Daily Telegraph, 23 November 2007

Moral babies or born to be wild?

A new study suggests that babies can differentiate between good and bad behaviour from as early as six months. Psychologist Dorothy Rowe disputes claims that humans are born with an innate morality.
Babies are born with one thing: an instinct to survive

Babies are born helpless. Their survival depends on other people. Babies can make their distress known to others, but those people won't necessarily respond in the way the baby needs. To survive, babies need to be able to assess whether an adult will be helpful or not. So do toddlers, for whom being able to read feelings is essential.

My own mother had an erratic, explosive, dangerous temper which she usually vented on me; my survival depended on being able to read her danger signs.

For the Yale experiment, six- and 10-month-old babies were made to watch two colourful wooden toys either help or hinder another who was trying to climb a steep hill. After the baby viewed the characters, they were invited to pick one. The babies showed a strong preference for the toy that helped rather than hindered, proving, according to the Yale scientists, that babies can differentiate between good and bad.

Identifying good guys and bad guys is necessary for a baby's survival - and for our own as adults - but that ability alone doesn't make them, or us, innately moral. To develop a conscience, a baby has to form a bond with someone who mothers him. When a baby does form a bond, he wants his mother's love and approval. He soon realises, albeit unconsciously, that, as he is, he is unsatisfactory. He has to work hard to be what his mother considers "good" - which is not necessarily something off the usual list of virtues (courage, truth, honesty, loyalty…). Indeed, there are as many moralities as there are people to hold them.

Babies who have no opportunity to form such a bond, however, fail to develop a conscience. Not all become criminals — many become lawyers, politicians or successful business people.

As adults, our assessment of the potential degree of help another person will give us depends on our understanding of what psychologists call the Theory of Mind. We can never experience another person's thoughts and feelings directly, but most of us believe that other people have similar thoughts and feelings to us. The question psychologists ask is, when do we acquire the Theory of Mind? Many believe that the potential to recognise other people's feelings is present at birth.

The neurophysiologist Antonio Damasio considers that the potential lies deep in our brain. One of Damasio's patients, David, had suffered severe brain damage as an adult. He couldn't retain a memory of any experience whatsoever. Yet, in his day-to-day life, he showed consistent preferences for, and avoidances of, certain persons. Damasio set up an experiment in which David encountered two people he'd never met before. One of these was pleasant to him and one was unpleasant. Even though the bad guy was a beautiful woman, David refused to approach her when he saw her again. We may not be born good, but we are born with an instinct to survive.

Dorothy Rowe is author of 'My Dearest Enemy, My Dangerous Friend: Making and Breaking Sibling Bonds' (£9.99, Routledge)

British brains dominate list of living geniuses

Britain has more living geniuses per head of population than anywhere else in the world, according to a new survey which reveals the country's influence on science, technology, business and the arts.

Almost a quarter of those featured in the list of 100 living geniuses are Britons, including Sir Tim Berners-Lee, who invented the world wide web, in joint first place, and physicist Stephen Hawking at seven in the list.

British artists and musicians feature heavily, including Brit Art leader Damien Hirst at number 15, poet Seamus Heaney at 26, playwright Harold Pinter at 31, Sir Paul McCartney at 58, David Bowie at 67, Harry Potter author JK Rowling at 83 and filmmaker Ken Russell at 100.

Sir Richard Branson, the head of Virgin Group, at 49, chimpanzee expert Jane Goodall, at 58, and psychologist Dorothy Rowe, at 72, also made the list. With 24 Britons in the list, the country has generated one living genius per 2.5 million people - a higher proportion than any other country.

The list, compiled by a panel of six experts in creativity and innovation, is jointly topped by Sir Tim and Albert Hofmann, the Swiss scientist who created the drug LSD.

They are followed by George Soros, the American financier and philanthropist, Matt Groening, creator of The Simpsons and Nelson Mandela, the former South African president.

There are also some surprise entrants. Osama Bin Laden ranks at number 43, a spot he shares with Bill Gates, the Microsoft founder and Mohammed Ali, the former world heavyweight boxing champion

The Americans have 43 geniuses on the list - one per 6.9 million people.

Creators Synectics, a global consultants firm, chose their geniuses by awarding scores out of 10 to each entrant against a number of factors: paradigm shifting; popular acclaim; intellectual power; achievement and cultural importance. The firm emailed 4,000 Britons this summer and asked them to nominate up to 10 living people who they considered geniuses.

They received back 1,100 nominations for individuals in all walks of life, more than 60 per cent of whom were either American or English. Only 60 per cent were still alive.

The panel was then charged with ranking the list in order of genius and to present a resulting shortlist of 100, who were then scored against the five factors.

Nigel Clarke, a managing partner of Synectics UK & Europe, said: "Many people argue that a genius can be defined by their contribution, where it turns conventional thinking on its head.

"I think that Albert Hoffman and Tim Berners-Lee have this in common with the great geniuses of the past.

''Both of them have, in their own way, turned the world that we live in upside down. And it may be that alone that accounts for their acclamation as the world's greatest living geniuses."

October 28, 2007

Aunt Sally

I'm in love with and engaged to a beautiful woman. We met 18 months ago and have made
a huge joint financial commitment in a house. She is a very driven high achiever who has
been battling an anorexia/bulimia problem for the past 10 years, and she is very
controlling. Since we moved in together, we have had the most dramatic and unsettling
arguments, which develop over trivial things, and she becomes violent. I have offered to
go for joint counselling, but she refuses help, makes excuses (which makes me wonder if
she is in denial), and accuses me of trying to control her. She has no close friends and
feels that her family detach themselves. I'm not perfect, but I try endlessly to please her.

Anything she asks for, she gets. She keeps the house in pristine condition. I put forward
most of the money, but I'm not allowed (and don't dare) to wear shoes indoors or to make
a mess. With her food and cleaning issues, I never eat at home. We are getting married
next year and want to start a family, but I cannot bring children into such a stressful
environment. I would be grateful for any suggestions.

