"When, lo! as they reached the mountain-side, A wondrous portal opened wide, As if a cavern was suddenly hollowed; And the Piper advanced and the children followed, And when all were in to the very last, The door in the mountain-side shut fast." Robert Browning, The Pied Piper of Hamelin: A Child’s Story
Pied Piper of Hamelin by Aldin, Cecil Charles Windsor (1870-1935)
One of the stories from my childhood that used to both fascinate and frighten me was "The Pied Piper of Hamelin". This story is about a church going community that asked a piper to lead away an infestation of rats with his enchanted music. He does so with great success, but then the townspeople later refuse to pay him, so the piper plays the music again and this time leads away the town's children. Enlivened by this melody, they dance after the piper who leads them to the mountains. They enter a cave which the piper seals with a stone, and are never seen again.
Depending on the version, one or at most three children of the hundred remained behind: one had a walking impediment and could not follow quickly enough, the second was deaf and therefore could not hear the music, and the last was blind and therefore unable to see where he was going. The three children informed the villagers of what had happened when everyone came out from church. This image of reckless but pious adults not wanting to do their own dirty work (or by refusing payment, even acknowledging its necessity) terrified me. To this day I still have an irrational dislike of rats. I also work as a healthcare professional, a group that has a rather complicated relationship with money in both being paid and also paying for their own care.
As with all fairy tales and myths we can hear the story on a literal level and think about what might have really happened in the town of Hamelin-maybe experiences of the plague etc We can also hear the story more symbolically. So what symbolically is this story talking about? What do rats represent to us? What might it mean to psychologically enlist a ratcatcher/ a pied piper? Why would we choose to do this ?
Why might we choose to refuse to pay the fee for their removal? ...
The story of the Pied Piper of Hamelin appears to have emerged from historical events. The earliest known record of this story is from the town of Hamelin itself. It is depicted in a stained glass window created for the church of Hamelin, which dates to around 1300 AD. Although it was destroyed in 1660, several written accounts have survived. The oldest comes from the Lueneburg manuscript (c 1440 – 50), which stated:
“In the year of 1284, on the day of Saints John and Paul on June 26, by a piper, clothed in many kinds of colours, 130 children born in Hamelin were seduced, and lost at the place of execution near the koppen.”
The stained glass window and other primary written sources do not speak of the plague of rats. If the children’s disappearance was not an act of revenge, then what was its cause for the Pied Piper’s actions? There have been numerous theories trying to explain what happened to the children of Hamelin.
Some theories suggest that children died from local disasters such as an epidemic, and that the Piper was a symbolic figure of Death. Another theory suggests that the children were abandoned due to the extreme poverty and famine. A popular suggestion is this is a story describing a social contagion: There is an account of an episode of dance mania , also known as St. Vitus’ Dance. This type of social contagion occurred repeatedly in mainland Europe between the 14th and 17th centuries, and has been described as individuals dancing “hysterically through the streets for hours, days, and apparently even months, until they collapsed due to exhaustion or died from heart attack or stroke.”
However regardless of what really happened, at some point the symbol of rats began to explain the story and so it still remains.
The collective decision to incorporate rats is an interesting one. In British culture we can use the word 'rats' fairly regularly to convey a variety of meanings ...
Rats! I can't believe that I forgot to check that!
I smell a rat.
He was a love rat.
Work is a rats nest.
Don’t you dare rat on me to my manager!
The group was ratty after being publicly shamed
Rats are an animal that come with political controversy. Whilst some people keep them as pets, others breed them explicitly to experiment on. I have clear memories of dissecting rats in biology class in school. In European culture the rat tends to be perceived as a threat and associated with dirt, disease transmission and death. In Chinese culture, rats might represent wisdom, wealth and prosperity. In some African cultures, spirits of the dead are thought to visit their loved ones’ homes in the forms of rats.
Rats are tenacious and like humans have an ability to survive in a wide range of environments. Wild rats tend to go wherever groups of humans congregate: living in roof spaces, wall cavities or under floorboards, in gardens, they will burrow into grassy banks or under sheds. We see rats scurrying around bins, or in alleys. Importantly rats are found living in sewer systems and invade property when the sewers are in a state of disrepair. We tend to link rats with faeces and we know they will eat both human faeces and their own – up to 40% – as a source of nutrition and the gut flora required to maintain a healthy digestive system.
As humans take more and more space and build bigger and bigger living complexes for our ever growing societies, rats serve as the unwanted side effect of our creations and resistance to take personal accountability for maintenance and waste. What we also don’t see, or at least do not want to think about when we grow our towns and cities, is the pollution and destruction that is left in the wake. Rats are the living reminder that underneath the 'civilized' social worlds we construct and wake up to, that in the dark corners there remains a wild influence we cannot entirely control.
Rats are a constant reminder of our connection to the animal kingdom. Their essential needs of food, warmth and water are also our essential needs. They keep us in touch with how close we are to our biological realities. We are animals too. In paying attention to our rats we must also acknowledge our human bodies, our filth and wastefulness, our greed, our potential to spread disease and our deadliness.
