1984…

A loving, compassionate father figure

The Life Scientific
BBC Radio 4

With a career spanning over five decades, the world-renowned child psychiatrist Professor Sir Michael Rutter was an interesting and inspiring guest on BBC Radio 4's The Life Scientific (3 June). Interviewed by Professor Jim Al-Khalili, 'Mike' discussed his early experiences, career inspiration and lifelong work – and his love of it.

The interview began with a fascinating insight into Mike's childhood. Born in Lebanon, his father was a doctor who ran a hospital in the hills above Beirut. Before World War II began, the family returned to Britain and he was evacuated to North America aged seven. From 1940 to 1944, he lived with a Quaker family, separated from his parents and younger sister. Instantly, I saw a connection between this experience and his research on attachment and separation; a personal reason behind his academic interests. However, when asked about this possibility, he insisted that he never felt separated from his parents, because his adoptive family 'kept them alive' through conversation. In fact he felt as though he had 'two families – an English family and an American family'.

Mike returned to England as a teenager, and went on to study medicine at the University of Birmingham. The focus of the interview then moved on to his early career, and he gave some engaging anecdotes about his entry into psychiatry. Whilst interning with Professor Mayer-Gross, a Jewish refugee from Germany, Mike was sent to interview a patient and present a diagnostic assessment an hour later. However, he could not make 'head nor tail' out of the patient and confessed to failing the task. But Professor Mayer-Gross asked him to describe his observations, and showed him that they clearly pointed to a diagnosis of 'hebephrenic schizophrenia with thought disorder'. What had seemed like a humiliating failure was transformed intoa 'pseudo-success', and the experience sparked Mike's interest in psychiatry.

We then heard that this led Mike to his next appointment at the Social Psychiatry Unit at the Maudsley Hospital. The unit was run by Sir Aubrey Lewis, a 'towering figure of psychiatry', and a vitally important influence on Mike. As a teacher, Aubrey encouraged Mike to ask questions and make challenges based on scientific evidence. (Of course, this is what Mike later did, and continues to do throughout his career.) Interestingly, it was Aubrey who decided that Mike should become an academic child psychiatrist, a career that scarcely existed at that time. Though Mike felt cautious about this career decision, he decided to 'give it a go' and subsequently 'became hooked'.

As the interview moved on to discussing some of Mike's most notable research, it became clear that Aubrey had made the right decision for him! Fifty years later, Mike is credited as being the 'father of child psychiatry', and his impact on the field of developmental psychopathology has been remarkable. Just snippets of his findings include his discovery that autism is a neurodevelopmental disorder with genetic origins, rather than a psychogenic psychosis caused by a 'refrigerator' mother. He also challenged Bowlby's influential attachment theory, arguing that the attachment bond is not unique to mother and child, and highlighting the difference between deprivation and privation.

Mike also leads the study of resilience, which investigates the ability to adapt to environmental adversity. Jim questioned him on whether we are any closer to understanding what makes some children flourish and others flounder, in the same environment. Mike's balanced reply was that whilst we don't fully understand resilience, substantial progress in the field has been made. For example, we now know that resilience is not just the summation of good experiences over bad experiences. Rather, challenge is an important part of development, and we cope better with adversity after experiencing minor challenges. We also now know that genes affect how sensitive we are to environments, and therefore some individuals are more genetically susceptible to adversity than others. Lastly, we understand that experiences that seem neutral or risky in the absence of adversity may actually be beneficial in the presence of adversity. Adoption is a good example of this. In the context of adoption, the interview then turned to Mike's landmark English and Romanian Adoptee Study. For listeners unfamiliar with the study, Jim explained that following the fall of the Ceausescu regime in 1989, images of abandoned children living in Romanian orphanages were leaked around the world. Conditions in the orphanages were awful, with babies tied to their cots, fed through propped up water bottles and deprived of any form social interaction. The Western world responded by adopting thousands of Romanian orphans, but it was unknown how they would be affected by such early deprivation. Therefore, the Department  of Health contacted Mike and asked him to study the development of Romanian orphans adopted into English families, in a 'natural experiment'. 

The resulting longitudinal study produced 'the most surprises' in over 50 years of his research. Firstly, children adopted before the age of six months had no adverse consequences. However, in children adopted between the ages of six and 12 months, the rate of psychological deficits 'zoomed up' dramatically. Furthermore, recovery from the institutional deprivation took several years, and occurred well into adolescence. I was intrigued by these findings, and also struck by Mike's compassion towards the adoptees. He revealed that he still sees several of the adoptees (now in their twenties) as a clinician, because he feels he has a duty to support them.

