Rest thee well, Greg.

TVNZ journalist and news reader Greg Boyed died this week while on holiday in his wife’s home country, Switzerland. Unknown to me and many others, he was fighting depression and it appears that it got the best of him.

I knew Greg professionally because he interviewed me a few times. But I knew him personally as well because his wife and son attended the same playschool that I did with my son for a couple of years. Greg would come by regularly to share parental duties and he and I would reflect on the world of children and the larger world around us. From those conversations and my professional interactions with him, I can say that Greg was a good man with a keen mind and a fair heart, an honest journalist and a loving father. I am deeply saddened to see him go and I grieve for his widow and son.

In a business full of poseurs and shills, Greg was the real deal. He will be missed not just by his colleagues but by his audiences as well.  He is the second journalist friend of mine who has departed this realm in recent months, in similar circumstances. I can only despise the darkness that comes upon such talented and decent people and can only hope that others going through what they did can find the help that they need in order to carry on well before the darkness finally envelopes them.

May his whanau find comfort in the legacy he has left behind and in the affection and respect he received from a broad swathe of people.

Rest easy my friend.

Angry losers who can’t get laid.

What do Islamic extremists, alt-Right adherents and the Incel movement have in common? Many people might say “nothing,” but the truth is that for all their differences when it comes to socio-economic, cultural and ethnic identity, these almost exclusively all-male groups all share at their core the same misfortune: they cannot get laid. The inability to find sexual relief in turn fuels their regressive views of the social order and penchant for authoritarian governance because rather than fault themselves they blame others for their predicament, whether the others be infidels, “libtards” or women.

Of course, not every single jihadist or white supremacist is involuntarily celibate. Socio-economic and cultural conditions clearly factor into the extremist equation. But underlying all of that is sexual frustration expressed as sociopathic rage and, in many cases, violent to the point of homicidal tendencies. In some cultures, religiously-codified sexual repression produce a seething mass of angry young men unable to make basic connection with the opposite sex and/or drive them, at considerable peril, into closeted relations with other men. In other instances it is the inability to fit into the sexual mainstream (i.e. get a date) that drives individuals to extremism.

In previous years these social losers would by and large retreat into mastubatory isolation. Now, easy access to porn and the networking reach of social media allow them to feed off of each other’s misery and accelerate their descent into darkness. It allows them to mutually sharpen their objectification and contempt for those who would not have them. That makes them susceptible to manipulative explanations that their plight is the fault of others rather than themselves.

I say this because I have seen a fair bit of pop psychologising about terrorists but relatively little about other angry male sub-strata. When news broke of a Canadian incel running down people with a van in Toronto, it dawned on me that a common thread amongst virtually all male extremists is sexual frustration and rage. Again, this is not to claim that the trait is universal or that it is exclusive to Right wing militants, but there is enough evidence of it to suggest a pattern. So here is my pop psychology theory (which I shall call the “Psychosexual Theory of Extremism” in order to make it sound serious and give the impression that it is based on years of in-depth research): most Rightwing extremism has at its core a deeply rooted sexual origin, specifically manifest as sexual frustration translated into manipulable rage.

I am not sure which is worse, culture where sexual oppression is religiously condoned and institutionalised, or culture where sexual expression is by and large free but vacuous materialism and impossible to achieve post-modern notions of physical and social appeal combine in practice to limit carnal choices by the socially maladjusted or inept. And, whereas women tend to respond to feelings of social alienation by turning on themselves, men are more prone to act out their anger and frustration on others (I realise that I am generalising here so am happy to stand corrected).

Nothing I have said is new. The role of suppressed sexual desire in fostering rage that can be politically exploited is bound to be a constant in psychological studies of individual and collective violence. In fact, back in my days of working with unconventional warfare and counter-insurgency types, the joke was that many on the Left side of the extremist continuum joined in order to get laid (by other impressionable young militants) while those on the Right did so because they could not get laid even if their lives depended on it. That could well still be true.

Even so, it was my introduction to the incel crowd thanks to coverage of the Toronto murders and a conversation with an academic who thinks about such matters about the degree of misogyny and murderous anger expressed in incel circles that made me twig on the fact that they may well overlap with Alt-Right freaks and jihadi wanna-be’s much more than has been commonly acknowledged. Perhaps readers can illuminate me as to who has written in depth on the subject if that indeed is the case.

