The beginning

Before this beginning, there was an end. I guess that’s the way for most things; stories wax and wane, stop and start, fade and are reborn. For me, the end of the previous story was my stepping away from the NHS and my role there as a clinical psychologist. That was a whole different story that I’m not sure I’ll ever share in full. But the next part, the way out of the fog, the personal rebuilding, renovating, restoring took the form of creating something new, something energising, collaborative and connected. Along with a couple of trusted and much loved colleagues, I set up a social enterprise to allow us to work with people in the community who wanted to have healthier, happier, more connected relationships with others.

I wanted to share with you some of our thinking behind Altogether Human CIC and why it is centred in our unshakeable belief in people and the power of human connection.

Lessons from the NHS

I am still a huge supporter of the NHS and a service for people that is free at the point of access. I believe in this wholeheartedly. I wish it was possible, functional, feasible but without getting too political within this blog in particular, my experiences within the NHS over the past 15 years taught me that something significant needs to change in order for the NHS to work. And my sense is that this is not going to happen with the Conservatives in charge.

When I left the NHS it was like ending a relationship at a point when love was simply not enough to sustain it. I wrote a break up letter at the time which resonated with many others, and I’ve heard many more people speak in similar ways since then.

But what are the problems?

The NHS is overwhelmed. This was true before COVID-19 was on the scene, and now it is even worse. Burnout is high, compassion is low. Staff members feel undervalued and overworked. Staff wellbeing is low and mindfulness classes or compassion focused supervision groups are much needed but simply aren’t enough.

We live in a country where the divide between the wealthy and the poor is increasing, where family conflict, stress, confidence issues and physical health concerns (to name a few) are on the rise, where COVID-19 has led to increased isolation, worry and unpredictability, where children and teenagers are struggling to socialise, feel connected and deal with anxiety, where parents are trying to support home learning, working from home and changes to schedules happen at the drop of a hat. The demand for NHS services is far outstripping what can be provided by what is predominantly an individualistic model of psychological therapy geared towards individuals accepting they have an internal problem that they need to work out how to change.

In Greater Manchester, waiting lists are long. Gaskell House Psychotherapy Centre, an NHS provider for Greater Manchester for adults notes on their website that “there is a waiting list for most therapy which can be several months”. In 2020, our CAMHS services had a mean of 23 weeks wait for an appointment, although “routine” cases were closer to a 42 week wait. More recently, anecdotally, I’ve heard of longer and longer waits.

We need a different model; we need to find a different way. And we need to do this urgently.

So what can we do differently?

Good question, I’m glad you asked ;)

We have had a lot of ideas. For now, I’ve narrowed it down to these four (which was a challenge):

1. Agitate for change

2. Focus on the fundamentals

3. Stop treating people like they are their problems

4. Don’t forget friends and families

So here goes….

1. Agitate for change

I used to think I wasn’t politically minded. Maybe I was socialised into not expressing a clear opinion because I’m a woman, maybe there weren’t engaging conversations about politics at school, I certainly remember being put off most discussions when debating the issue was suggested (or foisted upon us). Maybe I was deceiving myself in this belief as memories of writing petitions in school and writing a letter to my father objecting to what felt like draconian discipline at the time are popping into my head and raising a smile as I type.

Anyway, I formed this belief about myself until I was in my thirties when I seemed to engage more in ideas about social change. I joined activist organisations like the Psychologists for Social Change movement, and formed a local activist group called the Chorlton Craftivists. Last year I even signed up for a qualification in Social Justice to help to shape our work at Altogether Human CIC (more on this another time)! Connecting with other people to amplify voices and communicate on important issues, policies and decision making is an important part of what we can do differently.

2. Focus on the fundamentals

Altogether Human CIC is so named because of our belief that we are all human. We do our best to live alongside one another in peace, showing kindness, care and love to our families, our neighbours, our communities. But we also know that we are flawed, sometimes deeply. We cause harm to others, we make mistakes, we hurt people and sometimes we cause such pain that we lose our connection with people we love.

We consider the fundamentals to be these things — our desire for human connection in many forms and our belief in identifying and reducing suffering where possible.

This leads me to the next point…

3. Stop treating people as if they are their problems.

Anyone who knows me knows I’ve had a problem with the medical model for quite some time. Perhaps this is connected to my past experiences of having been labelled and treated in particular ways as a result — again, possibly a story for another time. For now, at least, suffice it to say that people are not defined by their diagnoses (or other non-diagnostic terminology). And problems are much easier to deal with if they are externalised. Talk to a man about what has happened since jealousy came into his life and compare that (and the outcome) to what happens if you tell him he’s a jealous man. Talk to a child about what happens when worry comes around, and what happens to worry when courage turns up, and it’s a different conversation from the one you could have been having with them or their parents about them being an anxious child. And don’t even get me started on what often comes along with the heavier diagnoses (not necessarily for everyone but for many) — bipolar, depression, schizophrenia, personality disorder… people are not defined by their diagnoses and treating us this way contributes to all sorts of problems like shame, inertia, lack of motivation, isolation, stigma, criticism and so on.

But if we aren’t going to see people in this way, what is more helpful?

Read on, read on…

4. Don’t forget about friends and family

We need to remember that human beings are social beings. Of course, we all have our differing ways of being sociable, and differing ways of expressing our social needs, but on the whole, connectedness, being understood, being held (metaphorically or indeed literally), being valued, being accepted, are all absolutely essential to our wellbeing. This is why we advocate for systemic thinking and practice in our work, why we do a lot of work with parents rather than children directly (parents will be around for that child far longer than we will), why we invite family members into sessions, why we have “supporters meetings”, why we talk about the family members around people as well as the internalised representation of family members or others that we often have inside ourselves. This is also why a large part of work is developing community initiatives and groups where people can come together, share ideas, reflect on relevant issues, build and develop new relationships, talk about and nurture existing relationships, learn the building blocks of connected and healthy relationships and discover and develop new, non-violent, compassionate ways of being alongside each other.

Because this is how we can have a bigger impact and a greater reach than sitting in a therapy room with one person at a time. This is how we can develop a network of compassionate, connected communities.

And so, to conclude…

We do not exist in isolation, nor should we try to. Reach out, take a risk, have the courage to connect and to be altogether human alongside us and with each other.