The article focuses on a type of delusion in which individuals believe they are being filmed and which they believe will be broadcast to others for their entertainment.
Nearly half of all pupils have suffered from some form of bullying at school, according to Ofsted.
A study of 1,350 pupils by the education standards watchdog showed 58 per cent of those in primary schools and 41 per cent in secondaries said they had been “picked on” or bullied.
The most common forms of bullying related to aspects of the victims’ physical appearance, including hair colour, weight and the wearing of spectacles.
A handful of pupils said they had been bullied because of their sexuality. A greater number replied it was for “being different” or perceived as “weird”. One pupil wrote “because people thought I was something that I was not”. The report says pupils often dismiss offensive language – such as the word “gay” to mean rubbish” as “banter” despite the fact its usage could be prohibited in school rules.
“What is clear is that these pupils had experienced an upsetting interaction with another pupil that they felt was important enough to write down for inspectors,” the report says.
The report calls for better training for teachers in tackling bullying.
“Schools must develop a positive culture so all pupils learn in a happy and safe environment,” said Susan Gregory, director of education and care at Ofsted.
Children are being sold as conscripts into the Burmese military for as little as $40 and a bag of rice or a can of petrol. Despite assurances from Burma’s ruling junta that it is cleaning up its act in a bid to see Western sanctions lifted, recruitment of child soldiers remains rampant.
The Independent understands that 24 instances of children being forced to become soldiers have been verified by the UN in the first three months of 2012 alone – the equivalent of two a week. The International Labour Organisation is investigating a further 72 complaints for underage recruitment between January and April this year. The new details of child soldier recruitment have emerged at a time when Burma is desperately trying to attract foreign investors and persuade Western nations to lift sanctions against the country’s ruling military elite.
Some significant steps have been made, including recent parliamentary elections for a handful of seats and the release of prominent opposition leader Aung San Suu Kyi, who flew into Britain last night for her first visit in more than 20 years. The fact that Burma’s generals have allowed Ms Suu Kyi to embark on a European tour is an indication that it has changed some of its ways. Known as The Lady to her supporters, the 66-year-old’s release is part of a series of recent public shows by the junta to curry favour with the international community.
Many observers, particularly in the business community, have begun lobbying for an easing of sanctions. British businesses are keen to re-enter Burma, partly because so many Asian economies have already done so and it is seen as an untapped market. But human rights groups are concerned that reforms have been implemented very slowly. They point to the ongoing recruitment of child soldiers as an example of how little has really changed. Researchers for Child Soldiers International have just returned from a trip to Rangoon and the Thai border in which they interviewed child conscripts. They reported that military and civilian brokers scour the streets looking for vulnerable children whose identity documents are then forged to make them seem over 18. Soldiers who want to leave the army often have to find three to five replacements and young teenagers are often the first people they look to conscript.
“Children remain vulnerable to forced recruitment and use in hostilities by the Burmese military, due to the high rates of attrition in the army and the on-going conflict,” said Richard Clarke, director of Child Soldiers International, a London based advocacy organisation. “It is incumbent on the international community to put pressure on the Burmese government to stop this practice.”
Aung Myo Min, a Burmese exile who helps child soldiers from neighbouring Thailand, has concerns about sanctions being lifted without meaningful reform.
“Don’t be so quick to jump into Burma with business,” he warned. “It is still a country which has very little protection for its workforce, let alone the military. The government really wants these sanctions lifted but we still have repression.”
Case study: ‘No one checked our ID or age’
San Win Htut was 15 when he was drafted into the military. He left this year after human rights groups found documents proving he was a minor.
I met a sergeant on the road in June 2010. He said he was from the army and persuaded me to join. He said I could earn good money and buy a motorcycle. I didn’t have a job so I decided to go with him. He said I could leave the army after five years. I then went to a recruitment camp in Rangoon. Three other youths were taken with me and we were all under 18. Officials did not check our ID because the sergeant told them he knew us. Our days were filled with hard work. We were placed on sentry duty and ordered to work on farms. Everyone treated us badly because we were the youngest. They forced us to spend our salary on their drink and food. I was beaten up by a corporal because I did not buy oil for him. I eventually managed to run away.
Nearly half of unpaid carers in the UK are jeopardising their health due to a lack of support, according to a survey.
Carried out by Carers Week, a group of eight charities including Age UK, Carers UK and Macmillan Cancer Support, the survey found that 40% of carers had put off receiving medical treatment because of the pressures of their role.
In addition, 87% of the 3,400 carers surveyed said caring had been detrimental to their mental health, while 83% said they had suffered physical health problems. Another 36% said they had sustained injuries such as back pain and insomnia while caring for sick or disabled friends or family.
Helen Clarke, Carers Week manager, said the government had to do more to support Britain’s 6.4 million carers – both practically and financially. She called for more sustainable social care funding, better signposting for support services and regular health checks for carers.
“It’s a scandal that carers can’t get the time or support they need to look after themselves, which could be jeopardising their health as a result. Carers are feeling the strain of a woefully underfunded system and still we’re seeing more cuts. Unpaid carers save the government a fortune – £119bn a year – yet they’re let down in return. It is time for urgent action to tackle the crisis in social care.”
Another survey conducted by the Association of Directors of Adult Social Services last week revealed that social care budgets had been cut by £1.89bn in the last two years, and suffered a drop of 6% last year at a time when pressure from rising numbers of older and disabled adults continues to grow, at around 3% each year.
The Department of Health said it was responding to the carers issue via £400m in extra funding to the NHS for carers’ breaks until 2015.