I cannot offer a remedy to the problem of sexual frustration leading towards violent extremism because the causal mechanisms are not simple and the remedies are not just a matter of finding girlfriends, boyfriends, prostitutes, spouses or partners. I do not know how to properly “channel”  the sexual rage of politically and socially reactionary angry males. So if anyone has ideas in this regard, feel free to share them because anything short of electroshock or forced conversion therapy that reduces the chances of such types going off the rails is worth trying.

In the meantime, beware the wrath of the blue-balled monsters.

Spare a thought for grumpy old men.

At an early age, I knew that I was going to be athletic-minded. I used to say to my father “I am immortal until proven otherwise!” and, much to his consternation and that of my mother, set out to prove the point by engaging in a number of risk taking (read: stupid) activities. More constructively, from the age of seven I played sports, lots of them. I played team sports and I played individual sports. I ran, I swam, I rode bikes and I raced around fields throwing, catching and kicking balls. Those balls were big and small, oval and round, and I waved an assortment of sticks at them when duty required.  Heck, I even tried ice hockey even though I could not skate: the team made me a maskless goalie on sneakers while I learned to skate until I realised that was a losing proposition.

I  boxed and I tried judo. I was a gym rat that lifted weights and even tried body-building for a decade or so. I loved to run trails, desert washes and beaches, preferably barefoot on the latter. I enjoyed the camaraderie of team sports and the solitude of the long distance runner. I got hurt a fair bit and I lost more than I won, but it was the act of competing, of testing my limits, that I most enjoyed. As I say to my kids, there is honour in losing so long as you make the other guys work hard for their win. After I had to give up team sports I endurance raced in order to justify my (compulsive) training, was a referee/umpire and coach in a couple of sports for a while and even surf lifeguarded to hone my open water skills and contribute to the community in which I now live. I also was able to engage in physical activities connected to government service before I moved to NZ, something that complemented my sports-minded approach to life.

Although my physical decline began with injuries dating back to the 1970s, things really began to unravel about ten years ago when I had a near-death experience that ended my competitive endurance racing life. Five knee surgeries had already given me a noticeable limp, and osteoarthritis in my feet, knees and shoulders made doctors comment that my X-rays looked like that of an 80 year old rather than a 40/50/60 year old. I ate aspirin like cereal and served as a involuntary guinea pig for the testing of assorted balms, lotions and other muscle and skeletal ache remedies.

With weight bearing activities no longer possible, I switched to indoor machines and eventually set up a home gym with stationary bikes, a rower and an elliptical machine. I spun, I glided and I rowed to the tune of thousands of songs, something I would never do when training outdoors. I was determined to make the most of what I had left in me, and enjoyed being able to use music as an external displacement/disassociation  training method rather than the internalisation/association techniques that are the stock of endurance athletes (where you go inside yourself to monitor your body’s performance rather than diverting attention into things like music).

While rowing two years ago I felt a twinge in my hip. I rested for a week, then resumed, only for the twinge to come back, this time a bit more sharply. Over the course of the next months that twinge turned into a constant sharp pain in my left side. It eventually started to affect my gait, as it became difficult to walk uphill or downhill (particularly the latter). I eventually stopped gong to the pool, not because I could not swim but because the walk from the parking lot was too painful and I was too unsteady on my feet on the damp surfaces of the pool decks and changing rooms.

Based on what I described, my GP prescribed industrial strength ibuprofen and paracetamol, but that only dulled the pain. Eventually, I had to stop trying to exercise as inevitably something would tweak and I would be immobilized for days. The more I was unable to exercise the more I put on weight while my legs atrophied. It was a vicious circle.

A few weeks before leaving to the US last July and at the insistence of my wife I told the GP that I was in fact barely mobile because of the hip pain. She ran some basic tests and said something to the effect of “your hip is munted.” The trouble was that my family and I were leaving on a five month sabbatical to the US and so there was nothing that could be done until we got back to NZ other than to eat painkillers. And so I did.

What I did not anticipate was that I would continue to deteriorate exponentially. I was walking with difficulty when we arrived at our place in Florida. A month later, when we moved to Boston, I could barely walk two blocks without having to stop and rest. A month into the Boston stay I couldn’t walk more than 100 meters, and a month after that I could not go even 20 meters without having to stop and do pain management. My wife bought me a walking cane and I began to use it. It was not enough.

