The Power Threat Meaning Framework

According to the British Psychological Society (n.d.) the Power Threat Meaning Framework applies to everyone. This framework was initially created as an alternative to more traditional psychiatric nomenclatures. This model is trauma-informed and it is utilised by high profile hospitals such as Rampton Hospital (Willmot and Siddall, 2022). 

The framework consists in asking four initial questions, which answers can then be re-used to answer the two final questions. Willmot and Siddall (2022, pp. 32-33) state that the framework can also be ‘applied to understanding the needs of people who offend or behave in challenging ways’.  The framework makes some assumptions about trauma:

  • Mental illness and behavioural problems can be understood by analysing the role of power abuse. 
  • Abuses of power can impact negatively on people and can restrict them to the point where individuals might not be able to meet their most basic needs. 
  • Much of what we know as psychopathology can also be understood as learned responses people have developed to adapt or survive to adverse circumstances.  

Power 

The framework looks into the negative operation of power in a holistic way based on a person’s narrative. It is recognised that power can be biological/embodied, coercive, economic, social, cultural, and interpersonal. It also recognises that much of this reality is configured to privilege ‘white, male,  heterosexual, wealthy, educated, and mentally healthy people’ (Willmot and Siddall, 2022, pp. 32-33). 

Threat

Threat within the scope of this framework refers to the risks related to abuses of power which can prevent a person from meeting their core needs. There are several types of threats such as physical, economic,  health, social, emotional, quality of life, disability, or deprivation threats. These threatening events or potentials can lead to relational dysfunctions, disrupted attachments, abandonment fears; feelings of betrayal, shame, guilt, insecurity, and entrapment. 

Meaning

The framework is also person-centred, and recognises that every individual is unique. This leads to the assumption that people interpret events and give meaning to these events in unique ways. For instance, male and women due to societal stereotypes might have different expectations for behaviour. Different cultures give different meaning to different events, for instance, some cultures would engage in honour-abuse of girls who have been sexually assaulted. Therefore, the social, environmental, and political contexts all influence meaning. 

Framework

The framework posits that much of what we know as psychopathology are responses people develop to perceived threats in order to cope and/or survive (Willmot and Siddall, 2022). Ultimately, people at times develop specific habits, behaviours, or personality patterns as a result of their unmet needs. Hence, this framework seeks to ask some questions which answers can elucidate the unique perspective of the individual, potential power abuse triggers, as well as unique needs that must be met. These are the questions:

  • What has happened to you? (i.e. How is power operating in your life?)
  • How did it affect you? (i.e. What kind of threats did this pose?)
  • What sense did you make of it? (i.e. What is the meaning of these situations and experiences to you?)
  • What did you have to do to survive? (i.e. What kind of threat responses are you using?)
  • What are your strengths? (i.e. What access to power resources do you have?)
  • What is your story? (i.e. Pulling of these reflections together)

These questions allow for the understanding of how a person has experienced abuses of power, the threats that resulted from such dynamics, the unique meaning a person gave to these events, and the specific threat responses that were developed as a result, as well as the strengths. Having this information in place, proactive support plans can be formulated ensuring that all interventions are  trauma-informed, and person-centred. 

References

British Psychological Society (n.d.) ‘Power Threat Meaning Framework’ [Online]. Available at https://www.bps.org.uk/power-threat-meaning-framework (accessed 29 April 2022). 

Willmot, P. and Siddall, Y. (2022) ‘Trauma, Violence, and Gender’, in Willmot, P. and Jones, L. (eds) Trauma-Informed Forensic Practice, London, Routledge, pp. 32-48 [Online]. Available at https://www.routledge.com/Trauma-Informed-Forensic-Practice/Willmot-Jones/p/book/9780367626914 (accessed 29 April 2022). 

Photo by cottonbro: https://www.pexels.com/photo/person-in-black-pants-and-black-shoes-sitting-on-brown-wooden-chair-4101143/ 

Human Rights Fascism for Victims of Domestic Abuse in Canada

Victims are being thrown into jail for disclosing their experiences of domestic abuse. 

I recently had a deep conversation with a dear friend from Canada, whose name I will keep confidential. We were talking about narcissistic relationships and narcissistic abuse. I explained to her the status of domestic abuse in the UK, where previous to 2021 before the Domestic Abuse Act 2021 was passed, most domestic abusers got away with their crimes. I was curious to understand what the situation in Canada is about domestic abuse. The Canadian Women Foundation (2021) posits that every six days, a woman is killed in Canada as a result of domestic violence.

I was horrified to find out that the government is currently arresting both perpetrators and victims of domestic abuse simultaneously. What this means is that when a victim of domestic abuse calls the police for help in Canada, the victim is also placed in jail and if they have children, they are automatically placed in foster care. I was shocked, I could not believe the level of fascism that is taking place in Canada. My first thought was ‘how is the Canadian government getting away with these human rights violations’? As a founding member of the United Nations charter, Canada has international commitments to maintain peace and security. 

My friend disclosed to me that a few years ago she had been arrested and placed in jail for three days for calling the police about domestic abuse and to report her perpetrator. It seemed, the police could not make up their minds about how to tackle domestic abuse, so they decided to give equal punishment to both the victim and the perpetrator. This is unacceptable, since there exist international conventions which place a duty on the Canadian government to protect victims. However, what they are doing instead is victimising those who have been abused. 

I decided to conduct a little research about it, and found that many women are going through this in Canada, not just my friend. For instance, the Ending Violence Association of British Columbia (EVA BC; 2022a) deals with cases of domestic abuse and coordinates interventions to help victims. They have a Community Coordination for Women’s Safety (CCWS) program which formulates and implements strategies to support victims of domestic abuse (EVA BC; 2022b). The CCWS (2010) wrote a report which corroborated my friend’s story. The report  (p. 2) states: 

‘In  recent  years,  CCWS  and  EVA  BC  have  received  numerous  reports  from communities  of cases involving  the arrest of both parties  in relationship  violence situations. These communities have contacted us to express their concern. They report that women are being arrested even when there is evidence of a history of violence  by  their  male  partners’

Furthermore, they explain the impact that such situation has, such as: 

  • Less prosecution for these cases. 
  • More liability for police services. 
  • Empowerment of the perpetrator to continue the abuse. 
  • Victimisation of victims. 
  • Increased potential for homicide. 
  • Decreased likelihood that victims will disclose or seek help. 
  • Thwarted access to justice for victims. 
  • Thwarted attempts to access support for victims. 

Similarly, the Woman Abuse Council of Toronto (2005) published a report where they highlight the problematic situation of victims of domestic abuse being charged with domestic violence whilst living with abusive men. They made several recommendations which included: 

  • To take into consideration that women’s use of force is not the same as men’s (often, violence arising from women was  self-defence). 
  • That when it comes to arrests, the dominant aggressor should be identified in a relationship where domestic abuse has taken place. 
  • That there need to be mechanisms in place to ensure that victims are able to access support services and victim services, which are thwarted by criminalising the victim. 
  • That more legal aid should be available to women. 

Finally, and more recently Grace (2019) reported around the same problematic, persistent, and pervasive issues related to the inappropriate arrests of women in domestic abuse cases. The article explains that whilst the police has a duty to identify the dominant aggressor in a relationship, women continue to be inappropriately arrested in situations of intimate partner violence. She states: ‘Women experience these failures by police as betrayal. Some even feel the police become complicit to their on-going abuse. As a result, women who have been inappropriately charged in situations of intimate partner violence say they would be unwilling to turn to the police for protection in the future, even if they are again victims of violence’. Furthermore, she provides 18 case studies and accounts of this situation. 

As it can be seen in this post, the situation of domestic abuse in Canada is a mess. My friend was one of those people who were inappropriately arrested, and who now feels that no one can protect her from domestic violence, because the police themselves are being abusive of their power. This type of human rights violation should not happen in theory, but in practice, as it has been demonstrated, injustice is an everyday experience for many women in Canada. This situation has been going on for a long time, and despite recommendations and updates to policies, it continues to affect victims and to silence their voices through state-sponsored fascism. 

References

Canadian Women Foundation  (2021) ‘The facts about gender-based violence’, 29 October [Online]. Available at https://canadianwomen.org/the-facts/gender-based-violence/ (accessed 21 April 2022). 

Community Coordination for Women’s Safety (2010) ‘Women Being Arrested’, Ending Violence Association of British Columbia, June [Online]. Available at http://endingviolence.org/files/uploads/eing_Arrested_Backgrounder_Revised_June_2010_0.pdf (accessed 21 April 2022). 

Ending Violence Association of British Columbia (2022) ‘About us’ [Online]. Available at https://endingviolence.org/about-us/ (accessed 21 April 2022). 

