Dorothy Rowe

Dorothy Rowe Named As
One of the Six Wisest People in the UK

In January 2004 Saga Magazine published The Wise List, the people in the UK who the magazine stated 'had that laudable quality of wisdom. With this list, we aimed both to recognise and celebrate wisdom in a world which more often tends to celebrate beauty or wealth.' Dorothy Rowe was listed as one of the fifty wisest people in the UK.

Saga Magazine then asked readers for their nominations for the "wisest of them all" from the list of 50. In April 2004 Emma Soames, the editor of the magazine, wrote that 'the response has been magnificent. I won't call them winners, as the Wise List is not a competition, but the six people who received the most votes were:
	Lord Robert Winston, fertility expert Dr Jonathan Sacks, Britain's chief Rabbi Tim Berners-Lee, architect of the internet Dame Elizabeth Butler-Sloss, one of Britain's leading judges Dr Dorothy Rowe, psychologist and author Sir Martin Rees, Astronomer Royal Click here to visit the SAGA Magazine web site

The Wisdom Interview, Radio National, Australian Broadcasting Commission
Dorothy Rowe recorded an interview with Peter Thompson for Radio National which was broadcast as part of The Wisdom Interview series starting in August 2004. The interview was broadcast on Radio National and on the ABC website. After the interview an audiotape and transcript were available from the ABC.

Click here to visit the ABC Radio National web site

Review from: Clinical Psychology, issue 37, p.37, 2004.

Depression: the way out of your prison (third edition)
Dorothy Rowe
TJ International, 2003
There is an instant freshness about this book, which is remarkable considering that it was first written in 1983. Dorothy Rowe has an ability to capture the feelings of depression and describe them both with her own writing and with the many quotations from patients that illustrate her ideas. This makes the book useful both for us as clinicians and for any members of the human race trying to understand the complexities of depression.

The main theme of the book is laid out in chapter 3 ('How to build your prison') when Dorothy first quotes the Greek philosopher Epictetus. He said, 'It is not things in themselves which trouble us, but the opinions we have about these things.' She goes on to say, 'This book is about our opinions and how we can change them.' As I read on into the chapter, I began to wonder whether this book should be obligatory reading for every Cognitive Behaviour Therapy course, because within the pages are many of the fundamental ideas for cognitions and beliefs held dear to every person struggling with depression. How on earth can anyone begin therapy for another human being without looking as deeply into the scenarios as this book allows us?

Dorothy takes a specific philosophical stance away from the idea of original sin, illustrating that children learn a belief system through their experiences. I like the idea of psychologists helping all of us to think about ideas laid down by organisations or societies where harm may be inflicted on our mental well-being.

I like the antidote of humour within her pages. The idea of the heavenly housekeeping book, with one universal law - 'Your home must be perfectly clean and tidy at all times' - particularly made me smile. But on a serious note, Dorothy is quite clear about the specific beliefs held by those with depression, and how these must be challenged. By the time you get to chapter 8 ('Suppose I did want to leave the prison?') there are some helpful ideas about self-care, and whilst none of these may be new to us as clinicians, they serve as useful reminders, and certainly are so easily read as to be useful to many of the people we meet clinically.

Whether for an ancient clinician like me, or one who is fresh and new, I recommend this book for its sheer humanity and wisdom.
Lend it to your patients.
Janie Applebee

What others say...

• "Dr Dorothy Rowe, seer, has qualities which to my mind place her somewhere between sainthood and genius"
  Fay Weldon

• "Her appeal rests on a combination of clarity and vision, sanity, compassion, a deep-seated rationalisation and an eye, like Jane Austen's, for social satire. Her work .... forces you to think for your self, challenge received ideas and take responsibility for your own life."
  Linda Grant

• "Dorothy Rowe is essentially a chronicler of emotional pain, a suggester of solutions. Her perspective on existence acknowledges sadness, pain, anger but instantly makes things seem meaningful."
  Melissa Benn, The Guardian

• "Dorothy Rowe's books are exceptional. Rowe has not just got common sense but wisdom and real writing gifts. It's pleasurable to read her blend of quoted poetry, proper and powerful prose and good jokes."
  The Observer

• "Dorothy Rowe stands out among psychologists for her clear insight into human experience: her writing is refreshingly free from dubious theoretical constructs and jargon."
  The Independent
  
• "You can't go to a party without meeting at least two people whose lives have been changed by Dorothy Rowe"
  Linda Grant

Understanding Depression
& Finding Freedom

The Talking Book version

Written and read by Dorothy Rowe

HarperCollins AudioBooks
ISBN 0-00-104669-1
2 tapes : 3 hours of listening

Dorothy Rowe, the internationally renowned psychologist and expert on depression, brings together on this tape what her thirty years of research have shown her about depression, and shows us how every one of us can take charge of our life and find the way to happiness, hope and freedom.

Depression: the imprisoning experience of isolation and fear which comes when we discover that there is a serious discrepancy between what we thought our life was and what it actually is.

From birth onwards we create our own secure worlds of meaning. Challenged seriously enough, these worlds can crumble, leaving us despairing, frightened, isolated, helpless. But we are not helpless. We can resolve to save ourselves by embarking on a journey of understanding and self-acceptance, and finally and forever break free of the bonds of depression.

The Talking Book version is available from bookshops
and it can be ordered direct from . . .
HarperCollins UK Order Department
email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

"People don't suddenly become psychotic or depressed out of the blue, there's always a disaster that they suffer" 

'If you make happiness your goal, then you're not going to get to it," says psychologist Dorothy Rowe. "Philosophers have been saying it for thousands of years. The goal should be an interesting life."

Rowe has devoted her life to trying to help people free themselves from what she famously termed the "prison" of depression, to live that interesting life. In more than a dozen books, the self-help pioneer has set out what she believes are the obstacles that hold people back, and offered a recipe for, if not happiness, then a greater degree of satisfaction with their lot.

Drawing on her own life experience, including a miserable childhood and a marriage ended by her husband's infidelity, as well as her clinical work as an NHS psychologist, Rowe has developed a clear set of ideas about depression, and the best way to fix it. In the process, she has become something of a guru, with some admirers convinced that just reading her books is enough to bring about a transformation, even a cure.

Rowe believes talk of illness and cures is unsuitable. She prefers to speak of "mental distress", and rejects biological explanations for depression. "All the evidence has gone," she says, citing a recent study suggesting "life events" are what trigger depression in almost every case. "What we know now from research is that people don't suddenly become psychotic or depressed out of the blue, there's always a disaster that they suffer, and it's not always a disaster that other people can see is a disaster. It's a private personal one, but it always precedes depression, psychosis, obsession, mania, all of them."