All the meticulous planning for the division of labour while we were in Boston, where I was the designated support person, evaporated once we got there. I could not use pubic transport to shoulder my responsibilities as the primary caregiver, since even with the cane I could not get to the nearest bus stop in order to take the kid to the twice weekly pre-school we enrolled him in. Nor could I shop at the local grocery without assistance from strangers. By the time we left Boston I could not push a mop without having to take multiple breaks. That left everything in terms of domestic chores to the person who was there to do research and write, and that was not me. My physical condition became, and is, a family problem.

As part of the sabbatical we had a number of pre-booked domestic flights to take (we wound up taking 10 flights and spending 51 hours in the air during that trip).  By mid-October I could no longer walk through airport terminals even with the cane and started having to be wheeled from the check-in counters to the gates. Not only did I find that humiliating and a tremendous burden on my wife and four year old, but I discovered that many people simply do not see or dislike disabled folk and consider them nuisances or obstacles in their way. Making inter-terminal and rental car transfers were a nightmare, and contrary to popular belief, not all of my wheelchair bound passage was expedited by the TSA security people. Sometimes I got waved through, sometimes I was made to stand and go through the regular screening process, sometimes it was a little bit of both.

It was heartbreaking to see my old US friend’s faces when they set eyes upon me. The had images of me in my “prime,” and instead they got a hobbled shell of the guy that used to be. Although mellowed by experience, I still have the same persona, the same ideas, the same outlook on life as twenty or even thirty years ago, but the shell is not the same. It pained me to see how distressed my old friends were at the sight of me bent over on a cane at their doorsteps.

In December I presented myself to NZ Immigration in a airline-supplied wheelchair with a grumpy kid and a heavily backpack laden, sleep deprived Mom in tow. The arrangement with Air NZ, as far as I can tell,  is that they wheel people to the arrivals terminal greeting space. After that things are by private arrangement, including disposition of the the service chair in parking lots.

By the time we came back to NZ the hip pain had spread to the other side and lower back (it turns out that is typical of “end state” hip osteoarthritis). The day after we got back I saw my GP, who referred me for X-rays the next week. They showed that my left hip has no cartilage left and is bone-on-bone with spurs growing in the joint. The right hip is half as bad. Armed with that information, I was referred to a hip replacement specialist. I am now scheduled to have hip replacement surgery sometime in the next month or so.

When I saw the orthopaedic surgeon in early February the pain was constant and continues through the night. I was prescribed Tramadol, which again dulls but does not eliminate the pain even when taken in combination with other non-opioid pain relief. The hip is now structurally failing at inopportune times such as stepping from the porch to the footpath leading to the garage, to which can be added regular knee buckling when I overcompensate by putting most of my (over) weight on my right side.

There is no getting around the pain and structural failures. Consequently, we have curtailed our social activities away from home because I have great difficulty in accessing venues, and even disabled parking places are often too far from the destination for me to walk without stopping or assistance (I have a temporary disabled placard for the car, something that has introduced me to the special type of lowlife known as the able-bodied disabled parking space squatter). I try to avoid too many trips to the kitchen or bathroom because it hurts to get up and do the short walk to them. In effect, I am trapped in my body and pretty much homebound, using the car as wheelchair, the cane as a prop and relying on family and friends to help with simple chores. That sucks.

The real issue and the point of this post is pain. Pain robs one of the joy of life and even, after a while, of the will to live. Pain makes one timid, fearful that the next step will bring more injury and worse pain. Pain makes one irritable and short-tempered for no apparent reason. My ever patient and long suffering wife says that my smile is more often a wince these days. Pain makes one cynical, gloomy and pessimistic. Pain is an energy-sapping, tupor-inducing drain on life. It robs personality spark and it cripples spirit. If it cannot be stopped by medical intervention, it invites remedy by other means. Ever-present, pain is an all-encompassing, quality of life-ruining curse.

It ruins lives in many ways. I find myself getting short with my four year old when he is just being a kid and snap at my wife over silly or minor things. I increasingly dislike noise. I am mean-spirited more often than not. I feel envious of the able-bodied and am frustrated that I cannot chase my boy around the paddock or no longer do some funky chicken dance with him to the tune of the old roundtable or Mom’s CDs. The sum effect is to sink into a funk, although I am lucky in that I, for reasons known only to the goddess, have more of an optimistic than depressive personality.  But that does not mean that I am fun to live with in my current state. Because I, my friends, am a grumpy old man.