Ending Violence Association of British Columbia (2022) ‘Community Coordination for Women’s Safety (CCWS)’ [Online]. Available at https://endingviolence.org/prevention-programs/ccws-program (accessed 21 April 2022). 

Grace, A. (2019) ‘“They Just Don’t Care”: Women Charged with Domestic Violence in Ottawa’, Manitoba Law Journal 153 [Online]. Available at https://www.canlii.org/en/commentary/doc/2019CanLIIDocs2790 (accessed 21 April 2022). 

Woman Abuse Council of Toronto (2005) ‘Women Charged with Domestic Violence in Toronto: The Unintended Consequences of Mandatory Charge Policies’, March  [Online]. Available at http://www.oaith.ca/assets/files/Publications/womenchargedfinal.pdf (accessed 21 April 2022). 


Photo by NEOSiAM  2021: https://www.pexels.com/photo/person-s-hands-covered-with-blood-673862/

The Economic Cost of Domestic Abuse in the UK

Not preventing domestic abuse takes a huge toll on the system’s economy. It is very expensive to allow these negative events to happen. A lot of taxpayer money is used in reacting to domestic abuse, and reactive responses are more costly than preventive approaches.

According to the GOV.UK (2019, p. 6) the total cost for domestic abuse was £66,192m, and on average, it costs £34,015 to react to these incidents per victim, and up to £2.2m in cases of domestic homicide. Of course, these are estimates which do not include the dark figure of crime (i.e. the cases which have not been reported). Moreover, these costs include the police, the criminal justice system, the civil legal system, and the multi-agency risk assessment conferences. Furthermore, there are also costs associated with the services offered to victims after an adverse event happens, such as health and victim services. These yearly figures were for the year ending in 2017 (there does not currently seem to exist any more recent report). 

Police Service Provision

The police spend approximately £1,257 million per year responding to domestic abuse. The fees include the investigation, incident response, arrests, the collection of evidence, and the presenting of the case to the Crown Prosecution Service (CPS). All this amounts to approximately £645 per person. 

Criminal Justice System 

It costs approximately £336 million per year to cover criminal justice fees related to the CPS which include the services of taking a case to court, holding hearings, legal aid and perpetrator defence. This amounts to an average of £170 per case. The criminal courts are there to take cases involving grievous bodily harm and murder. 

Civil Legal System

This system of courts deals with aspects of domestic abuse related to injunctions (e.g. restraining or non-molestation orders), divorce, child custody, and child protection. The costs amount to a total of £140 million per year, equalling to an average of £70 per case. 

Multi-Agency Risk Assessment Conferences

These meetings involve governmental representatives and third-sector organisations, where information and support is provided to individuals assessed as high risk of being abused. It may also involve members of the police, child protection agencies, health organisations, and housing organisations. These conferences cost around £11 million per year, which amounts to approximately £5 per case. 

Health Services

These fees cover the treatments for injuries caused by domestic abuse, ambulances, and also mental health services treating emotional and psychological trauma. In total, it costs £2,333 million per year, which amounts to £1200 per case. 

Victim Services

Victim support services involve specialists to support the abused individual, and also wider services such as housing, group services, and the support from the Department of Work and Pensions. It also covers third sector organisations and government-funded agencies. The total is £724 million per year, amounting to £370 per case. 

References

GOV.UK (2019) ‘The economic and social costs of domestic abuse’, Home Office, 21 January [Online]. Available at https://www.gov.uk/government/publications/the-economic-and-social-costs-of-domestic-abuse (accessed 26 February 2022). 

Photo by Anete Lusina: https://www.pexels.com/photo/unrecognizable-man-covering-mouth-of-woman-5723186/ 

The Complex Process of Profiling & Diagnosing Autism

According to the NHS (2019), ‘being autistic does not mean you have an illness or disease. It means your brain works in a different way from other people’. The core characteristics of autism are: (1) poor social communication; (2) poor social interaction; (3) sensory processing differences; (4) sensory sensitivity; (5) repetitive behaviours; and (6) obsessions and fixations on special interests. These characteristics can vary, and some individuals show two or three, whilst others might be more severely affected (Lincoln College, 2022). This blog post will explore these core characteristics, the unofficial subtypes of autism, and the complex process of diagnosis.

Individuals experiencing the behavioural abnormalities, will show a fixation on specific activities, tools, toys, etc. They may use these objects in particular ways. Furthermore, they may engage in repetitive behaviours such as hand flapping or spinning around, might become upset if their routine is disrupted, and will insist on maintaining consistency. Moreover, they might have unusual sensory interests, either a high or low tolerance to pain, unpredictable verbal outbursts, and might become upset at sensory intrusions. Finally, they might also engage in risky or self-injurious behaviour. 

Individuals experiencing communication difficulties might have a delayed language development, speech difficulties and/or reliance on alternative communication methods, high levels of articulation, literal interpretation of words (i.e. lack of understanding of jokes or sarcasm), problems starting and maintaining conversations, stereotyped and repetitive use of phrases, a monotonous voice tone, and poor interpretation of body language or other forms of non-verbal communication. 

Individuals experiencing social difficulties might struggle to form and sustain friendships, might show a lack of interest in social activities, might engage in inappropriate social responses, might have a lack of awareness of boundaries, might reject expressions of affection such as hugging, might prefer to role play,  and might be naive, suggestible and overly trusty of others. 

The Unofficial Subtypes of Autism

Due to current diagnostic manuals such as the DSM-V (American Psychiatric Association, 2013) and ICD-11 (World Health Organisation, 2019), individuals are generally given a diagnosis of Autism Spectrum Disorder (ASD) regardless of their profiles. Yet, there are unofficial categories used by the autistic community to understand differences better.

Individuals categorised as having Asperger’s syndrome tend to have a higher than average I.Q., and unlike other forms of autism, no speech or cognitive difficulties. However, interpersonal difficulties are prevalent for them, as they struggle to communicate and interact with others. Yet, the symptoms are invisible and difficult to spot. They may also have pathologies which affect their day to day life (Lincoln College, 2022). Asperger’s syndrome is no longer diagnosed (McCrimmon, 2018) but it is still generally seen as a subtype of autism. It is also believed that Asperger’s syndrome is a form of high-functioning autism (HFA) which according to Lincoln College (2022) entails a delay in development, an inability to read facial expressions, a hypersensitivity to light and noise, and a desire for socialisation without understanding how to effectively do it. Nevertheless, HFA is not diagnosable, although it is also recognised by autistic populations. 

Individuals categorised as having Pathological Demand Avoidance (PDA) tend to have intersubjective difficulties and to avoid the demands of everyday life. This profile is not an universally recognised form of autism by healthcare professionals, however, it is still generally used by autistic populations. According to the National Autistic Society (n.d.), an individual with this profile ‘(a) resists and avoids the ordinary demands of life; (b) uses social strategies as part of avoidance, for example, distracting, giving excuses; (c) appears sociable, but lacks some understanding; (d) experiences excessive mood swings and impulsivity; (e) appears comfortable in role play and pretence; and (f) displays obsessive behaviour that is often focused on other people’. Furthermore, Lincoln College (2022) states that these individuals have an anxiety-based desire to remain in control all the time, and can become aggressive if they feel they are not in control. They also seem to get stressed out if anything is expected of them. However, if they feel comfortable, they seem normal. 

Individuals labelled as having Kanner’s Autism also known as ‘Classic Autism’ are described as having impairments in communication, and a fixation on activities with restrictive or repetitive behaviour such as hand flapping. The criteria for this autism profile is: (1) an impairment in the use of non-verbal skills, poor eye contact, and an inability to interpret body language; (2) inability to make and maintain friendships; (3) inability to enjoy interests or share activities; (4) inability to respond appropriately to emotion in others; (5) delay in, or complete lack of language development; (6) repetitive use of language; (7) fixation on a particular interest; (8) inflexibility to change routines; and (9) repetitive physical movements (Lincoln College, 2022). However, this is not diagnosable. 

Individuals diagnosed as having atypical autism are those whose pattern of behaviour fits most but not all of the criteria for other forms of autism. It can often be undiagnosed for many years as individuals tend to be given this label later in life. 

Finally, individuals categorised as having Savant syndrome have skills which are uncommon to most people, as well as having the general characteristics of autism. Among the extraordinary abilities seen in savant autism are being able to mentally solve complex mathematical problems, having great memory for specific details of something, high quality artistic skills, and outstanding musical talent. 