In psychological narratives, Freud believed rats to be phallic symbols. He also felt that they represented dirty children: screaming, crying, and biting vermin. Within this context, rats can symbolize unwanted children or unwanted siblings. A Jungian interpretation might connect the rat to collective shadow.
In our media the symbol of a rat is used to invoke a narrative of a fantasy predatory relationship between rats towards humans. The symbol of the rat is used in language to evoke a fantasy of predatory behaviour from people who are homeless, refugees, unemployed in society, and whistleblowers in our work spaces. We use this predator rat fantasy to justify their destruction.
So if we have a dislike of rats and their presence can cause both suffering, spread of disease and destruction (and as such we don’t want to live alongside them), rightly or wrongly it might make sense to bring someone in to remove them. But why might we resist paying for this work? This question led me to thinking about the relationship as clinical psychologists we have with money, power and paying for services.
The relationship between Clinical Psychology Culture and money is a source of constant conversation in my peer supervisions and antiracist work. In fact I don’t know many clinicians in private practice (the rats that fled the NHS ship) that don’t regularly openly wrestle with questions about money. I also know personal relationships with money were rarely discussed in depth when working in the NHS or during training. Given that money and power are so intimately connected it feels neglectful and unethical not to examine it.
In the past I have worked hard to avoid my relationship with money and very much wanted to be the person that could embody that 'money isn't something I care about'. However the more I tried the less real that was. Of course I care about money and my security and being able to pay my bills. So while I want money, I don’t like it. Although that is also not true because I love being able to buy the things I want and enjoy having money in my bank account.
Carl Jung called our relationship with money a complex: a topic full of energy and emotion which can dictate our behaviours and how we view the world. Freud suggested that the desire for money/gold could be equated with the anal phase children go through: toddlers do not like to give up their shit without a fight. Freud and Jung both drew on ancient myths, fairy tales, superstitions and dreams, in unconscious thinking, to show we collectively link money and gold with defecation. If I am feeling playful I might extend this analogy to the political push to attain the gold standards in NHS care giving and the unblemished clinical psychologist identity. How many clinicians in the face of endless targets have uttered the words- “I cannot be bothered with this shit”. However faeces/shit is wonderful as manure and when applied with thought can facilitate growth.
In archetypes and myths the Greek gods take us on a variety of journeys with regards to money: Hermes was the Greek god of riches, trade, and good fortune. He was also the messenger or herald of the gods and as such a God necessary when transitioning worlds and crossing boundaries. (Mercury was his Roman equivalent). Hermes was known as the patron god of flocks, herds, and shepherds, an attribute possibly tied to his early origin as an aspect of Pan. Pan was the son of Hermes. He is often associated with shepherds, sexuality, fertility and rustic music. Pan is connected to rebirth and the season of spring. The pan flute is named after Pan, the Greek god of nature and shepherds often depicted with such an instrument. It is possible the story of the pied piper holds echoes of this father son combination - Hermes (money and boundaries) and Pan (music and shepherding).
As money possesses archetypal value we know it is important in terms of our collective psyche. As such, if our collective belief system tries to reduce the complex meanings of money, the psyche is threatened. Interestingly, the everyday psychological language of well-being and soul is also the language of economics: depression, inflation, interest, accountability, credit, uncertainty and insecurity. We cannot ignore or separate the relational aspect of money and its links to both wellbeing and power.
When thinking about psychology, culture and money I start with thinking about early career psychologists and how so many work for ‘free.’ I personally benefited from an unpaid post. An opportunity not everyone is given/or can afford to take. With adult eyes I also see that my unpaid work cost the NHS something: my supervisor’s paid for time and the NHS resources that it takes to make space for and accommodate a member of staff. A long line of NHS patients were supplied for me to develop my novice clinical skills. As such financial and human suffering were being utilised as resources and investments made in me and my career rather than in solely meeting immediate patient needs. I was and am grateful for this. I am confident without the stewardship in those formative experiences I would not have made it through. However it is also often easier to access forgiveness than permission.
It is not only the early career psychologists that work for free in our culture. Many qualified and trainee clinicians also offer to work 'for free' in supporting an early career psychologist advancement or taking on pet projects. We tell each other this is 'morally right' and people are 'giving back' and 'contributing ‘. Kind people, good people don’t ask for payment. Deep suspicion is encouraged about those who charge for their time. Money is seen as dirty or contaminating something good. Yet with no financial trail how do we keep account of collective resource distribution?
It can feel profoundly validating to have someone offer their professional care for free, it can make us feel like we are on the right track and our potential has been seen. Or rather, as giving care is expensive, someone else paying the fee for my opportunity. But this gift of validation can also be silencing. It can hush protests. How do people report abuse, complain or compare quality? How do people wrestle with ambivalence to allow a discernment process? When you have to be grateful can you be seen to go back on what you asked for? How do you say no when everyone has invested so much in you? In the structure that we have where professional shepherding of younger clinicians 'should' be free (or rather the costs kept out of sight), cronyism, tokenism and oppression go hand in hand. When costs are magically absorbed, what is magically taken away and do we even notice? No wonder by the time we get to qualification non-completion rates of training are typically less than 1%.