Tracy Sloan, a carer for 20 years to her son Phillip, who has severe cerebral palsy, said she was diagnosed with cancer after missing a regular screening appointment. But once she had begun receiving treatment, there was still little time for recovery.
“Looking after Phillip is so full on, that it just didn’t occur to me to keep an eye on my own health,” she said. “I was really shocked when I discovered I had cancer and needed an operation. I came home from hospital exhausted, emotional and fragile. I really needed the chance to rest but instead I had to deal with Phillip’s demands too, and that took its toll on my recovery.”
Carers Week, which also includes the Carers Trust, Independent Age, Marie Curie Cancer Care, the MS Society and Parkinson’s UK, said that Tracy’s experience is not an isolated one.
A spokeswoman for the DH said: “Carers make an invaluable contribution to society and it’s vital that we support them to look after their health and wellbeing. We know how important it is for carers to be able to take a break from their caring responsibilities, to protect their own physical and mental health. That is why we have provided £400m additional funding to the NHS until 2015 for carers’ breaks, and why we’ve given the NHS the clearest ever direction to make carers a priority.
“We also want to place the rights of carers on a much firmer footing, so that the law recognises carers’ rights and their role in caring for others.”
According to Carers UK, 1 million carers – one in six UK carers – are forced to give up or cut back work to provide care, which can mean a significant drop in income. They said carers clocked up an average of 27 hours a week.
Angela Eagle, minister of state for pensions and ageing society has said the government would introduce reforms that would enable carers working for more than 20 hours a week to build up an entitlement to a basic state pension.
The “scandalous” scale of the NHS‘s neglect of mental illness has been described in a report which suggests only a quarter of those who need treatment are getting it.
The report claims that millions of pounds are being wasted by not addressing the real cause of many people’s health problems. Nearly half of all the ill-health suffered by people of working age has a psychological root and is profoundly disabling, says the report from a team of economists, psychologists, doctors and NHS managers, published by the London School of Economics.
Talking therapies such as cognitive behaviour therapy relieves anxiety and depression in 40% of those treated, says the Mental Heath Policy Group led by Lord Layard. But despite government funding to train more therapists, availability is patchy with some NHS commissioners not spending the money as intended, and services for children being cut in some areas. “It is a real scandal that we have 6 million people with depression or crippling anxiety conditions and 700,000 children with problem behaviours, anxiety or depression,” says the report. “Yet three quarters of each group get no treatment.”
Layard added: “Mental health is so central to the health of individuals and of society that it needs its own cabinet minister … The under-treatment of people suffering from mental illnesses is the most glaring case of health inequality in the NHS … Despite the existence of cost-effective treatments it receives only 13% of NHS expenditure. If local NHS commissioners want to improve their budgets, they should all be expanding their provision of psychological therapy.”
A third of families have a member suffering a mental illness, the authors found. The report says mental health problems account for nearly half of absenteeism at work and a similar proportion of people on incapacity benefits.
In 2008, Layard and others won the argument that treating anxiety and depression saved the NHS money. A programme called Improving Access to Psychological Therapy (IAPT) was set up to train thousands more therapists.
Official figures, however, show that too few people are getting treatment across the country. There were 6.1 million with treatable anxiety or depression in England but only 131,000, or 2.1%, entered talking therapy in the last quarter of 2011.
There are stark differences between primary care trusts. Walsall did best, with 6.4% of depressed and anxious people in talking therapy, followed by Swindon with 5.8% and Northumberland with 5.5%.
But Hillingdon, west London had only 0.1% in treatment – 17 out of 29,000. Barnet and Enfield, both in north London, had 0.3% and 0.4% respectively.
Layard said commissioners were wrong “if they think ‘why don’t we cut a bit of that [talking therapies]’ when they are spending money on infinitely lower priority conditions. Depression is 50% more disabling than conditions like angina, arthritis, asthma or diabetes.” Even including those on medication, treatment only reaches a quarter of those in need.
Commissioners needed to understand that treating people with mental illness saves money, the report says. Layard pointed to a survey at two London hospitals which found that half the patients sent for an appointment with a consultant had physically inexplicable symptoms, such as chest and head pains for which there was no organic explanation. “These are people with somatic symptoms as a result of mental stress,” he said.
In the long term he said he would like to see psychologists and therapists working alongside physical medicine doctors in the acute sector, to help determine the real cause of people’s apparently inexplicable symptoms.
Dr Andrew McCulloch, chief executive of the Mental Health Foundation, said the report showed mental health remained a poor relation to physical health for the NHS. “The government has rightly committed to a parity of esteem between physical health and mental health in the health and social care bill, and surely they must now deliver on what they have promised.”
Dr Clare Gerada, the chair of the Royal College of GPs, applauded the efforts of Layard and his colleagues to increase the availability of talking therapies.
“We live in a stressful society and the number of patients with mental health problems presenting to GPs is on an upward spiral,” she said. “GPs face tremendous challenges in caring for patients with mental health problems in primary care and we welcome any development which will help us improve their care.”
The care services minister, Paul Burstow, said: “Mental ill-health costs £105bn per year and I have always been clear that it should be treated as seriously as physical health problems … the coalition government is investing £400m to make sure talking therapies are available to people of all ages who need them. This investment is already delivering remarkable results.”
Or should I say the “lack of relationships” after sexual assault… Trust is a difficult thing, especially when you’ve fallen victim to a rape. After becoming a victim myself and eventually seeking therapy, I couldn’t trust anyone, not even myself. Can you imagine the feeling of not being able to trust yourself? I am still very mistrustful and fearful. To understand why, I would have to revert back to the crime itself along with some common misconceptions.