Hopefully all of that will end once I have the hip emplacement surgery. I am relatively young and am told that the pain goes away immediately, and that after the physical rehabilitation work I should be back to near-normal (that is, no more Ironman but I will be able to throw and kick balls with the kid and yes, trot after him when doing so). I sure hope so, and hope is my friend at this point.

But for others not as fortunate as me, hope may not be enough or no longer be possible. So please spare a thought for grumpy old men and women. Be it as a result of sports injuries, hard physical labour, chronic illness or accidents, many senior people are not irritable by choice. They too, are products of their pasts and they too are trapped in bodies that bear the physical consequences of lives spent in something other than splendorous leisure. Showing them empathy and compassion may not take away their pain, but it will at least show them that you share the understanding of what it does to them.

That is the best palliative of all.

Impoverished

The other day David Farrar got in a pre-emptive whinge about Bryan Bruce’s Inside New Zealand documentary on child poverty that aired last night on TV3 (you can watch it on demand if you missed it).

Maybe the outrage expressed by David and others of his ilk is somewhat justified. This is not a grey, respectful, nominally-neutral sort of a work; it’s an impassioned and at times ideological work of advocacy arguing that New Zealand society, and in particular its governments, ought to be ashamed at the circumstances many of our children live in, and a significant portion of that burden of shame can be directly linked to the policies of National governments. It airs four days before the general election. The Labour and Green parties bought lots of advertising during it.

So if David or anyone else wants to bring a BSA complaint against the broadcaster, or — as David implies by calling it a “free hour” for Labour — if he wants to complain to the Electoral Commission that the documentary should have included an authorisation statement as a campaign advertisement, then I think they should do so. Fair enough, if they can make something stick.

But consider the response: a documentary about child poverty, covering the appalling housing, health and nutritional outcomes borne by children in our society, and the immediate response is to launch a ideological defence of the National party and deride the work as nothing but partisan propaganda. But an interview Bruce gave to Glenn Williams (aka Wammo) yesterday, before the screening, contained the following exchange:

Wammo: “Politically, though, it’s tough, isn’t it, to remove that money from the ambulance at the bottom of the cliff and put it at the top.”
Bruce: “Politically?”
Wammo: “Yeah.”
Bruce: “This is not a political question, this is an ethical and a moral question. We all have to get together and figure out how we’re going to solve this, and what I’d like to see is a commitment from all the politicians that, after the election, whatever shade of colour they are, they sit down and talk about this and come up with a long-term plan for our children, just in the same way as we came up for the over-65s with our superannuation. The only problem is kids can’t vote.”

Yeah, it’s election week, and yeah, Labour are emphasising their poverty alleviation focus on the back of this documentary. But I haven’t heard a peep out of National about what they plan to do about the problems since it aired. Isn’t it more telling that National and its proxies immediately and reflexively go on the defensive, rather than acknowledging the problems of child poverty and renewing its commitment to resolving them? As Bruce makes clear to anyone who actually watches the film, the root cause is a bipartisan commitment to trickle-down neoliberalism over the past 30 years, and indeed, the illness and malnutrition that affects these children did not happen in the past three years; these were problems under the last Labour government as well.

But National are the government now, and their defensiveness, I think, signals that they know they bear some responsibility for child poverty. And yet they’re apparently not willing to do much about it, beyond the tired old saw of “a rising tide lifts all boats”, and announcements that they will further constrict the welfare state to force the parents of these sick children to seek jobs that aren’t there. (And yes; National bought time during the documentary as well: the “cracking down on benefit fraud” ad was a particularly cynical form of irony.)

They’d rather whinge about media bias and electioneering, casting themselves as victims, than concede the problem and tell us what they plan to do about the victims of their policies. That’s what I call impoverished.

L

Things that scare me

Today I was waiting in my doctor’s waiting room and, as my older daughter played with the water machine, I espied in the hands of a kindly, grandmotherly looking woman, a copy of the July edition of Investigate magazine — the one about how Obama is going to eat everyone’s babies. But also the one with the article about whether North & South got their recent report on vaccination right.