To be clear. People not having enough money to access clinical psychology pathways is a serious problem that needs to be addressed in real terms. None of my intention in discussing this is to imagine anyone should somehow magically be able to conjure up payment, or that it is superior to self-fund. But rather can we just talk about the complexity of money, openly and honestly.
There are dangerous risks being taken in our professional and also societal refusal to acknowledge the complexity of the costs of care. The potential dangers, in unconsciously shushing down complaint, nor holding the importance of wrestling with ambivalence to develop psychological growth, are never more alive than in a politically popular and professionally mandated therapy called 'gender affirming care'.
Affirmation being the process of agreeing with and acknowledging what someone is saying about themselves is true.
In this therapeutic approach I have heard the therapeutic relationship being described as a space where the clinician should delicately affirm an experience whilst helping the patient explore the different realities of their experience. This explanation was a useful insight to me into something being fundamentally wrong. What is being described here is not therapy as psychologists typically know it - it is what I would understand as well intentioned manipulation. A technique someone might try with an insecure friend about a life choice such as whether to have an abortion or which partner to choose. The emphasis is on the friend/ally/therapist maintaining contact through holding a position of 'usefulness' whilst also maintaining power and authority through affirming. The side effect of this is that the therapist who must affirm, by default, becomes seen as a person that knows what's best for the patient. In turn the patient must remain dependent and someone who needs affirmation/ favourable judgement from a powerful other and once accustomed to it, without this affirmation the person can feel unable to know their own mind. For some they not even know if they exist. If affirmation from another is necessary to sustain reality then the need to be constantly affirmed must also be sustained.
Clinical Psychologists’ professional siblings, psychotherapists understand that the tensions produced in resisting therapist affirmations are important parts of the therapy experience and likely lead to the therapeutic process of rupture and repair. This is the uncomfortable psychological growth equivalent of muscle strengthening. There is gold in these shitty experiences of struggle in the therapeutic relationship, that can leave the patient profoundly psychologically wealthy and holding significantly more relational power, inside and outside the therapy room.
The metaphor might be that of a caterpillar transforming into a butterfly, only to have the affirming therapist pick a way at the cocoon to alleviate the internal struggle and help the process along. In doing so there isn't enough resistance for the wings to strengthen and the butterfly struggles to fly. Therapists in most other therapies offer a watchful waiting, containing a space for an internal struggle to occur and to caretake the natural process of transformation, without trying to predict what will emerge at the end. As such, therapy typically is a place of robust containment, where someone is supported in developing greater understanding of themselves.
As clinicians we all know it is vital to hold onto the fact that none of us really know ourselves very well, and that minimisation and denial are standard fare. We know that no individual or group is too clever for denial and nothing is too big to be denied. Psychotherapists also know it is the patient that must learn to analyse themselves, that is not actually the task of the clinician. Clinicians don’t read minds and don’t know what they should or shouldn’t be affirming. The clinician’s task is only to clear some space so the patient can work out their own psyche and strengthen their ability to live in reality. Insight often does not lead to change, but it does lead to understanding and self-acceptance. It allows us to make choices based on what things can actually give us, rather than the fantasy of them.
Sadly gender affirmative care whilst well intentioned opens up clinicians for a huge blind spot in care giving for clients that do not or cannot have the insight necessary for accurate self assessment. As the clinician in this affirmation therapy frame must be seen as someone who can affirm, they must constantly reach for evidence and an opinion - no matter how sparse. In needing to be seen as affirming parents are told their children will kill themselves if they don't comply and people are given evidence that euphoria follows after surgery. The affirming clinician might even give evidence and reassurance that serious regret is shown in only 1.0% of those who have their penis removed or a double mastectomy compared to 20% regret rates found in knee surgery. As if these body parts all hold equal value. The lack of valuing the sexual body in these comparisons is bewildering.
Whilst, for some, affirmation may work out fine and they can be happily affirmed into transition, and for others they are able to change their mind regardless of intervention, where is the valuing of those people who are more vulnerable? The cautionary space held for those bodies who once transformed, cannot be recovered no matter how big the regret? In any other area of health care, incorrectly utilising ‘affirmation’ as a therapeutic technique just once in connection with this type of irreversible harm would be legitimate cause for professional inquiry. Never mind having it happen so frequently it becomes able to held as a percentage and its accuracy the subject of debate. Primum non nocere.
In the story of the pied piper the community did not want to live with the rats, or pay for their removal. Clinical Psychology as a community does not seem to be curious about our unconscious group processes (our rats). One example of this is evidenced in our lack of conversation about money and how instead we try to encourage a culture where some people do not need to pay or get paid. We dismiss the importance of reflecting on what this might do to the relationships in our groups and work environments. We ignore how money transforms our understanding of value and our relationship to ambivalence, struggle, complaint and whistleblowing. We are not then able to recognize the value of these experiences when presented in our work groups and importantly in our therapeutic relationships. Instead of doing the dirty work of containment we prefer the effort free approach of affirmation. Worryingly it is the people we are responsible to care for that must absorb for impact when this goes wrong.