Since writing about this publicly, many people, mainly men, have argued with me that rape is an act that men cannot help executing because of their “natural” sexual drives and desires. This misconception is also the reason why victim-blaming excuses often fly without much questioning from others. “She was dressed like a slut,” “She is very promiscuous,” and many many more excuses for rape crimes take the blame off the perpetrator and place it on the victim. At one point, I too thought that rape was a sexually-motivated crime. When it happened to me I was young, cute and totally disinterested in the “friends” who raped me. I thought that maybe they had wanted me bad and knew they couldn’t have me so they resorted to rape as it was the only way to “get” me. It made sense in my head, at the time.
This is, of course, wrong. Rape is not about sex. It is about control. It is a crime like any other where something is taken without consent. If a man walks into a bank with a gun, he uses the gun as a weapon to procure money from the bank. Rape is similar. A rapist overpowers the victim by using sex as a weapon, much like a gunman scares bank tellers into submission by waving around a firearm.
A rapist is similar to a bully in the schoolyard picking on smaller kids so he can feel “bigger.” It is possible that the friends who raped me did it because they knew I would never sleep with them in a million years willingly. This still doesn’t make it about sex. Maybe they wanted to have sex with me but they knew that I wouldn’t, and out of anger and resentment decided that they were going to have sex with me with or without my permission. That night, they put something in my drink so they could do it without fear of me remembering or finding out (or so they thought…). In the end, they got what they wanted, despite what I wanted. Yes, what they originally wanted might’ve been sex, but without my consent what they wanted from me surpassed the sexual and entered into the realm of control: They wanted me to do what they wanted.
Since starting counseling, my ability to trust has greatly decreased. For some reason, talking about what happened has opened whole new metaphorical can of worms. Not only do I have trouble trusting others, even family and friends I’ve known for years, but most of the time I feel like I cannot even trust myself. This is a problem many victims of sexual assault experience, and it often results in isolation from friends and family as well as a failure to forge new friendships and relationships.
A lot of people have difficulties in relationships, but a person who has survived rape will have extra issues. It takes a patient and special person to be their lover or even just their friend. Sometimes the additional trials and issues involved in relating to a sexual assault survivor are very, very sad. Last weekend I was invited to an awesome concert by a good friend. It was an all-day music fest, and it would be just the two of us and one of her good guy friends. I wanted to go but the idea of crashing at her place along with some guy I didn’t know terrified me. Even though he was a good friend of hers, someone she knew and trusted, I could not bring myself to trust. Because she is such an understanding and kind person, she wasn’t insulted when I told her why I was uncomfortable going. But not everybody is that understanding. Most people are not.
The friends and family I have both from my “real life” and those I’ve met online are the some of the most patient people in the world. I spazz. I am afraid. I do not and sometimes cannot trust. I overreact. I am overly emotional. With all those terrible traits, they are always there for me. They know I am trying but cannot help it. What has happened to me, to my emotions and my mind, is equivalent to a physical handicap. My perception of life and everyday occurrences will never be normal. They can never be put right again. Like a person who has lost a limb in an accident, the damage has been done and nothing will ever bring that limb back. Now that the limb is gone, they are presented with more challenges. They still have to live life as they did before they had a physical handicap, but now they must find new ways to do the things that used to come naturally to them. Now there are extra obstacles they must surpass to live normally; permanent obstacles that will be a new layer upon the structure of what they used to consider their normal daily life. Over time, things do become easier, but they will never again be the same, and only the strongest people can be friends with and participate in relationships with a person who has experienced this type of emotional trauma.
I sarcastically said that this article should be titled the “Lack of Relationships After Sexual Assault” because it takes an empathetic and patient person to be supportive and understanding to someone who has experienced that kind of trauma. Many survivors, including myself, have been dumped by a significant other after revealing that being a victim of sexual assault was part of our pasts. Though the term “survivor” sounds pretty tough, the truth is that survivors are often fragile, and find themselves being ditched by guys and friends alike who are often too callous or impatient to deal with the emotional rollar coaster a rape survivor experiences and deals with on a daily basis. It is easy for a survivor to become overly dependent on friends once they learn that they can open up and trust again because it feels so amazing to finally be able to trust a person.
Sometimes being honest about being a survivor or even just being yourself ends up pushing the friends who cannot handle it away. And though it always hurts, the heart knows in the long run that by being ditched, these “friends” were actually doing you a favor. I know that as a survivor of sexual assault, I do not need half-assed cold-hearted men or friends in my life, people who are scared of the mental scape that makes up my reality. Imagine living in my head? Imagine experiencing my fear and trauma firsthand? If a person cannot be there to hold my hand when something becomes difficult for me, if he or she does not feel that my good qualities outweigh my bad ones and cannot be forgiving of my emotional issues or the way I handle things, then maybe they do not deserve my friendship. Relationships after sexual assault are not always easy. In fact, sometimes the relationship with the self is as challenging as the relationships with the people around you. True friends will reveal themselves in time and it is those friends who must always be appreciated and never forgotten.
Elderly patients are to receive legal protection against being denied medical treatment simply because of their advanced years, ministers will announce today.
A ban against age discrimination in public services, such as health and social care, is to come into force in October. It will outlaw doctors, care home staff and hospital managers from deciding on levels of care on any grounds other than medical need.
Patients or relatives who believe they have been discriminated against because of their age or are being regarded as a lower priority than younger people with the same condition will able to sue health managers.
Nurses and carers will also face a legal obligation to treat older people with respect and dignity.