As the interview drew to a close, I was left in awe of Mike Rutter. After an extraordinary career to-date, he continues to work as Professor of Developmental Psychopathology at King's College London, aged 80. His love of psychiatry and unwavering commitment to research is clear; fuelled by what he describes as the 'addictive' nature of scientific discovery. I very much enjoyed listening to this interview and would recommend it to laypeople and experts alike.

To listen, visit www.bbc.co.uk/programmes/b04581j9

Reviewed by Jessie Baldwin who is a PhD student at the Institute of Psychiatry at King's College London 

Packed with psychological science

Abused by Therapy: How Searching for Childhood Trauma Can Damage Adult Lives
Katharine Mair

Who remembers the heated debate about 'recovered' and false memories, which raged most strongly in the late 1980s and 1990s? Is there much to learn from this history? Katharine Mair's book is such a history, and one that is packed with psychological science.

Mair describes early days when she was asked to review case files of psychotherapists in her own NHS Trust who were pursuing and recovering buried memories that patients seemed to have been previously totally amnesic about. Many had somatic complaints only. The 'recovered memories' included ritual abuse and extreme and repeated torture.

At the heart of such active searches or 'memory work' was a strong belief that repressed or dissociated memories of trauma had been cut off from consciousness as a defence mechanism, and the recovery of those reliable and intact recollections was essential to healing. Mair examines those theories and the evidence. She next examines the various forms of facilitation or 'recovered memory therapy' engaged to bring this about.

The story is far from over. Mair evaluates the particular role of the International Society for the Study of Trauma & Dissociation (ISST-D) and their workshop trained therapists and 'experts by experience' (newly self-identified survivors).

Although most serious professional organisations caution against the use of active memory recovery techniques, there has been a mushrooming of charities and  clinics where such therapists work.

As Mair explores the 'backlash' from sceptical sources and the laboratory studies on false memory development, she is throughout even-handed and sobering. This book is an informative story told well.

Matador; 2013; Pb £10.99
Reviewed by Bryan Tully who is a Registered Clinical & Forensic Psychologist based in London

At the tipping point?

Blurred Lines: The New Battle of the Sexes
BBC Two

As I write this review, comedian Sarah Millican is making headline news in tackling internet trolls over her choice of BAFTA dress. Over recent years, the barrage of targeted attacks via social media as well as overtly sexual media in general has amassed. In this timely documentary, Kirsty Wark explores the instances and reasons for the mass of online and physical abuse directed at women in this 'post-feminist' era. With a wealth of examples to choose from, this programme investigates whether these attacks are specific to women, or exaggerated amongst a wealth of internet trolling.

A key discussion throughout the show is the change to female opportunities in society over recent years. Various speakers identify an increase in male misogyny in print, online and interpersonal interactions as a rebellion against female 'equality'. Evident from the 1990s in lad culture and men's magazines such as Loaded, men are argued to be stamping their place as the dominant sex in an ever-'blurred' world of sexual roles. Feminist Germaine Greer argues that this male reaction has led to gender roles being even more disjointed than they were pre-feminism 45 years ago! With an increasing abundance of crude media openly available during this sexual identity struggle, behaviour towards women is now also blurred for the vast majority. Young people and adults alike are reportedly unclear: Where can the line be drawn between 'joke', harassment or in severe cases, even rape?

Interesting insight is provided by researchers. Dr Clair Hardacre at Lancaster University charts the 'endless cycle' of sexist ideas: feeding from newspapers to online behaviour of public figures and back into print media. Dr Thomas Ford from Western Carolina University provides insight into the interaction between male attitudes towards women and their perception of gender-focused humour. Discussion of the internet as of inherently male design was particularly interesting. With only 15 per cent of internet engineers being female and male-orientated porn and gaming key to the internet's success, it is argued that women are automatically excluded to some degree from online participation. This is only accentuated via online attacks via social media.

This documentary certainly provided food for thought of the experiences of women affected by misogyny and the processes behind its arguable prominence today. A somewhat optimistic conclusion sought women to fight back via social media in the vein of young feminist activism. However, a tipping point is evident. If we allow misogyny to persist in popular and web culture, there will be severe consequences for the youth of tomorrow. Timely education is key to ensure positive attitudes to women, with psychologists key in developing relevant communication to achieve this.

Reviewed by Emma Norris who is a PhD student at University College London and Associate Editor for 'Reviews'

Making sense

Incognito 
North Wall Arts Centre, Oxford
Do you know what confabulation means? asks Martha, clinical neuropsychologist, working with patients with amnesia. She explains: It's telling stories to ourselves to make sense of the world. There's no single part of the brain that is 'us'.

