Just like Freud, books are not just for Christmas, they're for life!

One of the last emails I received before we broke for Christmas was from a colleague enquiring about my presentation at the last School Staff Development Day. My colleague had seen a number of book covers flash up on the screen, but had missed the point of my slide. She wondered if I could send the full reference please. Of course the details of all the books referred to will appear in the University of Salford Institutional Repository in due course. The presentation was just me stealing a cheeky moment to advertise Creative Approaches to Health and Social Care Education.

This is the latest book edited by my colleague Sue McAndrew and myself. The book further develops our work exploring the relationship between knowledge, knowing and not knowing. The final chapter, ‘Thoughts in search of a Thinker’ provides the springboard for our work in 2010. It is a book brings together some of the brightest and most creative thinkers in the world of nurse education. The aim in what is a series of works is to explore some of the opportunities to think differently about how and why we educate our students. I think I was rather tongue in cheek, suggesting that the books might make great Christmas presents. So I was amused to see that despite the Creative Approaches book only being published on the 10th December, by the 12th of December it was possible to purchase this (as a new copy) at £2 less than the publishers listed price.

In any event, I took a copy to my parents when I went to see them last Sunday. My Dad enjoys reading everything I write, including the blog. So I was surprised when between the nut roast and Christmas pudding he asked who I wrote the blog for. It was an interesting question to ponder. I said, possibly my ‘alter ego’. However, on further reflection perhaps the blog is really an example of Freud’s Psyche Theory and the relationships between the Id, Ego, and Super ego.

Freud described the id as being is responsible for our basic drives and basic impulses. The id is regarded as the reservoir of the libido or the ‘instinctive drive to create’. The id is unconscious by definition. The Latin term ego refers to ‘the I’. Contemporary meanings of the term ego include a sense of one’s self-esteem, an inflated sense of self-worth, or in philosophical terms, one’s self. According to Freud, the ego is the part of the mind that contains the consciousness. Freud revised his original meaning (a sense of self) to mean a set of psychic functions such as judgment, tolerance, reality-testing, control, planning, defense, synthesis of information, intellectual functioning, and memory.

The Super-ego on the other hand, aims for perfection. It comprises that organised part of the personality structure, mainly but not entirely unconscious, that includes the individual’s ‘conscience’. It is this conscience that criticises and prohibits our drives, fantasies, feelings, and actions. Thus the Super-ego strives to act in a socially appropriate manner, whereas the id just wants instant self-gratification. The Super-ego controls our sense of right and wrong and guilt. It helps us fit into society by getting us to act in socially acceptable ways. Not quite QED, but perhaps QEF (Quod erat faciendum) which appeals more to my notion of being the good enough blogger!

Anyway, I hope you all had a great Christmas Day. I was lucky enough to be able to get out early and walk for an hour around the hills and reservoirs of Horwich. The sun shone, the snow glistened, and for a short while, all was peaceful. This is the last blog of the year. I look forward to seeing you all in the New Year. I hope it will be a year where you are able to achieve all that you aim for. All the very best wishes to everyone for 2010.

A Tale of Five Dinners and Cello Discovers Snow

It has been another busy week and a week that has added to my already expanding waste band. One downside of my job is the numerous lunch time meetings I attend at which sandwiches and other similar convenience foods are provided. I have stopped eating these, partly out of boredom and partly as a silent protest against the institutional promotion of such unhealthiness. This week, has also seen me out every night on University related business. On Monday I was a guest at the University of Leeds annual meal to celebrate all those members of staff that had retired in the last academic year. I was there with two colleagues who had decided to put their chalk in the desk draw for the last time.

The meal was hosted by the VC, and we ate in wonderful hall at the University House. There were cabinets full of silverware, wooden paneled walls and a graceful air of elegance. Whatever happened to those days of the Senior Common Room? The meal was served by immaculately dressed waiters in a highly coordinated approach to getting all the diners fed at the same time. I had a wonderful goat’s cheese, pear and spinach starter, followed by a equally delicious leek and cheese strudel. Outside, the rain lashed down and I got soaked getting the train station. However, unlike the previous occasion I was a guest at Leeds, I did manage to stay awake on the train home and got off in Manchester and not somewhere in the wilds of Merseyside.

Tuesday I attended the first of a revised University of Salford professoriate. I have made my feelings known about this professoriate before. It was an interesting experience. I have to say that whilst the vast majority of participants were male, and over 50, there was not much danger of being overwhelmed by a testosterone fuelled debate! The meal was an evening variation of the usual lunch time offerings, so I left early and was home by 9pm.

Wednesday was hectic from 7am. Much of the day was given over to working with the School Executive – and it was good to see so much excellent work emerging from the Whole School Project work groups. As a School we are developing a robust evidence base upon which to improve our approach to enhancing the student experience. In the evening, the School Executive went out for a Christmas meal. Smiths in Eccles. The food was good, a cauliflower cheese starter, with a delightful leek and cheese strudel as the main course. The conversation around the table was a mixture of funny nostalgic stories of times past (we were just across the way from Peel House) and good humored commentaries on the changes we and our university had gone through in the last year.