Diagnosing Autism

The advantage  of diagnosing Autistic Spectrum Disorder (ASD) is that individuals and their families can find as much information as possible about the condition and engage in psychoeducation, which can foster a sense of relief. The diagnosis might help the individuals have more clarity about their difficulties, and might give them more insight into potential comorbidities or wrong diagnoses. Moreover, a personalised care plan with strategies can be devised for ongoing support in all sectors. Nevertheless, a disadvantage of diagnosis is that individuals have to live with the stigma (i.e. negative stereotyping) associated with psychiatric labels, and how the label can affect their relationships and lead to prejudice and discrimination. Furthermore, another disadvantage is that individuals might become depressed with the fact that autism has no cure. They might also experience more adverse circumstances as a result of having a diagnosed disability, and all these negative variables might lead the individual to internalise the label and to embrace the maladaptive behaviours associated with the label which shapes their identity (Lincoln College, 2022). 

Diagnosis is usually done through a person’s GP; however, a paediatrician, a speech and language therapist, an educational psychologist, and/or a specialist psychologist might also need to be involved; and sometimes this multidisciplinary approach can take years before a diagnosis is given (Lincoln College, 2022). Moreover, information for diagnosis is also gathered from relatives, teachers and friends of the individual presenting with symptoms. The individual might be observed as he or she conducts activities and skills might be tested. Furthermore, professionals working with people with autism must take on board the National Institute for Health and Care Excellence (NICE; n.d.) guidelines. These specifically state that anyone working with autism should be skilled and competent and have tactful communication skills (Lincoln College, 2022). 

There are several factors that influence the diagnosis of autism: (1) culture— behaviours classed as ‘abnormal’ by a society might bring attention and concern to others. Some countries might perceive different behaviours as ‘symptomatic’, whilst others might see the same behaviours as completely ‘normal’. Also, stigma might become a barrier to diagnosis; (2) age— even though the symptoms of autism can be spotted when the individual is 2-3 years old, many professionals refuse to make a diagnosis until later on. However, some professionals are also reluctant to diagnose adults; (3) sex— males tend to get a diagnosis of autism more than females. Some believe that this is due to how different the characteristics manifest, with girls being more able to hide the symptoms; (4) parental attitudes— some children might not get diagnosed because their parents cannot effectively spot the symptoms, or they might ignore these manifestations out of fear of being judged. Alternatively, parents might insist to the family GP that the child has a problem even if such is not the case; (5) coexisting conditions— autism often has mental and physical comorbidities, making it more difficult to pinpoint the exact cause for specific behaviours, and making diagnosis more complicated; and (6) genetic factors— autism has a genetic link that runs in families. 

Furthermore, there are also barriers to diagnosing autism such as a lack of local services for autistic people, which means that a formal diagnosis with the necessary multidisciplinary specialists is not always possible as a GP might have limited knowledge of the condition. This might subsequently lead to individuals not being diagnosed for a long time, which might prevent them from wanting a diagnosis in the future. It can also lead to individuals not having a documented developmental history, which can affect the process of diagnosis.  Moreover, another barrier to diagnosing autism is how subtle some of the symptoms can be, and how subjective the interpretation of these symptoms also is (Lincoln College, 2022).  

References

American Psychiatric Association (2013a) Diagnostic Statistical Manual of Mental Disorders, 5th ed.

Lincoln College (2022) ‘The diagnosis and characteristics of autism’, TQUK Level 3 Certificate in Understanding Autism [Online]. Available at https://lincolncollege.equal-online.com/courseplayer/autisml3/?ls=8663048&cpid=223390  (accessed 22 February 2022). 

McCrimmon, A. (2018 ‘What happened to Asperger’s syndrome?’, The Conversation, 8 March [Online]. Available at https://theconversation.com/what-happened-to-aspergers-syndrome-89836 (accessed 22 February 2022). 

National Autistic Society (n.d.) ‘PDA — a guide for parents and carers’ [Online]. Available at https://www.autism.org.uk/advice-and-guidance/topics/diagnosis/pda/parents-and-carers (accessed 22 February 2022). 

National Institute for Health and Care Excellence (n.d.) ‘Autism’ [Online]. Available at https://www.nice.org.uk/guidance/conditions-and-diseases/mental-health-and-behavioural-conditions/autism (accessed 23 February 2022). 

NHS (2019) ‘What is autism?’, 18 April [Online]. Available at https://www.nhs.uk/conditions/autism/what-is-autism/ (accessed 10 March 2022). 

World Health Organisation (2019) ‘International Classification of Diseases – 11th Revision’ [Online]. Available at https://icd.who.int/en (accessed 22 February 2022). 

Photo by Polina Kovaleva

Categories
Forensic Psychology

Signs, Symptoms and Indicators of Domestic Abuse

This blog post will educate the reader about the signs of domestic abuse, and how to identify it in every day life. It also touches on the specific symptoms and indicators of female genital mutilation, forced marriage, honour-based abuse, and digital domestic abuse; as well as who is most at risk from experiencing these.

Physical Abuse

Individuals affected by physical violence present with recurrent physical injuries such as black eyes, bruises, split lips, marks on the neck, or sprained wrists. Moreover, the explanations given for these injuries might be inconsistent, and might be obviously a cover-up for something else. Finally, they might also wince when making motor movements as if in pain and trying to avoid pressure on a specific part of the body. However, it must be noted that perpetrators tend to be wary of where they leave marks, so as to avoid getting caught. So in many cases, physical abuse is hidden from the public eye and the victim is manipulated into keeping things secret. Physical signs of domestic abuse might not always be visible because the perpetrator might be ensuring that they leave no evidence that could incriminate them. This might mean that they will attack the victim in specific hidden places such as the head, the stomach, or breasts, among other places. Furthermore, they might have manipulated the victim to hide the marks, or to keep silent; and the victim might actually be using clothing, make-up, and accessories to actively cover the injury. 

Emotional & Psychological Abuse

Individuals affected by emotional abuse present with symptoms of agitation and anxiety, chronic tiredness and insomnia, substance or alcohol use disorder, submissiveness (e.g. apologising all of the time), anhedonia, low self-esteem, low self-confidence, fear or wariness, depression, and/or suicidal ideation. Whilst these symptoms might not always be caused by domestic abuse, these are commonly experienced by people who are in abusive relationships. Therefore, it is important to take into account these indicators when safeguarding adults from potential abuse which might be hidden. Emotional signs of domestic abuse are inherently invisible and can only be detected by observation. If the victim does not have a support network who knows them well, it might be more difficult for anyone to notice any differences in behaviour. Furthermore, not everyone is equipped with the knowledge to correctly identify signs of emotional abuse. Moreover, victims might actually avoid disclosing anything, especially if the perpetrator has manipulated them to keep things to themselves through blame and/or threats. 

Individuals affected by domestic abuse present with behavioural markers that could reveal their ordeal such as drastic behaviour or personality changes, unjustified self-isolation, being unable to attend scheduled meetings, avoidance of social gatherings, the sudden reluctance to engage in activities once enjoyed, and/or secretive behaviours. Furthermore, the individual might appear anxious and/or fearful, and their behaviour might seem extremely ‘well-behaved’ when around their perpetrator. These individuals may try to cover up the abuse they are being put through by giving excuses that are unrelated to what is actually happening. Behavioural signs of domestic abuse are difficult to pinpoint if the victim is not known to the witness very well, and therefore the witness cannot notice a change in usual behaviour. This means that unless someone notices the situation, a bystander intervention is unlikely, especially when the victim makes excuses for apparent unusual incidents which no one can recognise as an inconsistency. 

Coercive Control

Individuals affected by coercive control present with signs and indicators such as asking their perpetrator for permission to socialise with others, receiving numerous texts and/or calls from their perpetrator, having no money or access to it, having no car and being picked up by their perpetrator all the time, and/or needing to be home at specific times. These individuals might also keep these patterns secret, and might actually feel shame related to their ordeal. Signs of coercive control are often quite hidden from everyday life because the victim might appear to be respectful rather than fearful of her perpetrator. Others might not pick up on the abusive flood of texts and/or calls, or might not understand that all of these communications come from the perpetrator. Furthermore, victims might feel embarrassed to disclose their financial situation and/or dependencies, and might avoid answering truthfully when questioned about details. 

Female Genital Mutilation (FGM)

Women who have been genitally mutilated present with difficulty walking, sitting, or standing; they show signs of being in pain, and may spend longer in the toilet than usual. They might be anxious, depressed, and/or might be self-isolating without a justification. They might present with drastic changes of behaviour and personality, may engage in truancy at school/college/university, might become absent from work and/or might withdraw from social activities. Furthermore, the Home Office has a list of countries flagged as ‘risky’ when it comes to female genital mutilation. These are Somalia, Kenya, Ethiopia, Sierra Leone, Sudan, Egypt, Nigeria, Eritrea, Yemen, Kurdistan, and Indonesia. Women and girls at risk of female genital mutilation are those who speak about special ceremonies or rituals about womanhood in their culture, those who say that they are going on holiday outside the UK, those who say that a ‘special’ relative is coming to visit them, and those have family members who have been already mutilated. This means that when women and girls present with any of the above indicators, and especially when they have connections to any of the blacklisted countries, they should be safeguarded through bystander intervention.