So begins Nick's Payne's stunning piece, Incognito. From this scene, between Martha, and new friend Patricia, we're introduced to Henry, M. who, following brain surgery, lives continually in the present. We meet  Dr Harvey, pathologist, who is building his life's work around detailed study of Einstein's brain. And then there are those who surround these characters, trying to make sense of them, as they make sense of the memories.

Four actors and 23 characters. Characters whose stories are introduced in fragmented scenes, that shift backwards and forwards in time, and across time. The effect is an incredible and engaging meta-journey, as we try to piece the characters lives back together, to recreate their stories in our own minds.

There is real psychology in this. Any self-respecting psychology graduate, myself included, will know the case of H.M. who lost his memory following surgery to correct epilepsy. They will dutifully have studied the role of the medial temporal lobes and hippocampus in memory. But that is textbook. Nick Payne moves expertly away from this towards a human story of memory. As the play is performed almost in the round, the audience is frighteningly close to the devastating emotional consequences – both of having memories one no longer wants, and of not having memories any more – portrayed movingly (without sentimentality) by a cast that click together beautifully, even as their characters are in constant flux.
This is a brilliant study of the fragility of the human mind, of how memories shape our relationships and our selves. It is also philosophy: what is it after all, that is being studied?

I saw Incognito written by Nick Payne, directed by Joe Murphy and performed by the theatre company nabokov (www.nabokov-online.com), at the North Wall Arts Centre, Oxford. I recommend you see it if it comes your way.

Reviewed by Siân Jones who is in the Department of Psychology, Oxford Brookes University

Excellent starting point

You Are the Music
Victoria Williamson

Victoria Williamson's You Are the Music explores the many ways music is central to human experience in a readable and engaging manner: Part 1 addresses music and human development from fetus through adolescence; Part 2 covers the role of music in adulthood; Part 3 considers music in the ageing process, and its relationship to mental health and well-being. Williamson acknowledges in her introduction that this 'journey' of music through the lifespan is an ambitious undertaking, and invites the reader to 'dip in' to the different parts and chapters of the book as interest dictates. This an ideal way to approach the book, as Williamson has been successful in making each discrete section accessible for standalone reading by readers with all levels of expertise in music and psychology. For example, while Part 1 necessarily examines the evidence behind well-aired topics such as the Mozart effect, Part 2 investigates the psychology of music in  adult professional settings, revealing perhaps less well-known findings such as the effect of different types of music on task performance in office settings, and the interaction effect of music and personality on job performance.

As a long-time psychology student and now psychology researcher who enjoys music whilst working, I was intrigued by Williamson's discussion of why music might be useful for some workplaces and individuals and not others, in terms of arousal, mood and cognitive engagement. Particularly interesting was the exploration of the concept that music might help 'absorb time' and support optimal concentration – providing an answer to my personal question of why I favour specific albums when writing long reports.

You Are the Music provides many such fascinating nuggets of information, and is an excellent starting point for anyone wanting to know more about the role of music in human experience.     

Icon Books; 2014; Pb £14.99
Reviewed by Imogen Marsh who is a Research Assistant with South Lanarkshire Council Psychological Service

Practical ideas

Therapeutic Communication: Knowing What to Say When
Paul Wachtel

In his book Wachtel aims to bridge the gap that a therapist can sometimes experience between knowing what they want to say, but struggling with how to phrase it in a way that promotes change and minimises resistance. However, before getting to this, Wachtel first considers the theory and implications of contemporary research, leading to an exploration of cyclical psychodynamics – the approach that guides Wachtel's practice. Although he refers back to this theory at points throughout the book, it seems an unnecessary deviation from the main thrust of the book, which is promoted as being focused on therapeutic communication.

The second part of the book provides clinical guidance for how best to promote healing through therapeutic communication. There is a reassuring familiarity to many of the recommendations as well as sufficient interesting insights to keep the reader engaged. The strength of this book is the space Wachtel gives to consider why ways of forming comments are helpful or unhelpful. These applications are brought to life through clinical case studies, which help demonstrate how powerful a therapist's comments and questions can be and the impact they can have.

For myself, working within a CBT framework, I found parts of the book less directly useful, as much of it focuses on psychodynamic ideas, such as transference and resistance. Although Wachtel claims this second edition is applicable to a broader audience than just psychodynamic or analytic therapists, his attempts to incorporate other modalities feel more forced and stretched than the psychodynamic elements.

This book was certainly a worthwhile read, with practical ideas that I can use in my therapeutic work.