At the heart of Rowe's thought is the idea that depression is a crisis in the relationship between the individual and the world. She believes that, as we grow up, we each develop a set of theories about how the world works. Many of these ideas remain private, though some may find shape in religious or political beliefs. But they are absolutely central to our understanding of ourselves and our lives. Depression is what happens when something challenges or upsets this worldview. "The reason people get into difficulties," Rowe says, "the kind of difficulties where they end up being a psychiatric patient, or difficulties like never being able to maintain a relationship, is that they believe that they are the way they see themselves, and the world is the way they see it."

Depression, according to Rowe, is essentially a defence against change, an emotional paralysis that afflicts us when we are unable to adapt. This insight came to her, she explains, as a result of the extended conversations she had with depressed patients while working in Lincolnshire in the 1970s, conversations conducted in defiance of the conventional wisdom of the time that what such people needed was drug treatment and, in extreme cases, electro-convulsive therapy (ECT).

"I realised that if you give somebody the opportunity to just sit and talk about themselves, and if you are interested in what they're saying, then over time you gradually build up a picture of how that person sees themselves and their world . . . So all I'd be doing, I'd be listening, we'd be talking, I would be there to offer alternative interpretations, to help the person see that whatever happens, we're free to interpret it in a multitude of different ways."

Rowe's early training in psychology was Freudian, and she has retained a strong sense of the importance of childhood events and relationships. Her early life, as "a country girl" in Newcastle on the east coast of Australia, was confusing and unhappy. She doesn't know if her mother really wanted children, but her father wanted a son. "He was very kind, but he hated any kind of trouble," she says. "As he got older he sort of withdrew, he just wanted a quiet life and would never intervene in anything that would get my mother going." Her elder sister, Rowe says, "was never on my side".

The family was dominated by her mother, whose fundamental dishonesty and insistence on her own point of view to the exclusion of all inconvenient facts drove Rowe herself to the brink of psychosis. "I know now that in my last year at school, had there been some kind of disaster in my life in that year, just a car accident or something like that, I wouldn't have been able to hold myself together . . . I'd have become very psychotic." In fact, nothing happened to tip the vulnerable teenager over the edge, and she left home to study for a degree in psychology 100 miles away in Sydney.

She became a teacher and began working as an educational psychologist, got married and had a son, Edward. Then she discovered that her husband, a lawyer, was having an affair. Partly out of respect for her adult son's feelings, Rowe has resisted writing in detail about her marriage, but in her new book, Why We Lie, she offers the story of the poet Cecil Day-Lewis, who was serially unfaithful to his wife Mary, as a kind of analogy. She suggests Mary was a substitute mother-figure for Day-Lewis, with the consequence that when she became pregnant, he felt betrayed. "He did what men like him always do in this situation. He had an affair."

Unlike Mary, however, Rowe did not wait for her husband to leave. She ended the marriage and, in 1968, decided to move to England. One of her correspondents had advised her there were jobs, so she signed up for a PhD at Sheffield University.

Now 79, Rowe lives alone in a quiet garden flat in Highbury, north London. She chooses her words carefully, and speaks in a distinctive hushed voice. She has recently had cataracts removed from both eyes, and is finding her improved vision a revelation. Lung disease during childhood went untreated ("the only thing my mother ever did about it was criticise me for coughing and say I was lazy"), and Rowe has suffered from bronchiectasis all her life. The illness, which requires her to spend time each day clearing fluid from her lungs, is a mild form of cystic fibrosis, and she recently suffered a severe attack. But she looks well.

"Loneliness is easy when you live on your own because there's always something you can do," she says. "My loneliest time was when I was married because I was trapped there. And I was lonely as a child but I could always go to the bush or the beach and just think about things."

Rowe's son lives in Australia. He remains the most important person in her life, and she moved to London partly to make it easier to meet when he travels to Europe. Her relationship with her elder sister remains strained. "When I encounter women whose sisters are their best friends, I am so tremendously envious, because that must be really, really nice, but that's not my experience," she says. Marriage, she decided, was "worth trying only once".

Instead, Rowe built her new life around her work. She arrived in the UK just as the NHS was beginning to invest in psychological therapies, and in 1972 was invited to set up a new department of clinical psychology in Lincolnshire. She describes it as a period of remarkable freedom. "Nobody supervised me," she says. "It was really a matter of having the time to sit and listen to the person. That's very difficult for psychologists nowadays because they've got managers and they're told, 'you can see people only for six sessions or 12 sessions'."

Jeremy Haldstead, a former colleague of Rowe's and a consultant clinical psychologist, says she "is a person full of knowledge and understanding. She has a lot of the generic qualities of a good therapist. I've had many conversations with her over the years and she will hold on to large quantities of whatever it is you happen to have said. Not everybody has the capacity to do that within a conversation."

In 1978 Rowe published her first book, The Experience of Depression (since reissued as Choosing Not Losing). In the subsequent decade she published half a dozen books and adopted the more explicitly self-help approach that would make her well-known. In books such as Depression: The Way Out of Your Prison and Beyond Fear, she offered advice to her readers in the second person ("Thinking that you will be helping your family by killing yourself can seem to be very virtuous, but it is not"), rather than simply describing clinical work, and recast depression as a personal challenge that could be overcome without professional help.

Writer Tim Lott, who suffered a severe depressive episode in his 30s and was successfully treated with anti-depressants, is one of those who believes Rowe's books can help depressed people to get better. Having been told by doctors when he was ill to disregard his dark thoughts as symptoms of his low mood, he was amazed to find Rowe took the opposite view: his feelings were the product of his thought processes, so his thoughts were worthy of close attention. He had been "quite hardcore on the idea that depression was a physical illness", he says, but became attracted by Rowe's framing of it as an existential problem. As he puts it: "Life can be shit, horrible things do happen at random to innocent people, and our mental defences can make things worse."

But while titles such as The Successful Self, Wanting Everything andDorothy's Rowe's Guide to Life placed Rowe in the vanguard of the expanding self-help industry, Lott believes "the way she's labelled a self-help guru does her a great disservice". She remains a champion of the original self-help idea, "the notion that the experts are rubbish and we can do this ourselves", but in conversation and in print she is more thoughtful and more political than much of the faux-spiritual, money-seeking advice that saturates the "self-help" market. Her previous book was a serious examination of sibling relationships, while Why We Lie is a wide ranging discussion of the uses of dishonesty in public and private life.