The moves follow years of reports of treatment being rationed by age – for instance with younger patients placed nearer the front of the queue for heart surgery – and accounts of elderly patients receiving sub-standard care.
Age discrimination in the workplace is already illegal and ministers have been deliberating for more than a year on whether the ban should be extended to the provision of services. As the timetable slipped, fears grew among campaigners for the elderly that the Government might be having second thoughts.
Ministers have dropped plans to outlaw companies and banks from charging older customers higher prices for products such as travel insurance, but are to implement the bulk of their initial proposals.
Doctors and hospital chiefs are formally advised only to allocate treatment on the basis of medical need and not age.
But studies suggest they are not always abiding by the instruction. Three years ago a think-tank concluded that older people had “differential access to services” – they were less likely than younger people to be referred to intensive care after a serious accident and waited longer in casualty departments. It also found they were not receiving equivalent treatment for conditions such as strokes and heart disease.
Paul Burstow, the Care Minister, will say today: “We know that older people are not always treated with the dignity and respect they deserve because of ageist attitudes – this will not be tolerated. Our population is ageing as more of us live longer. The challenge for the NHS is to look beyond a person’s date of birth and meet the needs of older people as individuals.”
Michelle Mitchell, of Age UK, said: “Discrimination based on your date of birth is as indefensible in 21st-century Britain as prejudice on the basis of race, gender, disability or sexual orientation.
“We hope the new law which will apply to the NHS, social care and other services will prevent older people being denied proper treatment because of their age. It sends a clear message to service providers that discrimination law will in future also protect older people.”
A growing number of older British people – including those in their 70s and 80s – are suffering from low self-esteem and anxieties relating to body image.
Interviewed for the Observer Magazine this weekend, Professor Nichola Rumsey, co-director of the University of the West of England’s centre for appearance research, suggests that “as adults, 90% of British women feel body-image anxiety”.
She said: “It doesn’t wane – many women in their 80s are still anxious about the way their bodies look, which can even affect their treatment in hospital when their health choices are influenced by aesthetics.”
Popular opinion suggests that body image-related anxiety is a young person’s problem, with recent reports focusing on the age (five years old) at which we are now vulnerable to pressures to conform to an expected ideal. Constant media coverage of the debate on teenagers and their negative relationship with their bodies has served to reinforce the message that it is predominantly young people who suffer such anxieties.
However, Rumsey’s studies in Bristol counterbalance this with evidence that these anxieties do not dissipate as the years pass, but merely evolve into different types of concerns about appearance and how we are seen by others.
“We have conducted a study of about 1,200 people, which confirms that appearance-related anxieties persist well into later adulthood,” Rumsey said. “At an age where most healthcare professionals focus on controlling pain and body functionality, many patients feel the way they look is as much of a concern, but isn’t a legitimate topic of conversation.
“It can cause substantial distress to look in the mirror and see an ageing body, especially if they have very visible conditions such as rheumatoid arthritis or an obvious skin condition, for example, yet in the UK we can be very dismissive of what is often construed as vanity. GPs are not trained to deal with the psychological impact of these anxieties, which can have a significant influence on overall wellbeing.”
Even those who are relatively fit and healthy in later years struggled with the idea that they no longer conformed to a youthful ideal, said Rumsey, who recently co-wrote The Oxford Handbook of the Psychology of Appearance. “It is a myth that older people don’t care what they look like: the ‘normal’ signs of ageing can prove very depressing and many people find it hard to see themselves in a positive light when they see a wrinkled face and a sagging body looking back in the mirror. We are now at a point where there is a social stigma around the effects of the natural ageing process, and this can lead to very low self-esteem and the classic signs of body dysmorphic disorder.”
These observations are echoed by the increasing number of body image-related cases in older people being seen by Dr Alex Yellowlees, medical director and a consultant psychiatrist at the Glasgow Priory Clinic, who is witnessing “an epidemic of self-consciousness. We are suffering from a collective body dissatisfaction, which is a contagion in our society, and we must acknowledge that it affects all walks of society, young and old.
“It was once the case that we were happy to coast into retirement and relax in our old age, but now even in these later stages of life I am seeing people who are preoccupied with shape, weight and looks in a way that was once the domain of younger people who had yet to find their path or identity in life.”
Yellowlees reports an alarming rise in older patients with eating disorders, as all sectors of society strive to achieve what he calls “an unrealistic physical ideal”.
“Today everybody is acutely aware of how they look, and our appearance has become a currency we trade on,” he said. “That means we value old people less because they don’t fit the currency of ‘youth’. This in turn leads to a lack of self-esteem in older people, because they don’t feel valued by a culture that can’t get past superficial image. Appearance is a very fragile currency to trade in because a civilised culture interacts on more sophisticated values such as character, behaviour and language.”
In a culture where increasing value is placed on our appearance, Rumsey voices concerns that we must look beyond the superficial. “Older people are the wise ones we have always looked to for their experience and knowledge, and if they are preoccupied with appearance anxieties this becomes the norm for future generations.”
Militias loyal to the former Ivory Coast president Laurent Gbagbo are recruiting child soldiers in Liberia to launch attacks similar to that which caused the death last week of 15 people, including seven UN peacekeepers.
Child soldiers as young as 14 are being groomed in training camps and used as scouts in increasingly deadly attacks in the volatile west of Ivory Coast, witnesses said. Human Rights Watch said that youths aged between 14 and 17 were being trained.
“They call us ‘small boys unit,’ and we are always safe when we go to the war zones in Ivory Coast. I don’t know the total that we have killed,” a child soldier told the campaigning group.
