A shared ‘somatic crisis’:[i] enough common ground?

A shorter version of this paper was presented at the INTAR (International Network Toward Alternatives and Recovery) international conference, University of Liverpool, UK (25-27 06 2014), Power to Communities: Healing Through Social Justice, on Day 1 (25 06 2014).

  • The ‘disappearing’ of gender as structural dis/advantage
  • The impact of feminist methodology and women’s peer process
  • Power, politics and casualties: gender, mental health and academic practice
  • Neoliberal fallout
  • A necessary chorus of dissent and co-creativity.

In response to the publication of Thomas Piketty’s latest book,[ii] Sean Baine, Chair of the Equality Trust writes:

Evidence of the devastating social and economic consequences of inequality has been growing for years. What we now need is for the corridors of power to take the issue of inequality much more seriously. As such, the Equality Trust is calling on all political parties to adopt our inequality test – an explicit commitment in their manifestos that the net impact of their policies will be to reduce the gap between the richest and the rest.[iii] Emphasis added.

Other Guardian letters on the same day refer to: “the problem of rising inequality and declining social mobility”; the ethical assumptions involved in economics (as suggested previously by Ha-Joon Chang,[iv] as well as “psychological expressions of differing beliefs about what constitutes human nature (sic)”; and one letter writer declares that “Equality is not the ‘natural’ state of man (sic); inequality is the persistent state of man (sic)”.

“Inequality”, “social mobility”, human nature”, “man” – my feminist heart sinks, my brain boils.

The ‘disappearing’ of gender as structural dis/advantage.
’The Spirit Level[v] evidence on inequality is encouraging many men on the Left (academics, politicians, journalists, activists) to define inequality as economic disadvantage or poverty.[vi] This position has historical and theoretical roots in C19 Marxism. In 2014, however, this stance can be seen to ‘disappear’ structural disadvantage consequent upon power differentials rooted in racism, homophobia and misogyny, which are patently not explained by social class and/or poverty.[vii]

In the public domain, masculinity and male identity are too often glossed within/by aggregated data and ‘generic’ media reporting, for example in relation to knife crime,[viii] drug-related gun crime,[ix] criminalization, incarceration, social conflict, ‘riots’, terrorism and war.[x] ‘People’, ‘spectators’, ‘demonstrators’, ‘hooligans’, ’criminals’, ‘terrorists’, are actually labels used to report on men’s behaviour and actions (usually in all-male groups, crowds, gangs), on the street, in other public spaces, and in organisational or institutional settings. [xi]

This gender-neutral language leaves the evidential role of gender un(re)marked. This removes gender and masculinity from scrutiny, understanding and critique; and by extension from intellectual (e.g. sociological) and political analysis. This is the default position: normative practice across most of the media, politics, and other areas of professional and business practice, including much academic practice.[xii]

The position of academia as part of this ‘consensus’ is significant, as the prevailing culture provides more than the backdrop to mental health discourses and practices, not least because it both straddles and attempts to theorise the boundary between academia and society; between academics, psychiatrists, psychiatric nurses, social workers, other health practitioners and specialists, as well as service users in the mental health field. It attempts to constitute as well as critique what is complex and contentious, as lived experience, not simply abstractions or speculation. There are apparent and hidden elements of power struggle in these relations, which can have material consequences for clients (a point I will return to).

It is therefore not surprising that there is evidence of cognitive and intellectual continuity with aspects of these wider social and cultural contexts, pressures and practices in recent descriptions and analysis of psychological and social approaches to ‘psychosis’, even as critical and oppositional discourses and practices promote their academic credibility and professional status (while – like aging rock stars? – practitioners simultaneously hold on to their ‘radical’ / alternative / anti-authoritarian identity).

Causes of depression are listed as:

  • family, relationship, loss, isolation, childhood and work.[xiii]
  • psycho-social factors include “unusual or traumatic experiences” and “childhood adversity”.[xiv]

“Stressors” are identified as:

  • “major unpleasant emotional experiences” (USA 1987)
  • “family conflicts”
  • “unusual or traumatic experiences” (London)
  • “psychosocial stress” (West Germany and East Germany)
  • “problems in interpersonal relationships” (Japan)
  • “childhood events” (East London)
  • and “psychological traumas” (Italy).[xv]
  • “Childhood adversities are associated with maladaptive functioning, such as parental illness, child abuse and neglect”.[xvi]
  • “The causal role of childhood adversity” is highlighted,[xvii] as is “childhood trauma”.[xviii]

This is gender-neutral language that serves to mask the realities of girls’ and women’s lives and the impact of those lives on their mental health and wellbeing. Even when “belonging to a disempowered group”[xix] is mentioned as a factor, it is linked to poverty and racism, with no mention of gender and the positioning of girls and women. And the generic term “social causation”[xx] gives no indication it might encompass gender issues or racism. Gender differences may be mentioned as ignored, but there is no gender analysis; the issue of gender / gender power relations is not simply a matter of noting / assuming gender differences. Highlighting the putative role of life experience “in shaping brain structure and function” produces another list:

  • “including attachment relationships
  • varieties of trauma and adverse social experience
  • social isolation and defeat
  • poverty and urban living”.[xxi]

Whether mainstream or specialist, language such as victim, survivor, criminal, patient, spectator, demonstrator, skiver, perpetrator, people; abuse, childhood adversity, social disadvantage, trauma and power, is gender-neutral, and needs contextualizing to serve women, rather than rendering us invisible within its discourses.[xxii]

The impact of feminist methodology and women’s peer process.
By contrast with these generic discourses, the executive summary of the Women’s National Commission report in 2010, on the health aspects of violence against women and girls, states:

 Since 2003 the Department of Health (DG) has acknowledged that women’s experiences of     domestic violence and other forms of abuse are linked to long-term mental illness (sic) and with      physical and sexual health problems.[xxiii] In 2007, the cross-governmental sexual violence action          plan recognized that the impact of recent and historic sexual abuse includes anxiety and panic    attacks; depression; problematic substance use; eating disorders; post traumatic stress; self harm   and suicide.[xxiv]

Here, mental health issues are explicitly linked to women’s lives and experience of sexual violence and abuse, and ‘symptoms’ are understood as consequences of those experiences.[xxv]

In 2014, 11 years after the Department of Health statement, 7 years after the cross-governmental sexual violence action plan, and 4 years after the publication of both the Women’s National Commission’s A Bitter Pill To Swallow and Southall Black Sisters’ Safe and Sane document, Liverpool’s What Women Want Group set up a Task & Finish Group to produce an evidence-based report, with recommendations for local, voluntary and statutory mental health services, based on national research findings and local women’s experiences of domestic abuse and use of mental health services”.[xxvi] It was produced via a peer group process that brought together women from different backgrounds, with various combinations of relevant experience and expertise (as service providers, service users, researchers, academics, activists, etc.). Findings include:

  • Women described various forms of psychological, emotional, financial, sexual and physical control used by partners to subordinate, threaten and isolate them.
  • Psychological control and emotional abuse were experienced as the worst aspects of the abusive relationship, with the lasting psychological impact of that abuse being a loss of identity, confidence and self esteem, anxiety, depression, social isolation, eating problems, harmful use of alcohol and substances, self-harm and suicidal ideation.[xxvii]

These experiences could be seen to fall within several of the categories already mentioned, such as:

  • major unpleasant emotional experience
  • family conflict
  • traumatic experience
  • psychological trauma
  • psychosocial stress.

Or these four psychosocial causal beliefs:

  • problems from childhood
  • day-to-day problems
  • death of someone close
  • traumatic event.[xxviii]

These summative categories demonstrate the significance of the questions researchers or practitioners actually ask; i.e. the categories their questionnaires and/or focus groups implicitly construct, and by default, the experiences they exclude, suppress or marginalise.

By contrast, Liverpool’s Domestic Violence and Mental Health report, is explicitly rooted in the lives and experiences of actual women, and acknowledges at the outset that gender-based violence against women, such as partner abuse (the most prevalent form of abuse) has its roots in unequal power relations between women and men.[xxix] While vital to the development of functional and empowering processes for both service users and service providers, this stand nonetheless understates the significance of the nature and role of heterosexism, homophobia and misogyny in societies, and within women’s relations with conventional / traditional heterosexual men and their own families.[xxx]

Women’s experience of domestic abuse irrefutably re-iterates the significance of a predatory, unequal heterosexual relationship, in which the woman is subordinated, controlled, coerced and isolated, and by extension, exploited, violated and terrorised. This is not every woman’s experience, but it is too common, too widespread, and apparently spreading. The impact of “conservative attitudes and value systems which justify violence against women and are unsympathetic towards mental illness generally” and the pressure to conform to “traditional gender roles as good and dutiful wives, sisters, mothers, daughters and daughters-in-law” are still significant, and explicitly inform and frame the interventionist work of Southall Black Sisters, for example.[xxxi]

Research over three decades consistently found that Asian women, particularly those aged 15-34,     are up to three times more likely to kill themselves than women in the general population.[xxxii]

SBS counsellor, Shahrukh Husain, has developed a new ‘hybrid’ model of psychotherapy that “combines established humanistic, cognitive-behaviourist and psychodynamic therapies in a fluid way. . . using when necessary, some directional elements drawn from Life Coaching”.[xxxiii] SBS have found this model effective in the treatment of Post Traumatic Stress Disorder (PTSD) and recommend that domestic violence as experienced by BME women should be added to the DSM-IV-TR diagnostic criteria for PTSD, either as a sub category within the Battered Women’s Syndrome (sic) or in a category of its own, “so that the impact of religious and cultural pressures such as notions of ‘shame’ and ‘honour’, and of racism, are taken into account.[xxxiv]

The Southall Black Sisters (SBS) model provides holistic specialist services for abused BME women by combining advice, advocacy and support services with counselling and psychotherapy. “It helps prevent the medicalisation or over-medication of BME women by recognizing and eradicating or reducing the social causes of their mental health problems.”[xxxv]

Women’s focus group testimony forms the powerful heart of the Liverpool report, and “the direct, causal connection between the abuse they had experienced and their symptoms of mental distress was a strong, recurring theme throughout the discussions.[xxxvi]

But women report that many health practitioners, including GPs (women or men), ignored, negated, minimised or played down the impact of abuse, referring, for example, to “relationship problems”. As one woman commented: “I do not have ‘relationship problems’. I am not in a relationship. It was domestic abuse.”[xxxvii] Too often, ”GPs, even when made aware of domestic abuse, did not offer support other than medication.”[xxxviii] This suggests a level of denial rooted in ignorance and bordering on contempt, which in turn, I suggest, implicates heterosexist and misogynist values and attitudes.

The problem evidently goes deep. There is alarming testimony in all three of these reports about women’s experiences at the hands of mental health practitioners, in particular GPs and psychiatrists:

  • their lack of understanding of gender issues, domestic abuse and all forms of violence against women, and the social causes of women’s distress
  • the emphasis on medication
  • unhelpful and judgemental attitudes.[xxxix]
  • “And psychiatrists are always men.”[xl]

The women in the [Liverpool] focus groups spoke of:

  • not being listened to or believed by family courts, police, social services and health professionals.[xli]
  • Above all, services did not ask the question about domestic abuse. And as one woman commented: “It’s not something you bring up without the question being asked.”[xlii]
  • Another woman reflected: “We have all (here) experienced horrendous things. My personal experience is that I had to be raped for the relevant agencies to kick in.”[xliii]
  • And only 2 out of 42 of the women we engaged with had been given information about or directly referred to a specialist domestic abuse support service by a health professional.[xliv]

The disconnect between services and different health practitioners, perhaps reflecting power differentials and unhelpful power relations and status conflicts, clearly presents obstacles to responsive and effective support and care. It seems to reflect, not just a lack of professional contact, co-ordination and mutual respect, but the gender ignorance / prejudice noted at the beginning of this paper: internalized sexism, and the fruits of a society increasingly saturated with pornographic, heterosexist and misogynist values and assumptions, which constitute not just disadvantage or inequality for girls and women, but real and (ever) present danger. A stifling, not just of opportunities, but of being and breathing.

As women’s activism and feminist theory have confirmed over the years, ‘context constantly threatens to make emotional and behavioural problems intelligible’:[xlv] thereby open to critical scrutiny and political engagement.[xlvi] The three reports drawn on here were all produced by mixed teams of women variously working in the field of women’s mental health. The WNC Report recommends support for women via “empowerment towards recovery” (rather than medicalization and medication), and that:

Mental health professionals should be required to be trained in the social model of mental ill-               health and in women’s mental health needs, using the experience from specialist violence against      women services to inform its development and delivery.[xlvii]

Southall Black Sisters stress the importance of:

  • minimum standards, guidance and compulsory training (being) developed by the NHS and other health and social care bodies in consultation with specialist, secular BME women’s organisations
  • the implementation of policies and practices which meet human rights standards, such as those required by CEDAW, within the health and social care services”[xlviii]
  • and the importance of “culturally competent” staff, capable of addressing issues of gender as well as race inequality.[xlix]

This last point clarifies how a social model of mental health in a diverse society that prioritises respect for difference, attention to social justice issues and a human rights framework,[l] requires health practitioners with a multi-disciplinary background, together with relevant expertise by experience. In 2014, social, cultural and political awareness and sensitivity are professionally vital.

These 30+ neoliberal years, with their heterosexist, hyper-sexualised, consumerist, competitive and violent culture, have rendered girls and women more vulnerable in both the private and the public domains, as media and business have intensified and exploited gender differences and divisions for power and profit. A recent product of this culture, British-born American student, Elliot Rodger, went on You Tube and “raged that he was a virgin and would exact vengeance.”[li]

I don’t know why you girls haven’t been attracted to me, but I will punish you, for it is an injustice.       I’ll take great pleasure in slaughtering all of you. You will finally see that I am the superior one, the           true alpha male.[lii]

This case will stir up old debates about male perpetrators as “mad” or “bad”. The ‘lone male’ boast of misogyny as justification for premeditated femicide is a reminder that:

There is no such thing as a lone misogynist. They are created by our culture, and by communities          that tell men that their hatred is both commonplace and justified.[liii]

But perhaps in 2014 this debate is better served by the greater prominence of feminist commentators and activists of all ages, particularly in the wake of the virulent misogynist attacks on women in the public domain in the UK in 2012/13/14, such as academic Mary Beard, MP Stella Creasey and feminist campaigner and journalist, Caroline Criado-Perez, and the continuing stream of historic abuse cases going through the UK courts since the death of Jimmy Savile.[liv]

If VAWG (including domestic abuse, partner abuse, and rape) is now the single most significant social determinant / causal factor for women’s mental distress, psychological chaos and ill health, should we not expect it to be more prominent in contemporary mental health discourses and practices? More embedded within current critiques and theories. Less marginalized.

Power, politics and casualties: gender, mental health and academic practice.
Mental health critique of the medical model recognises that service users are not just bodies, to be done to, in a process that amounts to objectification and commodification. Yet, as has been shown above, the problematic nature of the generic language and assumptions of psychosocial discourses and the testimony of women survivors of abuse / service users, as well as women service providers, suggest there remain serious, largely unacknowledged, gender issues within the profession that serve to compromise progressive mental health philosophy and practice.[lv]

The declared “focus on recovery not pathology”,[lvi] and on “a human rights and social model”[lvii] is welcome, but needs to demonstrate awareness of and action on the gender issues raised by women’s concerns and evidence, as well as critical self reflexivity regarding structural issues attendant on the profession’s current and longstanding demographic: its gender imbalance and the consequences of this for appropriate, good service provision for girls and women clients.

I return to a question I asked 10 years ago of a plenary speaker at a mental health conference, an ‘innovative’ psychiatrist running a mixed residential mental health service: “Given that we know that the biggest factor in women’s mental ill health derives from their negative (and abusive) experiences within heterosexual relationships, involving power and control, how could their recovery be effected within a mixed ward or environment?” [lviii] He observed, with a smile, that it was a very good question, but that he “pre-dated political correctness”. He declined to respond, and handed over to two service users / residents he had brought with him.

In the intervening years, women’s specialist, women-only services have established their expertise and effectiveness in the field of women’s mental health.[lix] These projects emerged from the culture created by women’s activism from the 1970s: and they were grassroots, feminist-inspired and community-based. The result in 2014, is a sort of parallel universe with regard to mental health service provision: male (overwhelmingly white?) psychiatrists on the one hand, and diverse (in terms of age, ethnicity, social class, sexual preference, for example) women activist practitioners on the other. This separation and disconnect comes through in the testimony of women victims and survivors.

The only reason I’m still alive is because I got out of the mental health system. It is a dangerous             place for abused women to be. (FGN)[lx] Emphasis added.

If you complain or ask to see a woman they write on your notes ‘aggressive non-compliant        patient!’ You learn as a kid to shut up and not complain and you’re treated the same by the NHS.   (FGN) [lxi] Emphasis added.

Psychiatry does nothing but harm women who have been abused in a profession where they are              supposed to alleviate distress. In my experience, they have no understanding of violence against     women, of child sexual abuse, and of the impact this has on women. (FGN)[lxii] Emphasis added.

I think psychiatry today is an essentially patriarchal institution that reproduces situations of lack of     dignity and powerlessness contained in the original abuse. (FGN)[lxiii] Emphasis added.

And, as in society at large, older women[lxiv] and disabled women[lxv] can find themselves particularly disadvantaged and ill served by mental health services and practitioners. The misogyny and ageism encountered in society are too often intensified away from the public gaze, within institutional settings meant to support and assist recovery.[lxvi]

I just can’t believe the things that I just was not taught. As a qualified nurse the social model of             disability was never even mentioned in my training. (FGK)[lxvii]

Is this also a hierarchy? Salaried professionals on secure contracts v the insecure and uncertain funding of women-only services over these many years, despite the specialist services proving their value to their client group: women damaged and derailed by their relationships with traditional heterosexual men. The material conditions of their lives, supposedly central to the social model of mental health.