Rowe describes herself as having embarked on a "long quest to educate journalists" in the 1970s, and says that back then the reporters she spoke to would be amazed when she suggested childhood experiences could affect us later on. She was part of a generation of professionals who proposed a revolution in parenting, arguing against old-fashioned techniques in favour of a much greater effort to see the world from a child's point of view.

Alessandra Lemma, head of psychology at the Tavistock NHS Trust in London, believes Rowe's gift for communication has been her most lasting contribution. "When she started writing, she would have been one of the first people trying to popularise psychology - and by popularising it you raise awareness," she says. "She stands for a capacity to translate complex psychology into something more accessible. Being out there in the media is important."

Within psychology, Rowe identifies herself with a small band of fellow professionals, known as "personal construct psychologists", whose most important idea, based on the work of George Kelly, is that we construct our own meanings in the world, in our lives and families, a theory she believes sits well with recent discoveries in neuroscience. While broadly in line with mainstream cognitive psychology, her approach is more open-ended and she has been critical of the government's preferred model of cognitive behavioural therapy (CBT) as a "quick fix".

Her early writings show her chafing against the grids and charts used by clinicians to make their diagnoses, and she says what she learned as an undergraduate "had no relevance to human life whatsoever". Recently, she wrote that she could not be considered a "proper psychologist" as she was too aware of the "curious mystery" of life.

This insistence on the validity of subjective experience, as well as her conviction that a person's childhood and early relationships may hold crucial keys to their present distress, in some ways place Rowe closer to psychoanalytic thinkers, and she shares with psychoanalysts dating back to Freud a huge interest in literature. She and psychologist friends love to sit around after dinner plotting a syllabus built entirely on literature. Edmund Gosse's Father and Son is her favourite book.

But her view of emotional life and the function of psychotherapy stops well short of the idea essential to psychoanalysis that there is a dimension of the human mind that is hidden from conscious thought. When Rowe refers to the "unconscious", she is careful to explain she does not mean the cauldron of secrets Freud envisaged, but a kind of storage facility for thoughts there isn't space for nearer the top. In some ways, she thinks, a therapist is like a friend, "in the sense that you're always concerned about the other person and you get to know them really well".

While she remains doubtful about evidence of a biological basis for depression, Rowe thinks of herself as a scientist, and suggests hopefully that the vast gulf between scientific understanding of the brain and ideas about the mind is narrowing. This idea finds some support among scientists, many of whom now share the view that depression is a complex outcome of nature and nurture. Dr Carmine Pariante, reader in biological psychiatry at King's College London, says the "psychological versus biological dichotomy doesn't really exist . . . in the overwhelming majority of cases there is at least an environmental component".

Rowe does not necessarily seek agreement with fellow professionals, preferring to remain an outsider. Her website attacks "the bamboozling lies that mental health experts and politicians tells us", while in a recent edition of Beyond Fear she criticised psychiatrists, psychologists and psychoanalysts in the space of a few pages.

Provocatively, she has stuck to her line that "you have to be a good person to get depressed", arguing recently that it is the determination to be perfect that causes difficulties for many high-profile people. But lest she be accused of moralising Rowe insists the case against lies that she presents in her new book is not about being a better person, because "you can tell the truth in a very vicious way, can't you?"

At school in Australia, Rowe was "often in trouble for writing about things I wasn't supposed to, like politics. I wasn't supposed to know that Shelley had quite strong political views and wrote political poems". Why We Lie, a polemic that includes Rowe's views on climate change and the global credit crisis, seems like her answer to some of the world's problems. Psychology, for Rowe, is the science of living in the real world, and she has thrown off all caution to declare what she believes to be the truth about everything.

But the book has a more personal meaning as well. For Rowe, the origin of untruth was her mother. "In calling me a liar my mother was being as destructive to me as she would have been had she attempted to murder me," she writes. On one occasion her mother threatened to kill them both. Like her life, Dorothy Rowe's new book is a tale of survival.

Breaking down the barriers

by Margaret Rice, 12/02/2009

Organising to interview psychologist Dorothy Rowe, the woman the BBC notes has been described as one of the six wisest people in Britain and one of the world's 100 living geniuses, it is easy to be intimidated. How accessible will she be? Will she be so remote that an interview with a mere mortal will be beyond her?

Rowe earned these labels because she is the author of 13 best-selling books at the classier end of the self-help spectrum, or at the most sombre, depending on your point of view. She has long written on the simple and yet at the same time challenging steps that we can each take as individuals to fight depression. And no wonder her books are international best sellers. The World Health Organisation notes that depression occurs in all societies, that 15 per cent of people in developed countries suffer from it, and that it will be the second biggest health problem world-wide by 2020. Although a long time resident of England, Rowe is Australian. This summer she is staying at her son's unit in Sydney. I need not have worried about Rowe's attitude. Her warm voice at the other end of the line was calm and down to earth. While making the interview arrangements she excused herself for a moment to talk to the dishwasher installer. ''Don't you just hate housework?'' she asked, when back at the phone, gleeful that she no longer has to waste as much time at the kitchen sink. So even though likely to be the wisest and cleverest person I would ever eet, she clearly doesn't take herself too seriously, an impression compounded when she said she doubted the survey processes.

During the interview itself, Rowe was relaxed but sharp. With her smartly cropped white hair, penetrating blue-green eyes and relaxed good humour, the 78-year-old is glad to be in Australia. She is avoiding freezing London, catching up with Edward, her 51-year-old, only child and doing a book tour, to promote her latest book, released last October, What Should I Believe?

During our chat Rowe talked about her many concerns. She wonders what global warming will deliver the next generation; she abhors the latest round of conflict in the Gaza and she is relieved that the presidency of George W. Bush has come to an end because she believes he is a good example of the very worst type of religious zealot, scrutinised in What Should I Believe?

Rowe's book follows a number of recent ''belief'' books, such as The God Delusion, by Richard Dawkins but unlike the others, her main focus is on the consequences that belief in God can cause to the self-perception of individuals. Rowe is no friend of organised religion, which she argues in What Should I Believe?, is responsible for immense personal suffering. Children of the uncompromisingly religious usually tend to develop a self-belief that insists that they have to be good but at the same time, they can never be good enough. ''If that's how you see yourself you become an expert in guilt and you blame yourself for disasters that have nothing to do with you. I often say that the Church keeps me in business,'' Rowe said. For the first time, because of this book, when Rowe gives a lecture she can find herself confronting several hostile audience members. ''It's only the belief that you are born in sin that makes salvation necessary. Yet I'm told 'that's not real Christianity', when I describe the impact of this,'' she explained.