Ivory Coast’s rugged western region is a stronghold of Gbagbo, whose refusal to leave power landed him in the international criminal court last May after five months of post-electoral conflict dislodged him.
But neighbouring Liberia has been reluctant to clamp down on mercenaries notorious for recruiting child soldiers, while high-profile members of the regime’s inner circle live unhindered in upmarket villas in Ghana despite international arrest warrants.
“There are training camps in Liberia, you can walk there in 20 minutes. They send boys over several hours before attacks, then they join in later,” said Traore Adama, an Ivorian soldier who fled to Abidjan after attacks in recent months. “Youths can make up to a third of the attacking groups. Some of them are older teenagers but others are waifs you’d never imagine carrying guns.”
On Friday, UN “blue helmets”, deployed to a suspected raid in a remote western village, were ambushed and killed by a large group of Liberian-based “militias or mercenaries,” Paul Koffi Koffi, Ivory Coast’s deputy defence minister, said. Eight civilians also died in the attack.
Liberia has since closed its 435-mile border with Ivory Coast, whose dense forests and maze of creeks make policing difficult. Hundreds began fleeing the mineral-rich region, where long-simmering ethnic tensions exploded in the massacres during last year’s political conflict.
Alassane Ouattara, president of Ivory Coast since 2010, has struggled to unify a post-conflict army composed of quarrelling former rebels (who are also accused of war crimes) and government soldiers whom they once fought against.
One former rebel soldier, Aboubacar Souleymane, said” “It’s very visible when an attack is imminent. Last week I told my superiors that Liberian mercenaries were planning an attack with the help of pro-Gbagbo supporters in the area. He said there was not enough evidence, so I fled the area. I wasn’t prepared to stay there and get killed.
“There are too many cases of soldiers not being on their post when they should be, and disappearing from barracks at odd hours.”
Officials say arms funding for the cross-border raids comes from Ghana, where several wanted Gbagbo insiders fled after the regime fell last year. Among them is Charles Blé Goudé, leader of the Young Patriots militia, whose armed supporters helped crush dissenters of the Gbagbo regime. Goudé, whom sources say is under investigation by the ICC, has said he is willing to face trial.
An African diplomat said cooperation was unlikely to be forthcoming from either of Ivory Coast’s neighbours in the near future. “Liberia’s armed forces’ capability is limited by its small size and corruption because they’re highly underpaid. But there’s more than just a lack of capacity in both countries for failing to go after well-known criminals.”
Outside, on a warm morning in March, students at the University of the West of England are shading their faces with textbooks, legs rippling in the sun. Inside, in a cramped, bright room lined with ring binders labelled “Intimacy”, the women who make up the world’s only Centre for Appearance Research (Car) are talking quietly about perfection. I arrived here after following a trail of newspaper reports – on the effect of airbrushing in the media, on men’s growing anxiety about their weight – reports used variously by politicians and educators to highlight the way our world is collapsing. It’s here, with their biscuits and gentle, resigned chatter, that a team led by Professor Nichola Rumsey and Dr Diana Harcourt is compiling the research required to understand how we deal with changing attitudes to appearance, and along the way helping answer the question: why do we hate the way we look?
Two years ago I started writing a column for this magazine, illustrated by a photo of my face. At times it made me feel odd (I have never liked photos), at other times sad, often anxious. It made me more aware that I don’t like the way I look, but more, I don’t like the fact that I don’t like it. But it’s not just me. All Car’s research suggests that Britain’s body image is in crisis.
Body image is a subjective experience of appearance. It’s an accumulation of a lifetime’s associations, neuroses and desires, projected on to our upper arms, our thighs. At five, children begin to understand other people’s judgement of them. At seven they’re beginning to show body dissatisfaction. As adults 90% of British women feel body-image anxiety. And it doesn’t wane – many women in their 80s are still anxious about the way their bodies look which, Professor Rumsey explains, can even affect their treatment in hospital, when their health choices are influenced by aesthetics. Many young women say they are too self-aware to exercise; many say they drink to feel comfortable with the way they look; 50% of girls smoke to suppress their appetite – is it too strong to suggest that these things, these anxieties, are slowly killing them?
Liberal Democrat MP Jo Swinson (who has succeeded in pulling a number of L’Oréal ad campaigns for being unrealistic) is one of a growing group of people whose campaigning indicates that it’s something worth worrying about. Last year I attended every session of her government inquiry into body image, the results of which were published in a report this month. She cited research showing how current “airbrushing” culture leads to huge self-esteem problems – half of all 16- to 21-year-old women would consider cosmetic surgery and in the past 15 years eating disorders have doubled. Young people, she said, don’t perform actively in class when they’re not feeling confident about their appearance.
It is research backed up by a new documentary by Jennifer Siebel Newsom,Miss Representation, about the under-representation of women in positions of power – women who are high “self objectifiers” have low political power. They’re less likely to run in politics, and less likely to vote: if value lies in their imperfect bodies, they feel disempowered. The long-term effects, the piling on of pressures one by one, like a dangerous Jenga tower, means women’s – and increasingly men’s, 69% of whom “often” wish they looked like someone else – lives are being damaged, not by the way they look but by the way they feel about the way they look. It’s complicated.
Even researching such a thing is tricky. The truth feels slippery. “Why,” I asked the psychotherapist Susie Orbach (who, since publishing Fat is a Feminist Issue in 1978, has become a loud and public voice in the conversation about body image), “when I know that beauty is subjective, that nothing terrible would happen if I put on weight, when my desk is covered in annotated research on bodies, do I still feel bad about the way I look?”