Asking a woman client, ”What has happened to you?” serves to expand the category of trauma beyond the gender-neutral lists cited earlier. Girls’ and women’s trauma-induced distress, disintegration and psychological chaos are gender issues, feminist issues. Trauma-informed service provision and trauma-sensitive therapeutic practices are necessarily feminist practices, tailored to girls’ and women’s needs and aspirations. Depression and anxiety, for example, are not attributed the status of first causes, but consequences.[lxviii]

For conventional male academics, politicians and psychiatrists (i.e. the majority), the basic fact of the role of VAWG for women’s mental health is presumably indigestible, because it implicates them as (heterosexual) men. It muddies, even threatens to undermine, their professional status. Ignorance and resistance is still deep rooted and widespread, for example amongst male police officers, GPs, psychiatrists and judges: in some cases a woman has to be dead before agencies take notice, and are willing to consider the man as perpetrator, a risk to a woman or child’s life.[lxix] The charisma of being another heterosexual man seems to act like a built-in protection. But the heterosexual frame can also make women service providers complicit with this resistance and denial. They too have a vested interest in seeing all heterosexual men as basically good guys. But, as feminist blogger, Melissa McEwan tweeted:

Dismissing violent misogynists as “crazy” is a neat way of saying that violent misogyny is an   individual problem, not a cultural one.[lxx]

For male practitioners, confronting the issue of VAWG and misogyny as at the core of women’s mental distress and psychological disarray, could dilute their professional credentials, purpose and capabilities, rendering them less powerful, even unemployable. After all, within this gendered dyad, with his masculinity a potential disadvantage, what possible roles and relational possibilities are open to (or to be avoided by) the conventional, male mental health practitioner (Counsellor? Mentor? Father figure? ‘Romantic’ interest? Predator?). All of these ‘positions’ echo the heterosexist relationship at the root of the girl, woman or trans person’s [lxxi] dis-ease / mental health crisis after sexual violence and/or domestic abuse. It is likely to be experienced (on both sides?) as an unsustainable, ‘inappropriate’ relationship, with scant therapeutic value. And the Nursing and Midwifery Council are likely to be less forgiving than the Liberal Democrat Party.[lxxii]

At the same time, some mental health practitioners already feel the heat of service-led movements for change, which they fear could derail their professional identity and status, as this psychiatrist’s outburst reveals:

 “I get sick and tired of being attacked all the time – from clients, families, professionals. So you              would get rid of all psychiatrists would you?”[lxxiii]

In these circumstances, to be asked to critically reflect on the nature and consequences of their own masculinity and sexual identity for their professional practice could presumably be a ‘last straw’, triggering identity crisis. Like academics, in the wake of years of neoliberal advances and their impact on the university sector (less secure contracts, erosion of tenure, increasing uncertainty around career paths, increasingly unsustainable workloads, and authoritarian, managerialist regimes), they are becoming newly vulnerable anyway: potential clients for their own services.

Neoliberal fallout.
Dr Clare Gerada, former president of the Royal College of General Practitioners, made it clear in interview that:

  • The number of doctors becoming affected by mental illness or addiction is a frontline issue that could have catastrophic consequences.
  • NHS occupational health services have been drastically cut in recent years, which coincides with increased workloads and stress.
  • For GPs, it’s the pressure of the workload, the denigration of what they are trying to do. For others, it is the loss of team structure.
  • An atmosphere of fear and uncertainty pervades the NHS, adding to doctors’ anxiety about being perceived as weak or unwell.
  • (Doctors’) problems are deep-rooted, psychological and social, part of a stigma in the NHS attached to weakness, addiction or mental illness.
  • There is absolutely no pastoral support, no help for doctors with mental illness, no post-traumatic stress counselling.[lxxiv]

A “50 year old consultant at the top of his profession, . . recently diagnosed with bipolar II disorder” who reckons he has had it for 20 years of his career, revealed the intense pressure on him not “to be found out”.[lxxv]

I lose a child, I lose a 20-year-old, and I go round the back of the hospital and have a fag and then          it’s straight back to work. There’s no debrief, no pastoral support.[lxxvi]

At the other extreme, unpaid carers (mostly women), who have been in role for many years, and who have no union, agency or support group to mitigate mental health crises or represent their interests, are themselves succumbing to ill health, desperation and collapse.[lxxvii]

Compare these examples of overload, isolation and lack of institutional care and support, with another expanding cohort with mental health issues in 2014. Combat Stress, the charity set up to provide for the mental health needs of war veterans, has recorded a 57% surge in those seeking help in 2013, its current caseload of 5,400 comprising veterans from Iraq, Afghanistan and Northern Ireland.[lxxviii] General Sir Richard Dannatt comments:

The Ministry of Defence will always try to talk the figure down for budgetary and compensation              reasons. But psychiatric injuries should be widely recognized and talked about.[lxxix]

He said that former soldiers were often caught up in a “culture of coping alone” and that it needed to be recognised that there were too many former combatants who ended up in jail as murderers, or as suicide victims.[lxxx] Meanwhile, it appears that more and more medics (salaried professionals) and carers (unpaid ‘volunteers’), both devoted to providing the very best care, struggle to survive and cope in their own private ‘combat zones’, and remain largely abandoned: invisible, unless identified (scapegoated?) as being culpable (for a ‘mistake’ or ‘failure’).

In 2014, the mental health movement also finds echoes in critique by beleaguered academics (‘exhausted, stressed, overloaded, suffering insomnia, feeling anxious, experiencing feelings of shame, aggression, hurt, guilt and out-of-placeness’[lxxxi]) of the impact of neoliberalism on the university sector.[lxxxii] The ‘disciplinary technologies’[lxxxiii] of neoliberalism, New Public Management practices and audit culture have been described as inducing ‘psychosis’ in modern public universities:[lxxxiv] an institutional exemplar of the social determinants of mental health: ‘Bad things happen and can drive you crazy.[lxxxv] And all this because, like other former public sector services (such as the NHS, social work, probation, socal care), “the university has become a place of work rather than a vocation”.[lxxxvi]

The diminution or loss of a working environment in which academics, medics, and others, experienced personal / professional agency and efficacy; could practise critical enquiry; and exercise co-creativity without fear or caution, has been replaced by heightened risks and surveillance, as a consequence of top down managerialist controls and government Cuts; and a loss of self esteem and status.[lxxxvii] None of these should count as privilege, rather as human rights. Professor Ronald Barnett, an acknowledged expert worldwide on higher education systems, reflects on the changes to the character of academic life in C21:

There is much to be pessimistic about . . . . Its super-saturated character, being dense with tasks         and expectations; its extending into the life-world and so affecting the life-world balance; its audit             and surveillance regimes; the ‘commodification’ of student learning; and its sheer      instrumentalism, as every activity in academic life is required to have an outcome or impact               beyond itself: these are just some of the sources of pessimism.[lxxxviii]

The public sector post 1945 created a wide range of opportunities (e.g. education, training, travel) and jobs that provided many people with not just a secure income and career path, but with job satisfaction: personal and professional purpose, daily meaningfulness and social conviviality in the workplace. Women especially benefitted from these changes. This is what has been under political attack in these long neoliberal years, and it has been experienced as a violation of the person, with integrity as a casualty; see Andrew Sparkes and Mary O’Reilly (16 05 2013).[lxxxix]

It is clear that mental health is not just ‘a whole population issue’,[xc] but in the wake of 30+ years of neoliberal coercion and control, a whole society crisis, as we stare down ravaging inequalities and consequential personal and social damage.[xci] We have a common enemy and it is not each other. Together we can pool skills and expertise, bear witness across difference, and build alliances that will effect the paradigm change, not just in mental health services, but in society, that will foster human dignity, equality and environmental sustainability.

A necessary chorus of dissent and co-creativity.
These further examples of the social determinants of mental distress and the evidence of widespread injury and damage (to students, workers of all kinds, creatives and professionals alike), lend urgency to the critique of mental health services:

  • that decontextualize the individual[xcii] and human distress;[xciii]
  • that identify ‘control by the powerful, for their own self-interests, of the relatively powerless’;[xciv]
  • a model of ‘control and coercion, not support and care’.[xcv]

The politics of health implicates and has consequences for us all. As has knowledge production: What counts as evidence? Who gets to speak? Who listens? Like academic critiques of neoliberalism, mental health activism, theory and critique go beyond identifying the needs and aspirations of a specific constituency. For example, the recent draft SWAN Mental Health Charter[xcvi] highlights values as well as practices, and implicitly addresses the question of power relations and responsibility, thereby engendering a vital conversation about what counts as good practice. In contrast to psychosocial practices that can (unavoidably?) serve to individualise misery and damage, it is part of a movement that advocates greater service user participation[xcvii] (i.e. partnership and collectivity), as well as self-advocacy,[xcviii] and collaboration, for example involving trade unions.

Moving away from demarcation and divergence, and the tensions and conflicts these have engendered within mental health services in the UK, the service-led group reVision[xcix] facilitates mutuality and reciprocity, beginning to establish a convergence of interests and values between service users, service providers, academics and activists, for example, without loss of face or individual identity. This is peer group process in action beyond the medical environment, and counters entrenched white western, masculinist cultural assumptions about the primacy of the autonomous individual (historically non disabled, white and male), and the virtue of hierarchy.[c] Mutuality, reciprocity, sociability, conviviality are no mere add-ons. Neoliberalism discounts and ridicules these values as beyond and irrelevant to the scope of market consumerism and corporatism.

It is clear that experiencing disadvantage as a function of racism, homophobia, misogyny, bullying, mental health issues, for example, is not simply a function of social class or poverty, although both these are likely to exacerbate mental health crises. Racism, homophobia, sexism, misogyny, social class prejudice, have been politicizing experiences for many of those at their sharp end, moving us beyond victim status and identity politics, to offer critiques of power in society: organizational, cultural, political and economic. Equality, human rights, sustainability and democracy are entwined projects.

Since 2010 and the ConDem onslaught, many single issue campaigns have sprung up, for example against the bedroom tax, the council tax, benefits cuts, NHS privatization, etc.. These have involved many older and/or vulnerable people unaccustomed to public speaking or action, who have no experience of political campaigning (discourse, language, strategy and communication). In the wake of the Con Dem Cuts and break up of public sector services and values, inexperienced activists may resist identifying their actions as ‘political’. They just want “better services”.

Moving suddenly from a position of social and experiential powerlessness and subjugation, into collective action, personal participation, and self advocacy is a steep learning curve, exposing differences and inequalities between the least and the most experienced activists, that can result in tensions and conflict, arising out of feelings of inferiority on the one side, and superiority on the other. But pain, anguish, anger do not suffice as political heft. Sharing experiences, testifying to disadvantage, bemoaning misery, venting anger, while important features of rising awareness, will not on their own effect the change campaigners need and want.

If you are to build effective alliances with other victims and enemies of the neoliberal project; if you are not to continue to be represented and done to by others / ‘experts’, a process of consciousness raising and politicization is vital. This is a hard call if you feel isolated and without hope or energy, as a result of mental health issues. And as with the claims of previous subjugated constituencies or uprisings, there is the inbuilt paradox of simultaneously claiming disadvantage (specialness, victim status) and agency (the ability to function ‘normally’, to be ‘hardworking’, contribute to other lives and to society). So wanting recognition of how debilitating depression or PTSD is, for example, accompanies the desire to be accorded full human rights and status. And it’s not an either/or.

Political awareness comes on the back of subjugation and injustice, and its endurance. The development of resistance follows. And in turn, we build collectivity and alliances. This process of politicisation is a movement outwards, from privacy into the public domain, from silence to voice, from fear to agency and co-creativity / co-production.[ci] A well-worn, historical path.

But Thatcherism and neoliberalism stigmatised and criminalized protest and political organisations, such as the unions. Neoliberal culture also had its sights on democracy itself, and has worked hard to convince people that politics was for ‘élites’ or ‘losers’, and that political debate was old-fashioned, unfashionable (unless packaged for BBC1’s Question Time) and pointless.

I have long argued that agency and creativity function for humans as both self-care and politics. This understanding has particular resonance in 2014 for the mental health movement. It has been claimed that:

Fighting for the rights of people deemed mad, who have already suffered more than enough, is               the last great civil rights movement.[cii]

This bold (over)statement implies, not just self-advocacy, but alliance and representation; a dissolution of boundaries as well as hostilities and prejudice, in recognition that previous liberation and sustainability movements have never been simply rooted in vested interests, but brought together diverse and hybrid individuals and communities of interest, to identify and address broad human rights, social justice and environmental issues. Vested interest politics, after all, belongs to the Right.

Acknowledging our shared “somatic crisis”[ciii] and the need to move from bullying and authoritarianism, control and coercion; from psychiatry (like universities) identified by women service users as an ‘essentially patriarchal institution’,[civ] towards ‘nurturing mental capital and wellbeing’,[cv] returning empathy and compassion to the public domain, on the basis of a human rights framework,[cvi] and a commitment to social justice, is the necessary, collective undoing of the neoliberal project, for all our sakes/souls. Common ground for urgent but long term cultivation.

val walsh / 25 06 2014

[i] See Andrew C. Sparkes (2013) Qualitative research in sport, exercise and health in the era of neoliberalism, audit and New Public Management: understanding the conditions for the (im)possibilties of a new paradigm dialogue. Qualitative Research in Sport, Exercise and Health: 13.

[ii] Thomas Piketty (2014) Capital.

[iii] Sean Baine (02 05 2014) letter to The Guardian.

[iv] Ha-Joon Chang (01 05 2014) Article in The Guardian. Also (2011) 23 Things They Don’t Tell You About Capitalism.

[v] Richard Wilkinson & Kate Pickett (2010) The Spirit Level. Why Equality is Better for Everyone. London: Penguin Books.

[vi] See CLASS,                                For a qualitative, nuanced analysis of inequality, see Danny Dorling (2011) Injustice: Why Social Inequality Persists.

[vii] As Derry Hunter’s gendered autobiographical narrative of sexual violence, oppression and psychosis testifies (18 11 2013): Madness and uncivilisation. ISP UK event, Liverpool Quaker Meeting House.

[viii] teacher killed in classroom

[ix] See Val Walsh (15 01 2014) ‘Picking up the pieces: men and masculinity in an outsourced world’. LJMU. In category ‘Conference papers 2014’. togetherfornow.wordpress.com

[x] Fergal Keene talk 2013. University of Liverpool.

[xi] See Owen Gibson (12 05 2014) Premier League chief under fire for sexist emails. The Guardian. And Rani Abraham (21 05 2014) Why I blew the whistle. The Guardian.

[xii] See Val Walsh, selection of unpublished letters to The Guardian at togetherfornow.wordpress.com: (02 07 2010) Opening a dialogue on rape, violence and gender [posted 19 09 2013]; (06 07 2011) Rape, violence and gender: the new normal? (posted 19 09 2013]; (07 04 2013) The Philpott case and the media: sensationalism, denial, obfuscation, irresponsibility. [posted 19 09 2013]; (17 05 2013) Daniel Cohn-Bendit: children of the ‘revolution’ [posted 19 09 2013]; (02 06 2013) Gender, violence and the media: free speech or irresponsible speech [posted 19 09 2013]; Anachronistic conduct [posted 21 01 2014]; Gender-neutral language ‘disappears’ men and masculinity [posted 20 04 2014]; Murder in a UK classroom [posted 02 05 2014].

[xiii] John Read & Jacqui Dillon (eds, 2nd edition) (2013) Models of Madness: Psychological, Social and Biological Approaches to Psychosis. London & New York, Routledge, published for ISPS (The International Society for Psychological and Social Approaches to Psychosis: 3.

[xiv] Ibid.: 2.

[xv] John Read (05 04 2014) University of Liverpool handout. 196

[xvi] Judi Clements & Emma Davies (2013) Prevention of psychosis. Creating societies where more people flourish. Read & Dillon (eds.): 296

[xvii] Judi Clements & Emma Davies (2013) Prevention of psychosis. Creating societies where more people flourish. Read & Dillon (eds.): 300/3002.

[xviii] John Read & Jacqui Dillon (2013) Creating Evidence-based, effective and humane mental health services. Overcoming barroers to a paradigm shift. Read & Dillon (eds.): 400.

[xix] John Read, Lucy Johnstone & Melissa Taitimu (2013) Psychosis, poverty and ethnicity. Read & Dillon (eds.): 191.

[xx] John Read, Lucy Johnstone & Melissa Taitimu (2013) Psychosis, poverty and ethnicity. Read & Dillon (eds): 200.

[xxi] Bryan Koehler, Ann-Louise Silver & Bertram Karon (2013) Psychodynamic approaches to understanding psychosis. Defences against terror. Read & Dillon (eds): 243

[xxii] Department of Health (2003) Women’s Mental Health: Into the Mainstream, Strategic Development of Mental Health Care for Women. Cited Women’s National Commission (January 2010) A Bitter Pill to Swallow: Report from WNC Focus Groups to inform the Department of Health Taskforce on the Health Aspects of Violence Against Women and Girls: 4.

[xxiii] Women’s National Commission (01 2010) A Bitter Pill to Swallow: Report from WNC Focus Groups to inform the Department of Health Taskforce on the Health Aspects of Violence Against Women and Girls: 4.

[xxiv] HM Government (2007) Cross Governmeånt Action Plan on Sexual Violence and Abuse. Home Office: London. Cited WNC (2010) A Bitter Pill To Swallow : 4.

[xxv] Recent evidence of numerous historic abuse cases, perpetrated by prominent men in the public domains of entertainment and politics (many carried out over a period of years) have amply demonstrated the lingering mental distress, ill health and damage caused by these violations.

[xxvi] (03 2014) Domestic Abuse & Mental Health.

[xxvii] Ibid.: 4.

[xxviii] Cited J. Read, N. Haslam, L. Sayce & E. Davies (2006) Review article. Prejudice and schizophrenia: a review of the ‘mental illness is an illness like any other’ approach. Acta Psychiatr Scand: 114: 307.

[xxix] See Refuge 2007; Home Office 2010.

[xxx] See Jessica Valenti (25 05 2014) Elliot Rodgers’ California shooting spree: further proof that misogyny kills. The Guardian.

[xxxi] Hannana Siddiqui & Meena Patel (2010) Safe and Sane. A Model of Intervention on Domestic Violence and Mental Health, Suicide and Self-Harm Amongst Black and Minority Ethnic Women. Southall Black Sisters Trust: 12.

[xxxii] Raleigh et al cited Siddiqui & Patel (2010): 9.

[xxxiii] Siddiqui & Patel (2010): 7.

[xxxiv] Ibid.

[xxxv] Siddiqui & Patel (2010): 11.

[xxxvi] What Women Want Group (03 2014) Domestic Abuse & Mental Health: 19.

[xxxvii] What Women Want Group (03 2014): 28.

[xxxviii] Ibid.: 25.

[xxxix] See WNC (2010) Psychiatry and mental health services; and Adult social Care Services for ‘vulnerable adults. A Bitter Pill To Swallow: 86-96.