In the 25 years her books have been published, Rowe has scrutinised the impact of a number of different beliefs on depression. In The Real Meaning of Money, published in 1997, she explained why money is part of our identity. In her 2007 book My Dearest Enemy, My Dangerous Friend Rowe discussed sibling rivalry and was surprisingly candid about her own suffering caused by her relationship with her unnamed sister, who is six years older and her only sibling.

Early in the book she talks about her childhood fear of accidentally destroying her sister's two miniature china dogs and the long-term hold this fear had on her. At the end she describes how on her sister's wedding day she squeezed her hand in a loving gesture but her sister responded by giving her a black look. ''I was shamed and worried that all the wedding guests had seen what happened. I am no longer frightened of my sister's black looks even though I still manage to earn them,'' she noted. These were only a few of the incidents that she described. I asked Rowe what impact publication of these had on their relationship. ''She said to me 'I'm not upset and I'm not going to discuss it.' Which meant: 'Yes, those things happened but I'm not going to discuss it.' That's it. And no, she didn't say 'I'm sorry'. What can you say? There's nothing. I don't know,'' Rowe said, pausing for a while.

Rowe has received many emails and letters since that book from people who said that it explained so much to them about their own family dynamics. This book may have revealed vulnerability and the latest is controversial, but like her previous books, they offered useful management tools to people suffering from depression. Rowe's main thesis for many years, based on extensive research, has been that depression is not caused by a chemical imbalance or an inherited gene, the view taught to and taught by many psychiatrists. She makes the point that depression is too complex to be ascribed to genes in this way. Instead, she argues that it is the unsurprising human response to a discrepancy between beliefs and reality.

When Rowe arrived in England from Australia, in 1968, after positive experiences working with children at North Ryde Psychiatric Centre, Sydney, she was shocked to find that those diagnosed with depression were locked up in old-fashioned asylums.

''The asylums were vile, just disgusting, dirty, horrible places. How they could think anybody would feel better in one of those I don't know if anyone was insane it was the psychiatrists. ''And they used to say if we made it nice they wouldn't want to go home,'' said Rowe. Rowe became increasingly concerned as patients were told that they had a chemical imbalance, when none of the scientific research proved the theory. Equally as disturbing was the fact that they so quickly went on to medication or electro-convulsive therapy. ''They weren't interested in anything that had happened to the person or the person's background. I thought this is just totally wrong, so that's why I wrote Depression: The Way Out Of Your Prison,'' she said. This was published in 1983 and since then Rowe has been a constant voice, questioning assumptions about the psychiatric management of depression. ''Everybody's vulnerable if they don't understand the way we react when we discover there's a serious discrepancy between what we thought our life was and what it actually is,'' she explained. ''When I talk about discovering a discrepancy between what you thought your life was and what it actually is, you'll see in the lives of some people that they might have had a series of experiences where that's happened. And then something happens which may not be to the outside observer a really big disaster. But that's when they fall apart, that's when they become depressed, when they are threatened with their greatest fear. For extroverts this is a fear of being left utterly alone. And for introverts it's chaos, complete loss of control,'' she explained.

Although horrible when it happens, it is part of human experience, she said. If depression is part of human experience, Rowe's corollary is that you can help yourself to overcome it. Rowe's tone became joyous and she was her most animated when discussing the practical way in which her books have helped people. ''What's really nice, giving a lecture or doing a book club event, is when people come up to me, taking a book out of a plastic bag and I realise it's one of mine, and it's almost falling apart with being read. And they say, 'Would you mind signing it?' And I think it's wonderful. If I can get a chance to look through these copies they're underlined, there's yellow marks, notes and comments and the person has used it as a work book. That's what I want it to be used as. You can do it yourself. Don't be misled by the psychologists and psychiatrists, you can work it out for yourself.''

Rowe is pleased that the British Government is now financially supporting talking therapies as a first step before medication, for the depressed. ''The British Government, following a report by the economist Layard on depression and how it costs the country vast sums of money, is now putting a lot of money into developing a walk-in therapy service for depression as part of the National Health Service,'' she said. In Australia, sessions of counselling are also now funded through Medicare, for those who see their general practitioner for depression. But Rowe raises concerns about how heavily pharmaceuticals are subsidised by the Federal Government here, something which means there is no price signal to ensure that they are not over-prescribed. ''Ideas are maintained because somebody profits from them,'' she commented sagely. No doubt the themes she explored in our discussion are just a few of the many that she will tackle at her talks in Canberra, which promise to be lively and challenging.

Dorothy Rowe will talk on ''Depression and Happiness'' at Paperchain Bookstore, Manuka, on February 24 at 6pm and then give a general talk at Tilley's Devine Cafe Gallery, Lyneham, on February 25 at 8pm.

Questionnaire published in Therapy Today, February 2009, Vol 20, Iss 1

World-renowned for her work on depression, Dorothy Rowe believes perfect happiness would be very boring

What made you decide to become a clinical psychologist?

When I left university, where I'd majored in psychology, I taught English, history and maths in high school and didn't enjoy it. When I was invited to train as an educational psychologist I seized the chance to escape.

What gives your life purpose?

The purpose of my life is to live.

What is your earliest memory?

I was lying on my mother's lap as she dried me, presumably after a bath.

What are you passionate about?

The stupidity of people who insist on creating and maintaining conflicts, and the stupidity of those who refuse to recognise the immediate peril of climate change.

Do you always tell the truth?

I tell white lies, and when someone asks me about my health I always say, 'Fine', no matter how I actually feel. Lifelong chronic bronchiectasis is a messy business and no one really wants to hear about it. I don't lie about important matters, and I make sure I don't lie to myself even when I'm lying to others in order not to hurt them.

What do you see as the lowest point in your life?

When I was in my last year at school and I knew that my family and my teachers wanted me to do what they wanted, but none of them cared about me. The teachers wanted good results for the school, and my parents and sister were totally wrapped up in themselves.

How do you relax?

I read, or I look at my garden, trees, sky and sea.

What keeps you awake at night?

Nothing. I'm a good sleeper.

Which person has been the greatest influence on you professionally?

Bertrand Russell and neuroscientists like Richard Gregory and Chris Frith.

How do keep yourself grounded?