It is quite difficult to understand why you stay with this woman. Perhaps you sweetly tried to keep
your letter short, but you didn't mention a single quality that might explain why you love her. So, I
am just going to have to imagine that she has great virtues. The problem is that they are
obliterated by her overwhelming need for control. The anorexic believes that if she (it is usually
women, although male anorexia is on the rise) can only control the messy functions and excess
flesh of the body, then the rest of the universe will also stay in shape. Compulsive cleaning and
obsessive tidiness are also issues of control and part of the same pattern of distorted thinking.

At the heart of all this is fear: an overwhelming terror that if she cannot control the chaos all
around, then she will be sucked into its vortex. It is what the psychologist Dorothy Rowe, in her
book The Successful Self, calls "fear of the annihilation of the self". We all have that fear, but in
your fiancée, it has spiralled out of control - hence her white-knuckle grip. It is hell to live with,
both for the sufferer and for those around them. Her violence comes from frustration. When she
can't control something (you, the weather, dust) she flies into a rage, or loses control. She needs
help but, as with all addictions (and anorexia is an addiction), she needs to be in sufficient pain
before she asks for it.

Addictions narrow the world to a tiny, airless room. That is why your fiancée has no close friends.
People are messy and uncontrollable. No matter how much we might want to impose our will on
them, they insist on doing their own sweet thing. We are powerless in the face of their
individuality. The only thing we can control is ourselves - and our immediate environment - but
control doesn't make for a comfortable or happy life.

So, I wonder why you have chosen it. Or let me put that another way: I wonder why she has
chosen you? It is all very well to want to please our loved ones, but giving up our shoes, home
cooking and the delightful mess of domestic comforts doesn't just seem obliging, it seems
borderline perverse. "Anything she asks for, she gets." I'm sure you do it for a quiet life, but a
relationship should be about cooperation. You need to look at the part of you that is so eager to
subsume your needs to those of another human being (it's called people pleasing).

Your suggestion that you should do joint counselling is a good one, although not for the reason
you imagine. It seems that you're trapped in fear too - fear of asking for what you want (in
therapeutic language, "getting your needs met"). Brutally put, the dynamic of your relationship is
control freak-meets-people pleaser. It might be helpful to work out what your needs are and ask
her to meet you halfway - the whole way would be too frightening. You may find that if you
challenge her (but do it with love), instead of trying to placate her, and if she wants the
relationship to work, she may feel enough pain to admit that she needs to try behaving differently.

If your fiancée refuses therapeutic help, you might suggest that she tries yoga and meditation.
Yoga has met with some success in the treatment of eating disorders, while meditation is brilliant
for anxiety, which is really at the heart of her problem.

Don't be surprised if she approaches them with her usual fierce perfectionism. While they are
noncompetitive, she will want to find a way to compete. But the astonishing thing about yoga and
meditation is that they work in spite of our best efforts to bend them to our will. If practised daily,
then slowly and imperceptibly, they introduce a spirit of gentleness and cooperation into our lives.

The Successful Self by Dorothy Rowe (HarperCollins £8.99)

If you have a relationship question for Sally, e-mail
In case of publication, names will be withheld. We're sorry, but Sally cannot answer letters personally

Fathers and Daughters

Published in The Times, 26 April 2007

Is it significant that many of the women who succeeded in a man's world had in their childhood a strong relationship with their father? Alfred Roberts was highly regarded in his home town of Grantham but his greatest claim to fame proved to be that he was the father of Margaret Thatcher. Hugh Rodham will be even more famous than Alfred Roberts if his daughter Hillary Rodham Clinton becomes President of the United States. Pandit Jawarharlal Nehru was undoubtedly famous in his own right as the first prime minister of India, but so was his daughter Indira Gandhi, the third prime minister. When William Edward Nightingale taught his daughter mathematics he did not expect that Florence would not only turn nursing into a profession but that she would become a remarkable statistician who, amongst other achievements, pioneered the visual presentation of statistics which is now so much part of our lives. It seems that in a close intellectual relationship with her father a girl can get something which she cannot get from her mother, particularly if the mother has concentrated her efforts on domesticity and motherhood.

These relationships between father and daughter are not of the 'Daddy's little girl' variety where the father delights in his daughter's feminine charms and rewards her for being pretty and charming. Rather, they are relationships where the father recognises and encourages the girl's intellectual ability. Right from the beginning the father responds to the girl's interest in the world. He doesn't direct her interest solely to what he sees as feminine things while ignoring or punishing her for being interested in what he sees as masculine things. He doesn't ignore or punish her for being interested in, say, fairies, but acknowledges that an interest in fairies can be accompanied by an ambition to become a genius in computing.

A father should reward his daughter's intellectual achievements, but he should not set this up in such a way that the daughter comes to see winning her father's approval as her main aim in life. A weak man who feels that he requires the adoration of a woman to maintain his appearance of being a strong, tough man will try to bind his daughter to him when he sees that his wife knows and despises his weakness. Men who cannot bear the thought that they will one day be surpassed by their children will withhold their approval in order that their sons and daughters continue to feel that they are failures. Most intellectual women, having survived a presidency with faithless Bill, would regard a seat in the Senate as a quiet but interesting way of completing their career. The fact that Hillary is working so hard to claim the greatest political prize suggests to me that she is still trying to gain from her father something he has never given, his unconditional approval. During the Second World War Hugh Rodham trained recruits in the US navy. Such officers never gave their recruits unconditional approval, and many of them had the same attitude to their children.

In my work with depressed clients I encountered many sons and daughters who felt that their sheer existence depended on the unconditional love and approval given by the dominant parent in the family. When this love and approval was not forthcoming, they blamed themselves.  Not all children who become locked into a lifelong battle to get their parent to give them unconditional love and approval become depressed. The child whose dream is to get unconditional love can become the adult who never quite leaves home, who stays close to the parent, caring for the parent no matter how unpleasant and demanding the parent might be. The child who believes that the parent's unconditional approval is absolutely essential can become an achiever who always sees yet another goal ahead that must be attained. Yet, no matter how great each achievement is, no achievement brings the desired approval from the parent.