“Because none of us lives in a vacuum,” she said. Simply acknowledging the pressure doesn’t eliminate it. “We don’t even know we hate our bodies because we take that for granted.” She sighed. “When I wrote FiFi there was a pretty bad situation,” she said, “but the women of my generation have given birth to… this.” To my generation – 60% of whom feel ashamed of how they look. But before anybody begins to deal with this, this crippling western-worldwide anxiety, it’s important to try and work out why. How did we get here?
At the Centre for Appearance Research, they discuss with me how invested people have become in their appearance. And how central it now is to the value they place on themselves. We’ve always compared ourselves to other people, but what has changed is the way we use images. There’s a famous study which looked at teenage girls in Fiji after television was introduced to the island for the first time in 1995. After three years with TV, the girls who watched it the most were 50% more likely to describe themselves as “too fat”; 29% scored highly on a test of eating-disorder risk. One girl said of the western women she watched on Beverly Hills 90210: “In order to be like them, I have to work on myself, exercising, and my eating habits should change.”
Today the web ensures that we are drowning in visuals: we’re no longer comparing ourselves to “local images” – our friends – instead we’re comparing ourselves to social-networked strangers, celebrities, and to Photoshopped images, of which we see around 5,000 a week. I always bristle a little when “airbrushing” or Photoshop is blamed for the rise of body-image anxiety. It seems too simple. While I was impressed by Jo Swinson’s campaign to ban airbrushing in advertising, I did cheer, a little, when I read Tina Fey’s thoughts: “Photoshop itself is not evil,” she wrote. “Just like Italian salad dressing is not inherently evil, until you rub it all over a desperate young actress and stick her on the cover of Maxim, pretending to pull her panties down. Give it up. Retouching is here to stay. Technology doesn’t move backward. No society has ever deindustrialised.”
The problem is not the Photoshopping itself – the problem is that Photoshopped images threaten to replace all others, and that in slicing off the rounded hip of an actress it reveals our difficult relationship with the female body. The problem is that, in their ubiquity, Photoshopped images have changed our standards of comparison. So that’s one reason. Images. I started to make a list.
The “size zero” debate that began a few years ago led to an angry dissection of the fashion industry’s preference for skinny models. In response, a circular argument was repeated, laying blame on fashion magazines (for printing the pictures), then model agencies (for hiring the models), then designers (for making samples that only fit the very thinnest of them). In this month’s Vogue, editor Alexandra Shulman launched the Health Initiative, a six-point pact between the editors of the 19 international editions, aimed at encouraging a healthier approach to body image within the industry. They promise to encourage designers to “consider the consequences of unrealistically small sample sizes of their clothing, which… encourages the use of extremely thin models”. Is this the industry taking responsibility for our broken body image, for its power? Acknowledging that they help sell not only clothes, but ideas of which bodies are acceptable?
“We’re not taking responsibility for it,” Shulman says firmly. “We’re saying we realise we’re in a powerful position and we can do something about it.”
We’re sitting in her bright white office, beside shelves displaying internationalVogue covers. She points at them one by one. “There’s Kate Moss in Versace. That [sample-sized] dress is tiny. You can see it’s pretty tight on her. Then there’s Scarlett Johansson in vintage Prada – you see, ‘real people’, actors as opposed to models, don’t fit sample-size clothes.”
Caryn Franklin, Erin O’Connor and Debra Bourne, whose All Walks Beyond the Catwalk initiative encourages diversity in fashion, talk to designers and students about creating more “inclusive” designs. “The fashion industry has changed in the past decade,” Franklin explains slowly, trying to put her finger on why our body image is in crisis. “The catwalk used to be a factory space. But digital changed everything – it’s now become a luxury positioning experience, a consumer space.”
It’s helpful for fashion buyers (the audience at catwalk shows) to see clothes on a shape that is as close to a clothes hanger as possible – hence the tall, bony models whose breasts will not bother the line of a shirt. But since catwalk imagery has gone mainstream, these model shapes have drifted into the public subconscious. “We’re helping the industry understand this,” adds Franklin. “This inconvenient truth.”
Shulman has been pushing for larger sample sizes since 2009, when she wrote a letter to major international designers complaining that their tiny designs were forcing editors to shoot them on models with “no breasts or hips”. Has she seen any change? “Hmm. There is still a bit of a… blindness. I think fashion is a bit out of step with this. They don’t realise that people would really like to see something different.” She’s right – Ben Barry (a PhD student at Cambridge University) surveyed 3,000 women, the vast majority of whom “significantly increase purchase intentions when they see a model that reflects their age, size and race”.
Shulman was invited to give evidence at Jo Swinson’s inquiry but turned her down. “I’m very anti-legislation, anti-government initiatives. I don’t think they need to get involved. God knows they’ve got enough to be thinking about without worrying about sample sizes. And it isn’t just about ‘common sense’.”
I’m learning this. I ask her about other myths – are there any commonly held beliefs about Vogue, the industry and body image? Her eyes fall on the magazine shelf. “Ah! I know one!” she says, leaning in. “We shot Adele for our October cover, and everyone said: ‘How typical of Vogue – they shoot Adele and only show a head shot.'” It’s true – bloggers were disgusted that they hid her size-16 body.
“But Adele would not let us pull the camera back,” Shulman explains. “As soon as any of her body was shown on the camera’s digital screen she’d say no. It was her desire to have a head shot, which I found very frustrating. I was desperate for a full-length picture.” That issue was one of the worst-selling inVogue’s history.