The knowledge that my time is running out.

What are you reading for pleasure right now?

I no longer have to set myself the task of reading boring material. Everything I read is for pleasure.

Do you fear dying?

There's no point. It will happen no matter how I feel.

What do you feel guilty about?

There are things in my life that I regret but I don't kid myself I feel guilty about them.

What makes you laugh?

The News Quiz on BBC Radio 4 and Have I Got News for You? on BBC2

Where will your next holiday be to and why?

I spend the English winters in Australia.

If you could change anything about society what would it be?

The leaders who start a war have to fight it themselves as foot soldiers. Land would be set aside where wars could be conducted, and anyone who didn't want to fight didn't have to. Armament manufacturers could go on making toys for boys.

What is your idea of perfect happiness?

Perfect happiness would be very boring.

Do you believe in God?

No.

What's your most treasured possession?

I don't treasure possessions.

What do you consider your greatest achievement?

It's too early to say.

Dorothy Rowe is a clinical psychologist and writer. She was born in Australia in 1930 and studied psychology and education at the University of Sydney. Dorothy moved to the UK in 1968, and in 1972 set up and headed the Lincolnshire Department of Clinical Psychology. She is now an emeritus associate of the Royal College of Psychiatrists. Dorothy is the author of 12 books. Her best known, Depression: The Way Out of Your Prison, is now in its third edition. Her latest book, What Should I Believe? was published by Routledge in October 2008.

The self-help delusion

Spurred by the atrocities of 9/11, critics of religion first turned their fire on the fundamentalists - initially those of Islam, then those of Christianity. Now,doyenne of the make-it-alone gurus Dorothy Rowe has conventional Christians in her sights

By Catherine Pepinster

If you have attended literary festivals you will know which kind of author is guaranteed to be a big draw. There will be a good crowd for a novelist, a few hangers- on for a poet reciting his verse, but the sellout stars are the gurus - the ones that people feel explain the world and make sense of it.

Once, that might have been the role of a priest, and certainly some of today's gurus reflect the characteristics of a holy man. There's the fire-and-brimstone, preaching-from-the-pulpit type - a Christopher Hitchens or a Richard Dawkins warning their followers of the dangers of religion. Or there are the emotional gurus, the ones attracting those wanting to confess their misery and their failings, looking for some kind of redemption from those who advocate psychological self-help. And among the self-help gurus, you don't come bigger than Dorothy Rowe.

Rowe, to give her credit, is no self-made selfhelper. She has earned her spurs, training as a clinical psychologist and working in the NHS, but since her deservedly successful Depression: the way out of your prison won the Mind Book of the Year Award way back in 1984, she has gone down the guru path with titles such as The Successful Self and The Courage to Live. Her latest volume, What Should I Believe?, is a publisher's dream, merging the two worlds of atheism and self-help into one. The festival queues will no doubt double in size.

Rowe should be taken seriously, just as Dawkins is, for her books are highly influential, albeit on a different kind of audience. To give her due, she is at least a welcome departure from the testosterone-fuelled attacks on religion by Dawkins, who is undoubtedly her hero, and his cohorts Hitchens and Martin Amis.

She acknowledges life as infinitely more complicated than they would ever do. She also has time for believers, in that she has encountered people of faith who have undoubtedly made an impression upon her and whom she respects. But she has little respect for the actual beliefs that they hold and the religious institutions to which they belong.

Rowe's intervention is a sign that the debate - or, rather, the attacks, have moved on from the critiques of religion that began with 9/11 and focused on religious fundamentalism, particularly Islamism. The focus now is on more moderately held beliefs, particularly conventional Christianity. Her argument is that religion - and it's clear that she is mostly focusing on Christianity - has left many people with debilitating senses of guilt and shame, and that religion's power is due to its focus on death, the great unknown of all our lives, and that religions seek to overcome it. Religion, she says, provides certainty, and rewards us for being good.

"So great is our fear of life and death that most of us allow hope to override our intellect," writes Rowe, continuing: "No religion accepts us as the person we know ourselves to be. Rather we are told that we are inadequate, unsatisfactory and helpless. We fear that this is so, and to give us hope we … construct a fantasy about how we are superior to those who do not share our views."

One can begin to see how her argument is shaping up. Rowe's hero, Dawkins, has taken believers to task, vilifying them for belief in religions that he says are counter to reason. He attacks religion as outmoded, defeated by convincing theories of evolution. He blames religion for causing wars and for being a threat to values.

Rowe moves from the scientific realm and the political to the personal, attacking religion for messing with our minds. Unhappy people are religious and they inflict their beliefs on others to make them unhappy. Rowe's thesis charts a path from Church and State coercing people into believing things that suit Church and State, to clergy telling people that it is their wickedness that is the cause of their illnesses, to believers viewing others with condescension.

While on the one hand Church and State make you feel guilty and therefore depressed, once people do believe they feed their pride, believing they are special and chosen. Given that Rowe is a psychologist and her case studies, which she quotes liberally as part of her armoury of arguments, are of people who are at least unhappy enough to have consulted a psychologist, this would suggest that she is basing her arguments on those who have come off worst in their encounters with religion. She does at least admit that there are people who have faith who appear to be, well, not so desperate as her clients. But she has a get-out clause: they would have been good anyway, whatever their beliefs.

Trying to get to grips with a vilifier of religion of this kind is rather like trying to fight one of those fairground knife-throwers: the weapons keep coming every which way. She loathes BBC Radio 4's "Thought for the Day"; Christian groups are meaner than secular ones and don't offer to pay her fees; Christian fundamentalists are so absorbed attacking homosexuality that they care nothing for the suffering of millions in places like Darfur and the Congo. One wonders how she can possibly know: has she checked the fundamentalists' bank statements for donations?

Yet there is a point that she makes that is valuable. While many of those working in psychiatry, psychology and therapy do not take religious belief seriously, Rowe does, seeing in it the possibility of hope for some people. There is a recognition that faith is something profound, a reality rather than a fantasy, a fact of life rather than a delusion.

But it is clear in her writing on the purpose of life that the chasm between psychologists who focus on happiness and self-esteem as the way to living at peace with ourselves and others and those of faith yawns wide. The link between happiness and virtue, highlighted in Abbot Christopher Jamison's Finding Happiness, published at the same time as Rowe's work, is in marked contrast to the self-help gurus' routes to being happy, seemingly the goal of twenty-first-century life. For Jamison's route, involving virtue, means that there is vice to be avoided or, more properly, sin. And nothing shocks and appals the gurus-cum-critics of religion more than the idea of sin.