Some parents mellow with old age and have no difficulty in giving their children the unconditional love and approval which the children desire. However, we should always remember that we each live within our own individual world of meaning. There are always meanings, that is, ideas, which lie outside our world of meaning and which we cannot comprehend. The ideas of compromise and reconciliation lay within Ian Paisley's world of meaning, but he wouldn't apply them to Sinn Fein until a combination of the mellowness of old age and a canny political sense allowed him to do so. I would guess that the idea that the Catholic Church is an admirable institution lies so far beyond Ian Paisley's world of meaning that there is no way he could make it his own. Similarly, there are parents for whom the ideas 'unconditional love' and 'unconditional approval' lie far beyond their worlds of meaning. They could no more show their children unconditional love and unconditional approval than Ian Paisley could become a Catholic priest. Adult children who cannot see that their parent is incapable of giving them what they want can waste their lives trying to get from their parent something which their parent cannot give. It's very sad to have to give up such a hope, but until they relinquish this hope they cannot be free and autonomous adults.

However, if we focus only on the daughter's need for the father's approval we miss the very profound effect that the father's interest in the daughter's intellectual ability has on the daughter. This effect is found in many women who didn't go on to become world famous though they may have done well in whatever field they chose to work. In my family my sister, six years older than I, was close to our mother and I was close to my father. I became an intellectual ('brainy' as my sister would say scornfully). My sister chose teaching domestic science and being in charge of a home, a husband and children. My father had left school when he was only eleven and went to work delivering groceries. He educated himself by reading and seeking out better educated people with whom to converse. His passions were history and politics. My mother didn't share these passions, and so he talked to me. My mother was interested only in what related directly and immediately to her, and my sister absorbed her way of thinking. I saw how my father's way of interpreting events differed markedly from my mother's interpretations of events. I found his interpretations infinitely interesting and my mother's interpretations infinitely boring. I didn't realise until much later that my father had given me an understanding of a masculine way of seeing the world.

What I call a masculine way of thinking is not confined to men and does not apply to all men. It is a way of perceiving the world in terms of seeing the essentials and stripping away the decorative and the dross. This way of thinking can be seen in Florence Nightingale's reports and statistical analyses. The feminine way of thinking, which again does not apply to all women, is made up of a myriad of observations, thoughts and feelings, with constant interruptions and changes in what is being attended to, often with details being attended to and the wider picture ignored. Not all women who think in a feminine way are as self-centred as my mother was. Most women are interested in all the people they encounter in their life and through the media, though the wider world doesn't always catch their attention. The feminine way of thinking grew out of domestic settings where women had a multitude of overlapping tasks, usually involving people, and where they had little control over their situation.

Many men, who think in a masculine way, make one major error. This is that, when engaged in interpreting a situation where people are involved, they disregard how these people interpret their situation. Men who make this mistake fail to understand that what determines our behaviour isn't what happens to us but how we each interpret what happens to us, and that no two people ever see anything in exactly the same way. The Royal College of Psychiatrists is an institution where men have always outnumbered women. Last year the Royal College abandoned their long-held idea that depression is caused by a chemical imbalance in the brain and declared that depression is caused by a combination of seven factors, all of which are events which may have occurred in the life of a depressed person. These are: life events, circumstances, personality, alcohol, being a woman, inherited characteristics and physical illness. Yet again the College fails to see that, if we interpret the difficult events we encounter as challenges to be mastered, we don't become depressed, but, if we see ourselves as causing or deserving the disasters that befall us, we do become depressed.

Thus a girl may learn from her father how to see the essentials, but, if he does not understand that an individual's perception of a situation is an essential, the girl is likely to be as inept in dealing with people as many men are. On the other hand, if her father shows her how essential it is to understand how other people think, she acquires the great skill of combining clarity of thought with compassion.

Another feature of a masculine way of thinking is being able to put aside emotion when it is appropriate to do so. A colleague of Hillary Clinton once remarked, 'Hillary can separate personal emotions from the goal and task ahead in a way few women can do.' Many men claim not to feel emotion, but they are lying to themselves in order to appear strong and manly. Later they are likely to discover that unacknowledged emotions take a mental and physical toll. To put aside our emotions when we know it is appropriate to do so, we need to be aware of our emotions but not let them overwhelm us. To do this we need to understand that emotions are solely about us. They are interpretations which relate to ourselves in terms of whether we feel safe (happy, content, satisfied) or in danger (fear, anger, guilt, hate, envy, etc). Acknowledging our own emotions can help us perceive and understand what other people feel, but, if we consider that our own emotions are of absolute prime importance, we are simply being selfish.

Humour comes in many forms, and is passed from parent to child. My son Edward and I always laugh at the same things, and, if Dad were with us, he'd be laughing too. Ours is that form of humour which is based on seeing the essentials and, in them, the contrasts, the ironies, and the sheer ridiculousness of human endeavour and stupidity. This kind of humour abounds amongst male comedians, cartoonists, and commentators, both public and private. My mother and my sister found such humour utterly baffling, whereas Sandy Tostig, with her immense delight in the ridiculous, and Linda Smith with her whimsicality which momentarily hid her uncompromising criticism of the stupid and the vain, show how a woman can combine the best of masculine and feminine thinking.

Having a father who appreciates his daughter's intellectual ability can have its drawbacks. Like her feminine counterpart, she can see in him the ideal man whose exact copy she forever seeks and fails to find. She can mould herself and her life to suit his wishes and never be herself. In emulating her father she can find herself alienated from other women, despising their femininity. She can spend her life trying to live up to her father's expectations, or to prove him wrong, and never get the response which she tells herself she must have. On the other hand, she can simply get from him a way of seeing herself and her world which gives her a larger vision and a greater understanding of the complexities of life.

Dorothy Rowe My Dearest Enemy, My Dangerous Friend: The Making and Breaking of Sibling Bonds Routledge, 2007

Dorothy Rowe Beyond Fear third edition, HarperCollins 2007.

