Wednesday, April 03, 2013

Tie Me Kangaroo Down Sport, Tie Me Kangaroo Down

I've been trying to write this since November - it's still not "right" but if I don't press "publish" now I never will, and having got used to blogging again during Lent it would be a shame to give it up for Easter.


I adopted the boxing kangaroo as my picture after the EDIC 2010 conference. I was so angry that the plausible theories of "The Recovery Model" actually boil down to leaving people to struggle without support, that professionals thought it OK to allow patients with a BMI of 11 to "choose to live with their illness" and that parents were still being encouraged to "let them hit rock bottom", that I decided the only reasonable stance a parent could take was to nurture his or her child safe away from this madness and hit out at anyone who suggested otherwise.

Of course it was a bit of black humour. I know that kangaroo parenting is preached against in the New Maudsley Method and thought I understood what it was and why I shouldn't do it.

I didn't really, and in an attempt not to be a kangaroo I think I've sometimes been an ostrich and ignored genuine opportunities to help and sometimes been a rhino and tried to head-butt others over obstacles when t would have been better to carry them.

It was only at the FEAST conference in Nottingham that I think I REALLY got the drawbacks of being a kangaroo and realised that I am still very much one. By advising carers not to be kangaroos the professionals aren't telling us not to care, to cook, to plan, to support the person. They're telling us not to cover up, make excuses, bluster, support the illness.

My ahah moment about this came straight after the showing of a brilliant film developed by Professor Treasure's team and funded by the Succeed Organisation. It showed a family acting out the kind of rhino meets kangaroo meets  jelly fish in the zoo from hell that can become the new normal with a misunderstood life-threatening mental illness in the house, and then the alternative when dad took the St Bernard stance. Doing so did NOT involve covering up the distress caused by the illness, or explaining to the angry brother that "she can't help it". It involved acknowledging his distress, rolling with resistance, and moving on.

Straight after the film was shown I logged on to Around the Dinner Table and found someone I know quoted (presumably without his express consent) as saying something controversial. Immediately I knew that the Dolphin or St Bernard approach would be to leave it up there and let people discuss it - these weren't the words of a vulnerable patient, they were the words of a robust clinician. They weren't being hammered down out of ignorance by a group of hostile harpies, they were being questioned by a polite but extremely well informed group of people with a passion for the subject. What I did was to try furiously to edit it to take out any identifying information. As I was doing this from a conference room via my phone all it did was mess up the format of the post and make it obvious that it had been edited by a madwoman. Just as in the first film clip, my attempts at saving the person, while well meaning, only ended up saving the misguided remarks.

I tend to do this with clinicians. I work with quite a few of them. I think I understand where they are coming from. I try to support them because I know that in general they are doing valuable work with the best of intentions. All too often though, in attempting to support the person, the organisation, the good parts of the work, I end up leaping to cover up the mistakes, to make excuses for the gaping holes in the system, to delete the unfortunate wording which "he can't really have meant, can he?????"

THIS IS THE KANGAROO STYLE THAT I AM ADVISED TO AVOID

It's difficult, especially when the whole system in which the clinicians I respect and want to do well are working IS under real attack. Try running the mouse gently from side to side over this "helpful" diagram and you'll get some idea as to what it's like within the NHS at the moment. But the dad in the film did it, and with a lot of help I can too.