Forced Marriage

Forced marriage happens here in the UK and also abroad. Sometimes only the woman is forced, and other times both parties are forced. Individuals affected by forced marriage present with truancy or absence from work, fearfulness and anxiety about holidays, failure to return to occupational life after a holiday, not being allowed to study or work, having excessive parental control,  depression or isolation, and/or attempts to escape their ordeal at home. Furthermore, those at risk of being forced into marriage include those who have connections to those who have already been forced to marry, and those whose culture promotes early marriage. Countries known to have child marriage include Nigeria, Central African Republic, Chad, Bangladesh, Mali, South Sudan, Burkina Faso, Guinea, Mozambique and India (Reid, 2018); as well as Pakistan (Ijaz, 2018). 

Honour-based Abuse

In some cultures, the family or community might attempt to protect or defend their shared values through abusive means and/or threats of abusive means such as harassment, assault, imprisonment, murder and rape. This is what is known as honour-based abuse and it is directly linked to beliefs, and attitudes. Individuals affected by this type of abuse present with drastic changes in behaviour or personality, anxiety, demotivation, poor performance, excessive control by others, self-isolation which cannot be justified, confrontational and argumentative behaviours, truancy or absence from work, attempts to escape their ordeal, self-harm, depression, substance or alcohol use disorders, suicidal ideation, and/or actual bodily harm (ABH). Furthermore, individuals at risk of honour-based abuse include those who have relatives who have been forced into early marriage, and those who come from cultures where honour-based abuse is perceived as normal. Countries flagged as risky when it comes to this type of abuse include Turkey, Kurdistan, Afghanistan, South Asia, Africa, the Middle East, South and Eastern Europe, and traveller communities. This means that people from these cultures are particularly at risk of being abused. 

Digital Domestic Abuse

Digital domestic abuse entails harassment, bullying, and/or stalking through an online platform, and/or the restriction of someone from  accessing technology. Individuals affected by digital domestic abuse present with an excessive number of texts/calls, appear visibly upset or distressed after texts/calls, online attacks against their integrity, and online embarrassing media involving them. Furthermore, individuals who are being coercively controlled through technology present with a monitored access to social media, emails, and/or the internet by their perpetrators,  signs that others have access to their personal digital accounts, a controlled access to technology by the perpetrators, a recurrent pattern of asking for permission from their perpetrator before connecting digitally with the people in their lives, an excessive guardedness about what is said in emails or other digital platforms, and/or a recurrent pattern of borrowing other people’s technology for access to the internet. Moreover, an individual can be both abused digitally, and also face to face, with punishments, reprimands and other negative consequences used by the perpetrator to intimidate the victim into obeying. 

References

Ijaz, S. (2018) ‘Time to End Child Marriage in Pakistan’, Human Rights Watch, 9 November [Online]. Available at https://www.hrw.org/news/2018/11/09/time-end-child-marriage-pakistan (accessed 14 February, 2022). 

Reid, K. (2018) ‘Untying the knot: 10 worst places for child marriage’, World Vision, 6 July [Online]. Available at https://www.worldvision.org/child-protection-news-stories/10-worst-places-child-marriage (accessed 14th February, 2022).  

Categories
Forensic Psychology Journalism

Understanding Domestic Abuse in England

Every person’s perception of what constitutes abuse is different. Some victims stay and accept their predilection, whilst others fight and/or leave. Some victims succeed in leaving, whilst others are killed in the process. Domestic abuse has statutory definitions that give an objective scope which applies to everyone in the jurisdiction, whether they have insight into their realities or not. According to the Crown Prosecution Service (n.d.), domestic abuse can be defined as ‘any incident of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members, regardless of their gender or sexuality’. This short definition has it within its scope that domestic abuse is something that happens in everyday life. 

Domestic abuse does not always entail physical violence. Psychological abuse has been hypernormalised in our societies, and every day forms of sadism are quite common and ingrained in policies and procedures. Furthermore, domestic abuse is relevant to the police, and thinking that it should stay behind closed doors is another misconception. Domestic abuse happens all the time, everywhere, and thinking that it is rare is another misconception. Domestic abuse is not always a crime of passion, and sometimes it is slow, prolonged and premeditated. Thinking that domestic abuse is always a loss of control is a misconception. Disagreements are not equivalent to abuse. Whilst disagreements are normal, abuse is not normal. Moreover, thinking that domestic abuse is only perpetuated by strangers is another major misconception. Finally, domestic abuse happens to all groups and classes of society. Assuming that it only happens to poor people is another misconception. 

Globally, the United Nations (n.d) defined domestic abuse as ‘a pattern of behaviour in any relationship that is used to gain or maintain power and control over an intimate partner. Abuse is physical, sexual, emotional, economic or psychological actions or threats of actions that influence another person. This includes any behaviors that frighten, intimidate, terrorize, manipulate, hurt, humiliate, blame, injure, or wound someone. Domestic abuse can happen to anyone of any race, age, sexual orientation, religion, or gender. It can occur within a range of relationships including couples who are married, living together or dating. Domestic violence affects people of all socioeconomic backgrounds and education levels’. Based on this definition, it can be said that domestic abuse is a form of sadism, as the latter is all about the subjugation of the victim. 

Locally, the Devon & Cornwall Police (2020) define domestic abuse as ‘the misuse of power and control by one person over another. This controlling behaviour may be exerted in various ways, such as through physical violence, emotional and/or psychological manipulation, forcing sexual acts or taking over your finances. It can begin at any time, can be obvious or subtle and can happen suddenly or gradually. It can happen to anyone regardless of class, age, race, religion, culture, disability, sexual orientation or lifestyle’. Based on this definition, it can be said that those who engage in domestic abuse are also engaging in sadistic behaviour

There are some misconceptions about victims of domestic abuse, such as believing that the victim wants to be abused because they are not able to leave the relationship, that the victim should leave the relationship if they want help from statutory services, that the victim is at fault for the criminogenic behaviours of their abuser, that only women are victims of domestic abuse, that women lie about their abuse, that some people/women are attracted to abusive people/men, and that some people like the violence in their relationship (e.g. rough sex defence). For instance, the Home Office (2022) published a policy paper explicitly stating that ‘consent to serious harm for sexual gratification’ is not a defence. Justice Minister Alex Chalk is cited saying ‘No death or other serious injury – whatever the circumstances – should be defended as ‘rough sex gone wrong’ which is why we are making it absolutely clear that this is never acceptable. Perpetrators of these crimes should be under no illusions – their actions will never be justifiable in any way, and they will be pursued rigorously through the courts to seek justice for victims and their families’. This means that even if a person consents to rough sex, if their partner abuses them to the point actual bodily harm (ABH), then this is by law a crime. This will give women more clarity on what constitutes appropriate touch, sex, and when to identify abuse and report abuse. Furthemrore, Keir Starmer (2013) published an article on The Guardian stating that false allegations of rape and domestic violence were rare. This shows the importance of taking all allegations seriously. 

What’s more, there are also misconceptions about the perpetrator such as believing that alcohol and drugs excuse such behaviours, that their abusive childhoods justify their behaviours, that mental health problems excuse domestic abuse, that they only attack because they are stressed out, that it is only a loss of temper on the abuser’s part, that just because they engage in domestic abuse does not mean they are bad parents (such as a father who abuses a mother and a child witnesses it), and that all abusers are men. 

The National Office for Statistics (ONS; 2021a) reported in November that domestic abuse as recorded by the police in England and Wales rose by 6%. There were 845, 734 events. There were 33 arrests per 100 cases. Yet, even though these rates increased, referrals to the Crown Prosecution Service (CPS) decreased by 3%. Furthermore, convictions decreased by 70%. This shocking evidence proves that even though the problem is increasing, the UK state apparatus is dealing less and less with the problem. The ONS (2021b) reports that 37.7% of offences were of violence against the person, and 18.8% of offences were of sexual nature. 72.3% of victims of violence were female whilst 27.7% were male, and 93.4% of victims of sexual offences were female, whilst only 6.6% were male. This shows that the issue of violence against women in England and Wales is far from being resolved. 

Moreover, moving more locally, the ONS (2021b) reports that there were 20,905 crimes of domestic abuse reported to the Devon & Cornwall police in the year ending 2021. This accounted for a 23.1% of total recorded crime. This saw a significant longitudinal increase in domestic abuse related crime from previous years. It went from 13.8% in the year ending in 2016 to 23.1% in 2021, increasing by over 9% in the past 5 years. There were 16, 464 offences of violence against the person, accounting for 41.1% of domestic abuse related crimes. This also saw a significant increase in the past few years. 