The North & South June edition, which contained the report on vaccination, was also on the magazine table. I’ve read it, and it’s sound investigative journalism about an important topic: how some diseases we thought were dead and buried are enjoying a resurgence because some otherwise sensible people decide not to vaccinate against them. I haven’t read the Investigate article in question, because my life is short enough as it is, and at any rate I refuse to fund Ian Wishart.* But the Investigate editorial position on vaccination — pretty well documented in previous articles which I have read — is just the sort of thing which raises the spectre of doubt in the minds of parents already nervous about having to hold their little treasures down so a nurse can stick a needle in them. Finding such a hysterically anti-science tract as Investigate in a doctor’s surgery bestows upon it a medical legitimacy it does not deserve. There’s a time and a place for this sort of material, but a medical context is not appropriate. It’s like the proverbial smoking doctors whose habits were supported by Big Tobacco in exchange for reassuring their patients that smoking didn’t do them any harm.

The other daughter? At the time, she was in the nurse’s office getting her jabs. I had a word to the nurse about it; she was almost as alarmed as I was and said she’d remove the offending rag. That’s something.

L

* I’m sure this entitles me to a free bout of Wishartian pig-wrestling and not-at-all-veiled implications about the standard of my professional work such as Scott received, but I’ll pass, thanks all the same.

As advertised

Late last year, when the ACC ructions were underway, the professionals working in the sector warned that people would die as a consequence of the reforms mandated by the new Clinical Pathway on the assessment and treatment of sexual abuse victims.

Since then, and on the basis of the pathway, ACC has taken to declining claims despite publicly claiming consistently throughout the past six months and as recently as today that there was no cost-cutting imperative. This has resulted in a drop of more than 90% in the number of claims approved year-on-year. Explain that, if you can. Nick Smith couldn’t, though he tried to do so during Question Time. It has also caused a chilling effect in which people are simply not applying, since they’d have to undergo the trauma of the exhaustive documentation and excessive review required by the pathway only to have their claims declined.

It’s impossible to separate these reforms from the overarching government plan to privatise — partially or wholly — ACC, and when viewed in this light it becomes clear what’s going on: this is how insurers make their profits. And, just lilke it said on the box, people are dying. It’s a good thing there’s going to be a review, but what’s better is that the sector is organising their own review in parallel. Should make for an interesting compare-and-contrast. I am aware that certain senior National party MPs are aghast at the conduct of ACC, so there may begin to emerge some pressure from within the party for change, as well as from outside. We’ll see.

L

Current events

I was reluctant to post while I had the chance on ANZAC day, since there was such a good debate going on, and now I’ve (temporarily) run out of time again. So just a few quick observations.

  • Phil Goff’s one-two punch on the top tax rate and Auckland governance is solid, and both are good orthodox Labour positions for him to take. But it’s more of the same: lacking verve and failing to get cut-through as a consequence. I mean to post on the positioning of the taxation pledge at some stage, but in case I don’t get to: this is a good opportunity for Goff to demonstrate compromise as well as differentiate himself, by coupling a reimplementation of the top rate with an increase of the threshold.
  • Even without Sunday’s tragic helicopter crash, Goff’s timing was poor in making these two announcements before ANZAC Day. I guess you take the opportunities you can get, but delaying things by a week would have been more useful in my view.
  • As an aside, my mum knew the three late airmen vaguely through Search and Rescue, and confirms the universal sentiment that they were of the very best sort. I’m pleasantly surprised that the crash hasn’t turned into a witchhunt about why we’re still using Vietnam-era hardware; as true as the sentiment might be, we can all do without people thundering “if we’re going to have a military, we owe it to our troops to have it decently-outfitted” under circumstances such as these. Such is the power of ANZAC day, I suppose.
  • On a related point, the discipline with which the military, government, police and media have adopted the Air Force’s framing terminology in this event is remarkable. All four groups are talking about “the Air Force family” and exploiting the metaphor for all it’s worth. Those words are used almost every time one of these people stands in front of a microphone, and in addition the three deceased are “brothers”; Mark Sainsbury reported live last night from the family’s “lounge”, the squad room at Ohakea air base; all four have referred to the Iroquois as being like “your grandfather’s axe” — the reference being that, although it’s very old, when the handle is worn it gets replaced, and when the head is worn it gets replaced, so while it’s his axe in spirit, it actually contains no parts of the original tool and is as good as new in function. On the one hand, this is compelling symbolic stuff: nobody who deviates from this framing can really be said to be showing the proper sort of respect and deference; on the other hand, it’s a bit creepy for everyone to be falling into lockstep behind Defence HQ communications. There are ways of saying these things without using the exact same words, and the constant repetition spooks me. Maybe I’m just sensitive. [Edit: There was a clean sweep for “Air Force family” or something similar in speeches supporting the Prime Minister’s parliamentary motion of condolence. No shock there, I suppose.]
  • On a somewhat lighter note, Councillor Tony Jack has picked the wrong district council to put a motion banning macrons in council materials. This is the Kāpiti Coast District Council, who moved to put the macrons into Paekākāriki and ÅŒtaki only a month ago. Jack’s motion was voted down, at which point he predictably declared that PC had gone mad. Bless. Of course, the Stuff article doesn’t contain the macrons, so I guess he wins as far as that goes.
  • Tim Watkin at Pundit continues to write excellent sense and ask smart questions about race relations in Aotearoa New Zealand. I think the emphasis in Tim’s piece is just right — there is a legitimate claim to indigeneity for non-Māori, but it’s not so obvious as Trevor Mallard’s “I was born in Wainuiomata”, and there’s a lot to work out before such definitions can be settled upoin comfortably. I’m all for having this discussion. I particularly like the ornithological allegory drawn by commenter “william blake” — we are all PÅ«keko!
  • Also on a lighter note, a (very) atheist friend whose six year-old daughter has chosen to go to Bible study classes recently asked him if, because Jesus had risen from the dead, that meant he was a zombie. It apparently took every ounce of his parental commitment to letting his girl make up her own mind to explain the origins of zombie stories, how myths come about, etc. rather than just saying, yes, Jesus is a zombie. Good on him — not sure I would have had the fortitude.
  • Speaking of things biblical, and of belonging, Joanna Newsom has a new album out, and here’s the first single — about tilling one’s own bit of the Garden of Eden:

