Psycho-Social Explorations of Trauma, Exclusion and Violence: Un-housed Minds and Inhospitable Environments By Christopher Scanlon and John Adlam

“This is a profoundly disturbing book in the best sense” writes Dr Gwen Adshead on the back cover of this remarkably wide-ranging yet compact volume. Buddha, Jesus, St Francis: history has given us stories of people who have forsaken in-group positions of power and privilege to work and identify with the marginalized, the un-housed. Chris Scanlon and John Adlam invite us to leave our “clinical high ground” and our “professional guilds” to look at what’s happening in the world outside our window in an era they describe as pitiless and disassociated and consider strategies for change. In a world of structural violence, it stands as a call to arms.

This is a difficult area for psychotherapists; our focus is on changing the world one life, or one group, or maybe one median, even one large group at a time, if we share Pat de Mare’s vision of the world and follow the work of Theresa von Sammaruga Howard. When Freud was asked how long it would take for the influence of psychoanalysis to eradicate violence, I understand his answer was about a million years. The statement produced by the IGA about the war in Ukraine condemns the violence, and offers our services thus:

“We are committed to developing group analytic theory and therapeutic processes that will contribute to our understanding, recovery and freedom from violence as citizens, group analysts and psychotherapists, and to sharing this endeavour with humility alongside all who suffer the consequences of violence, for the benefit of all.”

It’s a given that we should do what we can to alleviate the suffering caused by violence in all its forms, but we cannot say prevent its reoccurrence. In her powerful foreword that sets the tone of this book, Dr Anne Aiyegbusi talks of ours as a time:

“when the hegemony of many seminal psychotherapeutic texts and related concepts are being challenged from epistemological, ontological and social justice perspectives.”

She gives the authors due credit for providing “desperately required insights, especially for the discipline of group analysis”. Chris Scanlon and John Adlam abandon the clinical high ground to take us on a journey into “the wide-open psycho-social lowlands”. In such a slim and compact travel guide, the authors condense 20 years of working, thinking, writing together and with others to cover a remarkable amount of ground. They shine a light (or perhaps something more like Bion’s beam of intense darkness) on some of the most dangerous fault lines in our fragmenting world: racism, genocide, climate change and the inhospitable environments we create to re-house the unhoused. The authors argue that these calamities intersect because they are the result of the violence perpetrated by those of us, like them, who are in positions of power and privilege, “sitting pretty” on the proceeds of conquest, domination and colonisation, the in-group who in the author’s keyword, unhouse the out-group.

Considering this book is disturbing in the best sense, it’s a very good read. It is written in an engaging epigrammatic style, helping give a Tardis-like feel of a lot fitted into a small space. The authors draw on a wide range of sources, and a list of extensive references follows each chapter. It is engaging, which helps with the authors’ encouragement to be engaged with problems where the clinic alone is not the answer, problems which those of us with power and privilege have had a hand in creating and maintaining. The style helps the reader swallow some bitter medicine.

 Our authors acknowledge that the map they draw for the reader is not necessarily a new one – sadly and surely an indication of the deep-seated and intractable nature of the traumatic situations they write about. What is new is the psycho-social vantage point the authors take. In the words of the conventional metaphor, they have stood on the shoulders of giants – James Baldwin, Maya Angelou, Rosa Parkes, Greta Thunberg – and added their own perspective: the Diogenes Paradigm; but more about this in a minute.

We are urged not be just tourists, or bystanders, but to get involved and get messy. I’m involved in the Group Analysis India learning community, and I’m reminded the theme has come up in our work together. Angelika Golz presented a paper at a conference in Berlin entitled “Bystander, ‘Mitläufer’, Collaborator – a personal reflection on crossing borders between politics and psychotherapy”. Her paper is about working at another event hosted by a country that had been involved in a war where terrible atrocities had been committed. She attempted to raise these issues, to be met with largely defensive reactions, and was left feeling somehow complicit in the country’s history. She concluded that “Knowing truth gives us responsibilities, to change and to act”. A student, Safwa Latheef, has picked up this theme in her reflections on her learning so far, including considerations of power and privilege, and writes how she is reminded that “there is the concept of a ‘witness’ in the Quran, which calls on people to exercise a certain will power to stand up for truths no matter how inconvenient it may be.” (Unpublished paper). Our authors agree. In the chapter on Practices of Equality they say:

“We can’t be bystanders, keeping our fingers crossed that some Rosa Parks (of the Montgomery bus fame), will hold fast and not surrender her ground: we need to stop pushing her around in the first place”.

The Diogenes Paradigm is developed from the legend of an encounter in ancient Greece between the vagabond ascetic philosopher, whose home was a barrel, and Alexander, the Macedonian conqueror who was busy making much of Europe and Asia his home. Thinking again of Group Analysis India, other suggestions have included the meeting was between Indian philosophers called gymnosophists by the ancient Greeks, also known for their ascetic practices (or so says Wikipedia, so it must be right), so it would be ironic if there were some cultural appropriations here. But I digress. The encounter in question takes place in the Agora, the Athenian marketplace. Alexander is reported to have asked the philosopher if there was anything he could do for him, and Diogenes asked him simply to move out of his sun. Diogenes tells Alexander he is part of his problem, not the solution. In his pursuit of conquest, Alexander must have blotted out the sun for a vast number of people. For the authors, this encounter is emblematic of the rejection that we as intended helpers might receive from someone in an out group who does not see our offer as helpful at all, as they say “when an unhoused mind meets an inhospitable environment.” As someone who has worked in prisons where people are forcibly housed, and in NHS settings with people whose diagnoses led to labels of untreatability, this paradigm makes sense. No doubt like many readers I have experienced fraught encounters where in the authors’ words it’s been my role to speak Alexander’s lines. A particularly tense and difficult prison therapeutic community meeting comes to mind, where we-the-staff were told by they-the-residents, “We’re soldiers, you’re the enemy”.