There are four aspects that influence perceptions of domestic abuse: (1) the media, which often distorts information by not always identifying incidents of domestic abuse, sensationalising the reality of more subtle abuse and only focusing on more violent crime. Furthermore, the media also downplays the role of the perpetrator and sometimes attributes responsibility to the victim suggesting that the perpetrator was triggered. Moreover, because we live in a patriarchal world, the media sometimes covers more stories of violence against men, even though violence against women is most common. Finally, the media also sensationalises class, making it look like domestic abuse only happens in poor families; (2) religion, which has sets of dysfunctional beliefs which reinforce abusive practice such as the idea that honour-based abuse or forced marriage is acceptable, that women are inferior and should be submissive to men, that men as family heads should take disciplinary action at home against the rest of the family, that divorce is wrong, and that homosexuality is a sin; (3) culture, which has social norms that directly impact on perceptions of domestic abuse such as the ideas that men should assert power over women because they are ‘superior’, that the restriction of women’s movements/activities is acceptable, that women should accept physical violence as a method for conflict resolution, that women are responsible for the marriage working, that domestic abuse should never be spoken about (i.e. making it a taboo topic), that anyone who wants divorce should be ashamed of themselves, that brides should be bought and exchanged as if they were cattle (e.g. Iraq), that honour is dependent on female sexual behaviour, and that traditions such as forced marriage and female genital mutilation are normal; and (4) personal experience which influences perceptions of relationships, especially when people have lived experience in domestic abuse. Depending on their level of insight, some may fully reject abusive behaviour whilst others might accept it as a normal part of life.

Did you know…

The Matrimonial Causes Act (1978) made it possible for women to be legally separated from their abusive husbands, and the Domestic Violence and Matrimonial Proceedings Act (1976) enabled women to apply for court orders against their abusive husbands. In 1985, there were laws against female genital mutilation. In 1994 rape became illegal within a marriage, and in 2004 common assault became an arrestable offence. Police stations created dedicated Domestic Violence Units with specialist staff in the late 80s and early 90s. Moreover, the Protection from Harassment Act (1997) implemented measures against stalking and threats of violence, and the Domestic Violence, Crime, and Victims Act (2004) made stricter sentences so couples of the same sex could also apply for injunctions. In 2002, children were allowed to be removed from the home if they were witnesses of domestic abuse. In 2014, Clare’s law (named after Clare Wood) allowed the police to give details to potential victims of their partner’s abusive history in order to prevent abuse. In 2015 coercive control and revenge porn became illegal, and finally, the Domestic Abuse Act (2021) created a statutory definition of domestic abuse.  

References

Crown Prosecution Service (n.d.) ‘Foreword From Kate Brown, CPS Lead for Domestic Abuse’, Domestic Abuse [Online]. Available at https://www.cps.gov.uk/crime-info/domestic-abuse (accessed 7th February 2022). 

Devon & Cornwall Police (2020) ‘What is domestic abuse?’, 2nd October [Online]. Available at https://www.devon-cornwall.police.uk/advice/threat-assault-abuse/domestic-abuse/what-is-domestic-abuse/ (accessed 7th February 2022). 

Home Office (2022) ‘Consent to serious harm for sexual gratification not a defence’, GOV.UK, 31 January [Online]. Available at https://www.gov.uk/government/publications/domestic-abuse-bill-2020-factsheets/consent-to-serious-harm-for-sexual-gratification-not-a-defence (accessed 12 February 2022). 

Office for National Statistics (2021a) ‘Domestic abuse in England and Wales Overview: November 2021’, 24 November [Online]. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/bulletins/domesticabuseinenglandandwalesoverview/november2021 (accessed 12th February 2022). 

Office for National Statistics (2021b) ‘Domestic abuse prevalence and victim characteristics’, 24 November [Online]. Available at https://www.ons.gov.uk/peoplepopulationandcommunity/crimeandjustice/datasets/domesticabuseprevalenceandvictimcharacteristicsappendixtables (accessed 12 February 2022). 

Starmer (2013) ‘False allegations of rape and domestic violence are few and far between’, The Guardian, 13 March [Online]. Available at https://www.theguardian.com/commentisfree/2013/mar/13/false-allegations-rape-domestic-violence-rare (accessed 12 Feberuary 2022). 

United Nations (n.d.) ‘What is Domestic Abuse’ [Online]. Available at https://www.un.org/en/coronavirus/what-is-domestic-abuse (accessed 7th February 2022). 

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Opinion Tips

Blogging as a Method for Democratic Therapy

Blogs are a great way to express your voice. Even if your experiences have made you feel silent, oppressed, and unfairly treated at an intergroup relational context; you can still assert your thoughts, feelings and opinions in the online community. This way, blogging can be a method for cognitive-emotional democratic healing at both individual and collective levels.

Why is expressing your voice important?

Actions and reactions happen at inter and intra group levels for many reasons. Sometimes communicating our perspective helps elucidate a particular situation. So for instance, if you feel that some members of your social milieu have displayed hostility towards you as a result of the hostility that they themselves have been subjected to, you might be correct in assuming that such a hostility might have become hypernormalised at the group’s cultural level, and that such members are experiencing reactive-formative symptoms of trauma. For the minority individual, the experience of being let down, or rejected by a group, culture, system, or apparatus can be debilitating (i.e. it can feel like mob behaviour), and when this happens for a prolonged period of time; it can create feelings of marginalised frustration. Blogging is a good way to use your freedom of speech in a way that directly addresses the public audience, whilst simultaneously being an interpersonal method for expression.

The risk is to stay silent.

Setting up a blog

There are different ways in which you can begin your blog. The most common problem I hear when I speak with people about blogging is ‘I do not not what to say. I would not know where to start’. My answer is that such is precisely the way to start a blog. You do not need to know what to write about in order to express that you do not know what to write about. Sometimes it could be sharing your professional work. Other times it could just be about sharing an experience you went through. I tend to shift between these modes. Most of the time, I share some of my thoughts, feelings, and add something interesting that I have been researching about. Regardless of what your needs for expression are, blogging is an effective method for online communication and an interdisciplinary style for socialisation. But, what blog to use?

Choosing a blogging platform

Different people will prefer different types of blogs for their journalism depending on how much time or effort they wish to invest in the endeavour. Here are a few options:

  • Blogger: A very simple and generic user experience design for expressing thoughts. It has an archive of dates which store your thoughts across time. The interface is easy to learn, and it is free of charge. It is ideal for those only getting started in cybercultural activities.
  • Google Sites: This platform truly is flexible in terms of allowing the user to experience freedom in how to structure their pages. It is useful for creative projects and for getting started with digital design. It lacks an automatic blogging archive, so if what you are looking for is a place to log your thoughts, Blogger is a better option. All you need is a Google account.
  • WordPress: This blog (as you can see at the bottom of the page) is powered by WordPress. The reason why I personally prefer this platform is because it gives me a wide margin of flexibility when it comes to design, as well as simultaneously having an archive for blog posts which permits organization.
  • Medium: For those who do not wish to either hassle neither with the design nor with the other technicalities, Medium allows people to register and write. It is a community project, meaning that people from all walks of life contribute to the discussion.
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Journalism Videos

Psychological Survival Through the Coronavirus Pandemic

This is a short video answering some questions in relation to how to cope with the intensity of the coronavirus pandemic by focusing on psychological survival and wellbeing at home.

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Journalism

COVID-19: Situation Report, Administrative Challenges, and What Psychologists can do to Help the Crisis

UK-specific numbers

As of 10 April 2020:

CONFIRMED CASES: 73,758

PATIENTS DISCHARGED: 344

PATIENTS WHO DIED: 8,958

Worldometers (2020)

Are the numbers to be trusted?

There is a certain ‘mystery’ with the numbers. For instance, the GOV.UK’s (2020a) dashboard has not been updating the recovery section of its spreadsheet since the 22nd March. This has led to much confusion, and many people are suspicious of the numbers being provided. For instance, the media (Merrick, 2020) announced that health secretary Matt Hancock tested positive for coronavirus on the 27th March, 2020. Then on the 2nd April, 2020 he was back to work (Matt Hancock gives first coronavirus briefing since coming out of isolation, 2020) and was looking healthy. Nevertheless, the historic record spreadsheet did not register his recovery, indicating that maybe only those admitted to hospital are being registered in the records.

Another odd discrepancy is the fact that even though Worldometers (2020) updated for the first time this month the number of recovered patients yesterday to 344, the historic record document mentioned above- which is available on the GOV.UK’s (2020a) dashboard- continues to show 135 as the number of recoveries. This is worrisome as it gives an impression of misinformation and it elicits uncertainty. No wonder many people are having a gut feeling of ‘deception’ at the hands of the GOV.