[xl] Ibid.: 87.

[xli] Ibid.: 31.

[xlii] Ibid.: 40.

[xliii] Ibid.: 34.

[xliv] Ibid.: 42.

[xlv] M. Boyle (2011) in Rapley et al De-Medicalizing Misery, cited Read & Dillon (2013) Creating evidence-based, effective and human health services. Overcoming barriers to a paradigm shift. Ibid: 398. See for example, WNC Report (2010) A Bitter Pill to Swallow, and Hannana Siddiqui & Meena Patel (2010) Safe and Sane. A Model of Intervention on Domestic Violence and Mental Health, Suicide and Self-Harm Amongst Black and Minority Ethnic Women. Southall Black Sisters Trust.

[xlvi] See Val Walsh (2005) ‘Into the sunlight’: Gender, narrative, mental health. Resources for a missing conversation. togetherfornow.wordpress.com

[xlvii] A Bitter Pill To Swallow (01 2010): 14.

[xlviii] Hannana Siddiqui & Meena Patel 2010) Safe and Sane. A Model of Intervention on Domestic Violence and Mental Health, Suicide and Self-harm Amongst Black and Minority Ethnic Women. Southall Black Sisters Trust: 8.

[xlix] Ibid.: 113.

[l] See Human Rights Act 1998; the Beijing Declaration and Platform Action 1995; the Convention for the Eliminaton of All forms of Discrimination against Women (CEDAW) 1979; and the Convention on the Rights of the Child 1989.

[li] Rory Carroll (26 05 2014) US gun culture and mental health system under fresh scrutiny after shooting spree. The Guardian.

[lii] Cited Carroll (26 05 2014).

[liii] Jessica Valenti (25 05 2014) Elliot Rodgers California shooting spree: further proof that misogyny kills. The Guardian.

[liv] Matthew Taylor (02 06 2014) Savile abused 500 children, says report. The Guardian. A study by the NSPCC, commissioned by BBC Panorama in conjunction with The World At One. (02 06 2014) provide the latest evidence.

[lv] See Val Walsh (2005) ‘Into the sunlight’: Gender narrative, (mental) health. Resources for a missing conversation. togetherfornow.wordpress.com

[lvi] John Read & Jacqui Dillon (2014) Creating evidence-based, effective and humane mental health services. Overcoming barriers to a paradigm shift. Read & Dillon (eds.): 405.

[lvii] R. Kogstad (2012) Towards a paradigmatic shift in mental health care? cited ibid.: 404.

[lviii] See Walsh (2005).

[lix] Pat Craven’s The Freedom Programme, first available in Tranmere, on the Wirral, has proved influential and useful as both resource and process for women survivors, and has since been adopted across the country and made available as a book.

[lx] Cited WNC (01 2010) A Bitter Pill To Swallow: 89.

[lxi] Ibid..

[lxii] Ibid.: 90.

[lxiii] Ibid.: 92.

[lxiv] See ibid.: 93.

[lxv] See ibid.: 95.

[lxvi] As shocking secret filming inside institutions has shown.

[lxvii] WNC (01 2010) ibid..

[lxviii] See Boyle (2011) Making the world go away, and how psychology and psychiatry benefit. In M. Rapley et al (eds.) De-Medicalising Misery: cited Read & Dillon (2014) Creating evidence-based, effective and human mental health services. Overcoming barriers to a paradigm shift: 397/8.

[lxix] See for example, press cutting / murder

[lxx] Melissa McEwan, cited Jessica Valenti (25 05 2014).

[lxxi] See Jane Fae (30 05 2014) Is this a trans moment? The Guardian.

[lxxii] In 2009 the Nursing & Midwifery Council struck off a male psychiatric nurse, as a result of his five month “inappropriate sexual relationship” with a much younger female client, whose mental health issues (including suicidal ideation) were consequent on her experience of sexual abuse as a teenager by an older man. Contrast this with the drawn out process of denial and non-enquiry into, for example, the (now admitted) sexual harassment of younger Lib Dem colleagues by Lord Rennard. Fellow Lords are now “glad it’s all over” (Lord Steel, 29 05 2014) and demanding his re-instatement after his suspension from the House. See Rowena Mason (31 05 2014) Party grandees call for Rennard’s return to fold. The Guardian. See also Val Walsh (21 01 2014) Anachronistic conduct. Unpublished letter to The Guardian. Posted in togetherfornow.wordpress.com

[lxxiii] New Zealand nurse, John Clarke, personal communication to JR, 2012, cited Read & Dillon(2014) Creating evidence-based, effective and humane mental health services. Overcoming barriers to a paradigm shift: 398.

[lxxiv] Cited Louise Carpenter (17 05 2014) Bad medicine. The Guardian Weekend: 50.

[lxxv] Ibid..

[lxxvi] Ibid..

[lxxvii] See Judith Varley (08 04 2014) on the crisis of mental health for carers. Merseyside People’s Health Assembly Report: 3-7.

[lxxviii] Nick Hopkins (12 05 2014) Mental illness surges among war veterans. The Guardian. Dr. Nicola Sorfleet (12 05 2014), in charge of psychological therapies at Combat stress’s treatment centre in Leatherhead, Surrey, reported: Veterans are seeking help quickly. This gives us hope. The Guardian.

[lxxix] General Sir Richard Dannatt, chief of the general staff when British forces were fighting in Iran and Afghanistan. Cited Nick Hopkins (12 05 2014).

[lxxx] Ibid..

[lxxxi] R. Burrows (2012) Living with the h-index? Metric assemblages in the contemporary academy. The Sociological Review, 60 (2), 355-372. Cited Sparkes: 4. See also Stephen Ball (2003) The teacher’s soul and the terrors of performativity. Journal of Education Policy Volume, 18 (2), 215-218.

[lxxxii] See Sparkes’ chilling exposition and summary (2013). Mary O’Reilly (16 05 2013) searingly testifies to the current crisis in mental health care in ‘Human cost – Where does personal and professional integrity figure on a spreadsheet?’ BASW conference, London. The parallels between the analyses of Andrew and Mary are telling. As is the underlying (on the one hand) and explicit (on the other) pain, anguish and anger of their testimony. And their courage.

[lxxxiii] R. Craig, J. Amernic & D. Tourish (in press) Perverse audit culture and accountability of the modern public university. Financial Accountability and Management. Cited Sparkes: 7.

[lxxxiv] Ibid.: 8.

[lxxxv] John Read, Lorenza Magliano & Vanessa Beavan (2013) Public beliefs about the causes of ‘schizophrenia’. Bad things happen and can drive you crazy. In Read & Dillon: 143.

[lxxxvi] Ronald Barnett (2014) Conclusion. Academia as workplace: A natural pessimism and a due optimism. Lynne Gornall, Caryn Cook, Lyn Daunton, Jane Salisbury & Brychan Thomas (eds.) Academic Working Lives: Experience, Practice and Change: 302.

[lxxxvii] See Lynne Gornall et al. (2014) Introduction: Starting the day fresh: hidden work and discourse in contemporary academic practice. Gornall et al.: 1-9. Also Rod Kelly & Rebecca Boden (2014) How management accounting shapes academic lives. Gornall et al.: 94-101; Lynne Gornall & Brychan Thomas (2014) Professional work and policy reform agendas in a marketised higher education system. Gornall et al.: 110-118; Sandra Acker & Michelle Webber (2014) Academia as the (comp)promised land of women? Gornall et al.: 199-206.

[lxxxviii] Ronald Barnett (2014) Conclusion. Academia as workplace: A natural pessimism and a due optimism. Lynne Gornall, Caryn Cook, Lyn Daunton, Jane Salisbury & Brychan Thomas (eds.) Academic Working Lives: Experience, Practice and Change: 296.

[lxxxix] refs to Andrew Sparkes, Mary, et al.

[xc] Judi Clements & Emma Davies (2013) Prevention of psychosis. Creating societies where more people flourish. in Read & Dillon: 296.

[xci] See Val Walsh (09 09 2013) ‘Why set up a blog now’ and ‘Democracy in turmoil: Lies, exploitation, corruption, damage, division, conflict, abuse. . . Is that all there is? (With a nod to singer Peggy Lee.)’ togetherfornow.wordpress.com

[xcii] John Read & Jacqui Dillon (eds.) (2013), 2nd edition) Models of Madness: Psychological, social and Biological Approaches to Psychosis. East Sussex, Routledge: 399.

[xciii] John Read & Jacquie Dillon (2013) Creating evidence-based effective and humane mental health services. Overcoming barriers to paradigm shift. In Read & Dillon, ibid: 394.

[xciv] Ibid: 393.

[xcv] Mick McKeown, Fiona Jones & Helen Spandler (2013) Challenging austerity policies: democratic alliances between survivor groups and trade unions. Mental Health Nursing 33(6): XX.

[xcvi] (04 2014) SWAN Mental Health Service Charter.

[xcvii] See Jacqui Dillon, Peter Bullimore, Debra Lampshire & Judi Chamberlin (2014) The work of experience-based experts. Read & Dillon (eds.): 314.

[xcviii] See ibid.: 310.

[xcix] The mental health organisation, reVision, aims to be “an alliance of critically aware thinkers”. Its statement of intent and purpose refers to empowerment through research and education, the connections between individual experiences and structural oppression and disadvantage, facilitating collective empowerment, and speaking out against the medicalization of inequality. For more information: revision.liverpool@hotmail.co.uk

[c] See Boyle cited Read & Dillon: 397.

[ci] See The Resilience Space 2014. Surviving Work: the Activists’ Survival Guide. http://www.survivingwork.org

[cii] Dillon , Bullimore, Lampshire & Chamberlin (2014) ibid.: 315.

[ciii] Cited Andrew Sparkes (2013) ibid.: 13.

[civ] WNC Report (2010) ibid: 92.

[cv] Clements & Davies (2013) ibid: 297.

[cvi] Mary O’Reilly (2013) points out that the NHS constitution, part of the Health Act 2009, makes clear that healthcare and human rights go hand in hand. See also Hannana Siddiqui & Meena Patel (2010) Safe and Sane. A Model of Intervention on Domestic Violence and Mental Health, Suicide and Self-Harm Amongst Black and Minority Ethnic Wome, citing the importance of human rights obligations as a framework for best practice. Southall Black Sisters Trust. And Women’s National Commission Report (January 2010) ibid.







Intercultural co-creativity: More than liminal adjustment.

  • Introduction
  • The problem of the status quo:
    social class
    gender inequalities, misogyny, homophobia
  • ‘Beautiful Words for Difficult Times:
    We are the sum of our parts.’
  • The relevance of Liverpool’s social, cultural and political waters.
  • Poetry as community, as partnership.
  • Interculturalism and identity.
  • On the night.
  • Art as experience, art as behaviour.
  • Engaging as intercultural communities.
  • From ‘gift’ to gifted, to gifts. The significance of women for social recovery and renewal.
  • Appendix 1: Our founding statement for the poetry event.
  • Appendix 2: From first version of the poster for the event.
  • Appendix 3: Two poems:
    ‘High Wire Act’
    ‘The Politics of Love’.

An edited version of this paper was presented as a keynote address at the EUROPEAN FORUM of the Platform for Intercultural Europe Conference (08 06 2009), The Distinctive Contribution of the Arts to Intercultural Dialogue: A View from and on the Arts. Brussels, Belgium.


The paper opens with some scene-setting, regarding the entwined factors of demographics, political culture and equality issues in the UK City of Liverpool. These provide the backdrop to a community poetry event (05 04 09), which is discussed and analysed as a process, and as non-violent intervention. The issues of identity, empowerment, women’s lives and purpose as poets are considered; the significance of claiming our multiple identities; and performance as embodiment of both poetic and political purpose.

The paper moves on to identify the shifting ground of art and aesthetics, art and community, art and politics, and the more recent challenge posed by interculturalism. It cites the multiplicity of both the arts and interculturalism, and their synchronicity in the public domain, as virtues; as well as the central significance of women’s participation and creativity, in what are seen as core peace-making and community-building activities, rather than optional, cultural add-ons or ‘entertainment’ as distraction.

The problem of the status quo.
“A sense of belonging in an intercultural society cannot be based on race, religion, or ethnicity but needs to be based on a shared commitment to political community. Such a commitment requires an empowered citizenry.”[1] 

In the wake of identity politics and multiculturalism from the 1970s, which were both important stages for social constituencies challenging marginality, oppression and subjugation, in the pursuit of equality and social justice, the concept of interculturalism provides key concepts and guidelines for the shift from multiculturalism, with its emphasis on acknowledging and celebrating difference and separation, towards intercultural dialogue, with its emphasis on what can be shared.[2]

Leonie Sandercock confronts the reader with two key concepts: a shared commitment to political community, and empowered citizenry; as prerequisites for a sense of belonging in an intercultural society. These do not happen by accident, or automatically through the mere passing of time. And to be clear about their urgency, think about the opposite: a lack of shared commitment; the proliferation of vested interests and conflict; a disempowered population, that feels subjugated or at least marginalized. Implicitly, Sandercock highlights the importance of political and cultural awareness. This suggests that citizens are knowledgeable and educated, as well as experienced. As opposed to subjects (as in the UK monarchical system), who are technically only required to be compliant and obedient.

Using the City of Liverpool as my starting point, I take as read that Liverpool is distinctive, as a port city, historically at the centre of the industrial revolution and empire; yet always ‘on the edge’; and not quite an English city. At the same time, it typifies some of the challenges of C21 cities, and is therefore instructive in relation to the concerns and ambitions of the Platform for Intercultural Europe, and Sandercock’s analysis and vision.

  • social class

Out of twelve industrialised countries, the UK now ranks as the second most unequal society, after the USA, calculated by how many times richer are the richest fifth, compared to the poorest fifth.[3] This intensifying social inequality is stark in the Liverpool city-region. Liverpool’s identity as 2008 European Capital of Culture, and the extensive inner city regeneration projects that were a feature of this process, only serve to underline the neglect of its outlying estates, where previous inner city populations now find themselves.

The city-region is 97% British white. Does this make it a C21 monoculture?

It includes many areas that are solidly white working-class: what might be described as another ‘layer’ of monoculture. This intense singularity promotes a sense of territoriality: marked by feelings of powerlessness / abandonment / defeat; manifested variously as apathy, defiance, violence, in the context of some of the worst levels of poverty, unemployment, ill-health and educational attainment in the UK.[4] Gangs, drug culture, violent crime and murder also feature.

‘Strangers’ are easily identified in these areas, and can be a cause for concern rather than interest. By definition, monocultures lack diversity and complexity; are more likely to be standardised, unstable, and fragile; need a lot of ‘defending’; and are vulnerable to degeneration, wipe-out or internal collapse. Against the backdrop of increasingly diverse and multifaceted populations, communities and countries, such enclaves of ‘purity’ stand out. These are cultural communities that identify themselves as indigenous. However, the fate of indigenous populations at the hands of capitalism and now globalisation (worldwide) has been either exploitation (worked to death or injury), or abandonment (dumped and ignored); or both. In these circumstances, whether in India or the UK, indigenous comes to mean, not settled and self-sufficient, with established (or sacred) rights: but poor, immobilised, outcast, left behind or moved on.

  • gender inequalities, misogyny, homophobia

At public meetings and events in Liverpool, whether cultural or political, the line-up of key speakers remains persistently mainly older white men. Depending on the event, these will be men from working-class backgrounds and/or middle-class backgrounds. I am not saying these men are irrelevant, past their use-by date; but they are part of the problem, a symptom, in that their unselfconscious dominance has blocked and continues to impede the participation and prominent contribution of other constituencies: notably women and members of BME (Black and Minority Ethnic) communities.

That this continues to be the public profile unselfconsciously presented in the C21 by institutions, the City Council, organisations, such as unions and corporations, suggests a lack of equality experience and expertise amongst organisers and convenors: resulting in no active seeking out of those different from themselves; and a lack of awareness of and concern about the resulting imbalance and exclusions; or resistance to involvement on the part of those absentees. And while nationally, homophobia has substantially receded since the 1980s, Liverpool does not feel as if it has quite joined the C21 in this respect, and gay men are likely to identify Liverpool as less safe and welcoming than nearby Manchester, for example.

The greater acceptance of lesbians and gay men nationally (though it is mainly men who have the visibility and increased business and cultural presence) has run parallel to a worsening of the pressures on girls and women, via the media and society’s institutions and industries, to preoccupy themselves with and conform to a hypersexualised, heterosexual norm that is costly, coercive, dangerous and damaging, and all about woman as body, as sex, as available. So, win some lose some.

  • ethnicity

Returning to Liverpool after ten years working in the USA, Dr Mark Christian, a Liverpool-born Black academic, now of the Miami University, Ohio, shared his dismay that the prospects for Black people seemed hardly to have changed. In two lectures during his recent visit: one at Liverpool’s new International Slavery Museum, entitled ‘The Age of Slave Apologies’,[5] the other, with co-presenter Dr Philip Boland of Cardiff University (also an ‘exile’), under the banner of: ‘Whose Capital and Whose Culture? Looking Back on 08’, as part of the WOW (Writing on the Wall Festival, 13 05 09), he concluded that the city had effectively failed to move towards equality and integration.

And I have often asked myself, why would members of the BME communities / people of colour, an undeniable minority @ c6% of the population, but nonetheless significant and important to the City, want to get together with whiteys, who have so visibly held sway in the City for so long? Not to mention the broader issue of our ‘shared’, unequal, painful and shameful history worldwide. Nonetheless, Liverpool has four universities attracting a wide range of international students. Yet it is not an integrated city, with its range of ethnic and social class communities held together in productive tension, or social and creative symbiosis. In the light of this recent history of multicultural failure, one wonders what lies ahead for more recent incoming communities, for example asylum seekers and workers from the enlarged EU.

As a white woman who came to Liverpool from multicultural London, I note, with Mark Christian and Tayo Aluko, that Liverpool has not achieved a working level of multiculturalism and equality, and that therefore it has a way to go before it achieves Sandercock’s shared commitment to political community, and an empowered citizenry, and can identify itself as an intercultural city. Meanwhile Liverpool is marketed as a European Capital of Culture (2008); ‘the world in one city’; and as ‘cosmopolitan’.

‘Beautiful Words for Difficult Times: We are the sum of our parts.’
This was the title of a poetry event that took place in Liverpool (05 04 2009). It was organised as part of a wider, interdisciplinary, multicultural festival, PAX, which ran over several days, at one of Liverpool’s iconic Victorian venues, The Black-E, an arts and community centre focussed on: ‘education / exploration / enthusiasm’.[6]

The relevance of Liverpool’s social, cultural and political waters.