I remember Orbach explaining that none of us lives in a vacuum. “Vogue,” Shulman continues, “is one of very few [women’s interest] magazines that never publishes diets, never points out when someone’s put on weight. We don’t come from that unhelpful culture where you forensically examine the way a woman looks. That’s appalling. We don’t have to put our hands up about that.”
Are today’s diets – the way we are encouraged to eat cognitively – to blame for our anxiety? An eating-disorder specialist at the inquiry confirmed that the “Atkins diet generates many cases for my work”, but the problem is not eating disorders but disordered eating. Disordered eating includes competitive dieting and eating in secret – it can lead to both eating disorders and obesity, but more commonly just adds to the eater’s anxiety.
Rates of depression in women and girls doubled between 2000 and 2010; the more women self-objectify, the more likely they are to be depressed. Could the mainstream media’s warm embrace of disordered eating have contributed to that rise? Grazia reports that Beyoncé lost 60lb of “baby weight” by eating only lettuce. Cosmopolitan wrote about Kate Middleton’s “Dukan diet”, which begins with seven days of pure protein, and later two “celebration meals” a week. If women don’t look like Beyoncé or Kate Middleton, their flat stomachs a testament to their stamina then, it seems, they are not working hard enough.
One celebrity whose body is frequently scrutinised (and scorned) by the tabloid media is The Only Way is Essex‘s reality star Lauren Goodger. “Never heard of Spanx, Lauren? Miss Goodger shows off muffin top in very unflattering dress,” read one Mail Online headline. There are 546. “Oops, maybe you should’ve tried the next size up. Lauren Goodger’s tiny dress feels the strain.” “Haven’t you learned your lesson? Lauren Goodger steps out in ANOTHER pair of unflattering leggings.” Rather than the corrosive dripping-tap effect of reading these once a day over the last two years, read together these 546 headlines feel like quiet waterboarding.
I meet Goodger at Max Clifford’s office. She is weeks into a “drastic diet plan”. Many women feel judged on their appearance in some way, but what does it feel like to have those verdicts read by 99 million people a month? “It is quite… draining,” she says. “I can’t look at comments. I can’t buy the mags any more. I used to love them, but I was happy then. Then my weight became a story, not just for the show but for the press. Yeah, I’m definitely aware of the online scrutiny. My body becomes my work.” She thinks for a bit. “But just because someone’s not a size 10 it doesn’t mean she’s a bad person.”
Last year Goodger had a nose job because, she said, she’d hated seeing her profile on TV. Most of her female Towie cast members have had cosmetic surgery – mainly breast implants, a bum lift, Botox, lip fillers. “Where does it come from, the idea that natural is not beautiful, that we all need the model look?” Goodger asks herself. In response to Jo Swinson’s inquiry, the British Association of Aesthetic Plastic Surgeons (Baaps) has called for a ban on adverts for cosmetic surgery, highlighting promotions that play on vulnerabilities, such as “divorce feelgood” packages of breast augmentation and liposuction, and surgical procedures sold via online discount sites such as Groupon.
“Do you think there should be psychological screening for those seeking surgery?” I ask Goodger tentatively. “It’s a subject that’s hard to talk about,” she says. “Especially because I’m… within it.”
We talk about the idea of “naughty” food, about the different expectations for men and women, about the celebrities who say they’re “big and happy” then suddenly lose weight. There’s a pause.
“My little sister was anorexic at 11,” she says suddenly. “It started with someone at school calling her Miss Piggy. I mean, I didn’t even know about dieting until I was 18. Things have changed so much. She gets the mags, she wants the bags, the Prada shoes. It’s crazy. She’s a baby! She wears lashes, make-up. But you do what everyone else is doing – you compare yourself. She’s fine now, a year and a half later. But she’ll message me going: ‘Have you lost weight? You look really good’ and I’ll think: God, don’t say that.”
Goodger and I were both born in the 80s. In our lifetime (one that has seen the internet enter our homes, along with hundreds more television channels), expectations of beauty have changed enormously. What must it be like growing up today, when cosmetic surgery is advertised on public transport, when “baby-weight loss” diets are rife?
I gather together a group of under-20-year-olds at Livity, Brixton’s “youth engagement agency”, to talk about body image. It’s not a concept that needs explaining to them. Apart from Stephen (who says: “The fact that I don’t have an opinion on body image probably says something itself. Boys have it easier, definitely”), they have much to say.
First, some fictions they are keen to shatter. The pressure, the girls agree, is not, in fact, to be skinny – instead it’s to look sexy. “Hot.” “Everyone wants to look like Kim Kardashian, even though we know she’s a boring person – we don’t want to have her personality, just her body,” says Claudia. “Not Kate Moss’s. Curves, not bones.”
This is the first time sex has been discussed – until now, everybody has talked about thinness and control, rather than changing your body to attract a boy. But as Bridget points out, you can starve yourself bony: “The sexy body is much more unattainable.” “I think our generation is really savvy about the media,” says Amber as they move quickly on to the subject of airbrushed ads. “So you know an image has been manipulated, but I suppose… you don’t know what that’s doing to you.”
I wonder about the fact that these young people are so literate in the issues of body image (as opposed to simply “bodies”) that their thoughts on the subject are so close to the surface. “We’re forced to think about it!” says Bridget. “It’s on every channel, every night. Programmes like Supersize vs Superskinny, orHow to Look Good Naked, or freaky ones like Half Ton Mum, or A Year to Save My Life.” Everyone shouts out names – programmes about overhauling your body with diets, clothes or surgery. “They have mixed messages,” says Amber. “On one hand they’re saying ‘love your body’, then on the other ‘fat’s bad, the worst thing you could do is be obese’. The message ‘be healthy and do exercise’ is a bit different from ‘be happy in your skin’, isn’t it?” The rhetoric of empowerment, here, actually disempowers.