My Sister and Myself

 Saga Magazine April 2007

My sister was the first grandchild on my father's side of the family and her parents' only child. According to one of my aunts, my sister took considerable pride in her position. On her sixth birthday, when she was sitting on the birthday chair and her class was singing Happy Birthday to her, someone came and told her that she had a baby sister. Her world fell apart.

The psychoanalyst Juliet Mitchell says that, on the birth of the second child, the firstborn suffers a trauma from which the child never recovers. Mindful of this, most parents nowadays spare no effort in preparing their first child for the arrival of the second. There's much patting of Mummy's tummy, and conversations about and with the baby inside, and, on the day of the birth, a very special present. Sometimes whatever parents do is not enough. One mother told me that she thought that her four year old daughter had accepted the new baby, but one day the little girl, casting a disparaging look at her sister, said to her, 'Couldn't you have kept her inside you for longer?'

My mother never mentioned anything relating to sex, so of course she had not warned my sister of my arrival. Nor would she have tried to understand what my sister was feeling once I had arrived. Instead, she became very distressed and angry at all that was being demanded of her as a new mother. It seems from family accounts that her distress tipped over into depression. So my father and the aunt who was looking after me decided to send my sister to stay with another aunt. Her absence from her home might have been no more than two or three weeks, but to a six year old this would have aeons of time. Although my sister was always frightened of her mother she was anxiously attached to her, and she loved her father dearly. To be separated from her parents and from her home was torture.

Children have no control over their circumstances but they do have a choice over how they interpret those circumstances. Some of their early interpretations have major repercussions for the rest of their lives. When a new baby arrives and the older child feels displaced, that child has a choice of whom she should blame for the tragedy, her mother or the interloper. When Charles Dickens' improvident parents sent him to the blacking factory so that his sister Florence could continue her music lessons, Dickens chose to blame his parents. However, he was twelve and already had a close, loving relationship with Florence. A child as young as six knows that she depends on her parents for her survival, and so she cannot afford to blame them. So the newborn becomes the one who ruined her life. This not only set the course for much of my sister's life, it also set the course for much of mine.

When I was twenty my father told me about another sad event that followed my birth. He said that he had wanted a son who would become the passionate sportsman that my father was, and when I was born he was so disappointed that he did not love me. In an effort to awaken a spark of love, each evening when he came home from he would cuddle me and talk to me. One evening he heard my sister say to her mother, 'Doesn't Daddy love me anymore?'

Our parents never talked to my sister and me about our relationship. I felt that my sister did not so much dislike me as despise me. When we are wounded, in anger and pain we may seek to wound others, and thus my sister set about undermining my self-confidence much in the way that her mother was undermining hers with constant criticism. Our relationship was at its best when my sister was teaching me something, because she loved to instruct and I loved to learn. However, I was much more academic than she was, and once she could no longer instruct me she scorned me for being 'brainy'. We had learned to express our anger in the way that our mother did, loudly and often violently. Our parents would break up a fight if our noise disturbed them, but they never sat us down and talked to us about what led to our fights. Feelings weren't talked about in our house, because the strongest feelings expressed in that house were my mother's rages and what I came to call sulks. She could go for as long as six months not talking to us, though occasionally issuing orders from behind her bedroom door. During these times my father and I found the tension in the house close to unbearable. What my sister felt I do not know. When I've raised the subject with her she's said that she doesn't remember, not even the six month sulk that Mother had when my sister, a respectable married woman, became pregnant.

It was not until I was in my thirties and working in a child guidance clinic in Sydney that I realised that I'd been born into a problem family. The children of problem families have to adapt as best they can to the situation in which they find themselves. When they find that their parents are incapable of parenting them, some siblings form a close bond so that they can look after one another. I longed to be close to my sister, but I think she felt that she didn't have the strength to look after me as well as herself. Part of surviving a long term difficult and dangerous situation involves making a decision about how to remember painful events. There are two basic techniques. One is to push the memory of bad events deep into your unconscious mind so that your memory of the past is patchy and vague. The other is to think about past events, trying to understand what had happened so that you can be prepared for whatever may come. It's a choice between amnesia and paranoia. My sister chose the first and I chose the second. Each method worked well for each of us while we were still at home. My quest for the answer to, 'Why does my mother behave as she does?' widened into the question, 'Why do people behave as they do?' which became my life's work. However, in later life, our different ways of dealing with the past has created an unbridgeable gap between us.

When siblings grow up they can have some fun conversations and some almighty arguments about whose memory of their shared past is correct. When I was researching for my book on siblings I frequently came to the conclusion that some of the pairs of siblings I met had grown up in different universes. Reconciliations are possible, but only when both siblings are prepared to accept that neither sibling is in possession of the absolute truth and that compromises are needed on both sides. This is not possible when one sibling has repressed all memory of her past and wishes to keep it that way.

In the course of my work as a psychologist I have seen how secrets destroy people lives simply because they are secrets. Whenever we think that we have to keep something secret, the content of the secret assumes a mythical importance way out of proportion to its importance in reality. When secrets are taken out into the clear light of day, they shrivel, becoming ordinary, even amusing. However, uncovering dearly held secrets requires a good deal of self-confidence. My mother thoroughly destroyed my sister's self-confidence. She had never recovered from this. As a result, if I inadvertently allude to something in the past, be it some happy event, or an event where I feel great sympathy for my sister, she silences me with a look of considerable ferocity.

I used to find this very annoying, especially if I was seeking some information about my family's history. Now I find it sad. Like my mother, my sister has become benign in her old age. When she was eighty, Mother gave up watching her daughters closely so that she could vent her displeasure if they dared to break one of her rules. She had spent her life inveighing against the universe, but now she told me, 'I've had a good life.' This was the equivalent of Ian Paisley declaring that he'd always admired the Catholic Church. Similarly, after a lifetime of ordering me around, my sister now thanks me if I phone or call to see her, and she expresses concern about my health. It's only quite recently that I've felt brave enough to write about her and the effect she's had on my life, and doing this has helped me reach a point where all I feel is sadness that the kindly relationship we enjoy now didn't exist for all of my life.