What is the government’s plan?

As of the date of this writing, the GOV.UK’s (2020b) coronavirus action plan is full of misinformation and inaccuracies. I wrote to the Department of Health & Social Care (GOV.UK, 2020c) on the 1st April in order to communicate my concerns in regards to their published document and to request more frequent reviews of it. Nevertheless, nothing has been done about it, and the file continues to create feelings of confusion and uncertainty. Here you can download the analysis I conducted. You will be able to understand the discrepancies better after reading it.

What is the WHO saying?

I attended the World Health Organization’s (2020) press briefing yesterday (10th April). Dr. Tedros Adhanom Ghebreyesus, Director-General stated: “When health workers are at risk, we are all at risk”. There were many important calls to action, such as ensuring that medical staff are able to have adequate rest periods instead of long, exploitative shifts; the development of an immune response; and the clarification of the severity of the disease. For instance, so far we have heard about patients who are in mild, and critical conditions. It was mentioned in the conference that an explanation of the moderate condition would be helpful, as there are confirmed cases of pneumonia which have not required hospitalization.

Another important point discussed was that the death of health workers has become a ‘tragic’ stimulus to action. The health environment was spoken about as a double-edged sword. It was also raised that personal protective equipment (PPE) is therefore a must have in hospitals in order to reduce the exposure of health workers to infectious hazards. This reminds us of the importance of staying at home and protecting the NHS. Furthermore, it was also suggested that psychosocial support for front-line and health workers should be made readily available, and reasonable adjustments should also be made by administrative staff in order to prevent doctors and nurses from developing fatigue as a result of extremely long shifts.

What can psychologists do to help the coronavirus crisis?

The coronavirus (COVID-2019) impacts on different people in different ways. Psychologically speaking, this requires an ongoing decision-making process based on the likelihood of catching the virus, and the perceived severity of the consequences.

“The barriers component may comprise both physical limitations on performing a behaviour (e.g. expense) and psychological costs associated with its performance (e.g. distress)”.

Abraham and Sheeran (1996, p. 33)

The outbreak is by all means a stress-generative situation. Exploring the psychopathology of the coronavirus pandemic, such as the negative and positive symptoms it causes (e.g. confusion, neurosis, and psychosis) would help both, professionals and students to feel more efficient in their preparedness for what is to come next. For example, the concept of normal distribution and the curve as illustrated by The Visual and Data Journalism Team (2020) would help people understand what is meant by “the peak” of the outbreak that so many sources are expecting and talking about.

Psychologists are also encouraged to help people understand the serious challenge at hand, and the levels of vulnerability in individual differences. Moreover, it would also be helpful to stimulate the GOV so they respond quicker without the need for the tragic stimulus of death explained above. Furthermore, exploring the cycle of panic and neglect that manifests as response to the threat would help soothe emotionally vulnerable human beings. Advice about how to strengthen the system is welcome. When it comes to forensic psychologists, it would be useful to elucidate how data formulates policy, and why it is important to have accurate data in order to prevent confusion at subnational levels, including criminal justice settings.

How can I check the coronavirus numbers for myself?

There are two ways you can check the coronavirus statistics. For global numbers go to Worldometers.info/coronavirus.

For UK-specific numbers:

  1. Go to the GOV.UK’s (2020a) Dashboard.
  2. Click on the ‘About’ tab at the bottom of the page.
  3. Click on the ‘Access historic data from the dashboard (xlsx)’ link.
  4. Save the file on your device.
  5. Open the file with a spreadsheet software such as Google Sheets (n.d.), Microsoft Office Excel (n.d.), or LibreOffice Calc (n.d.).

Please note that GOV staff have neglected the recovery section in the official spreadsheet since 22nd March, 2020. If you are concerned about the numbers, please contact the Department of Health & Social Care on https://contactus.dhsc.gov.uk/ and explain to them your concerns.

References

Abraham, C. and Sheeran, P. (1996) ‘The health belief model’, in Conner, M. and Norman, P. (eds) Predicting Health Behaviour, Buckingham, Open University Press, pp. 23-61.

Google (n.d.) ‘Google Sheets’ [Online]. Available at https://www.google.co.uk/sheets/about/ (Accessed 11 April 2020).

GOV.UK (2020a) ‘Total UK COVID-19 cases’, 4th April [Online]. Available at https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (Accessed 11 April 2020).

GOV.UK (2020b) ‘Coronavirus action plan: a guide to what you can expect across the UK’, 3 March [Online]. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/869827/Coronavirus_action_plan_-_a_guide_to_what_you_can_expect_across_the_UK.pdf (Accessed 11 April 2020).

GOV.UK (2020c) ‘Department of Health & Social Care’ [Online]. Available at https://www.gov.uk/government/organisations/department-of-health-and-social-care (Accessed 11 April 2020).

LibreOffice (n.d.) ‘Calc’ [Online]. Available at https://www.libreoffice.org/discover/calc/ (Accessed 11 April 2020).

Matt Hancock gives first coronavirus briefing since coming out of isolation (2020), Youtube video, added by The Sun [Online]. Available at https://www.youtube.com/watch?v=qrF6Z8s5dmw (Accessed 10 April 2020).

Merrick, R. (2020) ‘Coronavirus: Health secretary Matt Hancock tests positive’, The Independent, 27 March [Online]. Available at https://www.independent.co.uk/news/uk/politics/coronavirus-matt-hancock-boris-johnson-test-positive-covid-19-symptoms-a9430031.html (Accessed 10 April 2020).

Microsoft (n.d.) ‘Office Excel’ [Online]. Available at https://products.office.com/en-gb/excel (Accessed 11 April 2020).

The Visual and Data Journalism Team (2020) ‘Coronavirus pandemic: tracking the global outbreak’, BBC News, 10 April [Online]. Available at https://www.bbc.co.uk/news/world-51235105 (Accessed 11 April 2020).

World Health Organization (2020) ‘Coronavirus Disease (COVID-2019) press briefings’ [Online]. Available at  https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings (Accessed 10 April 2020).

World Health Organization (n.d.) ‘Biography of Dr. Tedros Adhanom Ghebreyesus, Director-General’ [Online]. Available at https://www.who.int/antimicrobial-resistance/interagency-coordination-group/dg_who_bio/en/ (Accessed 11 April 2020).

Worldometers (2020) ‘COVID-19 coronavirus pandemic’ [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 11 April 2020).

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Journalism

Coronavirus (COVID-19): Understanding the New Status Quo, Following Governmental Advice, and Interpreting the Numbers

We have heard the advice, but how can we interpret the information? Why follow the lockdown protocols? This article will clarify the coronavirus’ status quo.

UK-specific numbers:

CONFIRMED CASES: 47,806.

PATIENTS DISCHARGED: 135.

PATIENTS WHO DIED: 4,934.

(GOV.UK, 2020b)

What’s the difference between the coronavirus and COVID-19?

The coronavirus is what people catch, and the COVID-19 is the respiratory disease that can develop. A good analogy for understanding the differences between the two terms is HIV and AIDS. Whilst not all people who test positive for HIV develop AIDS, those who do develop it become severely ill. Similarly, not everyone testing positive for the coronavirus develops COVID-19, but those who do develop it are hospitalised and become severely ill. This is why preventing catching the coronavirus is just as important as preventing catching HIV.

What is the likelihood of catching the coronavirus?

As of the date of this writing, and according to Worldometers (2020a), there have been 47,806 confirmed cases in the UK, which has a population of 67,802,457 (Worldometers, 2020b). This means that the total number of hospital admissions per 1 million population is approximately 704, and the number of deaths per 1 million population is 73. Furthermore, Plymouth (the city where I live) had a population of 264,200 as of February (World Population Review, 2020), and as of the date of this writing it has had a total of 102 hospital admissions (GOV.UK, 2020b), out of which 13 (approximately 12.8%) patients have died (O’Leary, 2020); which means that even though there is a low risk of catching the virus, those who do catch it and develop COVID-19 are at high risk of dying.

Why should I stay at home?

Because you do not know whether you are infected or not, and if you are coronavirus positive but you have not developed COVID-19; you could still pass the virus onto other people who might be more vulnerable than you and who might develop COVID-19. Alternatively, you could catch the virus and in the worst case scenario die.

How is staying at home protecting the NHS?

When you prevent catching the coronavirus, you also prevent spreading it around. This means that you are doing everything you can to make sure that the NHS does not become overwhelmed with patients.

What preventive action can be taken?

  • You could self-educate on the topic in order to feel confident that you know what’s going on, and how to survive the crisis.
  • You could stay home in order to prevent becoming a patient, or spreading the virus (creating patients). This means that the NHS will have more supplies to deal with the overwhelming number of cases, and those severely ill will have a higher chance of getting the medical attention and equipment that they need.
  • You could share the information with your friends and family.