Thursday was a colder day. There was sleet at lunchtime and by the time we were all making our way to the VC’s house for an informal cocktail party, it was snowing heavily. The VC had invited about 60 colleagues from the School to attend what he described as ‘our house’ for an evening of conversation, drinks and nibbles (some would say canapés). About 40 colleagues were able to make the evening. The house was quickly filled with people eating, talking and occasionally having a glass of wine. As at the Leeds event however the service was impressive and unobtrusive.

There was much speculation around ‘that painting’. Some colleagues recalled that ‘our house’ had in times past, been a nurse’s home for those nurses working in nearby Pendlbury Hospital.

Oh and George, in response to your email about missing the last train home, I don’t think the VC meant you could kip down on the sofa when he was talking about it being ‘our house’. By the time we left it was well below freezing and the roads were treacherous. I abandoned all thought of continuing the celebrations in Manchester city centre. The finger food had left me feeling full but not with the sense I had actually eaten anything substantial.

Friday morning revealed the snow that had fallen during the night. Cello who has never seen snow before, reveled in the experience as he rushed around outside.

I on the other hand, was less impressed, it was 05.30, dark and still well below freezing. The day included the judging of the best decorated office. I thought the ‘Credit Crunch Christmas’ theme was a good one, but perhaps not as well designed and executed as the ‘Black Forest’. The results are to be declared next week.

That evening many of us were at the Faculty Christmas Party at the VA Hotel in Manchester. Despite the freezing temperature outside, there was more naked flesh on display than can be seen on a Newquay beach on a hot bank holiday weekend. Perhaps I am just getting old. I should have had a goat’s cheese, pear and spinach starter, but it never arrived. The main course was what by now had become the ubiquitous leek and cheese strudel. As the DJ turned up the music even louder, and the bright young things got up to dance I knew it was time to go home.

I had baked beans on toast when I got in, and boy did they taste good!

Understanding the Message and a Magic Malaysian Duck

I noted that whilst Twitter has triumphed in ensuring freedom of speech (for an up-to-date example, just Google Trafigura); Facebook has had its problems this week. It seems that in how we chose to communicate with others personal privacy and agency might become hareder to protect.

Who we intend to communicate with and to what end we engage in such communications, have all featured strongly in my experience of the last week.

For example, a colleague sent me an email this week (more of emails later). This particular email came complete with an attached copy of the latest policy statement released from the Department of Health setting out its vision for the future of the NHS: Prevention, Person Centred, Productive.

Interestingly this statement was released after the Pre-Budget Statement. Is the first message being communicated here that the NHS is safe in the Governments hands. Predictably, being a DoH document, it was rich in rhetoric:

Although this will be the most difficult challenge it has ever faced, we believe that the NHS can approach it with confidence, building on the major improvements of the past decade. Improving quality will continue to be at the heart of everything the NHS does. Improvements will be led by NHS clinicians at the local level, based on what is best for the public and patients in their area. There will be no ‘blueprint’ imposed by the Department of Health and no top-down reorganisations of the NHS.

Again it appears the message being sent out is about ensuring that the ontological security of the great British public is protected – the NHS will always be there for you whatever your needs. The rhetoric continues:

Our commitment to encourage and foster innovation in the NHS, and particularly the diffusion of innovation, is clear. We have created a £220 million Regional Innovation Fund to support quicker innovation and more universal diffusion of best practice across the NHS. We have developed NHS Evidence, a pioneering system to improve access to information, providing clarity on what good looks like. This will lead to better clinical and commissioning decisions and increase diffusion of best practice.

The message here perhaps, is that although other parts of the public sector may have to make massive cuts, Universities for example, who face £600 million cuts which are predicted to hit at the range and amount of research undertaken and the breadth of taught programmes, the NHS is different. Research, education and development will continue to be important and protected in the new NHS. Two and Two might not make four when added together.

And there are still further beguiling messages, including:

There should be early interventions for staff with musculo-skeletal and mental health conditions, to help minimise the time staff must spend suffering with these problems and to support early return to work.

A good sounding message, well at least in away that Talcott Parsons might have recognised.

Parsons will always have a special place in my heart. I drew on his work in constructing my PhD. For me, he successfully brought together sociology and psychoanalytical thinking in his exploration of our relationships with each other and with the institutions of the State. For Parsons, ‘being sick’ was not simply a condition, but something imbued with the customary rights and obligations based on social norms. His theory presented two rights of a sick person and two obligations:

Rights:

The sick person is exempt from normal social roles

The sick person is not responsible for their condition

Obligations:

The sick person should try to get well

The sick person should seek technically competent help and cooperate with the medical professional

For the individual, organisation and the wider society, clearly, these rights and obligations can give rise to problems, and there are many critics who over the years have rehearsed the problematic nature of Parsons contentions. However, it seems that some 60 years after publishing his ideas, both Parson’s theories and our privacy are still in danger of being challenged by those interested in exerting social control. The effects of social control can be experienced at an individual organisational and societal level. Perhaps it is because the many new technologies, particularly ICT, allow us unprecedented opportunities for communicating that these tensions are beginning to emerge.