© Dorothy Rowe 2006

Saga February 2007

The Real Causes of Depression

How many times have you heard it said, 'Depression is caused by a chemical imbalance in the brain'? If you've been depressed and consulted a doctor it's very likely you've been told this in tones of absolute certainty. If you've been prescribed one of the SSRI antidepressants like Prozac or Sexoxat you were probably told that this drug would replace the serotonin that was missing from your brain. The SSRI drugs certainly do put serotonin in the brain, but there wasn't any missing in the first place. There never has been any evidence that any brain chemical was depleted when a person was depressed. However, psychiatrists kept hoping that one day their hypothesis that depression was caused by a chemical imbalance would be proved to be right. Now, thirty years after the hypothesis was first produced, the Royal College of Psychiatrists and the Institute of Psychiatry have accepted that depression isn't caused by a chemical imbalance. But you'll find this out only if you visit their websites. They haven't issued a press release saying, 'We were wrong.'

On the Institute of Psychiatry's website there is a lengthy notice about an important conference on depression which will be held in April 2007. The preamble to this notice reads, 'Depression cannot be described any longer as a simple disorder of the brain, but rather as a series of behavioural and biological changes that span mind, brain, genes, body - and indeed affects both psychological and physical health.'

The website of the Royal College of Psychiatrists has dropped all references to chemical imbalance causing depression. If you look at the very detailed and informative pamphlet on depression made available on the website, under the heading, 'Why does it [depression] happen?', there is a statement which says that sometimes there's an obvious reason for becoming depressed and sometimes there isn't. It's different for different people. Then there's a list of the things that can lead you to be depressed. These are: things that happen in our lives, such as a bereavement, a divorce or losing a job; circumstances, such as having no friends, being stressed or physically run down; physical illness, such as having a life threatening illness like cancer or a chronic disease like arthritis or bronchitis; personality which 'may be because of our genes, because of experiences in our early life, or both'; alcohol 'It often isn't clear which came first - the drinking or the depression'; gender 'Women seem to get depressed more than men do. It may be that men are less likely to admit their feelings and bottle them up, or express them in aggression or through drinking heavily. Women are likely to have the double stress of having to work and look after children'; and genes - depression can run in families.

All of these causes have to do with how we see ourselves and our world and how we live our lives. This includes the possibility that genes are involved. For many years geneticists have been saying that a single gene cannot be the cause of complex behaviour, but only recently have psychiatrists stopped talking about 'a depression gene' or 'a schizophrenic gene'. Genes and the multitude of proteins which genes express interact in very complex ways. Specialists in physical illness whose genetic basis has been identified know only too well that the outcome of the disease in each individual depends on how the individual interprets his situation. If cystic fibrosis, an inherited disease which shortens life significantly, is identified in the first four years of a child's life AND the parents meticulously follow a daily programme of helping the child to clear his lungs, AND if the child as he grows doesn't fail to carry out this daily programme, then he can look forward to a life of normal span. We all know that nicotine and alcohol can kill us, but many people continue to smoke and drink to excess. It's not what happens to us that determines our behaviour, but how we interpret what happens to us.

Moreover, developmental psychologists studying newborn babies have shown that babies born to depressed mothers become distressed and then apathetic when their mother fails to respond to the baby's attempts to engage his mother in those little conversations which undepressed mothers have with their babies all the time. Also, when parents try to inculcate a sense of guilt in their children in order to teach them to be socially responsible, the lessons can be learnt far too well and the child becomes an expert in feeling guilty. Many depressed people have told me that as children they had felt responsible for their father deserting the family or their mother dying, and that their guilt for their failure remained as keen as ever. Depression does run in families, but it's not through the genes

Many people will continue to believe that their depression has a physical cause. The one great advantage to this belief, is that you don't have to feel responsible for your depression. However, there is one great disadvantage. There's no physical cure. Psychiatrists don't talk of curing depression but of managing it in a way similar to the way doctors manage a chronic illness like diabetes or epilepsy. If you see your depression as being the outcome of how you see yourself and your world and how you live your life then you are saying that, while you didn't set out to make yourself depressed, this is the outcome of what you have actually done. We often get results we didn't plan for. Having to take responsibility for yourself can seem like a tremendous disadvantage, but there is a great advantage. If you don't understand how you created your depression, then by learning more about yourself you can uncreate it. In the same way many people diagnosed schizophrenic have recovered by coming to understand themselves.

The different experiences which psychiatrists call mental illness or mental disorder begin with an overwhelming fear and a feeling that your very self is shattering, even disappearing. This happens when you discover that there is a serious discrepancy between what you thought you life was and what it actually is. Mental illnesses are not illnesses but defences to hold the person together when he feels that he is falling apart. These desperate defences are terrible to endure but, if we are willing to learn, they can teach us that we need to change the way we live our life. It isn't always easy to change how we see ourselves and our world but, as the testimonies of many people show, it is in our power to do so.

http://www.rcpsych.ac.uk/ http://www.iop.kcl.ac.uk/apps/depression/introduction.aspx

Saga Magazine January 2007

New Illnesses for Sale

Have you bought a new illness lately? We're being told about them all the time, and what we have to do to keep well. I'm taking fish oil, though I'm not too clear whether it's to keep my heart healthy, my memory functioning, or my lungs working. It's nice to think that one small capsule is doing me so much good. However, the fact that a number of people like me ingests some substance regularly and go on to have healthy hearts, brains and lungs doesn't mean that this substance caused them to be healthy. We're complex organisms living in complex environments, and so it could be something else that brought about a beneficial result.

In good scientific research there is always a control group made up of people who don't take the drug being tested, but instead some inert substance known as a placebo. If the experimental group do significantly better than the control group we can be reasonably confident that the substance taken does have a beneficial effect. However, some of the people in the control group will show benefit from the placebo they've taken. These people believed that what they were taking would do them good, and it did.