Published by the Menzies Centre for Australian Studies, Kings College London, The Australian Centre, Strand, London WC2B 4LG.

Monash Institute for the Study of Global Movements, Monash University.

ISBN 978 1 85507 143 8

In his preface to this book Carl Bridge explained that David O'Reilly had set out 'to explore the varied characters and accomplishments of some of the most prominent Australians in Britain, and through Britain the world, today.' David O'Reilly was a distinguished political journalist whose journalism and books provided a serious, informed and critical study of Australian politics and politicians since 1974 when he became a cadet journalist on the Australian until his untimely death in 2006. By then he had completed only 16 of the 20 interviews he had planned, and many of essays on those interviewed were only in draft form. His wife, Sue Corrigan, and several of his colleagues completed his work so as to ensure the publication of this important book.

The list of 16 global Australians includes Carmen Callil: the Virago, Germaine Greer: Controversialist, Geoffrey Robertson: In Defence of Humanity, Robert May: A World of Dispassionate Clarity and

Dorothy Rowe: Wisdom's Child

Dorothy was interviewed twice for this chapter, first by David and, after David's death, by Sue. David had written an outline of this chapter and so Sue filled in what she saw as gaps in the story. As a result, this chapter contains some material which had not been recorded elsewhere. This included an account of someone who became a strong influence on Dorothy's work.

p.250 

Dorothy Rowe taught for a while before deciding to train as an educational psychologist, specialising in working with emotionally disturbed children. So began her work as a liaison officer at North Ryde Psychiatric Hospital in Sydney, where she came under the influence of  Sara Williams who ran the children's unit. Although it would only become clear to Rowe years later, William's clinical approach was years ahead of its time in its sensitivity to the needs of the patient.

'When I look back, I could see that at that time Sara treated patients like they were real people. She wanted to know all about them. She got involved with them --- like the day she had to climb onto the roof of the place in a beautiful brown velvet suit to talk a distressed youngster down.'

This woman can make you happy 

Observer Sunday July 8, 2007

For 25 years, the clinical psychologist Dorothy Rowe has helped millions out of depression. Now she tells Louise Carpenter about her own tormented childhood and marriage - and why happiness is a state of mind. 

The sky hangs over London like a dark, oppressive blanket. It has been drizzling all morning and is about to break into a downpour. I am in Highbury Fields looking for the flat of the clinical psychologist and writer Dorothy Rowe, renowned author of the worldwide bestseller Depression: The Way Out of Your Prison, and 11 other books including the latest, My Dearest Enemy, My Dangerous Friend: Making and Breaking Sibling Bonds, a definitive exploration of how siblings can both wreck or enrich one another's lives depending on how the cookie crumbles. I am lost and late. 'It's the ugliest, most uncared for building on the block,' Rowe says bluntly when I call for guidance. I find it immediately.

It's in this same matter-of-fact tone that Rowe, in her new book, tells of the unhappy first 40 years of her own life, disclosing for the first time candid details of a tyrannical childhood and marriage in her native Australia. Her mother was a depressive. 'She let me know I was fat, ugly and lazy and went into a crazy rage and would beat me and declare that she was going to kill me and then herself ,' she writes. Her elder sister too, 'would look at me curiously and comment with the fascinated disgust of someone who had inadvertently kicked over a stone and found a particularly strange and loathsome slug hiding there'. Then there was a passive father, and, later, a cheating, lying husband who made Crocodile Dundee look like a fairy.

Rowe opens the door to her garden flat and ushers me in from the rain. She is small with an elfin face, wire-rimmed spectacles and dark, unruly brows under shorn, silver hair. Rowe once observed that 'bitterness is so bad for the complexion' and she seems to have heeded her own advice. In well-cut jeans, loafers and a cornflower-blue shirt, she looks considerably younger than her 76 years. She is clearly not bitter if her books are anything to go by. There is, however, a poster in the porch saying 'A Woman Needs A Man ... Like a Fish Needs a Bicycle', but who can blame her for that?

Her husband cheated on her not long after their son was born, fathered a lovechild and then suggested that Rowe become his mistress instead. Three years later, Rowe and her 10-year-old son packed up and left for Britain, the other side of the world, a drastic measure, but one that was to be her saving.

She leads me into the sitting room, simultaneously grandmotherly (which incidentally she isn't) and modern. Plush fitted carpets and hulking brown furniture vie with stark white walls hung with abstract paintings. In the fireplace there is a collection of framed photographs, none of her mother or sister, but plenty of her son Edward, now 49 and in Australia, including a particularly touching one of them together when he was a toddler in which Rowe is bending down to talk to him, a young woman in her twenties, wearing a turtle neck and pencil skirt. Her hair is thick and white blonde and combed into an elegant chignon. The photograph must have been taken roughly five years before she found out about her husband's betrayal - one of the two periods of her life, which she calls the unhappiest, and the closest she came to experiencing depression herself. 'I couldn't have been properly depressed,' she tells me now, in her matter-of-fact Australian accent, 'because I was studying for a diploma, holding down a job and bringing up my son. Depressed people don't do that. They don't do anything.' She goes on, 'depression, once a state of mind of which to be ashamed, is less stigmatised, but it is discussed endlessly and described as a vast epidemic sweeping the planet - "depressed" and "depression" are applied to any dysphoric feeling such as unhappiness, disappointment, lack of enthusiasm, even irritability.'

Rowe's view that the diagnosis of depression, or rather the doling out of drugs to treat depression, has become far too prevalent, is particularly pertinent right now. (When I mention a depressed friend who grew up with a depressed mother and was recently prescribed Prozac herself, Rowe shakes her head and says, 'Dear oh dear ... Prozac ... awful, terrible.'). The latest figures show that, in the past 10 years, Britain really has become a Prozac nation. The consumption of antidepressants is at a record high - 31 million prescriptions were written out by GPs last year, a six per cent rise, which many ascribe to patient demand for the drugs, rather than diagnosis of psychological need. As if to prove the point, there was a 10 per cent rise in the use of Seroxat and Prozac, the most popular and well-known of the selective serotonin reuptake inhibitors (SSRIs), despite the fact that three years ago the National Institute for Health and Clinical Excellence (Nice) recommended that they should not be used as a first-stop remedy.

Depression is estimated to affect as many as one in five people at some point during their lives. At any given moment, there are 1.5 million sufferers between 16 and 75, hence the prescriptions. But in a recent report issued by Mind, the leading mental-health charity, current advice is much more in favour of counselling, therapy and exercise.