Guilford Press; 2013; Pb £18.99
Reviewed by Zoe Tweedale who is a trainee Psychological Wellbeing Practitioner

Worth investigating

Behavioural Analysis of Crime: Studies in David Canter's Investigative Psychology
Donna Youngs (Ed.)

The first thing that I learnt as I worked through Behavioural Analysis of Crime is that David Canter has a fascinating CV. While Professor Canter is nowadays best known for his work in establishing the field of investigative psychology, his route there took him through studies in other areas, most notably environmental psychology. This book provides a brief overview of his career but, as its title suggests, focuses largely on his efforts, and those of his associates, to develop a psychological knowledge base for criminal investigations.

Following an overview of Canter's approach to investigative psychology, the subsequent contributions to Youngs' volume discuss lines of research that his work has inspired. The reader will learn how concepts such as self-narratives, the action systems model and facet theory, and approaches such as multidimensional scaling, geographical profiling and signal detection, have been applied to the understanding of criminal behaviour. If you are now forming the impression that the book has a rather technical flavour, you would be correct: it will leave you with an appreciation of the theoretical and methodological achievements in the field to date, as well as laying out the challenges that have yet to be tackled. In his own contributions to the volume (including, among other things, some observations about offender profiling) Canter expresses an admirable preference for scientific rigour over populism.

While I found the content of Behavioural Analysis of Crime to be generally interesting and stimulating, I also found the writing a little unclear in parts. Fortunately, it makes up for this by being generous in the provision of references that may help the uninitiated reader to make sense of the material discussed here (for example, Canter's 2000 paper in the Journal of Legal and Criminological Psychology).

This book will be of obvious interest to those who wish to apprise themselves of the latest developments in investigative psychology research. However, I think that those working in other areas of applied psychology will also find the content useful, as the discussions could be translated to any endeavour in which psychological research is used to address practical problems.

Ashgate; 2013; Pb £45.00
Reviewed by Denham Phipps who is a Research Fellow at the University of Manchester

Sharing aspirations

Mindfulness and Psychotherapy (2nd edn)
Christopher Germer, Ronald D. Siegel & Paul R. Fulton (Eds.)

This second edition of Mindfulness and Psychotherapy describes the compelling research in the field of mindfulness as well as its clinical applications and practical examples. It has the quality stamp of being edited and written by leading practitioners in the field.Essentially, the book demonstrates the potential of mindfulness for enriching psychotherapy, having both disciplines' objective of alleviating emotional suffering.

The first part of the book provides a thorough and compelling review and introduction to mindfulness and the significant increase in research interest in the last decade. The book suggests that mindfulness 'must be experienced to be known' therefore it outlines simple exercises to practise mindfulness, which bring the research and theory to life. Further in Part I the book explores the overlaps between Buddhist psychology and Western psychotherapy, and looks at how mindfulness itself can be perceived as a common element.

Parts II and III approach psychotherapy as a relational process, seeing mindfulness practice as a valuable framework for structuring and deepening our connections with one another. Following on from this, the book provides frameworks for clinical applications of mindfulness. These include: teaching mindfulness in therapy; mindfulness to support in the treatment of different clinical conditions, such as depression, anxiety, psychophysiological disorders, trauma and addiction; and working with children.

The last section (Part IV) looks back at the ancient understanding of mindfulness, its historical and philosophical roots. This section also looks forward to our modern scientific world, providing a review of the neurobiology of mindfulness practices and the possibility of changing the brain. The final chapter delves into the links between positive psychology and Buddhist psychological insights along with mindfulness, as they all have similar aspirations.

Guilford Press; 2013; Hb £30.99
Reviewed by Veronica Azua who is a talent manager and executive coach 

The 101ers

1984
The Playhouse Theatre, London (until 19 July)

This production brings the legendary George Orwell book into the 21st century. 'No interval, no re-admittance' is echoed by numerous staff on arrival – very Orwellian! What follows is 101 minutes of suspense that will take your breath away. Indeed, the lady next to me shrieked and jumped out of her skin on more than one occasion!

The core play is bookended by a discussion taking place after the year 2050 of protagonist Winston Smith's account of events. The psychological nature of the play's events is prominent throughout, stretching from love to torture, betrayal and terror. These emotions are only strengthened by an unparalleled use of lighting, sound, video and set design. The scene changes are absolutely amazing and their detail and transition are totally unexpected. These combined with the use of video cameras to capture first person views make for a truly immersive experience. Tickets can be very affordable, with 101 £19.84 tickets available for each showing. Just be prepared for very little legroom in the upper circle. A great twist on a classic read, this interpretation highlights the surveillance state in ever-inventive ways. Well recommended!

Reviewed by Emma Norris who is a PhD student at University College London and Associate Editor for 'Reviews