Ok, so not so brief after all. Discuss. I’ll dive back in as I can. You can treat this as an open thread as well: post what you want to talk about.

L

ACC: tell ’em

I have received the following communique originated by NZ Association of Psychotherapists member Kyle MacDonald; an easy means for you to tell the Minister for ACC what you think about sexual abuse recovery rationing:


Grass Roots Political Action, a step by step recipe.

“The death of democracy is not likely to be an assassination from ambush. It will be a slow extinction from apathy, indifference, and undernourishment.”
— Robert M. Hutchins

  • Time required: 10 minutes.
  • Ingredients: Four pieces of A4 paper. Two envelopes.
  • Method: go to Kyle’s website www.psychotherapy.org.nz and click “Grass Roots Political Action: A step by step recipe”.
  • Select which Minister, and print one out for Pansy and one for Nick.
  • Read the letter; react and critique.
  • Insert your details into the angle-brackets. Change the wording to your heart’s content; the more varied the letters the better!
  • Print, and sign.
  • All mail to Parliament is free, so simply pop in an envelope!
  • Bask in the glow of flexing the democratic freedom you are lucky enough to possess, and pass both the word, and this email, on to everyone who you can possibly think of…

Update: There’s also a petition, for what that’s worth.


Grass Roots Political Action Part II – Gather Support.

“In a democracy dissent is an act of faith. Like medicine, the test of its
value is not in its taste, but in its effects.”

— J. William Fulbright.

Dear friends, colleagues and supporters of counseling and therapy in
Aotearoa New Zealand,

Many of you will now be aware of attempts by ACC to change the Sensitive
Claims Scheme which provides counseling to victims of sexual assault and
abuse. These changes are being rushed through with inadequate consultation
and the professional organizations representing the providers of this
treatment have been lobbying parliament to stop the changes.

Now there is something you can do to help! Follow this link to an online
petition and sign up to show your opposition to the proposed changes.

http://www.petitiononline.com/ACC0909/petition.html

Please also circulate this petition as widely as you can to friends, family,
colleagues, clients and your professional networks. The aim will be to
present this to The Minister for ACC Hon. Nick Smith prior to the 12th of
October.

Thank you for your time,

Kyle MacDonald
Psychotherapist


There. Easy.

L

Sexual abuse recovery rationing by the ACC

This morning the New Zealand Association of Psychotherapists delivered an open letter to the Minister for ACC asking him to explain and justify the proposed changes to ACC’s sensitive claims policy. This issue was covered by Anjum last week and is now picking up steam.