The placebo effect shows that what is important is not what happens to us but how we interpret what happens to us. People who want to sell us something will work very hard to get us to change how we interpret that thing. Over recent years various health campaigns have tried to persuade us that that some aspect of our behaviour isn't just something that we do, a habit, but is, in fact, an illness. We've always known that some of our habits aren't good for us. We know that tucking into cream cakes or relaxing over a second gin and tonic could lead to some physical discomfort in the future, but life is always a matter of balancing immediate pleasure against future pain. However, over recent years, the medical profession has managed to turn every aspect of our lives into a medical or psychiatric problem. Fat people used to be just fat people, but now they're evidence that an epidemic of obesity is sweeping the country. A young woman cannot emerge from being held hostage on her own for eight years and show herself to be courageous and intelligent. The experts on these matters know that at some point in her captivity she was struck down by the dreaded Stockholm Syndrome.

We allow ourselves to be persuaded that we have some new medical or psychiatric illness, syndrome or disorder because thinking about ourselves in this way allows us to avoid taking responsibility for ourselves. If your scales tell you that for your weight you need to be five inches taller, instead of saying to yourself, 'I'd better cut down the amount I eat,' you can say, 'It's my metabolism. My body just doesn't burn up the calories as it should.' If you find that you're getting increasingly afraid of attending social functions, instead of saying to yourself, 'I must face up to this and do the commonsense things necessary to get over this,' you can tell family and friends, 'I can't go to social functions. I have Social Phobia Disorder.'

Thus you play into the hands of those people who gain enormously from the medicalisation of our lives. Doctors are now experts on an immense range of new diseases. Psychiatrists create mental disorders out of the usual trials and tribulations of life. All these disorders are listed in the Diagnostic and Statistical Manual (DSM). You're in it. Mourn the death of a loved one, and you have Bereavement Disorder. Worry about your exams, and you have Academic Disorder. In the list of Personality Disorders you'll find everyone you know, including yourself, probably under 'Personality Disorder Not Yet Specified'.

The emergence of every new disease or disorder brings joy to the heart of the pharmaceutical industry because they can now create a new drug for each new disease, or simply re-brand an old drug and say it cures this new disease. Thus that tired, irritable, bloated feeling before a period starts has become Premenstrual Dysphoric Disorder (PDD). The pharmaceutical company Eli-Lilly offers a cure, a drug called Sarafem, which is simply the widely used anti-depressant drug Prozac. Eli-Lilly and the manufacturers of the other selective serotonin reuptake inhibitor drugs (SSRIs ) have been forced to admit that these drugs have some unpleasant and sometimes dangerous side-effects. You mustn't assume that your doctor will be sure to give you this kind of information.

In the creation and medication of new diseases the alliance of the medical profession and the pharmaceutical industry has been joined by public relations companies, government departments, the media and patient advocate groups, though not the groups of patients and the relatives of patients who have been harmed by the treatment they have received. This is big business, and, as we all know, big business is not always at its most scrupulously moral. Its critics call what this alliance does 'disease mongering', defined as, 'the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments.' Of course there are many doctors who know that some of the drugs available won't actually help their patients and may in fact injure them. These doctors know that not prescribing a drug is often the best treatment for particular patients. However, not prescribing can be very difficult to do. Some of my psychiatrist colleagues have told me how they have been reprimanded or, in one case, sacked, because they wouldn't prescribe drugs which they knew would harm their patients. Often it's the patients who demand their prescription. They're seen television programmes and reports in the media about some wonderful new drug tailor-made for their disease. They believe the 'experts' in the media rather than their doctor who might, perhaps, know them quite well.

Even when we have a physical illness whose existence can be demonstrated by physical tests we have to continue to take responsibility for ourselves by making sure we understand the nature of the disease and the treatment programme we have been advised to follow. If no organic basis for our symptoms can be found and we are told we are suffering from 'stress', or if we have been told that the particular misery we are suffering is a mental disorder, we shouldn't pass responsibility for ourselves over to the experts. Something is amiss in the way we are living our life, and we have to be prepared to change. Fish oil might not be the answer.

Published in Saga Magazine

November 2006

An Explanation is Not an Excuse

I often hurl criticism, even abuse, at my radio and television. Not that I ever get a reply, but doing so relieves my feelings. What I might say has varied over the years, but ever since the destruction of the Twin Towers what I quite often say is, 'Can't you tell the difference between an explanation and an excuse?' The person to whom I direct this criticism is usually someone who ought to know better. For instance, when, in an open letter, a group of leading Muslims, including three Labour MPs, explained that many young Muslims were greatly angered by the government's policy in the Middle East, the Foreign Secretary Margaret Becket on the BBC said that any link between government policy and the terror threat was 'the gravest possible error', and that this was 'part of a distorted view of the world, a distorted view of life. Let's put the blame where it belongs: with people who wantonly take innocent lives.'

The Muslims who wrote the letter were trying to explain why some young Muslims behave as they do. Margaret Becket took their explanation as an excuse for the actions of these young men, and she rejected this excuse. She had mistaken an explanation for an excuse. She ought to know better.

I am very familiar with this kind of situation. If in public I give an explanation as to why some men become paedophiles I can be sure that someone will accuse me of excusing such behaviour. In my explanation I say that the research shows that, while not all children who are sexually abused become paedophiles, all paedophiles have been sexually abused as children. To understand why this is so we need to looks at what happens when a child is treated badly by an adult who should be caring for that child. The child is faced with having to decide between two possible interpretations of what the adult has done. He can interpret the adult's actions as, 'I have been wrongfully treated by that bad adult,' or as, 'I am bad and deserve what has been done to me by that good adult.' Children who receive physical punishment have to choose between these two interpretations. Some children who are beaten decide that the adult was wrong to inflict such pain, and resolve not to beat their children in the way that they were beaten. However, choosing such an interpretation means criticising an adult, often a parent, and they have been taught that that is not allowed. As the Commandment states, 'Honour thy father and mother so that thy days be long in the land.' Criticise your parents and you're dead. Hence many children interpret their beatings as, 'I am a bad child and deserve my punishment from that good adult.' This is the process whereby children learn to think of themselves as being unacceptable and having to work hard to be good. Unfortunately, some of them also grow up to say, 'I was beaten as a child and it never did me any harm.'