What reliable advice is available?

  • The World Health Organization (WHO; 2020a) has a section dedicated to the coronavirus pandemic with all available scientific information.
  • The NHS.UK (2020) has a section also dedicated to the disease.
  • The GOV.UK (2020a) also has a section dedicated to the lockdown in relation to the pandemic.

How is the virus transmitted?

According the World Health Organization (WHO; 2020b) “COVID-19 virus is primarily transmitted between people through respiratory droplets and contact routes […] transmission of the COVID-19 virus can occur by direct contact with infected people and indirect contact with surfaces in the immediate environment or with objects used on the infected person […] Airborne transmission is different from droplet transmission […]can remain in the air for long periods of time and be transmitted to others over distances greater than 1 m”.

References

GOV.UK (2020a) ‘Coronavirus (COVID-19): what you need to do’ [Online]. Available at https://www.gov.uk/coronavirus (Accessed 5 April 2020).

GOV.UK (2020b) ‘Total UK COVID-19 cases’, 4th April [Online]. Available at https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (Accessed 5 April 2020).

NHS.UK (2020) ‘Advice for everyone’, 3 April [Online]. Available at https://www.nhs.uk/conditions/coronavirus-covid-19/ (Accessed 4 April 2020).

O’Leary, M. (2020) ‘Ten coronavirus deaths confirmed in past 24 hours across Devon and Cornwall’, Plymouth Herald, 5 April [Online]. Available at https://www.plymouthherald.co.uk/news/uk-world-news/coronavirus-death-toll-uk-risen-4021937 (Accessed 5 April 2020).

World Health Organization (2020a) ‘Coronavirus disease (COVID-19) pandemic’ [Online]. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (Accessed 5 April 2020).

World Health Organization (2020b) ‘Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations’, 29 March [Online]. Available at https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations (Accessed 5 April 2020).

World Population Review (2020) ‘Plymouth population 2020’, 17 February [Online]. Available at https://worldpopulationreview.com/world-cities/plymouth-population/ (Accessed 5 April 2020).

Worldometers (2020a) ‘COVID-19 coronavirus pandemic’, 5 April [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 5 April 2020).

Worldometers (2020b) ‘U.K. Population’, 5 April [Online]. Available at https://www.worldometers.info/world-population/uk-population/ (Accessed 5 April 2020).

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Journalism Opinion Science

Coronavirus (COVID-19) Brief: Protection Motivation Theory, Outbreak Appraisal, and Understanding Collective Behaviour

The world is in chaos. The coronavirus has accelerated at an unprecedented rate, leaving planet Earth feeling vulnerable and in a state of collective sorrow. Things have never been like this. Unless you are over 100 years old, you have never witnessed this level of transnosological danger in your entire life. Due to the panic-ridden headlines, many people are experiencing an aversion to potential loss or potential grief. Others seem to be in denial. Where is the balance? This article aims to explore some of the facts, figures, and dynamics determining coronavirus-associated behaviour.

“Protection motivation theory describes adaptive and maladaptive coping with a health threat as the result of two appraisal processes: threat appraisal and coping appraisal“.

Norman and Conner (1996, p. 11)

Threat Appraisal

Worldometers (2020)

As of 28/03/2020:

TOTAL GLOBAL CASES: +602,000

TOTAL GLOBAL DEATHS: +27,400

TOTAL GLOBAL RECOVERIES: +133,500

How severe is the threat?

The threat is perceived by the public as extremely severe and unprecedented. Here in the United Kingdom it has been set as high risk; and this is why Primer Minister Boris Johnson has enforced the draconian lockdown (Cabinet Office, 2020). The virus is very contagious, and due to the increasing death rates people are feeling very susceptible with this disease threatening their physical integrity, and potentially their life or the life of those whom they love. Nevertheless, it must be objectively said that 95% of recorded cases worldwide report mild symptoms. Yet, from mild symptoms have arisen many deaths.

How susceptible am I to the threat?

It seems that among the high risk groups are people over 80 years old, those with underlying health conditions, and smokers with chronic pulmonary problems. Furthermore, according to the United Nations (2020): “The risk depends on where you are – and more specifically, whether there is a COVID-19 outbreak unfolding there”. In other words, demographic variables will indicate the level of risk in specific areas. For instance, the South West area where I live in the UK is the area with the lowest risk of contamination (GOV.UK, 2020b), and my city (Plymouth) has only 26 cases so far (O’Leary, 2020). Furthermore, commenting on the safety of packages and deliveries, the UN (2020) further states: “The likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes COVID-19 from a package that has been moved, travelled, and exposed to different conditions and temperature is also low”. So if you are concerned about me, don’t worry, I am ready.

I sanitise my body, my environment, and my mind. Call me mad, but I’ll survive.

How is the virus appraised by the global government?

The World Health Organization (WHO) has warned the world about the fact that no antibiotics, no medication, and no vaccination has proven to prevent or cure the coronavirus. Therefore, they appraise this as a serious situation.

World Health Organization (2020).

What are mental health experts saying?

Mental health experts understand that this is without a doubt a stress-generative situation. The uncertainty that COVID-19 triggers is in many cases inevitable. Furthermore, the unpredictability and uncontrollability that manifest with the facts and figures are a source of anxiety for many people. Nevertheless, this does not mean that pre-emptive and preventive action cannot be taken. The GOV and the WHO have issued specific guidance which can help reduce the hazard and intensity of the situation. Sanitary action is in this case reasoned action, and this can be planned, performed, and maintained in order to cope with the threat in an adaptive way. Moreover, because this is an extraordinary situation which has disrupted the standard routines of many people, there is a certain level of confusion, fear, and worry. Remember to:

  • Wash your hands with soap as frequently as possible for 20 seconds.
  • Stay indoors unless it is absolutely necessary to go out to seek medical care.
  • Order groceries online as infrequently as possible instead of going to the shop (even though online deliveries are the least unsafe option, there is still a risk of contamination through such medium).

Coping Appraisal

INTERNAL LOCUS OF CONTROL: Factors which can be totally controlled by and depend solely on the individual.

EXTERNAL LOCUS OF CONTROL: Factors which can’t be controlled by and do not depend on the individual.

(Norman and Conner, 1996).

I see people behaving like nothing is happening. Am I too paranoid?

No. What you see happening is a state of collective denial. People keep going to work, doing physical exercise outdoors, and attending social gatherings because they are underestimating the severity of the threat. The kind of self-absorption that is dominant in individualistic, Western societies is an intellectual disadvantage in this case which requires an analysis of global events and behaviour. It only takes analysing what is happening in China, the US, Italy and Spain to understand that due to the incubation period of the virus (up to 2-3 weeks; Worldometers, 2020) it is quite possible that the COVID-19 is having a delayed impact in the UK. The virus does survive a long time in the air, meaning that it can be breathed quite easily. This is why a two metre distance is advised. Those behaving as if nothing was happening are not able to rationalise the threat because being able to move around gives them a false sense of being in control of the situation. In my opinion, it is an unnecessary risk they are taking. Similarly, those going to work outside the emergency system are still playing down the risk.

According to Norman and Conner (1996), the more an individual perceives potential health susceptibility, and the more that the threat is perceived to be severe, the more fear arousal there is. This means that the way people respond to the outbreak will depend on their level of awareness about the high risk the coronavirus poses. For instance, here in the UK there are more deaths than recoveries, and the counter for recoveries has been stuck at 135 (GOV.UK, 2020b) for several days already, unlike the counters for new cases and deaths, which keep burgeoning. This is problematic and worrisome. So if you are feeling too paranoid and as if you are being too careful, rest assured that you are just being as careful and responsible as you and everyone else are expected to be.

What can I do to calm down?

This is a good question, as everything functions better when people remain calm. There are many variables that are within your locus of control, such as the way you interpret the situation (perception) which can be optimised by engaging in intellectually stimulating activities such as reading, watching films, or having conversations. The more you learn, the more confident you will feel in assessing risk, and the more you will engage in reasoned behaviours that promote health and prevent disease. Another variable that you can control and nourish in yourself is your emotional wellbeing, which can be enhanced by ensuring that you get enough sleep (this will also boost your immune system, and will therefore help you fight off infections; NHS.UK, 2018), that you eat well, and that you have a tidy and clean environment around you. If you have long-term conditions, it is necessary that you continue to take your prescribed medications during this time in order to keep healthy. Furthermore, remember that you have the capacity of preventing contamination by following the guidance. Successfully executing the recommended courses of action will help you feel self-efficient and safe. Engage in some yoga or pilates at home, entertain yourself, and stay in touch with your family and friends digitally. Keep the following points in mind:

  • Neither underestimate nor overestimate the magnitude of the situation. Stay tuned for the facts and figures.
  • You can sign online petitions to participate in requesting specific outcomes for the common good.
  • Plan for short to medium term supplies and associated variables of a lockdown.
  • Mental contagion can happen if you allocate too much time and attention to digital material which is sensationalist or misinformed. Be wise about the type of information you consume.
  • Double check that your beliefs about what is healthy are not based on misinformation. Here are some myth busters to keep in mind:

What factors are not under my control?

