I have just finished reading the book 'Time to Think' by Hannah Barnes. It is about the activity of the Gender Identity Development Service for children (GIDS), a nationally commissioned unit at the Tavistock and Portman NHS Foundation Trust in north London.
This detailed analysis of the failed NHS service is painful to read. However, it feels much needed.
The more of the book I read, the more I connected to the story of Hansel and Gretel and their encounter with the wicked witch within her gingerbread house. As such, these are my thoughts and associations to the book Time to Think under the lens of the Hansel and Gretel fairy tale. As ever each character in the story might represent a part of the self, a part of the group or a part of society. Others’ thoughts and associations would be welcome so please do share them with me if you have any.
Hansel and Gretel is a German fairy tale collected by the German Brothers Grimm and published in 1812 in Grimm's Fairy Tales. It is also known as Hansel and Gretel, or Little Step Brother and Little Step Sister.
Once upon a time there was a famine across the land. A poor woodcutter and his wife live at the edge of a forest with their two children. The children are called Hansel and Gretel.
Finally, the family has so little food that the mother persuades her husband to give the children one last piece of bread each, lead them into the forest, light a fire, and then leave them there to fend for themselves. Although the woodcutter initially rejects this plan, he’s talked round, and agrees to go along with it.
The next day the children are led into the middle of the forest by their parents. Their father invites them to gather some wood to light a fire. The mother prepares the fire and instructs the children to eat their bread. The mother then tells the children to lie down by the fire and that she and their father are going away.
Hansel and Gretel settle down by the fire. They hear an axe struck, so think their father is nearby. But it was not the axe that struck, but the branch from the tree that their father tied, so the wind would beat it back and forth. Since they sat by the fire for a long time, the children were tired and soon fell asleep. When they woke, it was already night.
Hansel and Gretel must find their way. Due to Hansel's cunning and foresight initially, they find their way home. But they return, only to wake the next day and have the same thing happen again. However, the first time he dropped pebbles as a guide, whereas the second time he chose to use his bread to create a trail. Predictably the breadcrumb plan doesn't work and now they have even less resources. Regardless of this Hansel refuses to admit defeat and determinedly leads the way (and it doesn’t occur to him to ask Gretel what she thinks they might do). Gretel, overwhelmed by feeling, does not volunteer ideas and mostly cries.
Eventually they come across a bird that leads them to a house made of gingerbread.
They are ravenous and start breaking off parts of the house without even asking.
Unknown to them - the house is a trap set to entice starving children. A cannibalistic witch lives there and intends to eat them. The witch does not eat them straight away but keeps Hansel in a cage and feeds him well, she gives Gretel minimal care and insists Gretel keep the house clean and tidy. They are both terrified but don't know how to escape. Eventually an opportunity arrives, and Gretel finally finds her aggression. She outwits the witch, killing her by pushing her into an oven. Gretel takes time to listen to the screams as the witch burns to death. She releases Hansel who is finally able to ask for a hug. The two children then escape with their lives.
However, they are not out of the woods yet. They reach a body of water and search for a bridge but cannot find one. Suddenly Gretel spies a duck swimming and she asks for its assistance. The children realising the duck cannot carry both at once, take turns to use a duck to cross a lake to safety. Finally, working together, they can find a way home carrying with them the witch's treasure.
Since they were last at home their mother died, but their father remains and welcomes their return ...
The Hansel and Gretel fairy tale goes back to a cohort of tales that originated in the Baltic regions during the Great Famine of 1314 to 1322. One academic estimated that the Great Famine impacted 400,000 square miles of Europe, 30 million people, and may have killed off up to 25 percent of the population in certain areas. In the process, elderly people chose voluntarily to starve to death to allow the young to live. Others committed infanticide or abandoned their children. There is also evidence of cannibalism. In this context we see the themes of the story are not simply metaphor, but as with all archetypes - born from a reality.
Archetypes connect us both to universal, recognizable physical realities but also offer symbolic imagery to facilitate understanding of a situation. The more we understand their origin, the more understanding we can make of their symbolic use. The story covers themes of famine, starvation, abandonment, survival, cannibalism - along with use of deceit, cunning and aggression. As clinicians we might wonder what is the psychology evoked in starvation, abandonment and betrayal.