In order to say that the adult was acting correctly in beating him, the child has to ignore the pain he did suffer, and go on doing that. Whenever we deny our own pain, our ability to perceive the pain that other people suffer diminishes. Children who are sexually abused have to choose between interpreting what happened as a wicked act perpetrated by an adult, or as something that they deserved. Just as some adults tell the child they are beating, 'I'm only doing this your own good,' so do paedophiles tell their victims that they are fortunate to have such an experience. This, of course, is a lie, just as beating a child for his own good is a lie, but, if the child interprets the lie as truth, in adulthood he to prove it is true by inflicting on other children what had been inflicted on himself. Thus some of the children who are beaten go on to beat children, and some of the children who are sexually assaulted go on to assault children.

In tracing the line of explanation of why some adults beat children and some sexually assault them I have talked about how children and adults interpret situations. Our interpretations are the prime cause of what we do. You encounter a situation, you interpret it, from your interpretation you decide what do, and you act. This is how we behave all the time. Sometimes our interpretations of a situation are based on sound knowledge, logic and reason, sometimes our interpretations are based on nothing more than fantasy, and mostly they are somewhere between the two, but, whatever our interpretation is, it determines what we do.

Whatever the situation we are faced with, we always have a choice about how we shall interpret it. People often say, 'I had no alternative but to do so and so,' but what they should say, 'Out of all the possible interpretations, this is the only one I found acceptable.' Even in extreme situations, say, when we're dying, we've got a choice of dying nobly, or of giving our family as much trouble as possible. We can explain why we behaved badly, but our explanation does not excuse our behaviour because we could have chosen other interpretations. Disagreeing with government policy does not lead inevitably to murder.

When Margaret Becket and others confuse an explanation with an excuse they show that they have not grasped the one salient fact of being human. We invest our world with meaning because we continuously interpret whatever happens, and it is our interpretations which determine what we do. If we want to understand ourselves we need to be aware of our own interpretations and see them as interpretations and not as absolute truths. If we want to understand why other people behave as they do, we need to discover how they have interpreted their world. We may deplore the conclusions they have drawn, but we have to accept that what they think is a fact that plays an absolutely central role in what they do. If we want to change this fact of what these people think, there is no point in hurling abuse or bombs at them. Extreme actions result only in more extreme ideas. It is possible to find out what other people think by talking to them as equals, finding out what they want and fear most, and developing our own ideas as we find out about theirs. Doing this requires patience, cunning, and intelligence. Why can't politicians be clever?

Dorothy Rowe

Published in Saga Magazine

October 2006

How Friendship Hit the Rocks

A common sight on Australian roads is a well polished sedan car with four occupants, two middle-aged or elderly men in the front and two middle-aged or elderly women in the back. It can be assumed that the women are discussing family, friends and shopping while the men are discussing important matters, that is, sport. They are either going to or coming from some social event. The two couples have known one another for many years and they are regarded by themselves and by others as being good friends.

 Similar pairs of couples existed widely in Britain, though the minutia of social behaviour might be different from that of couples in Australia. Such friendships can be tremendously rewarding. A shared history means that so much does not have to be explained. An abiding affection means that individual peculiarities are tolerated, and individual disasters result in sympathy and support, not criticism. Alas, not all friendships between couples bring such rewards. Some friendships start off well and remain so for many years, but the changes that increasing age bring can mean that tolerance of one another, even affection for one another become harder and harder to maintain. Some friendships have always contained a measure of difficulty because one member of a couple is not the easiest person in the world to get along with. In the early years of the friendship the other couple tries to adapt to the prickles and quirks of the difficult one, and in the privacy of their own home they discuss their friends in order to relieve their own negative feelings and to work out a way of dealing with their difficult friend while supporting the difficult friend's long-suffering partner.

 As the years go by, we all change. Some of us mellow. We come to realise that the things that were two thousand per cent important to us really aren't important at all. We get more confidence in ourselves, and so we don't have to maintain our personal pride by winning every point, or demonstrating our superiority to others. In short, we become nicer. Unfortunately, not everyone gets older in this way. As my Sydney University lecturer Jack Lyle used to say, 'The older we get, the more like ourselves we become.' We become fixed in our ways, more certain of the rightness of our views, and we see no reason why we should change. These kinds of changes mean that we become less of the person we might have been.

 Thus the young man who was so passionate in his determination to eradicate injustice in the world becomes the carping critic of the world, oblivious to anything that might mean that there has been some improvement. Try to draw his attention to a benefit, and he attacks it with all the cynicism of the world-weary. The fact that you see it as a benefit shows how stupid and ill-informed you are. He may be expressing his profound disappointment over the way his life has turned out, but knowing this and sympathising with him does not protect you from the sharpness of his tongue. He may have married a woman with spirit, but over the years he has worn her down to unhappy acquiescence. The couple who are their friends have to learn to avoid any topic which provokes a tirade, and they try to give support to his wife without letting him know that they are doing so.

Then there is the woman who as a small girl had discovered that she could charm the grown-ups into helping and cosseting her when perhaps they should have been directing her towards self-reliance. By lavishing endearments on those who took her complaints about her health and her discomfort seriously she never lacked a coterie of helpers. Anyone who was insufficiently helpful to her was soon branded as being unacceptable and banished from her sight. She married a man who saw his task in life as looking after a woman in need of care. The husband might be trying to master a trauma in his childhood, such as being unable to cure his mother when she was dangerously ill, by caring for a woman whom he sees as being like his mother, but, even though you understand this, and understand that the wife might be trying to capture the attention of a father who deserted the family when she was a child, you find yourself wishing that the husband would not waste his energy on a hypochondriacal wife. Thinking this worries you because, if the wife suspects that you are siding with her husband, she will fall out with you in a very unpleasant way

 As part of a couple you can discuss these matters with your partner and at least give one another support, but, if you lose your partner through death or divorce, your relationship with the other couple can become increasingly fraught. You want to maintain your friendship with one member of the couple but not at the cost of enduring the unpleasantness of the other. Not to see the couple seems like abandoning a dear friend, but how much unpleasantness can you endure?