There are several variables that could become a source of frustration during the lockdown. Anything that is outside your mind, and outside your environment is outside your control. You are not responsible for the behaviour of others, and the best thing you can do is share the guidance with your loved ones and hope that they follow it. Moreover, you have no current participation in most of the decision-making processes of the jurisdiction (e.g. the legal measures being duly taken by the GOV in relation to this pandemic). If you are not able to work from home, and cannot make money as a result, you might feel like everything is going to collapse, and in such case all you can do is hope that the GOV will protect your welfare, as such decision is within their locus of control. If you are a key worker, you might feel that your life is being put at risk in order to save the life of others. All you can do is hope that the GOV will listen to the healthcare industry in regards to the much needed protective equipment, spaces, and ventilators. This too is within the GOV’s locus of control. For example, medical staff in Spain are being forced to sedate and asphyxiate the elderly to death in order to use their ventilators on younger patients. Because providing equipment is a decision which only the Spanish political leaders can make, doctors are having a psychological breakdown and are accusing the authorities of genocide for neglecting the welfare of vulnerable citizens. Take a look at this video:

References

Cabinet Office (2020) ‘Guidance: Staying at home and away from others (social distancing)’, GOV.UK, 23 March [Online]. Available at https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others (Accessed 27 March 2020).

GOV.UK (2020a) ‘Coronavirus (COVID-19): what you need to know’ [Online]. Available at https://www.gov.uk/coronavirus (Accessed 27 March 2020).

GOV.UK (2020b) ‘Total UK COVID-19 Cases” [Online]. Available at https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (Accessed 27 March 2020).

Hamzelou, J. (2020) ‘How long does coronavirus stay on surfaces and can they infect you?’, New Scientist, 25 March [Online]. Available at https://www.newscientist.com/article/2238494-how-long-does-coronavirus-stay-on-surfaces-and-can-they-infect-you/ (Accessed 27 March 2020).

Johnson, B. (n.d.) ‘About Boris’, Boris Johnson [Online]. Available at http://www.boris-johnson.com/about/ (Accessed 27 March 2020).

NHS.UK (2018) ‘Why lack of sleep is bad for your health’ [Online]. Available at https://www.nhs.uk/live-well/sleep-and-tiredness/why-lack-of-sleep-is-bad-for-your-health/ (Accessed 27 March 2020).

Norman, P. and Conner, M. (1996) ‘The role of social cognition in health behaviours’, in Conner, M. (ed) Predicting Health Behaviour, Buckingham, Open University Press, pp. 1-22.

O’Leary, M. (2020) ‘Four new coronavirus cases confirmed in Plymouth’, Plymouth Herald, 26 March [Online]. Available at https://www.plymouthherald.co.uk/news/plymouth-news/four-new-coronavirus-cases-confirmed-3989498 (Accessed 27 March 2020).

United Nations (2020) ‘Coronavirus (COVID-19): Frequently Asked Questions’ [Online]. Available at https://www.un.org/en/coronavirus/covid-19-faqs (Accessed 27 March 2020).

World Health Organization (2020) ‘Coronavirus disease (COVID-19) advice for the public: myth busters’ [Online]. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters (Accessed 27 March 2020).

Worldometers (2020) ‘Coronavirus Update (LIVE)’ [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 27 March 2020).

Categories
Journalism Science

Coronavirus (COVID-19): Base Rate Fallacy, Everyday Heuristics, Panic, and the Media’s Influence

The digital world is spreading the panic disease at a faster pace than the coronavirus outbreak. It is very easy to panic when confronted with sensationalist information. This is why analysing the situation closely is the best thing anyone can do for their mental health.

Overview:

So far, there have been over 244,000 reported cases globally, and out of those over 10,000 have resulted in death, and over 87,000 have resulted in recovery. This suggests that the great majority of infected people recover. Moreover, there are over 147,000 active cases, out of which more than 139,000 are reported as in mild condition, whereas only 7,516 are reported as in critical condition. This indicates that most people diagnosed with the disease are at low risk of death in comparison with the minority which is at high risk of death. It is true that coronavirus death rates have been burgeoning. Nevertheless, there are many reasons why people die, and it is important to keep these rates in mind when making inferences.

Worldmeter (2020).

Daily global deaths:

  • Over 1,000 have died today due to COVID-19
  • Over 1,000 have died today due to seasonal flu.
  • Over 2,500 people have died today by suicide.
  • Over 2,500 people have died today due to malaria.
  • Over 6,000 people have died today due to alcohol.
  • Over 4,000 people have died today due to HIV/AIDS.
  • Over 13,000 people have died today due to smoking.
  • Over 21,000 people have died today due to cancer.

Worldmeter (2020).

UK specific figures

“As of 9am on 19 March 2020, 64,621 people have been tested in the UK, of which 61,352 were confirmed negative and 3,269 were confirmed positive. As of 1pm 144 patients in the UK who tested positive for coronavirus (COVID-19) have died”.

GOV.UK (2020b)

Understanding global emergencies

What is the level of risk with the coronavirus?

Based on the research presented above which was collected today, so far the risk that the coronavirus poses is very similar to the risk that the seasonal flu poses. The problem is that COVID-19 has no vaccination yet, and it is also extremely contagious in comparison to less contagious diseases such as AIDS/HIV. Another risk is that the virus is spreading very fast.

Should I panic?

No. Panic is not good for anyone. Panic happens because the media industry tends to engage in what can be described as a base rate fallacy (Hardman, 2015) which is the idea that people tend attribute a higher level of risk to a situation when they are not aware of the actual base rates of such phenomena. As demonstrated with the above mentioned figures, COVID-19 has still not reached a point where it surpasses other illnesses which are also global emergencies, such as malaria, HIV/AIDS, and cancer. And whilst it is true that the coronavirus’ rates have been burgeoning and it is spreading super fast, there is hope that it can be tackled (i.e. most people recover).

What other cognitive biases should I be aware of when it comes to illness?

Apart from the base rate fallacy, there is another everyday error people make when making sense of information, and this phenomenon is called availability heuristic (Hardman, 2015); which happens when people consciously allocate their attention to a specific situation whilst at the same time ignoring equally important situations, and then believing that whatever they paid attention to has a higher frequency than what they never consciously paid attention to. In the case of COVID-19, as demonstrated above, there are currently other diseases with death tolls way higher than this virus. Nevertheless, due to this cognitive bias people tend to think that COVID-19 has a higher frequency of deaths than other illnesses, but this happens because the media industry is selective about the information they present to the public, and the information they omit. The daily death tolls mentioned above are evidence about base rate fallacy and availability heuristics present in everyday interpretation of data.

What can I do to protect myself?

  • Follow the GOV.UK (2020a) advice.
  • Take a deep breath, we are all doing the best we can to help.
  • If you are experiencing flu-like symptoms, contact your doctor or call 111 (NHS, 2020).
  • Wash your hands regularly with soap and warm water.
  • Critically judge death rates without panicking.
  • Self-isolate, and remain informed about developments of the outbreak.
  • Be kind to emergency staff, as their job has no lockdown.
  • If you are a journalist, be mindful about how you present your information. Everything functions better when people remain calm.

References

GOV.UK (2020) ‘Coronavirus (COVID 19): UK government response’ [Online]. Available at https://www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response (Accessed 19 March 2020).

GOV.UK (2020b) ‘Number of coronavirus (COVID-19) cases and risk in the UK’ [Online]. Available at https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public (Accessed 19 March 2020).

Hardman, D. (2015) ‘Everyday errors in making sense of the world’, in Barker, M. J. and Turner, J. (eds), Living Psychology: From the Everyday to the Extraordinary, Milton Keynes, The Open University, pp. 51-85.

National Health Service (2020) ‘Coronavirus (COVID-19)’ [Online]. Available at https://www.nhs.uk/conditions/coronavirus-covid-19/ (Accessed 19 March 2020)

World Health Organization (2020) ‘COVID-19 situation’ [Online]. Available at https://experience.arcgis.com/experience/685d0ace521648f8a5beeeee1b9125cd (Accessed 19 March 2020).

Worldmeter (2020a) ‘COVID-19 Coronavirus Outbreak’ [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 19 March 2020).

Worldmeter (2020a) ‘Worldwide’ [Online]. Available at https://www.worldometers.info (Accessed 19 March 2020).