This week I was confronted with the tyrannical (and perhaps cynical) nature of the way we unthinkingly use email to communicate. Emails can be both anonymous and attributable, helpful or hurtful. Hence my new year’s resolution is to break the almost Pavlovian response to email requests for information, meetings, opinions, actions and so on. In future I intend to ask people to pick up the phone and talk to me and or come and have a chat, face to face. Whilst this approach might not be as Productive, it will be Person-centred, and might better Prevent misunderstandings.

That duck, well yesterday, Bernama, the Malaysian state owned news agency reported that an Imam and his wife were rendered spellbound after one of their ducks, this week, laid three black and three brown eggs. Apparently the shells of the black eggs bore an image of a man in a white robe, a pretty woman and Chinese characters. I am afraid you will have to work out for yourself what the hidden message might be here!

The Lambs of Silence, Keira Knightley and a Cocaine Chicken.

Amongst other things I had scheduled into my diary for the past week was a quick trip down to the Eileen Skellern Award Ceremony in London. I thought this was to be a relatively straightforward affair and quite good fun. The award evening is jointly hosted by amongst others the Journal of Psychiatric and Mental Health Nursing. This Journal is special for me, and I have been fortunate to have many of my papers published here. The annual award celebrates the contributions individuals have made to mental health nursing and the field of mental health care. The Lifetime Achievement Award celebrates a sustained career contribution. Whilst previous years winners have all been deserving and hugely influential in the field of mental health care, the 2009 award winner was a very special person. She is Helen Bamber. Her evening brought the souls of 100s of people into the room, and in so doing, she was able to demonstrate the importance of bearing witness as a therapeutic endeavour.

Standing in an auditorium full of people she quietly and in the most dignified way imaginable, told us of some of her life work. She studied psychotherapy as an undergraduate at Essex University and at the age of 20 she joined one of the first rehabilitation teams to enter the notorious Belsen concentration camp.

"When we passed through the gate of Bergen-Belsen, we dropped out of life and time."

"We had nothing to go by, no point of reference, not even a 'doctor' who selected those of us who were to be murdered straight away and those who were to be murdered somewhat later."

"Anyone who came to Bergen-Belsen dropped into chaos, into nothingness."

These are the words of three survivors of Bergen-Belsen.

I am ashamed to say that I did not realise that following the liberation of the prisoners, many remained there for a further two years. Like modern day political and economic refugees, they were viewed by their Governments as being a nuisance. It was in her work at Belsen, that Helen first encountered what she called ‘grotesque death’ an experience so dreadful that most people cannot deal with the emotional trauma however much their outward appearance and demeanour belies this. For example she talked of the children who were forced to clear up the mess in the gas chambers. Helen told of the way she and colleagues were many times taken in by the overt optimism on display (often seen in the way these former prisoners participated in competitive sporting activities). However what Helen and her colleagues couldn’t easily do, was to understand their silences.

When our students join the School, I meet with them in the first week and talk about the importance of learning to hear what it is that people say, the importance of understanding how and why they might say things and to recognise the individuals personal zeitgeist. I ask the students to also try and be aware of what is not said. The silences are as important as the words that get spoken, but harder to deal with and sometimes more difficult to understand.

But back to Helen. In 1961, shortly after its inception, she joined Amnesty International. In 1974 she helped establish the Medical Group within the organisation. In recognition of the Medical Group's work within Amnesty International, the British Medical Association established a Working Party on Torture. The BMA's publication on the findings of the Working Party resulted in its first Torture Report and the publication Medicine Betrayed. She continued to work with the Medical Group until 2002 when she stepped down to continue to treat her large caseload of seriously traumatised people. In April 2005 she established the Helen Bamber Foundation to offer support to people who had suffered human rights violations. Helen ended her talk by making us aware of what she was currently involved in. She has since 2008, been a member of the Women Leader’s Council of the United Nations global initiative to fight human trafficking. This work is aimed at positively influencing action in the fight against human trafficking by providing a high-level of professional outreach, with a wealth of knowledge and experience in the areas of women’s issues and human rights.

This work is important and thankfully for all of us, others are now coming forward to carry this work forward. Keira Knightley, the world famous film star, is the new face for Amnesty International’s human rights campaign. The actress is backing a new short film celebrating the 60th anniversary of the UN Universal Declaration of Human Rights.

And that chicken, well a man from Guatemala is today under arrest after US customs inspectors at Dulles International Airport discovered he was carrying a cooked chicken stuffed with cocaine worth more than 4,000 US dollars (£2,404).

His intention was to sell this life wrecking drug on the streets of America. I find it hard to believe that often it is still human beings that continue to be responsible for bringing misery to other human beings.