Do we hate our bodies because of reality makeover TV? Susie Orbach describes how they often provide “dysmorphic and distressed women” the opportunity to “compete over their body distress and win the prize of radical restructuring”. The earliest technologies of body enhancement utilised techniques used on Second World War burn victims. “To hear [winning reality show contestants] tell it,” Orbach says, “they’ve been through their own individual wars, too… Their compulsion to change their bodies is a result of a different kind of assault on women, and increasingly men, which is sufficiently damaging to have persuaded them that the bodies they live in are urgently in need of transformation.”
Both the cosmetic surgery and the cosmeceutical industries (anti-ageing products) are growing, fast. It’s these industries, “along with the fashion houses, the diet companies, the food conglomerates [which own the diet companies], the exercise and fitness industry, and the pharmaceutical and cosmetic surgery industries”, that Orbach is now combating, because, she says, “they combine, perhaps inadvertently, to create a climate in which girls and women come to feel that their bodies are not OK”.
Orbach debated with representatives from the diet industry in parliament to applause from the public gallery – outside women protested with placards saying: “Riot, don’t diet.” Discussing Weight Watchers’ recent £15m TV ad, she suggested it was affordable to them only because their members are locked into lifelong “straitjackets” of unrealistic weight-loss expectations. When I speak to her later, she goes further. “I do think we should be prosecuting the diet industry for false advertising,” she says firmly. If dieting worked, she argues, you’d only have to do it once. There is evidence that diets may in fact contribute to fat storage and that, in giving a sense that food is “dangerous”, create conditions for rebellion, which eventually makes people fatter than they were to start with.
When I began my research, all roads led back to Orbach. She’s been crucial in hammering home the dangers of body-image anxiety, yet figures show that we are feeling worse about our bodies than ever. “You have to make the argument that this isn’t trivial, then you have to make the argument that this is a substantial issue, then you have to combat the industries. I’m exhausted by it,” she says, throwing her head back. “But what other options do we have?”
She’s working on a psychoanalytic research project on the transmission of body image from mothers to daughters, and she’s pushing for interventions by midwives, trained to show new mothers how their own body-image dissatisfaction will affect their babies. “New mums are caught up in problems with their own bodies when they’re bringing a new body into the world. We need a counterpoint to the nonsense that you should have a pre-pregnancy body six weeks after having a baby, or ever. What’s the erasure about? That’s where it should start.” She takes a breath. “And teachers – it’s all very well them taking classes about body image, but if they don’t raise their own awareness about their own distress, then they’re just passing it on.”
Back at the Centre for Appearance Research, we make our way down the narrow university corridors for lunch. In this surprise heat, the café is full of academics fanning themselves with menus, the odd bare-legged man. I am feeling a bit hopeless. All the statistics about sadness; all the people, like me, who aren’t able to enjoy their own health, privilege, relative youth, because of this niggle. This feeling that we don’t look right.
Jo Swinson’s report detailed various recommendations being put to government, regulators, voluntary organisations and the private sector. In light of Orbach’s evidence, they call for a review of the “inaccurate” body mass index as the standard way of determining whether somebody is overweight, and for better support for new mothers. They ask advertisers to reflect “consumer desire for authenticity and diversity”, and for tougher regulation of the cosmetic surgery industry. But all the people I interviewed balanced their delight at the inquiry with a healthy wodge of cynicism at how much change these recommendations would effect.
And I wonder what we can do – us lot, the people with the faces we don’t like, with the cankles, the muffin tops, the limp, lifeless hair. It’s in the personal, day-to-day things, I think. Like consuming media critically. The media is a construction – this is no secret. Magazines, film, TV, newspapers – they all rely on advertising. So reminding ourselves that the body types we see represented are the body types that generate purchases. Asking ourselves: “Am I being sold something here?” It’s not a terrible thing, being sold to, it’s just a… thing. Unpicking the media we consume, and talking about it, will help us feel better eventually. Cognitive dissonance programmes in schools have been effective – encouraging young people to speak out against the unrealistic ideals of beauty they see. In talking about it we reduce the internalisation of beauty ideals, and feel less awful about our implied failings.
I tell Car’s Dr Phillippa Diedrichs about something Amber mentioned – about femininity and dieting.
“Eating becomes a means of communication,” Diedrichs says after lunch. “In our food choices we’re demonstrating our femininity.” But it goes further than that. “We’re socialised to be negative about our bodies,” she says, and a slideshow of moments flashes through my head. Women standing in the ladies’ loos complaining about their boobs. Or comparing their limbs to their colleagues’ unfavourably. She introduces me to the idea of “fat talk”, everyday conversation that reinforces the “thin ideal” and contributes to our dissatisfaction. Like: “You look great – have you lost weight?” Or, on being offered a bun: “Ooh, I really shouldn’t.” “After three minutes of fat talk,” says Diedrichs, “there’s evidence that our body dissatisfaction increases significantly.” Naming this – fat talk – makes much sense to me.
After a day at Car, my body-image anxiety hasn’t disappeared, but I can at least see a way to control it. We hate how we look because of our new, complicated visual culture, because of a fashion industry that has not adapted, a media that forensically analyses women’s bodies and saturates our culture with body-change stories. Because of the rise of cognitive eating, the increasing abilities and accessibility of cosmetic surgery. Because to be feminine, today, means to hate your body.
I leave their building feeling quite different from when I arrived. I have the same legs, the same face, the same teeth, but something in my mind has changed.