When asked to organise this event, I approached local poets whose work I knew, and whom I thought would be drawn to the stated aims and values of the PAX project. My goal was to bring together diverse poets, encompassing difference, including ethnicity.

These poets had all been involved in previous community events: such as   poetry events organised for International Women’s Day week in 2008 and 2009; as well as other poetry forays into the community, for example Liverpool’s annual Poetry Marathon, part of National Poetry Day, held in the magnificent Victorian Picton Library in the city centre; Liverpool’s now annual Peace & Ecology Festival, which brings together a range of activist groups inside the shell of a bombed out church in the city centre in July, with a view to engaging with the public in a positive way, including young people: enjoying music and poetry; providing information; participating in social and political discussions and debates, etc. in the best British tradition of free speech on the street or in the park.

There are a number of other festivals throughout the year, for example outdoors at the wonderful Wildflower Centre, and indoors at events organised throughout May by the WOW (Writing on the Wall) Festival, which in 2009 included theatre performances, e.g. plays and readings related to the Israel/Palestine situation; writers reading memoir and short stories; a multi-media community art/music/poetry performance; social/political meetings considering aspects of Liverpool’s recent history; and a meeting about the phenomenon of Barack Obama and the actual consequences and potential implications for the City of Liverpool (and the world), and in particular the BME   communities in Liverpool.

But segregation across these events was evident: for example (on consecutive evenings), between the Obama meeting (Afro-Caribbean) and the Palestine performances (Muslim). And at the event where Dr Mark Christian was one of two keynote speakers, apart from the WOW Festival co-ordinator, Madeline Heneghan, there was only one other member of the BME community in the audience: the architect, activist, writer and singer, Tayo Aluko. The rest of us were variously white. And, on taking a voluntary count, hardly anyone in the audience was indigenous: born in Liverpool.

Such social / cultural / political events provide opportunities for creative and campaigning groups to engage with the public, and for the latter to find a place for the day in a positive community setting: listen to music, play games, get information and learn stuff, discuss and argue, rub shoulders with people different from yourself, eat food, buy plants. And sign petitions![7]

But many of these groups and events attract the support of only small numbers of white working-class people from the outlying estates mentioned above, and fewer from BME communities; and even fewer of either as members and as activists. This suggests that these populations, along with asylum seekers, feel least like ‘empowered citizens’ and are least committed to a shared political community; and/or community action is all/mainly local to and within their own ethnic and social class ‘home’ patch.

The key locations over several years for the most mixing across and between communities and generations, have been street protests, marches, vigils and other events, involving food and films, triggered by the intensifying plight of the Palestinian people, notably events in GAZA in 2008 and 2009. On these occasions, we are all ages (from babies to the elderly), all cultures, all backgrounds, and all ethnicities. No longer strangers to each other, even if we haven’t met before, the action of risking visibility for a common cause, and in a city (and national) environment that is increasingly and tightly under camera surveillance and police control, produces a momentary bond. This is Liverpool at its integrated best: in solidarity and strength, standing up for peace, and against abuses of power, be they military or political.

Poetry as community, as partnership.

The process we went through in developing the first poetry event was a model of creative and social development that was not premeditated or mapped out, but experiential, informal, organic:

  • we came together as individuals
  • we formed a group
  • we became a team.

Starting as a top-down initiative, the project quickly moved to a flatter structure, where everybody felt able to engage (critically if necessary) with the initial suggestions and plan, and make their contributions to what would emerge as the performance on the night. [8]

Our patience and stamina were tested along the way, due to delays and postponements, but his did not dent our determination and commitment to deliver something special: because by then, we knew we could do something unique in and for Liverpool. Out of this process arose a new way of performing our poems together: not as a sequence of individual sets, but as an integrated performance; a choreographed sequence with harp accompaniment and back projections, within which individual voices intertwined to produce an experience, for both poets and audience, that was more powerful and more challenging than conventional approaches.

This new form was akin to a conversation or verbal dance, and suited our purposes, which were not simply poetic. As one of the poets, Brenda Vasona Gwanvoma, who came to Liverpool from the Cameroon via Paris, puts it in the title of one of her poems: ‘Building Bridges Not Walls’.

Dr Wendy Sarkissan, a social planning consultant, who has worked with Aboriginal communities in The Block, Sydney, Australia, recognises:

“the need for a language and process of emotional involvement and embodiment using a range of techniques, such as storytelling, drama, music and visualization, to enable people of widely different backgrounds to describe the world as they saw it.”[9]

As poets, we aim to cross the divide between social, political and cultural communities of interest; to get poetry to people who think they ‘don’t do’ poetry; and ‘politics’ to those who prioritise poetry as some apolitical, artistic special case. And to do this we must embody both the challenge of difference and its resolution: by being a team that encompasses, for example, differences of age, colour, culture, faith, health status and social and class background. Our complex and multiple identities are vital to this project, not as fixities, but as ingredients in our creative and social interactions, and our cultural output. (See Appendix I) [10] 

Interculturalism and identity.
“Poetry was privileged speech – simple, but never ordinary. The magic of poetry was transformation; it was words changing shape, meaning and form. Poetry was not mere recording of the way we southern black folks talked to one another, even though our language was poetic. It was transcendent speech. It was meant to transform consciousness, to carry the mind and heart to a new dimension.” [11] Added emphasis.

This is bell hooks reflecting on how she experienced poetry as a child, growing up as a black woman in the racist South of the USA. She illuminates the potential and purpose of poetry for everyone: the politics of language, speaking, writing, and being a poet in your society; and these insights are set firmly in the context of her understanding of both the psychological and political significance of speaking, in particular for the marginalized and oppressed, and women most of all.

“Speaking becomes both a way to engage in active self-transformation and a rite of passage where one moves from being object to subject. Only as subjects can we speak. As objects, we remain voiceless – our beings defined and interpreted by others.”[12] Added emphasis.

She also implicitly demonstrates how taking the lead from women’s lives and testimony affords insight into general human predicaments and social projects.

“To know our audience, to know who listens, we must be in dialogue. We must be speaking with and not just speaking to.”[13]

This observation is as relevant to individual poets as to community organisers, or politicians, and by extension, for intercultural dialogue and co-creativity. Poetry is exploration and discovery, of world, self and Other, and involves an effort to make sense of something, where we experience dissonance, a puzzle, discontent, friction, an intensity of experience, such as loss, desperation or anger: to dig deep. It is also an effort to communicate beyond the self, to a public, to create a community of co-participants, and to make something capable of countering powerlessness, fear, despair, even the impacts of fascism and corporatism on individuals and communities. As hooks says, ‘It is transcendent speech’: at its best, transforming, healing, courageous and ambitious.

The quantum physicist, David Bohm (1917-1992), wrote eloquently about creative process and the importance of dialogue (1996; 1998) in his later years,[14] in the context of his growing concern for what he saw happening in the world.

“The defence of opinions separates people. Each of us defends his (sic) own opinion, and then we don’t meet. We don’t really listen to one another; we try to win.”[15]

Bohm’s words point to the value of the methodology of the arts: which is about listening, about being receptive, about being willing to be changed; equalising power relations; combination and collaboration, not competing or winning. The C20 British poet, W H Auden, believed that all poems are love poems, which hints at a poem’s roots, as well as its transformational potential. And the C19 British poet, Percy Bysshe Shelley, invokes our courage and ambition:

To suffer woes which Hope thinks infinite;

To forgive wrongs darker than death or night;

To defy Power, which seems omnipotent;

To love and bear; to hope till Hope creates

From its own wreck the thing it contemplates . . .

We have used this stanza to open our poetry performances. We found it spoke directly to our human predicament, as well as our purpose and ambition as C21 poets and women.

We are not a group of women divorced from the common realities of women’s lives: as, for example, daughters, sisters, partners, lovers, wives, mothers, artists, non/professionals, colleagues, comrades, friends and activists, we variously embody women’s complexity, social vulnerability and strength. And we encompass the range of life’s disadvantages and sorrows: grief, prejudice, stigma, grievance, loss, abuse, betrayal, bereavement, exile, as well as the joys of intimacy, affection, love and community. And there are boys and men in our lives in various capacities, as well as in the audience; and as collaborators, providing lighting, back projections, sound technology and film documentation.

We nonetheless do not presume to represent women / all women, but to draw on, share and illuminate lives which infrequently take centre stage in the public domain, except, for example, as fodder for male fantasies, vehicle for corporate consumerism’s excesses, and as evidence of the widespread misogyny that continues to confine, damage and curtail too many women’s lives worldwide. Courage is what marks these women’s poetics. For speaking as a woman in and against a society that throws rocks in your path, because you are a woman, because you are Muslim, because you are old, because you have a disability or HIV status, because you speak (out / up), because you refuse to defer, remains a high-risk, ‘insubordinate’ act.

And identities, such as ‘academic’, ‘poet’, ‘activist’, ‘citizen’, ‘feminist’, rebel’, ‘woman’, ‘mother’, are not just attributed: labels acquired through position or performance. Identities are also to be claimed, taken up, activated: that journey from object to subject, so central to bell hooks’ critique and vision. For this is creative and political territory, involving struggles against oppression and injustice, stereotyping and marginalisation; as well as struggles over resources, policies, social, cultural and political priorities, and meaning. Women performing as EMBRACE in Liverpool, do so with some of those struggles under our belts too.

As editor Amy Wack testifies:  

“I’ve been privileged to witness the development of confident, technically astute, inspirational women poets of all ages. It is worthwhile to remind ourselves that these poems are the flowers that grew on battlefields.”[16] Added emphasis.

On the night:

  • What we had was a performance that went beyond individualism, and manifested our shared commitment to political community.
  • We were the sum of our parts: and more. We all felt it, poets and audience alike.
  • We were showing that we added up, that in that entwining, in that meshing and interaction, we make more sense, more beauty (and therefore safety): new possibilities of understanding and affection emerge and evolve; as well as intimations of future challenges. We were performing as empowered citizens.
  • We felt that our poems were enhanced and intensified as part of the integrated sequence, which itself had evolved so seamlessly out of our discussions, sharing and practices, because we listened to each other, gave each other good attention and support; and no egos reared up to create a negative or hierarchical organisational straitjacket. We are all women of substance (to borrow a phrase from my son); but there has been no competitiveness, no vying for centre stage or dominance. We have facilitated each other, and been clear and forthright when decisiveness was required.
  • Audience members said it had been, for example: beautiful / inspiring / inspirational / wonderful / so warm / lovely / thought-provoking / a lot to think about / beautifully performed with excellent content.
  • We went beyond poetry to act as a catalyst for community. But to go beyond poetry, we had to go via poetry. It is not the only route, but…… It’s the art element in experience and relationship that acts as both means and catalyst; triumph and surprise.

Art as experience,[17] art as behaviour

“All aesthetic judgements may eventually be re-examined and re-evaluated in terms of new cultural relationships.”[18]

Nathan Knobler signals the link between aesthetics and ethics; aesthetics and politics; aesthetics and people’s daily lives. Such a statement is a challenge to entrenched eurocentric values and assumptions, not least about the superiority of the white western way (in all things, not just art). It puts the idea of ‘civilisation’ up for scrutiny, and points to the ways in which these élite, disciplinary domains are open to plunder and reconceptualisation: not in the abstract, and strictly within the confines of the academy, but out in the wider, messy world, where beauty and hope are susceptible to attack and bleeding, as cultural relationships shift, become more interactive, even conflicted.

Thirty years later, artist turned author and social commentator, Suzi Gablik noted, in relation to what Ellen Dissanayake had referred to as ‘the anomaly of modern aesthetics’ [19] and Western art practices:

“One of the key points of contention in the culture war is the issue of intellectual and aesthetic merit. . . .[as] the site of aesthetic experience is shifting, . . . . from the self-referential orbit of museums  and galleries.”[20]

The “boundary which philosophical aesthetics so carefully makes between art and real life” [21] was becoming blurred and challenged by the practices of artists themselves, working out in the community, on the street, in the woods, etc.. Women artists, particularly feminists, were prominent contributors to this historical shift from the 1970s.

Ellen Dissanayake had asked, ‘What is art for?’

“When you view art as a ‘behaviour’ of making important things special, it seems quite evident that this is universal, even though every culture may not paint or sculpt or make installations.”[22] Added emphasis.

And she turns to the evidence of earlier societies, where, for example:

“Decorating and adorning were ways of showing that one participated in a social order and was a moral member of society.”[23]

The work of the EMBRACE poets in Liverpool attests to this social and cultural function: not as conformity, but as non-violent intervention. Similarly, Fiona Boundy discusses the cross-disciplinary and participatory practice of artist Lisa Cheung, who came to the UK from Canada via Hong Kong, and notes: “The relationship is the point rather than the outcome”. [24]

Carol Becker, Dean and Vice-President for academic affairs of the School of the Art Institute of Chicago, USA, identifies the enduring distortion in the West:

“This is a very bourgeois notion of freedom that we’ve encouraged, which is a freedom for the individual apart from society, not a freedom for the individual within society.”[25]

This individualism is also a gendered model of freedom: implicitly rooted in the lives, expectations and sexual anxieties of élite white western men, aspiring to roam ‘free’ of emotional attachments and domestic responsibilities that might curtail their ‘creativity’ and ‘autonomy’.

The conversations in Gablik’s book are now fifteen years old. There was clearly an expectation at the time that the tide was turning for the arts; away from an emphasis on objects cloistered in museums and galleries; away from the idea of the artist as necessarily separate and élite. This had been foreshadowed, notably in Gablik’s lightening-strike earlier book, The Re-Enchantment of Art, [26] in which she charted a new paradigm that ‘reflects a will to participate socially: a central aspect of new paradigm thinking involves a significant shift from objects to relationships’;[27] ‘making the transition from spectator to participant’.[28]

However, during the intervening years, turbo-capitalism has gained ground and dominance, and the western art world has split rather than morphed. It has bifurcated into, on the one hand, a lucrative market within the global economy, mainly focussed on objects: art as commodity;[29] and on the other, a cultural fabric teeming with local and community projects, public art and creative interventions, that include the critical, participatory and interactive.[30]

Engaging as intercultural communities.

“Diversity (has been) regarded at best as an issue to be managed, at worst a problem to be solved – just another thing that makes life more complex and tiresome.”[31]

This is the ‘diversity deficit’, which impedes ‘the diversity advantage’ (of cities, for instance), where ‘the complexity of diversity is to be embraced and harnessed’.[32] The concepts of intercultural praxis and cultural competence;[33] of mediation and relationship-building at the centre of intercultural theory find echoes in the methodology of the arts. The specific relevance of the arts is also anticipated by the acknowledged importance of ‘needs, desires, dreams and prejudices’.[34] Art processes and projects can be one of the best ways of ‘working with the grain of diversity’ [35] and moving away from the parallel lives[36] alluded to earlier. Factors that exacerbate distrust and disengagement can be diffused, even overcome, through, not least, the process of getting to know each other and acting together.[37]

The UK Kings Cross Development Forum highlighted the challenges of overcoming pessimism;[38] Manchester City Council’s Sense of Place project found enhanced cultural literacy to be central; as well as sensory impact, in exploring ‘the meaning of belonging and placelessness’.[39] Storytelling and role play may uncover hidden traits, suppressed memories, latent fault-lines and unrealised aspirations.[40] And as Theodore Roszak observed in relation to (early) environmentalists, it cannot be about coercion:

“They’ve usually behaved as if they could simply force people to change their habits by sheer guilt-tripping or scare tactics.”[41]

Art is not about telling; more about sharing, showing, exploring. It requires discipline, but is not disciplinary or authoritarian. These are vital virtues.

Art’s register is rooted in the model adult-adult of Transactional Analysis, rather than its obverse, the conventional, negative parent-child structure of authority, which spells and perpetuates inequalities and prepares the ground for abuse and injustice. The problem of gatekeepers, and the importance of dealing directly with each other, with communities and people[42] is linked to this too-prevalent dynamic.

In this connection, the arts can contribute to the process of unlearning the inculcation in childhood and early adulthood, of the superiority of one way over another[43] as well as undoing internalised inferiority, and alleviating its consequences for individuals and communities. Making art in and with a community can help people acknowledge and provide insight into, the unequal power relations so influential in their lives, and wedded to differences, such as social class, ethnicity and gender; but, crucially, without the process undermining or breaking them. And so another western binary, art v therapy, gets disrupted.

Leonie Sandercock points to the extent of the challenge:

“The ‘right to difference’ at the heart of interculturalism must be perpetually contested against other rights (for example, human rights) and redefined according to new formulations and considerations.”[44]

Art too involves this critical, self-reflexivity, though its importance is still contested, in particular by those still wedded to the dominance of the western gallery system.[45]

To address societal problems, David Bohm, whose roots were hybrid (born in the USA of Hungarian-Lithuanian Jewish parents; later taking British nationality), wrote a proposal for a solution that has become known as ‘Bohm Dialogue’, in which equal status and ‘free space’ form the most important prerequisites of communication and the appreciation of differing personal beliefs;[46] as opposed to élites at the top and the disaffected at the bottom. The methodology and processes of the arts can facilitate and enact the transformation envisaged by Sandercock and Bohm. Rome’s L’Orchestra di Piazza Vittorio is one such inspiring example: fifteen musicians, eight languages, eleven nationalities.

Nine years ago, the project’s instigators, Francesca Povoledo and her rock musician husband, Mario Tronco, moved to a part of the city of Rome taken over by immigrants and avoided by ‘native Romans’. They found ‘an island of exhuberant diversity in one of Europe’s most conservative and conformist capitals’.[47] The initial idea, which could be seen as artistically motivated, underwent a sudden transformation, as Tronco explains:

“But then came 9/11, and what had seemed like just an idea became a political exigency,”[48] in the face of the escalating fear and suspicion of immigrants after the attack on the Twin towers. However, marrying so many diverse musical genres is no easy task.

“The Arabs, for example, don’t have the concept of four beats to a bar; they mark time essentially in twos. The most difficult thing was – and, at times, still is – the issue of tempo.”[49]

Sandercock spells out the learning curve required and the material obstacles:

“Reducing fear and ignorance can only be achieved by addressing the material as well as cultural dimensions of ‘recognition’. This means addressing the prevailing inequalities of political and economic power as well as developing new stories about and symbols of national and local identity and belonging.”[50] Added emphasis.