As such, there are many psychological interpretations of this story. It becomes an inquiry into what we do when we are deprived, starving and without a guide - a story of emotional abandonment and coping; a story of addiction; a story of individuation and integration of the shadow. We could summarise all of this by saying that Hansel and Gretel ultimately is a story of betrayal trauma.
Betrayal trauma is defined as a trauma perpetrated by someone with whom the victim is close to and reliant upon for support and survival: Hansel and Gretel have no choice but to be loyal to their parents and they return again and again. The concept of betrayal trauma originally was introduced by Jennifer Freyd in 1994, in her betrayal trauma theory. The theory predicts that the degree to which a negative event represents a betrayal by a trusted, needed other, will influence the way in which that event is processed and remembered and therefore acted upon.
Betrayal trauma theory suggests that any individual (such as a child, spouse, employee, patient), who is dependent on another (such as their caregiver, partner, employer, clinician) for care or belonging, will have a higher need to dissociate and deny traumatic experiences from conscious awareness in order to preserve the relationship. In more simple terms, when we are betrayed and we are also still reliant on the person who just betrayed us, we will be 'loyal' and act in a way to ignore the betrayal. So for example, we may not speak about an upset, or ask questions about an event or make reference to being let down. Or if we do speak, we will not act on disturbing or jarring information gleaned. Our minds will actively try and forget and carry on as if nothing has happened.
It is as though we can become both Hansel - who's ability to act is trapped in a cage and Gretel - who's emotional sensitivity is used solely to tidy up someone else's emotional mess. In this way betrayal becomes an experience that is known (as in witnessed and physically felt) but just not thought about. This is what is referred to as an experience being an 'unthought known'. Sometimes people also call this a hidden narrative or a lived narrative that is unknown to the person living it.
This phenomena is also known as betrayal blindness. That is the unawareness, not-knowing, and forgetting exhibited by people towards betrayal (Freyd, 1996, 1999). This blindness may extend to betrayals that are not traditionally considered "traumas," such as adultery, inequities in the workplace and society, etc. Victims, perpetrators, and witnesses may display betrayal blindness in order to preserve relationships, institutions, and social systems upon which they depend.
A good example of someone investing consciously in betrayal blindness is in the film 'Love Actually' and Emma Thompson’s performance as Karen, the betrayed wife of Alan Rickman’s Harry. Karen finds some jewellery meant for the other woman, but then chooses to continue on as if nothing has happened. She keeps her grief away and with steely determination carries on with family life as before. On discussing the role and also her own experiences of betrayal Thompson says: “What I learned was how easy it is to be blinded by your own desire to deceive yourself.”
What is devastating about betrayal trauma is that to put up a “steely” front and stay loyal, we are privately left humiliated and open to attack for our playing a part, tricked by our own desire to belong and do the right thing. We can also feel under threat by anyone who chooses not to participate in the betrayal blindness - we displace our shame and rage onto them and so we work to shoot the messenger.
When I think about the mother in the Hansel and Gretel story I try to hold her as an archetype. So I do not just think about biological mothers. I also think about holy mothers, ward matrons, brick mothers (institutions), mother countries and mother nature. What do we do when our world has insufficient resources to meet the needs and desires of everyone? What do we do when there is insufficiency in our institutions - education, healthcare, prisons, legal systems? Are we in a type of famine currently? If so - what are we actually hungry for? What has become a scarce resource: time, community, connection, intimacy, love, touch, ‘face to face’ encounters? What looks like care and might appear full of sweetness, but in reality acts to support the cannibalistic appetite of a devouring caregiver, who is also in the middle of a famine?