Briefly, the proposals (which are due to come into effect in September) would change both the nature and amount of entitlement of treatment to which sexual abuse or assault victims are entitled. The changes represent a move from a therapeutic model mostly operated by psychotherapists and counsellors to a symptom-management model mostly run by the mental health system. Victims’ entitlement to treatment will generally be reduced to a maximum of sixteen hours, essentially meaning that many victims of the most severe abuse will not be fully treated. In addition, victims will need to explain themselves to as many as three different assessors in order to access this limited treatment, with each assessment a form of revictimisation. As if that wasn’t enough, knowing that many cases simply will not be treatable in the mandated 16-hour timeframe, some psychotherapists have indicated that they will refuse on ethical grounds to begin the work, knowing that they cannot finish it, on the basis of the ‘first, do no harm’ principle which underscores their practice as clinicians.

This means the already-high barriers to effective treatment of sexual abuse trauma are about to get higher. In effect, they are being rationed so as to exclude the ‘worst’ cases who require the most work (and therefore the most cost) to treat. However the revictimisation of repeated assessments and the uncertainty of treatment form a strong disincentive – not wanting to open a wound without being sure it can be closed, many people will simply not seek treatment, and many counsellors will simply not be able to provide it on ethical grounds. This chilling effect will lead to sexual abuse being pushed further underground and the problem fading from the public view to a greater extent than it already is, with potentially catastrophic long-term social consequences. At last count, sexual abuse cost NZ about $2.5 billion per year including the costs of crime, imprisonment, drug and alcohol, other health issues, unemployment and the cycle of abuse which an absence of treatment sustains. For the cost of a few million dollars in treatment, how much will that be allowed to increase?

The most absurd thing is that these are cuts to front-line services for victims of serious crime; the very thing the government said it would be increasing. ACC’s Sensitive Claims Unit costs $30m or so annually to deliver $20m of front-line services, and these cuts will shift that balance much further toward the back-office by relying more heavily on already-overworked case managers and the top echelons of the practice – psychiatrists and clinical psychologists who currently do 10% of the work – rather than the relatively cheap and numerous psychotherapists and counsellors who do the other 90%.

For the inevitable conspiracy theorists, this also isn’t a matter of psychotherapists feathering their nests – for most, ACC work is a small part of their practice, and not an especially lucrative part of their practice, since most can charge (much) more on the open market than what ACC will pay.

Expect this to be a fairly big deal in the coming weeks. It is an issue which is deeply embedded in many policy fields: justice, victim’s rights, human rights, child abuse, crime, drug and alcohol abuse and mental health are just a few. It’s not going away, because sexual abuse is not going away.

L

Disclosure: I was involved to a small extent in the process around this open letter. I have family members on both ends of this issue – both providing and receiving treatment. You probably do, too, even if you don’t know it.

A bullet came to visit a doctor in his one safe place

In the United States on Sunday George Tiller, a doctor, was shot and killed as he attended church. Tiller, who ran one of only three remaining clinics providing late term abortions in the US, had been shot in 1993, his name has been on anti-abortion assassination lists and his clinic was bombed in 1985.

In New Zealand we have never had an abortion doctor killed, but we have had doctors, nurses and clinic staff threatened, attacked and harassed. I pray that no further anti-abortion violence comes to New Zealand, and at the same time I pray that we will progress the issue to give women the right to control their own bodies and that we will find a social consensus for a woman’s right to choose.

But right now the cost seems very high, and all I can do is pray for the safety of everyone ensuring women continue to have access to the limited choices they are given. George Tiller was a great man whose personal actions gave more to women than I could ever hope to.

I try to not end too many posts with lyrics, but today I can’t help posting a section of Ani DiFranco’s Hello Birmingham. With an echo of Pablo’s recent posts, she is talking, at least in part, of the powerlessness of electors to make the changes that matter.

           now i’ve drawn closed the curtain 
in this little booth where the truth has no place 
to stand 
and i am feeling oh so powerless 
in this stupid booth with this useless 
little lever in my hand 
and outside, my city is bracing 
for the next killing thing 
standing by the bridge and praying 
for the next doctor 
martin 
luther 
king 
  

it was just one shot 
through the kitchen window 
it was just one or two miles from here 
if you fly like a crow 
a bullet came to visit a doctor 
in his one safe place 
a bullet insuring the right to life 
whizzed past his kid and his wife 
and knocked his glasses 
right off of his face 

and the blood poured off the pulpit 
the blood poured down the picket line 
yeah, the hatred was immediate 
and the vengance was devine 
so they went and stuffed god 
down the barrel of a gun 
and after him 
they stuffed his only son