Building sustainable communities requires committed funding for the arts; not the insecurity and low status of sporadic, temporary, project funding (or no public subsidies from the Italian state, in the case of L’Orchestra di Piazza Vittorio; only promises). In C21 the arts and interculturalism go head to head with the media and its arsenal of resources: financial, political and cultural; as well as the forces of globalisation. Both treat us as targets and markets.[51] As consumers. This inequality / iniquity needs to be acknowledged and proactively redressed via funding agencies and public monies. These are Bohm’s equal status and ‘free space’ prerequisites, which have to be ‘designed in’, not left to chance.

Sandercock goes further, to emphasise the importance of ‘the critical freedom to question in thought, and challenge in practice, one’s inherited cultural ways’ and ‘the recognition of the widely-shared aspiration to belong to a culture and a place, and so be at home in the world’.[52] Here she touches on the core difference, even conflict, between dogma and the creative arts; between authoritarianism, fundamentalism and fascism, on the one side, and the aspirations and complexities of open democracies, academic and media independence, and interculturalism, on the other.

Through the arts, conflict can be experienced, plumbed and illuminated;  worked through, rather than denied, avoided and buried; only to erupt at a later date, often in an unrelated context. The turbulence that may be part of intercultural praxis need not be seen as a sign of failure or deficit. Friction, after all, is part of healthy relational process as well as creativity.

Echoing Bohm’s concern about separation and hierarchy, Sandercock maintains that it is vital to ‘recognise and nurture [those] spaces of accommodation and intermingling’.[53] These are, by definition, dangerous, liminal locations; where borders spill over or recede and reconfigure, and where hybridity flourishes. These ambiguous and unpredictable spaces and places can be experienced as intimidating, because unfamiliar, turbulent, and the site of ‘strangers’; but they are where movement, hope and creativity can break through stereotype and mistrust; fear and a sense of unbelonging and powerlessness. These are the liminal sites of creativity, interculturalism and renewal.

“Thus we arrive at a lived conception of identity/difference that recognizes itself as historically contingent and inherently relational; and a cultivation of a care for difference through strategies of critical detachment from the identities that constitute us. In this intercultural imagination, the twin goods of belonging and of freedom can be made to support rather than oppose each other.”[54] Added emphasis, last sentence.

The problems alluded to at the outset, in relation to the status quo in the City of Liverpool – of social class / ethnicity / gender / misogyny / homophobia  – are connected, deeply enmeshed. Hence the importance of educational, social and political action to combat the organised and well-funded forces of bigotry and prejudice in society (such as religious fundamentalisms and the rise of fascism in Europe), in addition to violence rooted in ignorance, inexperience, fear and uncertainty; as well as lack of education and opportunity. But this paper argues that, without the mind-opening, liberating and heart-healing opportunities afforded by the arts, and projects that ‘deepen communication and lead to celebration and cohesion’,[55] there can be little progress towards interculturalism and productive co-existence. 

From ‘gift’ to gifted, to gifts.
The significance of women for social recovery and renewal.

Women’s movements across the world have made women’s gifts / talents more visible, as we have risen to the challenges bequeathed us. Rochdale Open Forum in the UK, is but one example that ‘showed that women across cultures could connect in ways that men would not’.[56] Historically, women have been ‘gifts’: to be bought and sold, and as the means by which societies and cultures have been organised and controlled. The position, status and rights of women in different societies and cultures in C21 remain the sharpest, most poignant and most disturbing reminders of these differences, and how forcefully they are defended and secured.

It follows, therefore, that being at the centre of difference and conflict, women are well placed to act as creative agents for change, within the arts and interculturalism: helping undo the damage inflicted on populations, individuals and the environment, and envisaging ways out of the mess.There is a history of men and their hostilities, divisions, competitions, wars and abuse (colonial, tribal, economic, sexual). We need to build a history of humanity, and quick. If women, children and men remain buried in the rubble of men’s history and conflicts, sustainable communities will remain an unrealisable aspiration.

This paper has intimated the connections between inequalities and oppressive practices too often seen as distinct and separate. It follows that interculturalism, like anti-fascism, cannot be conceived as solely about anti-racism, but must embody the realisation that partnerships and sustainable communities require a more holistic approach. In C21 neither the arts nor interculturalism can proceed as single issue politics or cultural practice. Their synchronicity lies in their common and proven capacity to address our human complexity and the diversity of our identities, despairs, failures, dreams and aspirations. Simultaneously: as acts of responsibility and imagination. (See Appendix 3.) Even in making room for laughter.[57]

References, endnotes.

[1] Sandercock, Leonie (2004) ‘Reconsidering Multiculturalism: towards  an intercultural project’ in Phil Wood (ed.)  Intercultural City Reader. Book 1. Stroud, Comedia: 19.
[2] Landry, Charles (2004) Riding the Rapids: Urban Life in an Age of Complexity. London, Building Futures in association with Comedia: 24. See also Wood, Phil (ed.)(2006) Planning and Engaging with Intercultural Communities: Building the Knowledge and Skills Base. Stroud, Comedia.

[3] Wintour, Patrick (22 07 2009) ‘Britain’s closed shop: damning report on social mobility failings’. The Guardian: 4.
[4] Health is Wealth. A Report for Discussion (April 2008). The Liverpool City-region Health is Wealth Commission. See Walsh, Val (19 06 2008) ‘Health is Wealth. A report for discussion. Personal response.’ http://www.hapfel.co.uk
[5] Aluko, Tayo (06 2009) ‘A Christian greeting to the former Capital of Culture’. NERVE Issue 14: 23.
[6] The Black-E was in fact the first such centre in the UK, when it opened its doors in 1969, with the aim of drawing in its surrounding multicultural communities (it lies at the entrance to China Town in Liverpool and in close proximity to Toxteth, an ethnically mixed area mainly identified with the Afro-Caribbean community), as well as others, such as students and those in  informal education, to events and exhibitions which always placed the emphasis on interaction and participation: on creative involvement and co-operation. The Black-E was seen as a suitable venue for PAX, because of its declared emphasis on creativity, the values of intercultural dialogue, and trans-national communities and understanding.
[7] Aside from these events, this strand of community and public life is sustained routinely in the city centre throughout the year, by a variety of community and campaign groups: for example, peacefully setting up their tables and publicising the issues that concern them. These range from, in 2008/9: Animal Rights, No To Identity Cards, Freedom for Palestine, Keep Our NHS (National Health Service) Public, Liverpool Friends of the Earth, and most recently, the national, anti-racist, anti-BNP (the fascist British National Party) HOPE NOT HATE campaign, in the lead up to the EU and local elections, jointly sponsored by a national newspaper, The Daily Mirror, and a national union, UNISON.
[8] We also had to cope with organisational obstacles and inconveniences not of our own making and beyond our control over several months, as the date got put back more than once. These delays and obstacles could have led to a loss of motivation and confidence, given that as women we all have busy lives, other responsibilities and are mainly time-poor.
[9] Cited Wood, Phil (11 2006): 39.
[10] The team of women, known as EMBRACE: Women’s Words Live. Liverpool Poets / International Voices, in itself attests to our potential and purpose, when we present ourselves to an audience or community, before a single poem is read. We simultaneously embody our visible (and invisibe) differences, as well as our willing partnership. (See Appendix 2.)
[11] bell hooks (1989) Talking Back: Thinking Feminist – Thinking Black. London, SHEBA: 11.
[12] Ibid.: 12.
[13] Ibid.: 16.
[14] See Bohm, David (1996) On Dialogue, editor Lee Nichol. London, Routledge; and (1998) On Creativity, editor Lee Nichol. London, Routledge.
[15] Cited Gablik, Suzi (2000) Conversations Before the End of Time. 19 Dialogues on Art, Life & Spiritual Renewal. New York, Thames & Hudson: 108.
[16] At the end of her Introduction to Salzman, Eva & Wack, Amy (eds.) (2008) Women’s Work: Modern Women Poets Writing in English. Bridgend, Wales, Seren: 38.
[17] Art as Experience (1934) was the title of the philosopher John Dewey’s influential book.
[18] Knobler, Nathan (1966; 1971) The Visual Dialogue. An Introduction to the Appreciation of Art. Holt, Tinehart & Winston.
[19] Dissanayake, Ellen (1988; 1991) What Is Art For? Seattle & London, University of Washington Press..Cited Gablik (2000): 38.
[20] Gablik (2000): 31.
[21] Ibid.: 275.
[22] Dissanayake, in Gablik (2000): 43.
[23] Ibid. (2000): 46.
[24] Boundy, Fiona, Lisa Cheung, Colchester, First Site Papers, cited Khan, Nasseem (2006) The Road to Interculturalism: Tracking the Arts in a Changing World. Intercultural City Series: Book 4. Stroud, Comedia: 30.
[25] Becker, Carol in Gablik (2000): 362/363.
[26] Gablik, Suzi (1991) The Re-Enchantment of Art. New York & London, Thames & Hudson.
[27] Ibid.: 7.
[28] Ibid.: 83. See also Walsh, Val (1995) ‘Eyewitnesses, not spectators – activists, not academics: feminist pedagogy and women’s creativity’, Katy Deepwell (ed.) New Feminist Art Criticism. Critical Strategies. Manchester & New York, Manchester University Press: 51-60.
[29] See Wu, Chin-tao (2002) Privatising Culture. Corporate Art Intervention since the 1980s. London & New York, VERSO.
[30] This certainly describes Liverpool’s cultural fabric, with its proliferation of writers, poets, musicians, singers, and other creatives and performers, meeting and making in a wide range of groups and venues across the City.  See also Higgins, Charlotte (09 07 2009) ‘The birth of Twitter art’, The Guardian.  For some bureaucrats and funders, still bound by conventional categories and demarcations, this poses the ‘problem’ of how do you identify what is ‘art’ and what is ‘environmental’ and/or ‘community’ and/or therapy and/or (worse) ‘political? And how do you judge ‘intellectual and aesthetic merit. . . .?! In Liverpool, if a project is identified as ‘political’, rather than ‘cultural’, it will not get funded. NERVE magazine, ‘promoting grassroots arts and culture on Merseyside’, falls into this category.[31] Wood, Phil (ed.) (2006): 10.
[32] Ibid..
[33] Ibid.: 7.
[34] Ibid.: 9.
[35] Ibid.: 11.
[36] Ibid..
[37] The Four Corners Project (now in its 4th year ) in Liverpool, is an example of participatory art processes being linked to making changes in the way people live. Residents made connections and links between themselves, others and the wider world: showing ‘how people can come together to imagine, create and realise new ways of being.’ Ruth Ben-Tovim, Artistic Director Four Corners 2009. The project brings together cultural organisations, neighbourhood management services and hundreds of residents from Liverpool’s five neighbourhoods, and culminates in an exhibition at The Bluecoat, an established visual and performing arts venue in the city centre.
[38] In Wood (2006): 28.
[39] Ibid.: 31.
[40] Ibid.: 15.
[41] In Gablik (2000): 341. See also Walsh, Val (2002) ‘Equal opportunities without “equality”: redeeming the irredeemable’ in Howie, Gillian & Tauchert, Ashley (eds.) (2002) Gender, Teaching and Research in Higher Education. Challenges for the 21st Century. Aldershot, Ashgate: 33-45.
[42] Wood (ed.)(2006): 36.
[43] Ibid.: 13.
[44] Sandercock (2004): 19.
[45] See the conversation with art critic Hilton Kramer (2000) ‘No art in the lifeboats’, Gablik: 106-132.
[46] http://en.wikipedia.org/wiki/David­­_Bohm Downloaded 27 07 2009.
[47] Hooper, John (17 07 2009) ‘A piazza of their own’, The Guardian: 11.
[48] Ibid..
[49] Ibid..
[50] Sandercock (2004): 19.
[51] See Wu (2002).
[52] Sandercock (2004): 19.
[53] Ibid..
[54] Ibid.: 19/20.
[55] Ben-Tovim, Ruth (2009), Artistic Director Four Corners 2009, Liverpool. Introduction, Four Corners 22-29 July 09 (programme & brochure): in which people in Liverpool’s five neighbourhoods explore the question: ‘What makes a neighbourhood?’
[56] In Wood (2006): 33.
[57]The members of L’Orchestra di Piazza Vittorio have had to learn to live with each other, not just to make music together: ‘We even manage to joke about subjects like Islam and homosexuality’, said Mario Tronco. Hooper, ibid.. And British stand-up comic, Chris Addison (21 07 2009), explaining ‘how to get comedy out of awfulry’, argues that ‘not only is it OK to laugh at bad things, sometimes it is – in all senses of the word – vital.. . . . Analysis helps us understand them; grief and sorrow help us exorcise them; but laughter gives us power over them’. Added emphasis. In ‘Any hedge fund managers in tonight? The Guardian: 22.


Our founding statement for the poetry event:

‘Bridges Not Walls’:

The Sum of our Parts

An evening of poetry, stories, music,

in the performance space at The Black-E, Liverpool:

5 April 2009.

Our vision and conviction are that culture and art are peace-making activities: the quintessential bridge-builders, with the potential to move us out of narrow and private worlds, towards each other and our co-creativity – personal / domestic / social / public. Pleasure and joy are vital parts of these experiences and efforts, as we hope the evening will demonstrate. And risk-taking is also required, if we are to work with and across our differences: not to become like each other / the same, but to like and trust each other enough to hold hands and dance!

This is a collaborative performance, evoking both difference and commonality, rather than a series of individual readings. From the problems of society, we move through matters of the heart: including loss and mourning; we celebrate recovery and renewal; life process itself, through poetry, story and music.

To avoid catastrophe, we must first name our concerns; through our co-creativity, we demonstrate our capacity for survival, reconciliation, adventure, and the enduring power of love.


From first version of poster (printed in a combination of colours):


Poetry and story from Liverpool’s

multicultural heart.

To be held in the performance space at

The Black-E: connecting artists and communities

Great Georges Street, Liverpool L1 5EW

 Sunday, 5 April 2009

Arrive @ 4 40pm for 5 00pm start. Finish @ 8 00pm.

Naming anger and despair
in the face of violation, atrocity and injustice.

 Demonstrating courage and imagination
in the face of damage, loss and bereavement.

 Evoking the healing processes
of conversation, compassion, community and creativity.

Asserting art and love
over the dead hands of fear and guilt.


Bring your community!


                                                                                             High Wire Act

is all about

you bring your
to me

I bring my
to you

and we begin
the process
of knowing

Val Walsh (2006)

The Politics of Love (May 2009)

[see togetherfornow.wordpress.com, poems section]

In 2009, ‘The Politics of Love’ was performed at the following events:

  • 16 05 2009: ‘Jamsoup’ multimedia event, in the WOW (Writing on the Wall) Festival at Park Palace, Liverpool.
  • 19 05 09: by radio presenter and former actor, Roger Phillips, morning show, Radio Merseyside.
  • 25 05 2009: HOPE NOT HATE open air Music Festival, sponsored by UK national newspaper, The Daily Mirror and UK national union, UNISON. Crosby Village, Liverpool
  • 03 06 2009: Dead Good Poets Society, Liverpool. Third Room, Everyman Bistro.
  • 25 07 2009: The Peace and Ecology Festival, within the shell of St. Luke’s Church, Liverpool.

‘Into the sunlight’: gender, narrative, (mental) health. Resources for a missing conversation.

This paper was originally written during 2004 and 2005. A shorter version was presented at the BSA (British Sociological Association) Auto/Biography Study Group Conference (2005), Lives and Times and Auto/Biography. London: Institute of Education. A lot has happened in the intervening years (now September 2009): some would point to progress; others to delay and resistance to change; or worse. There are still horror stories a plenty. However, the paper has not been updated, except for the addition of three references: Keane, 2006; Walsh, 2007; Johnson, 2008.

  • Gender, health and the status quo
  • Some structural features.
  • The dilemma of the professional therapist.
  • Anger and its uses. Aggression and its violations.
  • Life history process: memory, narrative, agency.
  • Women’s peer group process.
  • In conclusion.
  • References.
  • Footnotes
    The paper is hybrid in its materials, which include personal testimony, experiential evidence, journalism, feminist analysis, and   ‘fictional’narrative.  These are not seen as discrete categories: not labels, but narrative resources.  Similarly, academics, policy-makers, serviceproviders, service users and carers in the broad remedial and therapeutic field are not discrete and ‘pure’ identities, and this also counters stereotypes of the ‘mad / bad / evil’ Other, i.e.‘not me’.1  Trauma and recovery narratives make important contributions to a politics of health perspective which bears witness to and illuminates the role of gender and gender differentials in lives, and in the field of remedial and therapeutic practice. A politics of health perspective identifies gendered stereotypes of trauma, damage and the therapeutic in academic and media practices, as both evidence (hitherto ignored), and obstacle to health and well being.

Gender, health and the status quo.
The complex of equality and social justice issues combine to shape professional practice, service delivery, social experience, and experience as service users.2  This recognition sets the scene for recording the complexity and importance of experiential evidence; the transformational function of life narratives, peer group process,3 and alliance.  After over thirty years of various equality initiatives (activist, political and policy-driven), we can see how people’s experiential and organisational strategies in combination, ‘not all these little legislative steps that hardly add up’ (Shields, 2003: 251), contribute to optimal (i.e. effective and ethical) functioning, on the part of practitioners / service users, in our joint efforts towards health and well-being; dignity and social efficacy.4  These are profound journeys towards meaning; as well as efforts to change society and (find / make) our place within it.  As Professor John Ashton declared:  ‘I regard all public health as about mental health’.5   Good mental health may by extension be seen as a mark of a decent (just?) and sustainable society, rather than an individual accomplishment, personal virtue, or commodity.

Since the 1970s, the politics of health, and the politics of self, community and society, have been understood sociologically and by equality activists (including academics), such as anti-racists / feminists / disability rights campaigners and Age Concern, as about power differentials, disadvantage, stigma and abuse, for example.  Stereotypes prepare the ground for stigma, which functions as a powerful tool for hierarchical, social organisation, and the engineering of conformity and compliance.  For example, the stigma of social class, disability, old age, ‘ugliness’, mental illness, learning problems, ‘unmanliness’, impairment generally, requires and produces simplicity: instant recognition / fear / repulsion.  By attaching to the body, of victim and offender alike, stigma organises a hierarchy of rejection and acceptance, shame and virtue, (and in UK New Labour terminology: exclusion and inclusion).  In a society dominated by images of the élite, designer body, (affluent, fast, successful, workaholic, ‘perfected’, ‘beautiful’), the powerlessness which attaches to marginality, poverty and damage, is itself a social stigma, and produces shame, which further reinforces disadvantage and vulnerability.

