In Place of Fear – an on-going conversation.

Last week, John, Chris and myself, the three authors of Intelligent Kindness, did a webinar for the Royal College of Psychiatrists, ‘In Place of Fear’

You can watch it here if you’re interested: In Place of Fear

We provoked some interesting discussion, and the hour flew by quickly with themes left hanging and questions left unanswered. Like so many such events, it felt like the start of an interesting conversation so we thought it might be useful to take up some of the themes and questions and continue the discussion in our blog over the next few weeks.

For those of you who weren’t there, we were deliberately using the title of Aneurin Bevan’s book that described the foundation of the NHS.  We began, however, by considering fear in general, looking at the pioneering work on primates by the ethologist Michael Chance, and using this to think about human organisations and groups.  Chance’s work considers how different groups of primates both use and manage fear to organise themselves, and how this may determine their states of mind and capacity for intelligent problem solving.

Some of you may have been at the webinar and others may want to listen to Chris’s entertaining account illustrating the two main modes of group functioning with photos of our primate relatives. I followed this up by exploring the experiences of staff working in Intensive Care with Covid patients, the fear they are experiencing, and how their work depends on sustaining mutually supportive and creative relationships, despite the crisis conditions in which they are working.  John finally examined the experience of all healthcare workers, whatever the circumstances, and the need for careful attention to their relationships, with each other and with patients.  He highlighted some of the ways that everyone, especially leaders, can make that difficult or consciously work to facilitate a constructive and sustaining culture. Our lecture ended with us urging that a comprehensive strategy is required to address the mental health problems across society, some the result of the pandemic, some longer standing.

Giving the lecture on zoom was nerve-racking, to say the least. I’m sure it’s something I would get used to if I did enough of it, but for me it felt odd and unfamiliar even though I work on zoom much of the time. Despite the support of the team from the College, I was anxious that the technology wouldn’t work as it should, anxious how I looked, and once I’d started talking, I was aware of how inhibiting it felt, not to be able to move around a bit and gesticulate with my arms as comes naturally to any primate. It was unsettling not being able to see the audience and the sheer number of people watching seemed awesomely huge – many more people happy to sign up for a webinar than would turn out for a lecture in London on a cold February evening.  I occasionally clicked on the chat or the Q&A to find a dazzling number of comments, far too many to read, some of them, tantalizingly, from colleagues I hadn’t seen for years. 

All this came to a head with the final question from the chair and president of the College: if we each had a minute with the secretary of state, what three things would we say to him? Panic stations! I could think of lots of damning things to say but worried it would be unhelpful to end such an event on a negative note. There was so much to say, but where to start? Why on earth hadn’t I rehearsed the answer to such an obvious question?

‘Over to you Penny, you have the final word?’  And my mind went into ‘fright/flight’ mode!

An answer would normally trip off my tongue – after all, between us, we’ve written 100,000 words on the subject.

So here goes. This is what I wish I’d said:

1. Face the situation full on, facing the worst and managing the anxiety that this causes. This means listening intelligently, not just to the scientists, but to the sections of society that are worst affected.
2. Pay great attention to ‘building back better’, focussing particularly on building social capital.
3. Invest heavily in the health and well-being of the population, nurturing and supporting the organisations and the people within them that will make this happen whilst also addressing the systemic inequalities that contribute so much to poor health.

Phew. Got that off my chest. Easy. But what a timely illustration of the power of anxiety to paralyse the thinking process.

There were other things we wished we’d said, and questions we are looking forward to exploring, so more in the next blog…..

Penny