A window into the pressures on victims

Khadj Rouf watches 'What's The Matter With Tony Slattery?', a Horizon documentary.

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

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

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

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

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

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

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

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

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

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

- Watch the programme now 

Dr Khadj Rouf, Consultant Clinical Psychologist 

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

References

Read, J., Hammersley, P., & Rudegeair, T. (2007) Why, when and how to ask about childhood abuse Advances in Psychiatric Treatment,(13), pp. 101–110 doi: 10.1192/apt.bp.106.002840

Read, J. and Bentall, R.P. (2012) Negative childhood experiences and mental health: theoretical, clinical and primary prevention implications. The British Journal of Psychiatry, 200, pp.89-91.

Sweeney, A., Clement, S.,  Filson, B. & Kennedy, A. (2016) Trauma-informed mental healthcare in the UK: what is it and how can we further its development?", Mental Health Review Journal, Vol. 21 Issue: 3, pp.174-192

Recommended reading 

BPS (2018) Safeguarding Children and Young People: Every Psychologists Responsibility 

BPS (2016) Guidance on the Management of Disclosures of Non-Recent (Historic) Child Sexual Abuse    

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

NSPCC 

National Association for People Abused in Childhood (NAPAC) 

The Truth Project - see also our interview with Rebekah Eglinton

Rape Crisis England 

The Samaritans

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