Humorous Psychiatry - You Tube Clips

http://www.youtube.com/watch?v=BZPAt5ynZdE

http://www.youtube.com/watch?v=IyuRj6TsyvQ

The Influence of the Pharmaceutical Industry

In 2005 the British government's Health Committee undertook a official report into the influence of the pharmaceutical industry. It stated that "The consequences of lax oversight is  that the industry’s influence has expanded and a number of practices have developed which act against the public interest". The practices they list are:


"that clinical trials were not adequately designed – that they could be
designed to show the new drug in the best light – and sometimes fail to indicate the true
effects of a medicine on health outcomes relevant to the patient. We were informed of
several high-profile cases of suppression of trial results. We also heard of selective
publication strategies and ghost-writing. The suppression of negative clinical trial findings
leads to a body of evidence that does not reflect the true risk: benefit profile of the medicine  
in question".

The report is interesting see:
 http://www.parliament.the-stationery-office.co.uk/pa/cm200405/cmselect/cmhealth/42/42.pdf

The Importance of Suffering

My new book has just been published on this topic by Routledge. It is called 'The Importance of Suffering' - you can view it here:

http://www.amazon.co.uk/Importance-Suffering-Meaning-Emotional-Discontent/dp/0415667801/ref=sr_1_1?s=books&ie=UTF8&qid=1322334067&sr=1-1

BBC's Breakfast Doctor gets paid by Pharmaceutical Companies

I recently discovered that the BBC’s Breakfast Doctor, Dr Rosemary Leonard, who has advocated antidepressants in the media, gets paid by a number of pharmaceutical companies for PR activities on their behalf. Once again, current editorial policy does not protect the millions of people who follow her advice everyday from the potential conflict of interest she may have and the biasing effects of this interest. Here is the evidence for her pharmaceutical ties: Firstly, there is a statement on her website this says, and I quote: "In view of her extensive experience, she is often asked to present medical corporate videos and take part in PR activities for drug companies"  http://www.drrosemaryleonard.co.uk/about   

The financial nature of Dr Leonard’s ties are declared to the “Medicines and Healthcare products Regulatory Agency”. The following PDFs from the MHRA website show that Dr Leonard has undertaken paid PR work for pharmaceutical companies like Lilly, Crookes Healthcare and GlaxoSmithKline. You can find confirmation of this here:   http://www.mhra.gov.uk/home/groups/pl-p/documents/committeedocument/con003471.pdf

and here:

http://www.mhra.gov.uk/home/groups/es-cb/documents/committeedocument/con2015695.pdf

BBC - More Evidence of Non-Disclosure

I have found more evidence of the BBC not disclosing the financial links of the 'mental health experts' it quotes. The following people extolled the virtues of antidepressants on BBC News Online in 2009. The BBC did not declare their conflicts of interest. So let me make them available here: 

BBC article: ‘antidepressants work instantly’ (Oct 2009)
http://news.bbc.co.uk/1/hi/health/8304782.stm

In this article, Dr Catherine Harmer was extensively quoted favouring antidepressants, what we weren't told is that she has acted as a consultant for Lundbeck, Merck, Sharpe, Dohme, and P1Vital

(Proof: http://www.mentalhealthacademy.com.au/journal_archive/acn0839.pdf

The article also extensively quotes, Dr. Michael Thase. What we weren't told is that he has acted as a consultant to AstraZeneca, Bristol-Myers Squibb, Cephalon, Cyberonics, Eli Lilly, GlaxoSmithKline, Janssen, MedAvante, Neuronetics, Novartis, Organon, Sepracor, Shire US, Supernus, and Wyeth; is on the speaker’s bureaus of AstraZeneca, Bristol-Myers Squibb, Cyberonics, Eli Lilly, GlaxoSmithKline, Organon, sanofi-aventis, and Wyeth; has equity in MedAvant; and receives book royalties from American Psychiatric Publishing, Guilford Publications, and Herald House. 

(Proof:  http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=1379

BBC Article: ‘Antidepressants Not Overused' (Sep 2009) http://news.bbc.co.uk/1/hi/scotland/north_east/8256501.stm

In this article, Professor Ian C Reid was extensively quoted extolling the virtues of these pills. What we weren't told is that he has been paid consultancy and speaker fees by Sanofi Aventis, Wyeth UK, Eli Lilly, and AstraZenec 

(Proof:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734353/pdf/bjgp59-644.pdf)

BBC article: 'Drugs can help mild depression' (May 2009)

http://news.bbc.co.uk/1/hi/8027440.stm

In this article, Professor Tony Kendrick was extensively quoted supporting this position, what we weren't told was that he has received fees for presenting at educational meetings and/ or research funding from Lilly, Lundbeck, Servier and Wyeth pharmaceuticals, and has also received HTA funding for research into psychological treatments. (Proof:  http://www.hta.ac.uk/fullmono/mon1322.pdf)

