practitioners on a local level, or perhaps interested University faculties. This means there is a huge disparity in what evidence is available for NICE (or those advising NICE) to base their decisions upon.

And the evidence is skewed.

Reference
Whittington C, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. The Lancet, 24 April 2004; Volume 363: Number 9418, 1341-45.