Dorothy Rowe was sceptical about the prolonged, isolated chemical treatment of depression as long as 20 years ago (she concedes drugs can be useful in the very short-term). Depression: The Way Out of Your Prison was first published in 1983, long before the emergence of Prozac and all these scary statistics. Her stance, then as now, is broadly this: depression is a prison which we build for ourselves as a defence mechanism to survive. She calls it 'a period of unhappy withdrawal, an uncomfortable hibernation where the person comes to realise that something has gone wrong with his life and that something needs to be put right'. The 'putting-right' part is the tricky bit because, ultimately, human beings are terrified of change. It's not that the depressed person wants to stay in bed all day with a pillow over his head, it's more that the idea of confronting the alternative, and what it might reveal about their previously held ideas of themselves and others is so supremely terrifying.

In layman's terms, the pattern translates roughly like this: something dreadful happens to you - it doesn't matter how big or small the world measures it to be, the key is that to you it seems vast and unmanageable - and then your body goes into a kind of emotional and physical paralysis in order to survive. The ensuing, deep unhappiness becomes a prison, infinitely more attractive because of its familiarity, than the painful process of change and reassessment of life needed to get yourself out of it. The backbone of the theory is that, as children, we are brought up to believe in a just world, the pursuit of being 'good', so that only we are responsible if things go wrong. So, if your mother hated you, your father abused you, your boss took away your job and then you lost your house and your wife, it must be your fault. 'The biggest cause of depression is to turn natural sadness into depression,' Rowe tells me. 'All you have to do is blame yourself for the disaster that has befallen you. Only good people get depressed - good people are those people who feel that they are never good enough, they are experts in blaming themselves and feeling guilty. Ninety-nine per cent of suffering isn't caused by natural disasters, it's caused by the ideas we hold and if we believe these ideas are absolute truths then we suffer and we force other people to suffer. But if we understand that our ideas are created by us, then we know we are free to change them.'

The rise in depression today, she says, is down to many things. Among them is the fact that more people feel able to talk about it, whereas in the past women were 'depressives' and men were simply 'alcoholics'. Children get it; it's often a misused label for anxiety; and the standards by which we measure our lives now - our so-called 'life project' - are largely to do with wealth, tangible success and even a degree of celebrity: 'In the past, the "project" was to get to heaven,' Rowe explains, 'and at least you were singing hymns for eternity. Now even what we regard to be success is transitory.'

Her friend and former colleague, consultant clinical psychologist Craig Newnes, says, 'There is nothing remarkable about Dorothy's approach. She is kind, attentive and absolutely believes in the power of people to change. Depression is of course a scam - when we were training together in the Seventies virtually no one was diagnosed with depression but then the drug companies realised they needed a new market and claimed distress was caused by biochemistry. For as long as I have known her, Dorothy has stood up for a conversational and caring approach to helping people.'

Rowe doesn't seek to belittle personal tragedy, far from it. Heaven knows, she has experienced a bellyload of it herself. But what she advocates is trying to interpret it in a different way without saying that it doesn't matter. In the current climate, where pharmaceuticals reign supreme, her ideas, almost 25 years old now, continue to feel fresh. Certainly her following has not diminished, hardly surprising since it comes as a relief to believe that, in most cases, depression is not 'chemical'; not a result of us all being lifelong 'victims' in denial or in 'recovery' from something, a view peddled largely by the 'You-can-do-it!' American self-help culture, which often fails to recognise tangible problems caused by society - such as poverty or abuse; that what really matters to recovery is not the event itself but how we interpret it.

The writer Tim Lott discovered Rowe's work while he was working on his first book about his mother's suicide and his own nervous breakdown, cured by antidepressant drugs. He was sceptical at first, even a little angered by what he considered to be Rowe's unhelpful stance, but after reading her books he became one of her millions of followers throughout the world: 'She changed my life, as she has changed many others,' he says. 'The idea that she is simply a self-help writer is deeply inadequate and misguided. She is more a practical philosopher than anything else.'

Linda Grant, another writer who has known Rowe for around 15 years, agrees: 'At one point in the mid-Nineties, you couldn't go to a party without meeting at least two people whose lives had been changed by Dorothy. She is read by deeply intelligent people, mostly because she has uncomfortable truths for all of us. The reason why she isn't even more well-known than she is, is because her books are considered in a genre of "self-help", but in fact she is telling us much harder, philosophical truths about the world in which we function. She is trying to portray a world full of darkness, and is constantly bombarding us with difficult and complicated ideas. This is not the realm of the boosterish quick fix. It is more a philosophy of life.'

So what exactly does she do? One of Rowe's followers, a woman who suffers from depression, emailed me the following: 'What Dorothy writes feels like the truth, due to the accurate case histories, together with her uncanny ability to view human frailties from the reader's perspective. Through her eyes, you come to know yourself, or if you are lucky enough not to have suffered from depression, you are given a very clear projection of all the potential aspects of this complex condition. In Dorothy's view, the best person to know your pain is yourself, and you can therefore be in charge of your way out of the worst too. For the reader, it means that you have to come to terms with being your own instrument of change; not relying on others to pull you out of the mire. Therefore, you cannot remain totally closed off in the prison of depression if you have taken the decision to try and allow yourself to take some part, however small, in the world again.'

In 2004, Saga Magazine published 'The Wise List', the people in the UK whom the magazine stated had 'that laudable quality of wisdom'. Fifty people were on the list, and of those, the readers were asked to pick the six wisest of all. Rowe was one of those six, alongside fertility expert Lord Winston, chief rabbi Dr Jonathan Sacks, and judge Dame Elizabeth Butler-Sloss. OK, I say to her, I consider myself happy, but how can I ensure I remain so? How can I ensure I bring up happy, well-adjusted children, who

are also loving siblings? 'A book about bringing up children is the one book I will never write,' she explains, despite the fact that childhood seems key to the whole thing. (Childhood does, in fact, feature heavily in the recent sibling book, more of which later.) 'I will not add to the argument of a "right" way and a "wrong" way. All I can say is that children learn by example. If they are treated with dignity and respect and see their parents being loving and generous to one another, that is the best you can hope for

them.' She pauses, 'I cannot tell people how exactly to go about being happy, but I can certainly tell them how to stop themselves from being happy. Happiness is not something you can "achieve". It's a by-product of what you do. What you do if you want to be happy is value and accept yourself. I became an expert in my own happiness. I had to deal with happiness and unhappiness in my personal life and my professional life as a clinical psychologist and the turning point for me finally came when the intellectual knowledge I had as a psychologist - that I actually could eradicate my self-doubt and instead value myself - became knowledge of the heart and not just the head.'