 All of us in our childhood, youth and middle age had to endure many kinds of unpleasant situations because other people controlled at least part of our life. We had to please our parents, teachers, employers, and put our children's welfare ahead of our own. But, once we are no longer beholden to employers, our parents are either dead or we are no longer in their power, and our children are grown up, we are free to decide how much unpleasantness we need to endure in order to ensure the benefits of a particular situation. Thus it is possible to draw up a kind of profit and loss account where the difficulties of the situation are weighed against the benefits. Where the other couple is concerned, these might be enjoyable activities that otherwise might not be available to us, the pleasure of being with the member of the couple for whom we have great affection, or even the fun we can have when the difficult one is in a good mood. If the good outweighs the bad, then making this clear to ourselves can lead us to an extent of patience with the difficult one that we never knew we possessed. If the bad outweighs the good, then our task is to find some graceful way of exiting from the scene. That eternal feature of our lives, being busy, can provide acceptable excuses, while the greeting card industry can profit from our desire to appear affectionate while not actually acting to show that we are.

Saga August 2006

Son, Father and Man 

Jack had fallen off a ladder and broken his hip. When I went to see him after he'd left hospital he was reclining on a sofa with his wife May tending to his every need. I asked whether his surgeon had given him a programme of exercises to get him back on his feet and walking normally. He responded with a string of expletives which consigned the surgeon and his team to the netherworld. Jack was not going to do what that power-mad doctor and the bossy physiotherapists (Jack called them 'physioterrorists') told him to do. May chided him gently, 'Our GP won't be pleased with you at all, Jack.' Jack said defiantly, 'That doesn't worry me in the least.'

On a bus I overheard a woman telling the woman beside her about the holiday which she'd booked. She said, 'I think I deserve a good holiday. I've had a really hard year at work, and Mum's been ill and I've had to look after her, and then my son broke his collar bone playing football . . .' Her description of her selfless devotion to others went on for some minutes, but she finished with, 'The holiday's more expensive than usual but I don't feel guilty about that. I think I deserve it after all I've been through.' Her friend agreed.

Carol and I met for afternoon tea at a café that specialised in the most sumptuous cakes. She chose two rather large cream cakes, and said, 'I know I shouldn't do this, it's very naughty, but just for once.'

Disparate though these incidents might appear to be, they have one thing in common. The three people involved are physically grown up but they still think like children. They make their decisions about what they will do according to what their parents think, except their parents aren't the ones who created them but the parents they carry around inside them. We all carry our parents inside us as what therapists call 'internal objects'. For some of us our parental internal objects are no more than our memories of our parents, but for others they act as parents, rewarding and punishing the child within who obeys and disobeys as children do. Jack, his wife May, the woman on the bus, and Carol are like this. They don't experience themselves as one, whole adult person but as three people, a child, a parent, and an adult who tries to mediate between the child and the adult. Freud called these three people the id (the child), the ego (the adult) and the superego (the parent). Eric Berne, the founder of the form of therapy called Transactional Analysis, used the obvious terms, child, adult and parent, and studied how a person can alternate between being the child, the parent and the adult. 

The child is sometimes wilfully disobedient and sometimes tries hard to be good. When I saw Jack he was in his favourite role, that of the wilfully disobedient child who is defying the parent, represented in his mind by his doctors and physiotherapists. May is in the role of the good, obedient child, an older sister to Jack rather than his wife. The woman on the bus is in her parent role. She has assessed her child as having been very good, hard-working and uncomplaining, and therefore deserving of a treat. She feels that she must prove to her friend that she is not a naughty, self-indulgent child who has taken a treat which she does not deserve, whereas Carol is the child who wants to enjoy an undeserved treat and feel the thrill of being sinful.

Babies don't come into the world divided into three. They arrive as an embryonic whole person. However, they cannot enjoy this state for very long because they soon encounter good and bad, rewards and punishments. Much of what they do as a child is called bad by the adults around them, and so small children start to think of themselves as being bad, or at least unacceptable. They take inside themselves their parents' way of judging them, and soon there is a conflict inside them between their desire to please their parents and their desire to be themselves. Some people waste their lives trying to please their internal parent who gives nothing but grudging praise, while others seek revenge against an internal parent who as a real life person treated them badly. The child within tries to justify his or her existence to the internal parent, whereas an adult knows that we do not have to justify our existence by being good. An adult is good simply because it is more pleasant to live in a society where people behave well towards one another than in a society where they do not.

In childhood and adolescence the independent whole person, the adult, struggles to survive amongst the conflicts between the internal child and parent. Some children manage to establish a balance between their child, parent and adult so that as they enter adulthood their adult becomes their dominant way of assessing a situation and making a decision, but, alas, many people do not manage to do this. They lose the sense of being a whole person and live unhappily with a child and a parent battling inside them. That this is so is revealed in their ordinary conversation.

If Jack had been operating as an adult he would have said, 'I can't say I enjoy all the exercises I have to do but if I want to be as active as I once was I just have to do it.' The woman on the bus would have said, 'I've got a lovely holiday booked. I'm really looking forward to it.' Carol would have said, 'I fancy a couple of cream cakes.' However, being an adult means giving up some of the pleasures of being a child. Jack would have had to give up the pleasure of being cosseted by his wife/mother. May would have had to give up the pleasure of priding herself on being so good. The woman on the bus would have had to give up the pleasure of complaining about how hard done by she was. Carol would have had to give up the pleasure of being sinful. As Saint Paul said, 'When I was a child, I spake as a child, I understood as a child: but when I became a man, I put away childish things.' (1 Corinthians: 13:11) Anyone who's old enough to read Saga is old enough to be one whole person, an adult.