In a society and economy which steer us relentlessly towards ‘rugged individualism’ and ‘pathological narcissism’ (hooks, 2000: 81), western media imagery and reporting play an overly influential part in the construction of an aesthetic which serves economic, social and political ends.  The now pre-eminent western binary of beautiful (sexy) / ‘ugly’ (unsexy) seeps into everything as part of the process / price of commodification and marketing, be it of food, furniture, technology, bodies, identities, exercise.  In this scenario, there appears to be no honourable escape, for not to be visibly participating in the process of self-marketisation is to risk social contempt, as at the very least ‘old-fashioned’ (perhaps the most serious modern cultural ‘failure’, as it implies an element of ‘faulty choice’ / bad taste); or ineligibility (no choice here, simply the stigma of not being suitably equipped, e.g. wrong body, insufficient financial resources).  To be identified as without social or market value / status is to be deemed unsexy.

There are evident costs as well as consequences which flow from the unremitting (hetero)sexualization of society and culture, which penetrates and works to manage both individual self-esteem, and our relations with each other.6  While society and its institutions are now variously prepared to admit and tackle prejudice, stereotypes and disadvantage rooted in ageism, homophobia, racism and fear of disability, gender as a system of disadvantage and damage has never fully been accorded social and political acknowledgement as the problem, affecting everyone, beyond the liberal idea of ‘equality’: whether of women being seen as  ‘different but equal’ (the Equal Opportunities Commission slogan), or about women wanting to be like men, to do things the way men do things, and therefore no longer be regarded as second-class or subordinate.  Many women and men now see women as in no further need of ‘equality’: we have it all.7

“But we’ve come so far; that’s the thinking.  So far compared with fifty or a hundred  years ago.  Well, no, we’ve arrived at the new millennium and we haven’t ‘arrived’ at all.  We’ve been sent over to the side pocket of the snooker table and made to disappear” (Shields, 2003: 99).

Like any poison, the gender system is all the more serious when glossed over or denied.  Toxic levels build up to unmanageable proportions; any solution seems over-ambitious; the will to change, improve, recover (designated ‘unsexy’ and old-hat), ebbs away.  The galloping demand for therapeutic services and medication signal crisis (see Meikle, 2004).  Evidence of gender (heterosexism, homophobia, misogyny) as a powerful, distorting agency within the therapeutic field itself is therefore a matter for critical scrutiny.

Some structural features.
Therapy and the therapeutic are established ‘outsiders’ and ‘other’ to the academic community: on the inside mainly as subject-matter for scrutiny, research, judgement.  It is an established power relation into which sections of the modern media machine in the west have entered, lending their propensity for sensationalism, exploitation and the inculcation of fear and loathing, in the search for a ‘good story’.8   Despite this, the field of therapeutic practices has expanded exponentially since the 1960s, and the boundary between ‘mainstream’ and ‘alternative’ is now blurred by increasingly hybrid practices.9  This could be described as a ‘supermarket’ approach to self-maintenance and recovery: individuals pick and choose their preferred ‘product’ / service.  It could also be taken as evidence of a deepening recognition of   health and well-being as holistic projects of self and society, which reconceive and join education, therapy and politics, with personal and social creativity.  Women appear to be at the centre of this expansion and hybridisation, both as practitioners and as service users.  Latterly, celebrity men have come out openly as service users.10

The first key difference is between women.  Women-only self-help groups and networks have been important features of women’s consciousness-raising, self-organization and feminist politics since the 1970s.  Lived, but previously privatised (and ‘shameful’), experience is ignited by peer group process, for example on a domestic violence and abuse programme, a local self esteem or assertiveness course.  These groups are informal, experiential, and therefore risk being seen as ‘amateur’ (and these attributes render them clearly feminised zones), even when offered as part of a college curriculum in the community (such as PACE – Personal and Community Effectiveness – which brings together home-based parents and carers, and both the unemployed and employed).

Many women in the UK find themselves positioned outside formal educational and political practices, but in at the deep end in situations and relationships damaging to health and self-esteem, whether on the domestic front or in paid employment.11  These women can lay the basis for an understanding of the politics of health and the politics of identity, via the experiential, self-help, peer group route.  Nonetheless, they may remain encumbered by dependents, such as children and/or domestic partners, who exert control and power over the trajectory of their lives, time and concentration.12  Although women of different classes avail themselves of these community-based opportunities, the class and gender connotations of this split in access to ‘knowledge which saves lives’13 are resonant, perhaps reinforced by the fact that trauma, damage and the therapeutic signify inferiority, irrationality, lack of control (the feminine), to an academy which historically enshrines Reason, rationality, control (élite masculinity).

The ‘touchy-feely’ identity of the self-help group stands in sharp contrast to the ‘rigour’ associated with conventional academic and political peer groups (seen as zones of professionalism / élite masculinity).  Being onsite (university campus) or offsite (community centre) is more than a geographical designation, with lingering class and gender connotations.  Middle class women may feel they are entering a working-class space, and are in a minority.  Some will leave, unable to cope with associating with women disadvantaged by social class, lack of education and poverty.  Others will stay, learn and be changed by the experience.

Black women may also stay away, not only from what are perceived as white / white-dominated social spaces, but if they still ‘reject the idea that any “therapy” – be it self-help program or a professional therapeutic setting – could be the location for political praxis’ (hooks, 1993: 15).  As much as anything, this is about distrust of ‘mainstream psychoanalytical practices (which) do not consider “race” an important issue’ (ibid).  As hooks points out, it has been the celebrated fiction of black women writers which has identified the issues for black women, and provided not just black women with ‘imaginatively constructed maps for healing’ (ibid: 11).

Academic disdain and media contempt damn the self-help and therapy route as evidence of ‘failed subjectivity’, as proof of deficit as a person, and as a mark of hysteria and personal desperation.  This writes off the women as ‘ignorant’, and as gullible suckers, rather than knowledgeable, determined and courageous Subjects, in search of ways of learning from, dealing with, and moving on from loss, abuse, oppression, damage.  Identifying as victim has been an historically important first step towards political strategy and organization (e.g. trade unions, the labour movement, black American civil rights, women’s movements, environmental groups).  Labelling women’s personal initiatives for survival and recovery as ‘therapeutic’ / ‘crackpot’, turning us all into ‘patients’ needing treatment, deliberately denies (while perhaps being nervous about) the political import of these journeys, both for women themselves and for society.  It’s meant to put us off our stride.

Most of these groups are open to men as well as women, and become women-only environments because men stay away.  Men of any class may want to avoid the stigma and embarrassment of being the only man in a mixed self-help group on, for example, self-esteem or anger management.   So while gay men have demonstrated their networking, friendship, and self-help skills in maintaining mental health and keeping each other alive (notably since the advent of AIDS),14 heterosexual men too often appear to prefer public bonding around stereotypically masculine pursuits (sport, drinking, cars, women’s bodies, computer games, workplace agendas), rather than peer groups which take as their starting-point the critical challenges of modern masculinities.

Another feature of the differential position of women and men within these discourses is that women are more readily identified as ‘victims’ (done to), men as ‘offenders’ (acting on).  Peer group process across this binary divide is therefore unlikely: victims and offenders mix with difficulty, even danger.  And for a male offender, a self-help group may not only signal admission of offending behaviour, but a loss of power by association with that feminised space.  To be a victim is worse than being an offender: it is bottom of the pile.  The offender, after all, is seen as having power to exercise.15 And male offenders are glamourised.  They are the stuff of novels, soaps and films; and high-profile court cases.  They become film stars and national leaders.

This ‘segregation’ signals another gender difference.  Whereas women’s experience as victims drives many to seek out self-help groups, men’s involvement in therapeutic groups is more likely to be as a result of being referred, whether inside prison or within the community.  The offending behaviour (whether domestic violence or criminal activity) makes them a target for remedial treatment imposed by social services or prison authorities.16  Generally, therefore, these offenders are not early, willing or conscious volunteers in their own rehabilitation and development.  This may be a significant difference, in terms of what can be achieved.

On the other hand, women in self-help groups are looking deep into selves, lives, and at society.  Such women have decided, in the face of intense, even brutal opposition, hostility and abuse, not to give up on themselves.  In her book on black women and self-recovery, bell hooks speaks to all women; and all the injured, insecure, and ill-at-ease in society:

‘Living as we do in a white-supremacist capitalist patriarchal context that can best exploit us when we lack a firm grounding in self and identity (knowledge of who we are and where we have come from), choosing ‘wellness’ is an act of political resistance” (hooks, 1993: 14).  Emphasis added.

Yet another gender difference is how women’s and men’s trauma and recovery is identified  academically, in the media, and institutionally.  Women’s journeys are more likely to be viewed as proof of instability, inferiority, an inability to cope with life’s complexities.  A woman’s recovery narrative may actually serve to confirm the idea of inadequacy, and undermine power, influence and opportunities in the public domain (with a little help from the media if she is in the public eye).  By contrast, while the pressure on men to perform in a manly fashion makes it more difficult for them to admit to vulnerability, dis-ease, any sense of failing in their masculinity, when élite or celebrity men (usually white) tell their recovery stories, this can now produce a ‘revised (new) manliness’, a new ‘heroism’.  Their accounts and their lives circulate within the existing gendered political economy as both exceptional and virtuous (even if baffling).  These men may even be, consciously or not, ‘hetero-patriarchal whistleblowers’: men ‘recovering from’, in remission from, and even angry about, normative heterosexual masculinity and its injuries.17

The conjunction of class, race and gender is then, an influential and instrumental factor for service-users in a number of ways: in terms of access, and point of contact (early / delayed / late / avoided / as a voluntary commitment or as referral); how involvement is publicly interpreted; how women and men feel about their involvement and experience, in view of these demarcations and stereotypes; why they embark on therapeutic journeys, and the desired outcomes.  We know, for example, that many male offenders look to this work as a way of ‘improving’ and returning to a former heterosexual relationship, in order to ‘do it better’.  For women, on the other hand, therapeutic and other self-development work (including, of course, higher education) is more usually about getting or staying out of an abusive relationship, not going back for more.  These moves into self-protection, therapeutics and self-development may also be seen as the ‘personal’ initiatives of women failed by society’s institutions: for example, left unprotected and exposed to heterosexual male violence (whether in the home, on the street, or in the war zone).  The consequences of not managing to take these steps into the public domain, into the self-help peer group, can be catastrophic, even terminal.

Teresa was not just a victim of violence at the hands of her husband: she was also a victim of the state’s failure to prevent and punish that violence.  She was denied her constitutional right to equal protection under the law because she was a woman, a victim of family violence, and a member of an ethnic minority (Campbell, 2004a: 18).

The dilemma of the professional therapist.
“No-one has a clue what prevention is or might be” (Ashton, 10.02.04).

This is not a judgemental statement nor shameful admission: rather an honest recognition of the complexity of mental health and its disorders.   Clues and ideas abound, but to register and understand them, professionals and politicians must listen attentively to the experiential evidence of people’s lives, rather than determinedly continuing down the twin routes of medicalisation and criminalisation.   This is an issue of authority, power and hierarchy, for example in the therapeutic encounter.   Hanging on to traditional notions of ‘expert’ v. ‘patient’, ‘professional’ v. ‘deviant’, ‘well’ v.‘ill’, may be seen as territorial and defensive behaviour on the part of those in authority, faced with pressure from service users to be better represented within mental health structures and processes: i.e. at least to be seen and heard.  In his response to Frank Furedi’s book, Therapy Culture: Cultivating Vulnerability in an Uncertain Age, Harry Ferguson challenges Ferudi’s argument that:

“All social practices that exist to help people are actually doing the opposite.  They make people dependent and diminish their expectations by making them define themselves as unable to cope.”

There are undoubtedly practitioners who work in this way: intrusively manipulating vulnerability; perpetuating their client group; and protecting their own professional identity and authority.  But within the broad and diverse field of therapeutic practice, there are practitioners working in partnership with clients and/or group members.   Crucial to the difference between these two kinds of practitioners, will be whether they demonstrate equality awareness and commitment to social justice in these areas, in both their personal lives, and in their professional practice.

It is pre-eminently women’s autobiographical testimony, feminist activism, research and theory since the 1970s, which have articulated the core significance of sexual politics and gender power relations for professional practice as well as individual lives.  Issues of authority, dominance, control and abuse have been further illuminated by anti-racist activists and post-colonial theorists, as well as therapists such as Dorothy Rowe.18  It is clear that a person’s own biography and identity inform professional performance and role in ways which can be significant for outcomes: and no more so than in face-to-face work with (vulnerable) people, such as education, social work, healthcare, therapeutic practices.  Given the levels of prejudice and abuse becoming visible in our institutions (residential homes, the Catholic Church, psychiatric wards, prisons, for example), as a society we have clearly not yet achieved a sufficient level of social and self-awareness, care and protection for when we are most vulnerable (and lack authority), and when we are most powerful (and exert authority).

The liminality now inherent in such personal / professional encounters puts pressure on professional conduct, rooting and redefining it in terms of ethics and politics, rather than ‘neutral’ notions of authority, expertise and respect.   This invites (requires?) professional practitioners to ask themselves to what extent they have listened to and been changed by the lives, voices and narratives of the previously silent majority of non-élites and ‘marginals’, including of course, service users.   To what extent are service providers part of these social changes, or standing back, defending territory?   Have they undertaken a critical, self-reflexive journey into their own biography and identity (including fears, prejudices, hurt, social positioning), in order to understand how these might equip or dis-enable them in relation to their professional role?   I will illustrate the relevance of these issues with three examples.

A psychiatrist speaking at a mental health conference with a mixed audience of carers, service users, services providers and others,19 described a case-study involving one of his female patients.   When asked how old she was, he replied, ‘Twenty-four’.   ‘A woman then’, I said.  It was unclear whether he had heard me properly, as he continued by telling us that she had been self-harming since she was fourteen.  I said that at twenty-four, she was now a woman.  ‘Oh, did I say “girl”?’ he asked quickly, smiling.  I explained to him later, that I thought it impossible for anyone to accompany a young woman on a therapeutic journey, if that person, the figure of authority (and in this case, an older man, a ‘father figure’) thought of the young woman as ‘girl’.  This would be a parent / child scenario and distinctly unhelpful.  This was unfamiliar territory for him.

A consultant psychotherapist, responsible for setting up an innovative, mixed residential treatment centre, ‘run on democratic lines’, was asked to say something about how this community worked, given that familial and heterosexual power relations are key factors in abuse and damage.  How could a mixed therapeutic environment work, for the women in particular?   While he said it was a very good question, he was not willing to address it himself, and asked the two residents who accompanied him for this occasion to speak of their own experience.  When pressed, he made ‘excuses’ (smiling all the time) about the fact that he predated ‘political correctness’. . . . at which my internal alarm bells went off.   His use of the term ‘political correctness’ identified his resistance to taking gender issues seriously, either as a man or as a psychotherapist.  Audience members who came up to speak to me later, understood my question and were equally dissatisfied with his reaction.  They were all women.

For (male) journalists too, the idea can simply not occur, that gender is a significant factor when discussing mental health issues.  In an otherwise sensitive article about sportsmen and mental health, immediately following the suicide of cyclist Marco Pantani, journalist Paul Weaver consults an ‘expert’, an academic, Dr. John Kremer from the School of Psychology at the Queens University of Belfast, who ‘attempted to shed light on the subject’ (Weaver, 2004).  Kremer mentions three factors: the link between physical fitness and psychological well-being, and therefore the problem of consequent unfitness in retirement; the problem of coming off steroids; and the lack of forward planning by sportsmen before retirement.  Such a ‘rational’, tick-box list, which identifies each casualty as an individual (and there are many), who just slipped up in the management of his life.  No mention of (élite) masculinity as a factor in the onset of depression, after a career as a high-performing, élite male body (see Sparkes, 1996;1997), where ‘real life is put on hold’ (Weaver, ibid.).   We also get no sense that these men (the male suicides of sport and the academic ‘expert’) have anything in common.

This academic distancing is shocking, not least from someone working in a city which has provided gruelling evidence of normative masculinity as punishing, as a war footing: entrenched masculinities pursued relentlessly via disciplinary control and violence (mainly men on men).  The Ardoyne in Northern Ireland suffered thirteen suicides of young men in the two month period after Christmas 2003.  Some of these young men had been the subject of paramilitary persecution and terrorizing, with subsequent consequences for mental health, prior to suicide (C4 News, 24.02.04).

Anger and its uses.  Aggression and its violations.
“The last thing I want is to be possessed by a sense of injury so exquisitely refined that I register outrage on a daily basis.  Anger is not humanizing.  . . . Probably you will dismiss this as a crank letter from one of those women who go around begging to be offended, but you must understand that I am trying to protect Norah, and her two younger sisters, Christine and Natalie, who want only to be allowed to be fully human.  And you should know, as I set down these words, that I am shaking like a tree of nerves” (Shields, 2003: 221).20

‘If I die, I want you to tell the world what happened to me.  I don’t want other women to suffer as I have suffered.  I want them to be listened to.’  The police in Sonoma County, California did not listen to Maria Teresa Macias.  Her husband killed her on 15 April 1996 (Campbell, 2004: 4).21

Gender attaches to anger in this society.  Girls used to be brought up with an understanding that anger made them ‘ugly’, i.e. unfeminine, unladylike.  (Or was that just white, middle class girls?)  Girls were not expected to express dissatisfaction with their lot.  Boys’ anger was taken-for-granted as boys just being boys, preparing for some kind of dominance or leadership.  Recently, some girls and women have adopted aggressive behaviours, perhaps to demonstrate ‘independence’, to copy or compete with men.  And faced with rapid social change in heterosexual relations, some men are silently bottling up anger.  Anger which remains inchoate and unexamined, produces erratic, dominant and controlling behaviour: the aggression which turns men into abusers / offenders / prisoners.  Whereas angry women are more likely to see themselves as in disarray and despair: as victims.  This is not a fixed scenario:  Fathers4Justice in the UK present themselves as both victims and as lawless aggressors in pursuit of their cause.  Bob Geldorf is a good example of this emotive combination: (celebrity) victim identity fuelled by aggressive, misogynist rhetoric and anti-feminist demands and tactics.  Anger management programmes, using Cognitive Behaviour Therapy, propose ways out of all this dysfunction and destructive behaviour.22  But there are different versions to be had.