The Father archetype reminds me of daddy issues, religious fathers, father knows best, founding fathers and father time. As with any archetype, both light and dark aspects exist. When I think specifically about the father in Hansel and Gretel I remember his work as a woodcutter. A woodcutter is someone who cuts down trees or who chops wood as their job. The tree as an archetype is a pattern of growth related to our interconnectedness with nature. Woodcutters often worked in groups. Their work also involved high risk. In Europe and the USA Wood cutters often lived a migratory life, following timber harvesting jobs as they opened. It was seasonal work and exclusively male. They usually lived in bunkhouses or tents. Knowing that the woodcutter is meant to work in a group, to me emphasises the woodcutter's isolation even further. This makes me think of the impact on unemployment, loss of self esteem and depression in male psychology. The shame in not fulfilling the tradition of being able to provide. The importance of male companionship. How did this influence his ability to speak honestly and plainly to his children and prepare them for what was out there in the woods?
The children in the story, our heroes, might represent many things. The parts of us that need to have more developmental experience, the parts that are dependent on something bigger to sustain us, the parts that are not that mature. On a social level, are these minors, minorities? Certainly Hannah Barnes reveals children from marginalised groups are hugely over represented in the clinic. One imagines these complex children presenting in already overwhelmed CAMHS services and the relief clinicians might feel in being able to refer them on to a specialist service, one less mouth to feed.
In Barnes’ book we are given in painstaking detail a story of profound institutional betrayal by the NHS. Curiously, the GIDS NHS situation being discussed used gingerbread imagery, with common use of the genderbread image as a way to encourage children to take up these theories.
A particularly disturbing example of clinicians and children being trapped in institutional betrayal is demonstrated in the referenced on p124 of the book. Barnes describes how, in 2016, GIDS clinicians received new medical knowledge regarding the inability for natal boys to grow enough penile skin to perform vaginoplasty safely and effectively if their puberty is blocked too early. To those staff present at the meeting this was essential information to be disseminated to all relevant patients and their families. An information leaflet was quickly drafted. However, the institution shut down action - asking for clinicians to wait for approval before it was disseminated, ultimately the requests for officially sharing this information were ignored. Thus leaving clinicians left alone to navigate their employers' betrayal of both them and their patients. Clinicians were left waiting, like Hansel in the cage but also required to do the tidying up, like Gretel. It makes sense that betrayal blindness might take hold. Certainly a culture of tokenistic conversation/reflection with no action is described in the book - which fits this hypothesis. Staff become taken in by the sweetness of affirmation from this verbal support but later understand that it was not in service of care, but in service of something else. By which point it is already too late. The gingerbread house becomes a place of entrapment for those who enter.
I think this is such an important book for psychologists to be reading. Not just for the story itself but also because I think it is the first to really speak about the famine we are currently in, in the NHS and some of our reactions to the awful realities as caregivers being faced.
Hansel and Gretel begins as a story about a family suffering because of a scarcity of food.
The thought of two parents lying in bed discussing their need to abandon their children is too horrendous for many of us to contemplate. We are so accustomed to reading about parents who abuse or abandon their children that culturally many now have a belief that no-one ever suffers without predation. By ignoring reality we can not really prepare for the dark depths we might go to, to survive. The witch is also surviving this famine, but her survival relies on the gingerbread house not being recognized as a trap before it is too late.
Whether we can find empathy for the witch or or not, the fairy tale shows us that this witch must be killed and there is life sustaining treasure found in doing so. To survive, Hansel must learn to trust his sibling and not to do everything by himself. Gretel must learn she is not going to be able to talk the witch out of eating Hansel: Gretel must learn to act. To kill the witch Gretel must show determination and find her ruthlessness. They both must learn to set limits, think together, plan ahead and take up opportunities as they arise.
In this way, Hansel and Gretel teach us that if we apply our inner resources we can find a way to succeed.
Indeed, Freyd (2014) suggests that "One of the first and best steps toward betrayal reparation an institution can take is to undergo a careful self-study of past abuse, risk factors, and protective factors within its environment (Healy, 2012). While truly problematic institutions may not be open to this level of examination/critique, this type of study can protect an institution from future damage while encouraging trust among its members. At least one, if not both, of these outcomes should serve as motivation."
'Time to Think' by Hannah Barnes is a book that helps us do this. I urge clinicians and in fact all stakeholders to read it, so lessons can be learnt and a way out of these woods found.