Dorothy Rowe's unhappiness started at birth, in 1930 in Newcastle, Australia, when her depressed mother gave birth to her, three years after aborting a boy, and then never forgave her for being alive. In My Dearest Enemy, My Dangerous Friend, she writes: 'Once, on a rare occasion when there were visitors to dinner, my father said something about how my mother had had breast abscesses after I was born. Mother gave him one of her fierce black looks and Dad shut up like a man shot dead ... I do not doubt that she blamed me for those breast abscesses.'

Her six-year-old sister was sent away for the birth and, coming back to find Dorothy in the crib, she too spent the rest of her life punishing her for existing. This book was clearly born out of Rowe's destructive relationship with her sister.

There are many parts of the book that might easily have been exploited as the latest lucrative misery memoir. As it is, she dissects and explores the complicated dynamic of the sibling relationship, whether it be love, hate, resentment, lifelong competition to be 'the goodest' or, for the lucky ones, enduring or new-found solidarity.

For years she resisted publishers' requests to write the book. But only when her sister was elderly did the time feel right. (She admits even now to feeling jangled after the most innocuous telephone conversation with her sister.) It is hardly surprising since the most dominant feature of the first half of Rowe's life seems to be betrayal. In one painful paragraph, Rowe sums up it without

a trace of sentimentality: 'There can be painful events in our childhood from which we can recover and grow stronger, but betrayal by someone who should care for us and whom we trust is not one of them. We may be able to work out a way to live with the memory of the betrayal without denying it or becoming crippled by self-hatred, but we lose forever our innocent joy of being alive.'

Rowe provides many anecdotes relating to her mother and sister's betrayal, but one in particular makes the heart lurch. The first is of the adult Dorothy hearing her sister tell a story, during lunch at Fortnums, of a family member trying to train her pet. Rowe writes of what her sister told her: 'She said, "The kitten piddled on the floor and she picked it up and rubbed its nose in it. I suddenly remembered when you were a baby. You were propped up in your high chair and you wet and it went all over the seat and dripped on the floor. Mother rubbed your nose in it.' Dorothy adds, 'My sister told this story in the "fancy-that" tone of voice much used in my family to drain the significance out of any unusual event ... She was apparently unaware of the effect her story had on me.'

Her mother is long dead and her sister hasn't read the sibling book: 'My sister keeps telling me she doesn't remember things now. I've tried to talk to her but she would just change the subject. She can not bear to discuss anything in case I say something which clashes with her view of how things were.'

Has she forgiven them now? 'I don't understand this word forgiveness,' Rowe says sharply. 'People always go on about forgiveness without understanding what it is. You can forgive somebody for an injury when you no longer suffer from that injury, because it becomes irrelevant. So when somebody says "Do you forgive your mother?", I can only say it is irrelevant. I am still struggling with the effects of my childhood. I have been able to use the psychological effects of my childhood very effectively to build a career, but in terms of the physical, that's what I struggle with.'

Rowe begins to cough. From an early age she was diagnosed with brochiectisis, a mild form of cystic fibrosis in which damaging mucus builds up on the lungs. The condition led to constant coughing, which would send her mother into a wild rage, which often turned violent. Rowe thinks now that what prevented her from becoming a depressive herself was that she never felt guilty about disappointing her mother, largely because her primary concern was to keep herself safe from her mother's violence. Guilt, as

we've learned, is a nail in the depressive's coffin. Predictably, Rowe's mother's problems started with her mother. 

Rowe's illness was completely ignored by her family until, finally, after graduation, Rowe took herself off to a consultant, the beginning of a medical process which resulted in major lung surgery after the birth of her child (her mother refused to visit her in hospital). Now, Rowe spends three hours at the beginning of every day going through a process by which she can clear out her lungs, necessary in order to keep pneumonia at bay. She is under a brilliant consultant but, she says, 'the care is palliative'.

She tells me all this when I ask her if she has ever fallen in love with somebody else or experienced any degree of emotional intimacy following the breakdown of her marriage, about which she is also free of bitterness: 'That woman saved my life!' she cries of her husband's mistress. 'But no, I wouldn't inflict my illness on anybody. My husband left me for it. I think it's a romantic notion that we all find love again. I am very glad I experienced it once, but I'm better off dealing with this on my own. My son understands and my friends do, but I would be very hard to live with.' 

Over lunch at a local Turkish restaurant Rowe tells me she became happy very slowly. She didn't realise it until the summer of 1975 when, living in England, she looked down and saw daisies on an ordinary stretch of grass 'as if they were floating and dancing'. She had been so busy establishing and then heading a new department of clinical psychology in Lincolnshire that she hadn't noticed she was changing. 

'My great good fortune, by chance not design, was that I ended up a clinical psychologist.' She had been a teacher until her son was five, at which point she was offered the opportunity to train as an educational psychologist, which led to her working with emotionally disturbed children and gaining a diploma in clinical psychology. In 1968, three years after her marriage broke up, she accepted a post in Sheffield and began a PhD. By 1972, she was heading up a department: 'I spent hours and hours talking to depressed people,' she remembers, 'and it certainly got my family into proportion. My family certainly was not the worst family out there, by any means. But it gave me an opportunity to look at my mother from a different point of view, not just as the child of this woman but as an adult observer. Many of my patients had depressed mothers and I would tell them about mine and, if you tell a story again and again, finally all the emotion goes out of it and so what was once too terrifying to talk about becomes something really quite funny. All I was doing was finding another way of constructing it. When you laugh about somebody, you actually reduce their size. They are no longer giants looming over us; they are really quite small.'

After lunch, I watch her disappear down the street, a physically small septuagenarian swallowed up by the crowd. Later that evening, I get an email from a woman whom Rowe first treated back in Sheffield when the woman was 14. She is now in her fifties, married with children. (In 1986 Rowe gave up seeing patients to write full time.) 'I feel that if I hadn't met Dorothy my life would not be what it is now,' the woman wrote, 'indeed my parents did not think I would have a normal life and marry and have children. Dorothy has always been there for me however busy she may be and I'm sure I'm not the only former client who still keeps in touch with her. I feel very lucky. Having known her for nearly 40 years now I think of her as a great friend.'