In the prison Zoe Williams visited, for her article on the use of anger management work with male prisoners, she found an emphasis on ‘distorted thoughts’ (ibid: 32), which needed ‘rationalising’ (ibid: 36).  This model of self-control almost implies that male prisoners should be discouraged from feeling at all: any feeling could get them into trouble.  There is no mention of key factors in men’s violence:  the burden of normative heterosexual masculinity, the injuries of social class and racism; and that men’s heterosexual masculinity may be rooted in fear of failure to perform appropriately.  There seems little awareness that under pressure to be ‘successfully masculine’, heterosexual men frequently find it difficult to cope with, talk about, and express feelings without being controlling.  Communication skills are limited.   Intimacy is threatening.  Yet these prisoners were being encouraged to give up their usual means of control: ‘You can’t control someone with assertiveness’ (Williams, ibid: 38).

Williams describes the methodology and theory behind CBT as ‘essentially practical- . . . not about delving into anyone’s childhood, . . . or anything else typically associated with talking cures’ (2003: 32).   She refers to Noam Chomsky’s reservations in 1977, about behaviourist therapy providing ‘a palatable ideology for the application of techniques of coercion’.  This implies that CBT ‘teaches people to operate in society without causing trouble and, . . . . teaches them not to strive for fairness, or justice. . . .’ (ibid).  These were serious accusations, but more recent evidence has shown that the CBT cycle of change is not in itself mechanistic  or depoliticizing.

One of the key components of the CBT cycle of change is the importance of thought as a means of identifying experiences, as, for example: hostile or friendly, abusive or supportive, risky or safe, predatory or loving, controlling or nurturing, personal or general.  Within the CBT cycle, thought is seen as having consequences: feelings about what we have identified, how we have understood a situation or action.  This in turn generates behaviour.  So the CBT cycle can be understood as about thought as central to feeling, and not in binary opposition to it.  Thought as part of a creative cycle of awareness and behaviour.   And working-class men who grow up seeing thought and language as the prerogative of élite white men, or (now) educated women, are painfully disadvantaged within this problematic.  Language and speech are not the province of those young men heading into the underclass of the uneducated, untrained, unqualified, unemployed, unemployable, undesirable, whose numbers are increasing, and who fill our prisons.  And men schooled in rationality as masculinity, as emotional control, are likely to view feelings as ‘feminine’, disruptive, and as obstacles to be ‘tamed’.

More than thirty years after Chomsky’s comments, CBT has entered ‘alternative’ therapies and a range of self-help programmes, which are about activation not passification; agency and empowerment not conformity.  The best of these programmes count as equality work, which draws attention to coercion and conformity as undermining, even damaging.  I suggest there are three key factors which have brought about this change since the 1970s.

The first is feminist activism, research and theory / gender awareness / equality discourse and practice.  Women working with women (and men) have seen the potential of gender-aware CBT for domestic violence and abuse programmes, courses in self-esteem, assertiveness, and anger management, for example.  Because of its emphasis on critical self-reflexivity and peer process, with the right facilitator this work enables group members to take risks and develop their own tools for change. It places learning, responsibility and innovation in the hands of individuals within a supportive peer group context.

The rise to prominence of peer group process is the second key factor.  Peer groups displace the conventional leader and led formation, whatever the context: social, business, educational, therapeutic, campaigning.  The structure of authority in the group is dispersed and shared (see footnote 3).

The third key factor is the increasing understanding of and importance attached to ‘Energy’ (Ki / Qi) and spirituality in the west (the mind / body / spirit connection), drawing on holistic Eastern traditions, such as TCM (Traditional Chinese Medicine).  The programmes mentioned above may be offered in the context of other work, such as meditation and bodywork, as well as the possibility of one-to-one counselling.  Practioners working in these local contexts, for example a community centre or a healthy living centre, include those employed directly by formal educational institutions.  But they are likely to have more varied life experience and very different personal and professional profiles from those responsible for inhouse assertiveness training or anger management provided as part of a business environment (aimed at career salvage or advancement); or within a prison regime (working with ‘offenders’ in a bid to keep them out of prison).  This difference may be even more marked if staff are ex-army (as many prison officers are).   By contrast, increasing numbers of self-help programme facilitators / service providers / therapists, are now women who have themselves ‘graduated’ from victim to survivor to professional practitioner.23

As more heterosexual men find themselves living lives which resemble women’s (multi-tasking across the public / private divide, putting in longer hours, responding to contingency, living with less clearly defined boundaries, being required to cope routinely with ambiguity, uncertainty and complexity), many are running for cover: abandoning partners and families, for the apparent simplicity of life as an unattached male (with discretionary access to younger women).24  Many (older?) heterosexual men are angry at their (new) lot as men.  Upbringing and education have not prepared them for this hard work, now that ‘wife’ no longer means full-time, home-based ‘carer’ and all-purpose back-up.  Faced with unanticipated personal and social complexity, many lack courage and motivation.  And in these circumstances, perhaps heterosexual men fear the exposure of sharing and learning in peer groups.

The ‘certainties’ of manhood, such as they were, have gone (see Beynon, 2002).  Emotional literacy and communication skills are underdeveloped and under strain, yet more in demand by both women and organisations.  Unsupported and bewildered, feeling abandoned and angry, men may turn to recreational sex, drugs, alcohol, rock ’n’ roll. . . . and too often, violence and murder.  The testimony of one celebrity perpetrator whose behaviour landed him in prison on more than one occasion, captures the sense of out-of-control desperation:

“I had to tell myself that I didn’t have to enrol in the same programme for the next forty years, with the same things dragging me down – the resentments, the unadulterated anger, the mother-fucking rage.  I allowed myself to let go of that shit and it means that I’m no longer a miserable prick” (Downey, cited in Wilde, ibid: 6)

Far from being something incidental:  ‘Anger is a defining interest – your future is defined by revenge strategies . . . . ‘ (Williams, ibid: 39).  Williams conflates anger and aggression, perhaps because her subject here is male prisoners.  (See footnote 22.)  And victims of revenge are mainly women: for example, women whose autonomous actions (whether in choosing a disallowed sexual partner, or in attempting to escape domestic violence and abuse) are seen as a threat to heterosexual male power (see Addley, 2003; Butalia, 2003; Campbell, 2004), and are killed in the name of ‘honour’ or possession; or women in heterosexual relationships who decide that silent servicing is not a life as such, more a sentence, and that education, paid employment, their own income, and time for themselves, are not beyond the bounds of possibility or desire. They may even be prerequisites for mental health and well-being. . .

Working with male prisoners on anger management in a way which does not address issues of heterosexual masculinity, misogyny, racism and homophobia, would seem to be working at a dangerously superficial level, which will not in the long run produce greater safety or satisfaction for the men themselves, their partners and families, or society at large.  The problem of men’s violence towards other men, towards women and children, and towards society, cannot be covered by a set of institutional tick-boxes / government targets.  What counts is the context in which you explore your cycle of change, and why, and here again we see sharp gender differences.  At the moment, CBT for men / male offenders constitutes an intervention.  For (mainly) women in self-help groups, it is an initiative, even an ambitious adventure.

Does it have to be polarised in this way?  Suddenly faced with the trauma of degenerative disease while still a young man, Michael J. Fox eventually took the initiative, and found himself also having to face up to his identity as a man, and his lifestyle as a male celebrity.  He entitled his compelling memoir of this gruelling and continuing journey, Lucky Man.

“I didn’t suddenly burst out of a cocoon of fear. Neither was it a linear progression, an easily followed map of self-discovery. As Joyce [his counsellor] might say, it all came down to showing up for my life – and doing the work” (Fox, 2002: 218).

We should not underestimate how much courage it takes to develop reflexive critical auto/biographical consciousness and responsibility as a man in this society (see Fox, 2002; Jackson, 1990; 2004; Parsons, 1999; 2003).  It may even be more difficult (to get started) if you are not a known abuser, but just a guy overwhelmed by the challenges presented by un/employment and relationships, and struggling (consciously or otherwise) with contemporary, gendered realities in relative social isolation.  Recently, young men (in prison and at home) have been turning on themselves, giving up before they have hardly started, living is so difficult.  To avoid such casualties, as well as the toll on women’s and children’s lives, the supportive care and educational work on contemporary masculinities needs to start with boys as early as possible (see Doyal 2001).

Helping men move away from dependence on controlling behaviour and violence, and/or from falling into self-pity and depression, is a complex, long-term project, probably as complex and long-term as women’s feminist journeys away from deference, self-hatred, fear, internalised shame.  Within the constraints of a prison environment, a start may be made, but follow-up, transitional spaces and opportunities are essential if men are to properly support each other in their transformations and healing.

Life history process: memory, narrative, agency.
“But there is something more, a story from long ago that I will tell you face to face, father to son, when you are older.  It’s a very personal story but it’s part of the picture.  It has to do with the long lines of blood and family, about our lives and how we can get lost in them and, if we’re lucky, find our way out again into the sunlight” (Keane, (1996: 37).  Emphasis added.

We now know, because journalist Fergal Keene has since shared his recovery narrative, that he was alluding here to his own struggles with alcoholism, in the aftermath of his disrupted relationship with his alcoholic father, the actor Éamonn Keane (see Keane, 2006). The evidence of those who have made journeys from abuse and shame, addiction and despair, or lived in their shadow, suggests that we do have to go back as far as is necessary, and that the process cannot be undertaken only ‘in the present’ (a quick massage, the ‘right’ medication).

White American actor Robert Downey Jr. provides an example of one man’s journey from ‘pharmaceutically-fuelled, headline-grabbing mayhem’ (Wilde, 14.11.03), from addictive self-harm and aggression, to healing process and recovery mode – a return to both domestic commitment and creative / professional responsibility.  His testimony points to the deep roots of addictive and self-destructive behaviour.  He grew up in apparent privilege, but asked when his problems started, he says: ‘You’d have to go way, way back’ (ibid).   His pharmaceutical experimentation started before his teens, with ‘the active encouragement of his film producer father, Robert Downey Sr.’. And he is, after all, Robert Downey Jr..  To be  Jr. to a Sr. for most of your adult life must carry intrinsic disadvantages: always in the shadow of the father.  Downey’s recovery exemplifies a whole person process over time, carried out in the supportive company of others, be they specialists (therapists), peers or intimates.

‘That’s not to say that I’m in the clear yet. I might be shifting out of it, but I’m still the same guy that did all that crap’ (cited Wilde, 2003: 6).

The American novelist, James Baldwin, being poor, black, gay in 1950s America, and unhappily adopted, did not grow up in privilege. He also felt this shadow effect, and his first novel ‘was moulded by the painful relationship with his disciplinarian step-father . . . . who repeatedly told his stepson that he was ugly, marked by the devil’ (Field, 2003: 36).  [Emphasis added.]  Like all oppressors / abusers, his father made sure Baldwin experienced his stigma as written on the body.

Similarly, students on the MOWL project (Moving On With Learning) at the University of Liverpool, testify to the destructive impact of labelling on lives.  In their case, the ‘special needs’ label acted as a ‘ball and chain around my neck’, and with it came a whole vocabulary / stream of abuse:  stupid, backward, spazzy, slow, mental, retard.25  Stigma sticks: ‘I feel that pain deep down’ said Terry in his presentation to the Duncan Society in Liverpool.   And when black British footballer, Stan Collymore, spoke about his problems with depression, he too was mocked (Weaver, 2004).  Celebrity afforded exposure, not protection.

For people with learning difficulties, like Bill and Terry, who started off designated as ‘sub-human’, the struggle is not to recover from a downfall, but, now in their forties, ‘simply’ to achieve ‘human’ status and dignity.  Life history process helps in this, and the narrative power of their witness and public telling helps to educate and change those who work alongside them, and those (be they ministers or the general public) who come to listen and learn from them in their public presentations.  These men aspire to humanity before masculinity, and even in that, teach the rest of us something important.

“I used to be afraid to tell this story because it brought memories back . . . . Before I was nervous, I was shy.  Nobody would believe that now” (Terry, MOWL student: 10.12.03).

Black American writer, Toni Morrison, is in no doubt about the importance of our relationship with our past:

“Until one comes to terms with it, the past will be a haunting – something you can’t shake” (cited Jaggi, 2003).

Academic and social worker, Harry Ferguson, cites Judith Herman’s manual, Trauma and Recovery, and suggests her three-stage conceptualization of healing for abuse victims  provides a valuable insight and guide to working with trauma survivors:

“First, victims need safety. Then, once the violence has been stopped and they feel more secure, the task is to help them to remember the full extent of the violation, to mourn for the lost self. The final stage involves integration of a new self and reconnection with wider society” (Ferguson, 2003).26

Confession and intimacy are normally kept beyond the gates of academia, being seen as contaminants of academic rigour, but Ferguson argues that ‘confessional intimacy goes somewhere really important’, and is part of a process of ‘finding a voice and taking back [their] power’.  The process he describes is not something merely ‘technical’, nor some kind of quick fix, but attends to issues of power and powerlessness, including questions of poverty, resources and life-planning.  It is understood that clients are very often dealing with the aftermath of trauma (loss, abuse, violation), and this makes them vulnerable (and open to [further] abuse) but not necessarily helpless.  Bill and Terry (10.12.03) described how the labels made them public property, and legitimated a range of behaviours used against them, such as:  being shouted at, patronised, bullied, ignored, degraded, abused, disrespected, humiliated and dismissed.27

Abuse and violation are instant, whether as an isolated instance, or repeated over time.  Fear, self-loathing, anger, despair, a lack of self-worth, build up over time: hence the importance of looking back from a position of relative safety.28 Mental health activist, Judith Mawer,

describes ‘talking therapy as the only way to lasting recovery’ (10.02.04), and instead of getting herself married with children, as her doctor suggested, she took herself off to do a scriptwriting course as part of her recovery process.  As Morrison said in her Nobel lecture: ‘Narrative is radical, creating us at the very moment it is being created’ (cited Jaggi, 2003).

As a writer, Baldwin also recognized the importance of one’s roots and early beginnings, as both problem and ‘solution’: resources for self-understanding and change; for psychic recovery and creative purpose; for a kind of functionality (not ‘cure’ or problem-free existence), which wards off self-harm and addictive behaviour.  He too cites the significance of narrative and life history process:

Go back to where you started, or as far as you can, examine all of it, travel your road again and tell the truth about it.  Sing or shout or testify or keep it to yourself: but know whence you came  (Go Tell it on the Mountain, 1953, cited Douglas Field, 2003).  Emphasis added.

As all narratives of healing and self-recovery demonstrate, you need a team.  ‘The students made me feel wanted’, said MOWL student Terry about the university students who worked alongside him.  ‘I am a human being’, he said, claiming and celebrating his new identity.

Women’s peer group process.
As the example of Maria Teresa Macias shows, listening and being listened to are vital to survival.  Active listening is at the heart of human relationship, including intimacy: essential to proper conversation and dialogue.  Speaking plays its part in communication and relationship, but speaking not rooted in a listening habit too easily turns to dominance and control; display and arrogance.   Within the current arrangements, many (older?) heterosexual men seem to think listening is a sign of passivity, femininity, inferiority, lack of power.

“Inclusion isn’t enough.  Women have to be listened to and understood.”
“I’ve only had a handful of conversations with men, “ I said.  “Other than Tom.”
“I’ve had about two.  Two conversations with men who weren’t dying to ‘win’ the conversation.”
“I’ve never had one,” said Sally.  “It’s as though I lack the moral authority to enter the conversation.
I’m outside the circle of good and evil”  (Shields, 2003: 116).

As this excerpt from a conversation in Carol Shields’ final novel demonstrates, women’s peer process facilitates the joining in understanding of private experience, social arrangements and structures, and public pressures.  These are intellectual as well as emotional journeys; peer group process is the vehicle; self and society the targets.   Women’s peer process goes on every day, everywhere: face-to-face, by email, on the phone, in the car, on the sidewalk, up a hill, over a meal, in a group, at a conference (but generally, not in the gym).  It nourishes our lives and creativity.  It is therapeutic.  The best group-work resembles this mutual stimulation and nourishment.

Many women write as ‘self-protection’ during times of greatest turmoil and risk; as part of their recovery process; and as self-maintenance: whether as ‘secret’ scribblers, as members of writing groups, and/or on creative writing or scriptwriting courses; and of course, for publication (see Henke 2000; Butler 2000).  When individual women allude to this, they invariably say: ‘It kept / keeps me sane’.  Others use the visual arts and crafts in the same way.  We know in our bones the link between creativity and mental health and well-being: the importance of creative routine, repair and renewal.  In this process, ‘art’ and ‘therapy’ are not separate or opposed, but fused.29  Baldwin too made love and creativity his ‘redemption’ and healing, in his search for the means to function as a human being not damaged beyond repair.  This is everyone’s odyssey.  He understood: it is the artist in each of us that knows about reparation, regeneration and healing; how to move from damage to creativity / love. 

Working alongside women in five different self-help groups / courses which drew on CBT, I witnessed women growing in self-understanding, social awareness and courage, just as I had previously witnessed women in higher education, on communication studies and women’s studies degree programmes, achieving personal / intellectual change.  These ‘training programmes’ are able to take women’s experience openly as the core of the therapeutic, consciousness-raising, educational, peer process.  By contrast, inside academia the taboo on experiential learning is still very much in place, and women’s studies students and tutors, for example, have to work within its constraints on a daily basis.  Feminist academics are aware of the stigma attached to such work (see Caplan, 1994; Morley & Walsh, 1995); and the danger (see Lee, 2002).

Damage, abuse, loss, a sense of powerlessness, can lead any of us to ask: Tell me what to do, tell me what to think, to take away the pain and danger.  Give me the recipe.  Like going to the doctor to be cured, this invites the professional / therapist, alternative or otherwise, to be the authority figure, to direct and control.  But that is not my understanding of therapeutic process, educational process or creative process, and women’s self-care and healing is all these, as well as being a highly political process, with considerable social and political consequences, not just personal, psychological outcomes (see Butler, 2000; Cardinal, 1991; 1993; 1996; hooks, 1993; Walsh, 1997; 2007).

In conclusion
The historian, CLR James, who championed [Toni] Morrison in Britain, found Sula (her 1974 novel) astonishing and revealing in its implication that the “real, fundamental human difference is not between black and white but between men and women” (Jaggi, 2004).