Please Sign My Petition: Stop Antidepressants being Advertised on the BBC (and other media outlets)

Please click on the red tag in box below to sign the petition: 

Online Petition by iPetitions.com

The Petition runs as follows:

We the undersigned call upon the BBC to instigate an urgent change to its editorial policy for BBC News Online. We want this change to ensure that all BBC Health Editors cite clearly whenever a writer on mental health issues has received money from pharmaceutical companies. We ask that making these disclosures explicit at the foot of the article be a matter of common policy for the BBC, as it is for all respectable academic journals. At present we think it regrettable that someone receiving money from pharmaceutical companies can extol the virtues of antidepressants on the BBC, without the reader being fully informed as to the writer’s potential conflict of interest. When such financial links are not declared such reporting can constitute, at worst, a form of surreptitious pharmaceutical advertising that belies the BBC’s mission statement to offer impartial reporting free of commercial bias.

What Highlighted Us to this Problem? 

Some months ago an article appeared on the BBC News website extolling the virtues of antidepressants: http://www.bbc.co.uk/news/health-12716742 This article was heavily biased in favor of antidepressants, advocating their wider consumption. At the end of the article the citation stated that the author has “given lectures on behalf of a number of pharmaceutical companies”. Upon further researching these company ties we found that the BBC citation had omitted that the author had actually received consultancy fees and honoraria from many pharmaceutical companies including Janssen-Cilag, Eli Lilly, AstraZeneca, BristolMyers Squibb/Otsuka and Wyeth. The thousands of people who read this article were not told this.

After many months of pressing the BBC, the Health Editor finally conceded to change the citation to reflect this potential conflict of interest. The new citation now reads: “[the author has]… received fees and honoraria for providing consultancy and giving lectures on behalf of Jannsen Cilag, Eli Lilly, AstraZeneca, BMS and Otsuka Pharmaceuticals”.

By changing the author’s citation we welcome the BBC’s implied admission that full disclosure is the proper course of action. We, the undersigned, therefore urge the BBC to enshrine the obligation for full disclosures in editorial policy to ensure no such mistakes occur again. We believe that if the BBC takes the lead on this matter, then other media outlets are more likely to follow.

Sign Petition here:    http://www.ipetitions.com/petition/antidepressants/

Read Current Editorial Policy here: http://www.bbc.co.uk/guidelines/editorialguidelines/page/guidelines-impartiality-personal-view/ 

The BBC Still Drags its Heals....

I contacted the BBC over on month ago to request their editorial policy on citations (the citation is the information placed at the foot of an article about the author of the article). After two separate phone calls and two separate assurances that my request would be answered swiftly (initially I was told within 10 days), I have yet to receive anything at all. Does the BBC actually have such a policy, or do they simply make their decisions about citations ad hoc? I am beginning to wonder about the meaning of what now feels to me a very conspicuous silence. I shall call them again tomorrow......let's see what that achieves.

First Success - BBC Changes Richard Gray's Citation

First Success! - The Health Editor at the BBC has agreed to change the citation at the foot of professor Richard Gray’s BBC article. The old citation read that he has ‘given lectures on behalf of a number of pharmaceutical companies’. The new citation now reads: ‘Professor Gray is a co-author of a book on CBT for psychosis from which he receives royalties. He has also received fees and honoraria for providing consultancy and giving lectures on behalf of Jannsen Cilag, Eli Lilly, AstraZeneca, BMS and Otsuka Pharmaceuticals’.

Finally it is clear to readers that Richard Gray is paid by pharmaceutical companies. This puts readers in a better position to judge the integrity, objectivity and value of his article (which I argue promotes these pills in a heavily biased way). This is a small success, but we must not stop here.
 
What Now? - I have requested from the BBC its editorial policy on citations. Once I have that document, I am going to lobby the BBC to ensure its policy obliges editors to state clearly in every citation whenever a writer has received money from pharmaceutical companies – as has occurred above. This must be a matter of common policy, as it is for most respectable academic journals. If we can change the BBC’s editorial policy, then we can change the policy of other media outlets to. This form of surreptitious pharmaceutical advertising has to stop. And we must work together to stop it. I’ll keep you posted about ways you can help…..I shall be setting up an online petition soon.

See changed citation at:  http://www.bbc.co.uk/news/health-12716742

A Further Response from the BBC

After my last response to the BBC, I received the following reply. It is from the BBC's Health Editor. As I indicate below, I am unhappy with the editor's response so I am going to pursue this matter further with the Editorial Complaints Unit. The BBC's comments are in bold.