In her foreword Dr Aiyegbusi says that the authors put racism in the foreground, and this is the part of the book that had the greatest impact on me. She quotes from Dr Martin Luther King: “The arc of the moral universe is long, but it bends towards justice”. She questions this statement in the light of the white backlash that followed Barack Obama’s election as USA President, and says that it has yet to bend for justice to Black women. Another writer, Wilderson 111, is quoted by the authors as saying that changes right through from the Civil War to the Obama presidency were “merely changes in the weather”. For there to be real climate change, the authors argue we the white people need to change our habits and patterns and practices – including acknowledging our own racism, giving up our power and privilege, and “actively to make equality the ground and premise of all our interactions.”

The authors present a summary of their thinking in this Declaration of Independence style self-evident statement:

“We are all equal in our common humanity and that practices of inequality are therefore taken up in defence or hostile denial of that common humanity”.

From my forensic practice I am reminded that violence is far more possible when someone is seen as other, as lesser, rather than someone who has similar fears and desires, and vulnerabilities. Identification with the one who would be othered – a murderer or armed robber with a sex offender – is one of the factors that makes a therapeutic community possible in the toxic environment of a category B prison.

The authors cleverly have a chapter on disappointment and how they might disappoint their readers and in turn be disappointed by them. Malcolm X said: “If you have no critics, you’ll likely have no success.” I acknowledge that my main criticism arises at least partly from professional pique. In the chapter on (Dis)organised responses to traumatisation Psychologically Informed Planned Environments (PIPES for short) come under the authors’ brief scrutiny. I have been involved in work with PIPES, as have several other group analysts, and am aware of the group analytic thinking that went into their creation. The authors cite Timoclea, who says that the introduction of a PIPE in a women’s prison:

“leaves women extremely vulnerable to having a psy-constructed identity imposed on them and to accepting the agendas of a coercive prison environment”.

I think I can grasp the author’s point. Progression towards release from prison continues to rely on the principles of the confessional, taking personal responsibility for your crimes and engaging in various psychology-driven activities, which pay limited attention to the environmental factors behind someone’s offending; the violence done to them. As one man said: “I used to take it, then I learned to give it out”. I can see how my attempts to help people to find another way to deal with the problem left them feeling vulnerable. I remember a black resident in the therapeutic community telling me he had spent much of his life trying not to let himself be vulnerable to people like me. I saw men who had dropped their guard and allow themselves to be vulnerable (as hopefully we the staff had allowed ourselves to be vulnerable) reverse the change when the time came to go into lower category mainstream prisons. “I’m putting my system head back on”.

PIPES were established partly in response to that problem: to allow people to continue lowering their guard. An older TC resident wondered how long he would have to keep going to the gym to be strong enough to be safe. Prison TCs and PIPES were set up to be safer environments in a system where threats to safety are constant. The fact that by and large they are safer environments with greatly reduced levels of violence to others or to self is a testimony to the truth of the authors’ thesis is that the problems they address are indeed brought about by inhospitable and traumatising environments. That is something about them that is rarely acknowledged.

This is a personal reaction to some of the content of this book, possibly of little relevance to other readers. I think however that there is a more general point to be made. Prison TCs and PIPES are far from perfect and are far from the norm. In our authors’ terms, they represent an approximation towards “the ever-widening horizon” of social justice. The authors reject approximation as a strategy.

Karl Marx would have agreed. In an address to the Communist League he criticised the piecemeal reforms to address the injustices of capitalism as undermining the zeal for revolution, so acting to prop up the system rather than change it. Looked at in that light we are all potentially caught in what the Irish poet W B Yeats, quoted by the authors, in an “ever-widening gyre” of seeking to alleviate suffering while albeit working in systems that continue to marginalise those who suffer. Returning to Dr Aiyegabusi’s  foreword we might find ourselves with feet in two camps, and for me that’s a messy position, one where I have continually failed, will fail again and hopefully will fail better next time, to paraphrase the authors’ quotation from the playwright Samuel Beckett. I could wish that this book that this book said more to those of us who feel that we might never do better than to approximate.

That said, Bion claimed that thinking comes from a situation where there is disappointment, when a conception is not met with a realization, and this book has certainly left me thinking; that I do indeed need to get out more. I hope the next volume doesn’t take another 20 years; I realise strategies of approximation aren’t going to change things anytime soon and we might not have 20 years. The authors quote from a couple of Bob Dylan songs. In the words of another: “It ain’t dark yet, but it’s getting there.”

In memory of another great Irishman, Patrick McGrath.

Andy Downie: Biography

Andy’s first job was back in the 1970s, in a probation hostel. He had no previous relevant experience and no training, but risk assessments weren’t what they are today, and somebody thought that it was a good idea that he should spend a lot of time in sole charge of an establishment housing some serious offenders. He and the hostel wouldn’t have survived if it hadn’t been for the group being the solution to the problems they presented. He was a group analyst long before he knew what one was.

He trained as a probation officer, and a few years later when he found out what a group analyst did, he trained at the Turvey Centre. Since qualifying in the early 2000s, he has worked mostly in the therapeutic community field, in two prison settings, and just to balance things out, in two in NHS set

Since semi-retirement he now works with staff groups in both settings, in reflective practice in supervision groups. He has recently joined the Group Analysis India staff team, where he hopes he’s not engaging in an exercise in re-colonisation, but rather helping in the creation of what is more a learning community than a training course.