The increasingly sexualized context of the stereotypes of trauma, damage and the therapeutic in society produce damaging and differential consequences for women and men.  Within a politics of health perspective, gender can be seen as the most denied and the most pertinent factor in the alleviation of suffering, and the development of good mental health as a social as well as personal asset.  A more co-ordinated and diverse approach, rooted in the experiential evidence of lives and testimony, has consequences for professional identity, practice and training.  Narrative is a key evidential and healing strategy in the field, as opposed to ‘rational’ tick-boxes and instrumentalism.  And there is now evidence that gender-aware CBT can be part of a healing, creative process, as seen in women’s self-help peer groups.  Women’s experience and initiatives, as service users and providers, are mapping ways forward, and these creative initiatives offer heterosexual men a potential template for their own development and healing strategies.

The therapeutic / communication skills field is a modern hybrid, which brings together the technical, performative and cultural focus of language and communication work, with the emotional and intellectual self-reflexivity and creativity of therapeutic approaches to identity, trauma and social effectiveness.  Whether this is informed by a conscious, responsible politics of education / health / well-being, will depend on the professional facilitator’s own sense of identity, her/his sexual politics, as well as personal / professional skills and commitment.   This is because first, we are all implicated in the crisis.   Second, the problem of gender is not just a matter of gender difference or differentials (access, provision, respect, and opportunity).  Heterosexual men’s fear of femininity / women / mothers persists in some quarters; the cultural linking of sex, violence and male heterosexual desire has surged; the urge to dominate in the face of overwhelming desire / lack remains damaging; the slag / bitch / cunt mindset, which (young) women are now being encouraged to adopt in the name of ‘equality’, and in turn recommending to other / older women, as a mark of ‘progress’ and ‘power’30 is surely no answer.  All these factors make for a complex and volatile ‘crime scene’.

In addition (and like most young men), most young women are still denied an upbringing and education which provide them with an understanding of how they arrived at where they are now (individually and collectively as women), and the economic, social and cultural factors which continue to shape girls’ and women’s lives and prospects.  This unavoidably produces ignorance and social vulnerability.  Or is it possible that ignorance affords protection, enabling women to be and do in new and liberated ways, not determined by the exigencies of male heterosexuality; by still male-dominated, masculinist, domestic, social and working environments; by the unrelenting onslaught of advertising, fashion and popular culture; and by the escalating and widespread routine violence against all kinds of women?   Can ignorance be armour?  Maybe, short-term.

Narrative resources to support change are never written on a clean slate.   Commenting on the dilemma of journalists when China started to open up, ‘like a starving child devouring everything within reach indiscriminately’ (Xinran, 2003: 216), after years as a closed and authoritarian society, Xinran saw ‘a body racked by the pain of indigestion’ (ibid.).

“But it was a body whose brain they could not use, for China’s brain had not yet grown the cells to absorb truth and freedom.  The conflict between what they knew and what they were permitted to say created an environment in which their mental and physical health suffered ” (ibid.).  Emphasis added.

‘The words to say it’ (Cardinal, 1993) are rooted in our bodies, our lives, our relations, our imaginations.  We work together with the materials at our disposal, to create the (narrative) resources we need to go on: this is our co/creativity.  Life process itself.  To forge alliances, to build dialogue and good practice across demarcations, ‘restoring intimacy across social chasms’ (Morrison, cited Jaggi, 2004) is a tall order.  It means challenging academic disdain, media contempt and institutional instrumentalism where we find it.  Owning and flexing our hybridity is part of this process.  For once you acquire a label, you acquire a fixed and singular identity, as Judith Mawer found out.  When it came to returning to her job, she was told ‘either you’re sick or you’re well’ (Mawer, ibid).  Tough if that does not describe your reality, and you want a phased re-entry to paid employment.  While the professional or service provider must allow themselves to say, ‘Sometimes I’m effective, sometimes I’m not’; we all have to be able to say, ‘Sometimes I’m well, sometimes I’m not’.  That’s the reality we share.

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1 Myths of Madness, a film made by Headlines: Mental Health Media, was shown as part of a Duncan Society meeting at FACT, Liverpool (10.02.04), focussing on mental health issues.  Contributors on camera are presented first in their professional, work-related roles / identities, for example as academic, service provider or researcher.  Later, the same people identify themselves in terms of their experience of mental health problems and as service users.  In terms of the demarcation ‘them and us’, three themes from the film are particularly relevant at the outset: ‘1 in 4 people will experience severe mental distress at some time in their lives’ (cited Mental Illness: The Fundamental Facts, 1993), produced by the Mental Health Foundation; ‘Life experiences and mental distress – discrimination is bad for your mental health’; (Headlines notes on the film); and ‘In the last two decades of the community care policy the number of homicides committed by mentally ill people has not increased while the number committed by others has more than doubled’ (Finding a Place: A Review of the Mental Health Services, Audit commission, HMSO).

The Duncan Society in Liverpool is a public health debating society, which brings together professionals, service providers, service users and other members of the general public in monthly meetings.  Speakers include international and national experts and activists, as well as local and community experts and activists.  Emphasis is placed on full and open dialogue and debate.

2 While this paper focuses on gender as its primary theoretical and political construct, this is not meant to suggest that, for example, social class and racism are seen as separate or excluded categories of difference and disadvantage.  Rather that they intersect and are never ‘isolated’ from one another.  See, for example, the working-class community reported by journalist Matthew Parris on his return to the North East, in which the men had disappeared to leave the women to bring up the children in an environment shaped by extremes of poverty, unemployment and environmental decline.  The sense of abandonment was palpable. Parris noted that, twenty years after his last visit as a new, young MP, all the adults and children he interviewed were on serious levels of medication (tranquillisers, anti-depressants), without which they felt they could not cope with daily life.  See also ‘No holding back’ in which past and present service users and practitioners share their experiences of institutional racism in NHS mental health services. (Gould et al, 11.02.04).  Also Francis (11.02.04).  The problem of long term tranquilliser ab/use is highlighted in Meikle (11.02.04)

3 Peer group process does not refer to the composition of a group (i.e. same age or occupation), but to the relational dynamic of the group, which is based on everyone entering the group process as equal in terms of mutual respect and dignity, and what they might contribute.  It seeks to leave aside the parent / child structure of authority, and assumptions of dominance and submission, of hierarchy, as ‘natural’, inevitable or desirable in group process.  Peer process thus invites and facilitates a conscious, intuitive and responsible working with and through differences of identity and circumstance (such as age, affluence, experience, ethnicity, gender, sexual preference, social class), and differences of values (such as religion and politics), usually in pursuit of some ‘third thing’, such as skills acquisition; social and personal understanding; campaigning goals and strategies.

4 Particularly since the late 1960s, experiential and organisational initiatives within individual lives have also led to what have become enduring projects and organisations, which, in terms of their impact on lives, must be counted within both the therapeutic and political fields.  The London Lesbian and Gay Switchboard, which celebrates 30 years of action and care in 2004, is one such.  See Shifron, 2004.

5 Professor Ashton is Director of the North West Regional Health Authority, and was chairing the Duncan Society event at FACT, Liverpool (see footnote 1 above).

6 See Walsh (2003a; 2003b). Also Doyal (3.11.01) for a summary which provides some general ‘sex, gender, health’ background to the specific themes of this paper.

7 See Equal Opportunities Commission (July 2003), ‘”75 Years On”: Equality for women and men today?’

8 ‘Good stories’ are sensational, ‘shocking’, as the initial coverage by the UK tabloid press, of black boxer, Frank Bruno’s sudden removal to a psychiatric hospital demonstrated.  Such ‘good stories’ are above all about selling papers, not covering issues.  ‘On the news media – bulletins on BBC1 and ITV – of all the people with mental health problems that are presented, 70% of them are associated with violence’ (Adlam, 17.02.90).

9 These include talking therapies (psychiatric and/or therapeutic counselling; life history process; health narratives; trauma narratives); bodywork (massage, reiki, pilates, shiatsu, Qi Gong, yoga, as well as dancing, running, swimming, gym workouts); spiritual practices (meditation, chanting); other endorphin-inducing methods, including art and craftwork, film-going, theatre, performance, etc.; nutritional approaches; and finally, but not least, self-help groups, peer groups, networking groups.  This range of therapeutic practices / services demonstrates differences in what would previously have been referred to as diagnosis and treatment.  Avoiding this terminology, I suggest four approaches to life crisis / mental health problems, which in turn shape our therapeutic journeys / decisions:  numb the pain, make me forget; help me remember, understand and mourn; repair the damage, renew my strength; feed my fire, ignite my spirit / ambition, activate my connection to the wider world.

10 Robert Downey Jr, interview, Wilde (2003); and Michael J. Fox’s memoir (2002).  See also the recent interview with Peter Beresford, ‘the first “out” mental health service user to become a professor’ (Benjamin: 2005), as professor of social policy and a director of the Centre for Citizen Participation at Brunel University: ‘Historically, social policy has been about those who solve problems and those who have problems, and never the twain shall meet’.

11 See Walsh (2003b).

12 It is also possible to graduate with few or no tools of consciousness regarding the workings of society.  Since the early 1990s, new managerialism and its business ethos have shifted universities and many degree courses towards the confines of the narrowly technical and ‘specialist’, without contextualisation or the development of critical dialogue.  See Crace (2004); Walsh (2002); Howie & Tauchert (2002).

13 Alice Walker’s famous womanist claim / exhortation (1984); ‘Womanist is to feminist as purple is to lavender’, see p xi/xii.

14 See for example, Mike Nichols’ TV adaptation of Tony Kushner’s Angels in America, shown in the UK on C4, in two parts, at 9 00 pm –12 30 am, 7 & 8.02.04. See Fanshawe (05.02.04).

15 Does self-harming further exhibit the impact of gender differences and distortion?   Are women self-harmers, by ‘taking control’ of their bodies, by taking action against their ‘femininity’, ‘offenders’ in society’s eyes and masculinised in the process?   And are men self-harmers perceived as ‘feminised’ by making themselves visibly ‘victims’ and done to, rather than instrumental ‘action man’?  Both appear to muddy the neat gender binary, masculine / feminine, and in doing so, illuminate both ‘sides’ and their binary relation.

16 The fact that the majority of male prisoners are now black, illustrates how gender, race and mental health issues are imbricated.

17 See for example, Jackson (1998); (1990); (2004); Rutherford (2000); Stoltenberg (1990).  Male journalists and novelists have also started to explore this terrain, e.g. Parsons (2002; 2003).  See also Shields’ novel (1998).  And The Guardian has introduced several columns written as experiential, as well as analytical pieces by men, on disability, prison, alcoholism and depression, and other health issues.

18 See for example, Rowe, Dorothy (1987) Beyond Fear.  London: Fontana/Collins.

19 The occasion was a day conference on World Mental Health Day (10.10.03): New Approaches to People with a Diagnosis of  “Personality Disorder”.  The Wirral Mind Fountain Project, Birkenhead.

20This is excerpted from a letter written by the narrator (mother / wife / writer) to Dennis Ford-Helpern, in Carol shields’ complex and life-affirming novel, Unless.  Ford-Helpern has written a book about moral problems, in which ‘All the problem-solvers in your examples are men, all fourteen’ (ibid: 219).  The narrator writes to protest, in the nicest way possible:  ‘I don’t think you intend to be discouraging in your book.  I think you have merely overlooked those who are routinely overlooked, that is to say half the world’s population’ (ibid: 220).  This is a book of multiple strands and meanings, one of which is what it means to be ‘real, ‘good’, ‘moral’, ‘sane’; and the conditions for and obstacles against these states of consciousness and being.  Shields offers us the means to explore ourselves, our world, in all our vulnerability, frailty, and strength.  We accompany her characters to the edge and beyond.  See also the work of Algerian-born, French writer, Cardinal (1991; 1993; 1996).  The Words to Say It (1993) has been described as ‘world-renowned as the most important book ever written on the personal experience of psychoanalysis and the journey through therapy to recovery’ (The Women’s Press, 1996).

22 Anger is an important message from the self to the self, identifying a (potential) problem: whether about public, social justice issues, or personal affront or abuse.  It is an act of identification and self-protection: a warning.  Left unexpressed, unchannelled in appropriate and creative ways (for example, through language and/or public activism), it festers, and corrodes self-esteem and relationships.  This inhibition is a mark of a sense of powerlessness and fear (the unavailability of language, perhaps; and/or the fear of speaking, of making one’s needs known).  When people (including journalists) talk about anger, most of the time they mean aggression, which is different.  Aggression is a form of attack / dominance; it is violent and destructive (whether physical or verbal); it produces fear and intimidation in others; and is therefore also a violation of others.  Anger in itself is none of these.  So ‘anger management’ may be both a misnomer and misleading.  But bottled-up anger can lead to aggression.

23 The Rotunda Community College was a feminist-inspired, political initiative, set up in Liverpool in the 1980s, to provide a safe and stimulating place for local women to explore health issues together, and take up educational opportunities and skills training.  Today, its emphasis has shifted towards alternative / complementary therapies, and it has recently set up Rotunda Angels, a business run by fully trained, former College students, offering ‘treatments aimed at improving well-being and lessening tension’ (Rotunda Angels information leaflet).   Such ‘upward mobility’ can be seen as a feminist trajectory: moving from isolation, poverty and low self-esteem towards self-determination and greater financial independence.  It can also be seen as a retreat from political activism into the ‘pamper’ industry; an industry based on a recognition that many women are still having a very bad time living their lives; that more women have greater spending power today; that we will be allowed to address each other as service providers and service users, without opposition, because we thereby establish a new, expanding and profitable market segment; that the pamper end of the therapeutic field, can be conducted without politics (as a turning-away from the sources of pain and damage), as opposed to the education / healing / recovery end, which is more designed to help develop a politics of health and well-being perspective, enabling women to make life changes which support survival and well-being.  Another important difference, is that massage, for example, is individual and private; the self-help group is semi-public and collective.  These observations should not be taken to deny the value of bodywork (I trained as a shiatsu practitioner in the 1990s); but like the remedial and therapeutic field itself, we are variously positioned as active and passive within therapies, as ‘patients’ or partners, and that remains an important distinction.   I am aware that yet another industry is being built both on the back of women’s exhaustion, pain and desperation, and some women’s increasing affluence.  This is a political issue, not a medical matter: alternative therapies can act to disperse us as ‘consumers’ and clients, as opposed to facilitating collective awareness and action ‘as women’.  Any chance of a feminist constituency could be ‘pampered to death’ in the confines of the steam room and sauna, or on the massage bench.  While we may come away feeling more relaxed and invigorated, some alternative therapies serve to perpetuate denial, which as we know, is a short-term strategy while we gather our strength to do what has to be done.  A similar move appears to have taken place at The Health Place, Blackburne House, Liverpool, which offers ‘Holistic Health and Fitness for Women of all Ages’ (information leaflet).  Another feminist-inspired initiative, even down to its two women architects, when it opened about twenty years ago, Blackburne House was seen by many women in the city as the long-hoped-for hub for women’s networking and feminist-inspired education and training.  We were not thinking ‘creative nails’ (a recent event), more creative minds.  Has the politics bled out of these two inspired feminist projects from the 1980s?   In 2005 neither the Rotunda nor Blackburne House printed its information on recycled paper, so I assume they have no ethical / environmental policy.  Indications of a broader, environmental, internationalist perspective, such as has grown up in the UK since the 1980s, for example in relation to using local, organic and/or Fair Trade products, are not evident.  Any women’s business must beware commodifying women for its own purposes.

24 See Parsons (1991):  ‘But now I got it. Now I could understand the attraction.  Men of my age like younger women because the younger woman has fewer reasons to be bitter. . . .  It was cruel but true. The younger woman is far less likely to have had her life fucked up by some man. . . . ‘ , p 211.  See also Beynon, ‘Masculinities and the notion of crisis’ and ‘Millenium masculinity’ in Beynon (2002):  75-97 & 122-143.

25 The MOWL project at the University of Liverpool brings undergraduates together with students previously designated with learning difficulties, and left to languish in day-care centres.   MOWL is committed to their students rights to: choices, community participation, relationships, respect, rights as adults; and to this end provides support and opportunities for learning and achievement.  E-mail mowl@liv.ac.uk

26 And aggressors (like Robert Downey Jnr.) are first victims. See Mark Johnson’s (2008) account of his desolate childhood; his drug-fuelled youthful criminality and general love-lack; the trail of human casualties; and his path, from the age of thirty, out of chaotic behaviour and self-loathing, towards connection with others and wider society.

27 The new Mental Health Act introduces new labels, such as Anti-Social Personality Disorder, to identify those who are dangerous.  See Personality Disorder:  No longer a diagnosis of exclusion (23.01.03)

28 We have seen, in the recent surge of testimony from abuse victims, from residential homes in the UK, and the Catholic Church in the USA and Ireland, for example, that it can take many years, almost a lifetime in some cases, before survivors feel able to bear witness to their own and others’ systematic and often prolonged abuse by those in authority over them.  This measure of sufficient safety is not achieved individually, but collectively.

29 Speaking at a meeting of the University of Liverpool Creative Writing Society for Lifelong Learning, Tim Diggles of the Federation of Worker Writers noted a shift amongst its writers since the Federation was set up in 1976, from ‘anger to creativity’ (2.03.04).  The Federation had been male-dominated in its early days, and it is therefore possible to link this shift to the greater participation of women, as well as the passing of time and changes in the social and political climate in this period, which of course encompasses the Thatcher Years (1979-198 ).  This shift in emphasis and purpose would seem to echo the trajectory of the Rotunda Community College and Blackburne House, discussed in

footnote 23 above.  Anger has been historically important for working-class men’s politics.  Does the power and pleasure of ‘creativity’ enable people to throw off victimhood and/or channel anger differently?  Is this a turning away from the traditional politics of the left, and/or a redefining of politics and purpose?  Is this ‘feminization’ retreat or advance?  Certainly, moving away from anger as a motivational drive is significant, and I got the impression that in the Federation of Worker Writers, this shift did not just apply to the women.

30 This recent conversation with a young Norwegian woman highlighted what are probably both generational and cultural issues: we disagreed that this was misogynist language and therefore off-limits to women.  It is also a question of experience and education: by this I mean that, if you do not know any women’s / feminist history, feminist sociology and anthropology (cross-cultural knowledge), for example, it is all too easy to deny their importance for women today, and to believe that as young women you can create a ‘clean slate’.  (But saying it does not make it so.)

val walsh.  2004 / 2005