I was delighted to be awarded the VAMHN Early Career Researcher (ECR) bursary to attend the Trauma Summit in Dublin. The Summit was set to bring an array of international experts in the field of trauma recovery to discuss how to bring hope, healing and renewed life for the next generation. However, lockdown measures have thrust in-person scientific conferences onto virtual platforms (including mine). So, I was intrigued to experience the pros and cons of virtual conferencing on ECRs careers.
 
I am currently pre-PhD and my aims for attending this conference was to use the Summit to overcome the NIHR’s reported reasons for not being a successful PhD fellowship candidate. Those include a lack of ownership and feeling like the proposal came from your supervisor(s), gaps in supervisory teams, and insufficient dissemination plans. Therefore, I hoped to (1) learn what the current theories, techniques and practices were to treat/heal trauma (2) identify research gaps/assumptions specific to trauma caused by abused (3) network with international clinical and research experts to fill gaps in my supervisory team (4) note the real world challenges in theory practice gaps to develop an action-based dissemination strategy.
 
The learning was just as superb as an in-person conference with no technical glitches despite 1.5 thousand attendees logging in from around the world. The emerging themes included: how lockdown measures have impacted client’s symptoms and therapy practices, how talking therapies alone are no longer enough but physical techniques encompassing the body is imperative for wholistic healing and recovery and exploring a social justice approach to trauma treatment when it is caused by intergenerational, systemic abuse. Therefore, my aims to learn and identify were more than achieve online.
 
The online summit was adapted to include nine live keynote presentations and six pre-recorded workshops. During the keynotes you could anonymously pose questions to the speaker that would be voted by the other attendees. The questions with the highest votes were addressed. Whilst this was a practical solution the questions ECRs posted were never asked. Nearly every question that was answered was practitioner led. This was a disadvantage of the conference as the theory practise gaps unless explicitly note in the keynote was quite hit and miss.
 
The biggest ‘con’ of online conferencing is the networking element. A researcher’s calendar is already often overcrowded and these conferences are the prime opportunity to establish new as well as nurture old long-term, mutually beneficial relationships that can pay you back in dividends throughout the course of your career (particularly at the beginning stages). This is where the power of Twitter comes in. With no online way of networking option, I took to the Summit’s Twitter handle and followed the keynote and workshop leaders that interested me and made sure to tweet them about their talks. Likewise, I followed the conference tweets and followed/retweeted/ the attendees whose comments sparked my interest. Whilst not quite same as in-person networking I still managed to strike up potential research collaborations for the future.    
 
My reflections of virtual conferencing in a lockdown world would be to be proactive in your attendance. Write down beforehand what you’d like to get out of the conference. Keep a journal of your personal and professional research reflections to look over after the conference and get on Twitter and use that as a platform to facilitate networking.

Tony Slattery is a brave man. Brave to allow cameras and documentary makers to follow his journey into consulting rooms, to watch raw and intimate moments, to chart an unfolding story. Inevitably, there must be moments that we didn’t see, details which were edited out. So this review can only be based on what was included as visible narrative.

This moving documentary began explicitly with the question of diagnosis. Tony outlined his long struggles with mental health, but searching for an answer about what was wrong. The premise of the documentary was that if diagnosis was unclear, then treatment would be unclear. In essence, this programme was asking, ‘what is wrong with Tony?’.

There was a review of notes, of his history and symptoms, and debates about whether there was a missed diagnosis of bipolar disorder. There was a layering of presenting issues – talent and fame, overwork, alcohol misuse, cocaine, sleep deprivation, elated mood, slipping into mood swings, paranoia, depression, isolation and his feeling of stasis. 

The language used in the narrative was interesting – strikingly medical. We were led through a story which searched for ‘diagnosis’; ‘treatment’; and at points, made references to a ‘diagnosis lurking there’ or Tony being ‘suspected’ of having bipolar disorder. Several times, Tony mentioned waking up angry, and it wasn’t clear why; no-one appeared to pursue it.

Eventually, there was a question about Tony’s past, and whether it could be linked to his problems. When Professor Ciaran Mullholland enquired about Tony’s past, the scene was incredibly powerful. Tony spoke bluntly, relating a shocking experience, with the burst of someone who’d been waiting years and years to speak about what had happened to him. He disclosed that he’d suffered sexual abuse by a priest when he was 8 years old. This appeared to be the first time that any link had been made between childhood sexual abuse and his mental state; that the ‘symptoms’ could be seen as efforts to cope with abuse and its aftermath. Tony had already disclosed to his long term partner, Mark; but it was clear that Mark was taken aback by Tony’s stark words in the consultation. Abuse can have profound effects upon people, and it can take decades to feel able to speak about it.

What was especially saddening was that it appeared as though no clinician had asked him about abuse before. It was heartbreaking to hear Tony trying to digest that abuse could have harmed him, using terms like ‘self-indulgence’ when he was speaking about it. These comments are a window into the pressures on victims not to speak up, perhaps particularly for male victims within a society that promotes self-reliance and silence around men’s health. His partner, Mark, quietly pointed out how often Tony referred to his traumatic past, more than Tony realised.

For me, Tony’s story reinforced the importance of routine enquiry (Read et al., 2007; Read & Bentall 2012), foregrounding the issues around disclosures of non-recent abuse (BPS, 2016) and the need for trauma informed responses in mental health services (Sweeney et al, 2016). I was disappointed by the absence of a clinical psychology voice in the programme. 

Tony disclosed and there was almost passing reference to talking therapy for trauma. But his story of trauma appeared to slip away. Even as Tony mused on whether he was drinking to avoid other issues, he was redirected – in a somewhat didactic conversation - to reduce alcohol.

There was a chance for this documentary to match Tony’s bravery – to move to ‘What happened to Tony Slattery?’

The apparent sidelining of his trauma was startling. For all of us, it is our personal stories which make us who we are. It is under-recognised trauma which may explain ‘medication resistance’ for a number of people within mental health services. Drugs can dull pain, but they don’t rewrite the meaning of that pain. That is where talking is medicine.

Watch the programme now 
Dr Khadj Rouf, Consultant Clinical Psychologist 

Khadj is Chair of the BPS Safeguarding Advisory Group, and works for Oxford Health NHS Foundation Trust. She is also a survivor of child abuse and has also published resources from a personal perspective. Find more about her and her work in our archive.

References

• Read, J., Hammersley, P., & Rudegeair, T. (2007) Why, when and how to ask about childhood abuse.  Advances in Psychiatric Treatment,(13), pp. 101–110 doi: 10.1192/apt.bp.106.002840
• Read, J. and Bentall, R.P. (2012) Negative childhood experiences and mental health: theoretical, clinical and primary prevention implications. The British Journal of Psychiatry, 200, pp.89-91.
• Sweeney, A., Clement, S.,  Filson, B. & Kennedy, A. (2016) Trauma-informed mental healthcare in the UK: what is it and how can we further its development?", Mental Health Review Journal, Vol. 21 Issue: 3, pp.174-192

Recommended reading 

• BPS (2018) Safeguarding Children and Young People: Every Psychologists Responsibility 
• BPS (2016) Guidance on the Management of Disclosures of Non-Recent (Historic) Child Sexual Abuse    

If you have been affected by the issues in this article, please see sources of support:

• ​NSPCC 
• National Association for People Abused in Childhood (NAPAC) 
• The Truth Project - see also our interview with Rebekah Eglinton
• Rape Crisis England 
• The Samaritans