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ImageI  bought some Easter eggs yesterday. I used the self service check out and was surprised to have an alert come on the screen. I wondered what was in this egg that needed me to be approved by a member of staff. (The alert was triggered by my having bought an Easter egg which contained alcohol. Specifically some chocolates that had a small amount of Bailey’s liqueur in them. I assume that the actual alcohol content was so minimal as to be almost non existent.)

I mention this to highlight what seems to have become a feature of life these days. The ubiquitous Risk Assessment. Three cornered flap jacks are now banned because a child was hurt when one was thrown at him in a food fight in a school canteen. (All sorts of questions come to mid here. Where were the teachers? Why were these kids having a food fight? who won?) We hear of conker fights being banned because of a risk that someone might get hurt if one breaks. (I always thought that breaking one’s opponent’s conker was the point of the game!)

I teach psychiatric nursing and nurses and was in clinical practice for twenty years before that. I have seen the rise of the Risk Assessment mind set. It now dominates the thinking of most all the nurses and students I meet. I recently did a role play exercise with a group of mental health  nursing students. I was working with a student who was playing a patient who was hearing voices. In the course of our conversation I responded to the feelings he was sharing  with me. I commented on his feelings of shame and exclusion. “You sound as though you feel like a leper”. “Yes” he said, “that’s just how i feel.” I finished the role play and asked the class for their thoughts. One student put his hand up “Terry. You called him a  leper. Aren’t you worried that he’ll report you?” I was lost as to how to reply. When did using a simile in counselling become a reportable offence? Or any kind of offence? And what had this student seen and heard that he could worry about my use of language? (I use a lot of “language” in my lectures. This was the first time a student had ben bothered my choice of words.)

The psychoanalyst Jo Berke says of Risk “To be at risk is to be alive. At any moment the consequence of being alive entails sudden unforeseen changes which may enhance or endanger health”  (Berke 2003) Arthur Ransome’s more often quoted quip “Better drowned than duffers. If not duffers won’t drown.” has the same idea.

A year ago i had a bad cycling accident ( entirely my own fault!) in which i broke my wrist in four places and  also my hip. Getting back on my bike has been a long, slow process. The physical side was relatively easy involving exercises, work from an excellent physio and a determination to get my body back in shape. The fear was much harder to overcome. Every time i went round a corner, saw a pothole or felt a bump, my mind and body took me straight back to my crash. My instinct was to pull on my brakes as hard as possible and get off and walk.  One session with a hypnotherapist and a trauma workshop has me back riding. (I still get more anxious than pre crash but at least I can manage this anxiety.)

My point is that it is surprisingly easy – and logical- to want to avoid risk. Having had a very bad fall, nobody would blame me for giving up cycling and taking up dominoes. Or golf. Or something relatively safe. But I would know that i was not making a choice. My choice was being made for me. By fear. By anxiety. By loss of confidence. My world would have shrunk.  Fortunately, I have enough good objects inside to provide me with the resources to get back to Life.

No doubt Tesco want to prevent me from a future of alcohol abuse by putting a warning on their Easter egg. My student who was concerned that he might be  reported for risking a vivid image. But where does this lead us? To clinical work that is insipid and “safe”. To patients being failed because nurses have internalised a  highly critical censor. 

I am aware, also, of writing this blog in what we call Holy Week. The story of the crucifixion, however we understand it, seems to me to be at the very least a story about Risk.

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  1. I love Arthur Ransome’s telegram quote; it’s also not quite true. The risk is always there, duffers or not, although much reduced if we take a thoughtful view of life. I’m interested in watching young people who want to push all the boundaries and take all the risks. I don’t know if they do in practice, but they ‘talk the talk’ and occasionally you do see them come to harm (but amazingly very few of them in my experience).
    Constraint and restraint (not physical) can help to make a safer environment, but I think you need experience to be able to learn how to work within and without of them. Fear of litigation (or an organisational equivalent) is making it very difficult to get the experience and learn where the boundaries are for you.
    PS Very interested in the trauma workshop – can you write a piece about that for us, please.

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