Regarding the citation at the foot of the piece (i.e. "Professor Gray has given lectures on behalf of a number of pharmaceutical companies"), I would argue that
stating Professor Gray lectures on behalf of pharmaceutical companies
clearly indicates he is paid on such occasions. I would therefore argue readers can properly evaluate the piece. Indeed that is why we mention his links.

I appreciate your opinion, but would have also appreciated hearing your argument that supports it. In the absence of hearing an argument from you as to why readers will somehow be able to infer from your citation that Richard Gray has been paid by pharmaceutical companies, let me state my argument as to why your citation does not convey this important information. Your citation does not state that pharmaceutical companies pay Richard Gray. All it states is that he lectures on their behalf. There is a clear difference. Admittedly your citation does indicate he is linked with these companies. But there are many kinds of links, some financial and some not. Clearly Richard Gray’s links are financial, but your citation neither indicates nor openly declares this. However, as you appear to think that by not stating Richard Gray’s financial links readers will still somehow know that they exist, I think it best that I take this matter forward to the Editorial Complaints Unit. Perhaps this more independent body can assess whether your position is reasonable, and if it is not, whether a change of position or policy is required.

So again let me reiterate my complaint: BBC Newsonline has knowingly allowed a person who receives consultancy fees and honoraria from many different pharmaceutical companies to extol the virtues of pharmaceutical products (in a biased and inaccurate way) upon its website. In effect, your writer extols products manufactured by companies from whom he enjoys regular payments. Therefore I argue, firstly, that Richard Gray’s potential conflict of interest should have been made clearer to the reader by your openly stating his financial links; and secondly, that because these links were not declared, his piece may at worst constitute a form of surreptitious pharmaceutical advertising that belies the BBC’s mission statement to offer impartial reporting free of commercial bias.

In the light of the above, I now respectfully ask you to be forthcoming in supplying me with the following information. As it is clear from Gray’s declaration in the Journal of Pharmacology (2008) that “he has received consultancy fees and honoraria from many pharmaceutical companies including Janssen-Cilag, Eli Lilly and Co., AstraZeneca, BristolMyers Squibb/Otsuka and Wyeth,” could you please check with him whether he has been paid by any pharmaceutical companies for any activities beyond lecturing on their behalf  (these activities may include speaking at and chairing meetings, being involved in medical/scientific studies, clinical trials or training services, participating at advisory board meetings, or participating in market research where such participation involves remuneration and/or travel). If Richard Gray has indeed engaged in any of these activities, he has been involved in more than lecturing. And if this is the case, there is yet another reason why your citation is misleading. When you check with him the precise nature of his activities, I am sure you will insist that he is completely transparent with you, as it is better that any claims made now are not unexpectedly revealed as false or misleading as we proceed later.

Dr Clare Gerada regularly appears on a range of BBC outlets
because of her position as head of the RCGP. We like to have a range of voices on the site.

I am not suggesting you shouldn’t have a range of voices ‘for or against’ antidepressants. By all means do so. Debate is right and proper, as I know you agree. All I am suggesting is that when someone who is paid by pharmaceutical companies argues the position ‘for’ antidepressants on your website, then you should either indicate their financial ties clearly and unambiguously or, failing that, you should simply avoid publishing their articles in the first place.

Thank you for citing the previous BBC article on the placebo effect of antidepressants in some cases. As this makes clear, we aim to report relevant developments in research.

Great – this is the BBC at its best, reporting relevant developments. But I do not accuse the BBC of ignoring relevant developments, but with not being open or vigilant enough with respect to the financial ties of those who report these developments or other relevant material. It is important these financial ties are made explicit so the reader can judge whether a conflict of interest should be taken in account when they evaluate the value and impartiality of the article.

With regard to Prof Gray's reference, as this is an opinion piece we would not ask for a more detailed citation, though I am happy to pursue that with him in this circumstance.

Richard Gray makes many claims that he either implies or directly states are rooted in academic research. At these points, the fact that this is an opinion piece in no way obviates his professional duty to report his research responsibly. But some of his claims fly in the face of existing research, and some seem to have no research backing at all. I am surprised that the BBC did not ask Richard Gray to provide the academic research in which he suggests his claims are rooted. I think it regrettable that you are only checking his references now, after my prompting and after his piece has now been published. The fact that you did not check his references at the appropriate time is especially troubling given that you knew before publishing his piece that he is a paid pharmaceutical consultant, and therefore may have a serious conflict of interest. Was this lack of vigilance just a one-off mistake?

With regard to the side effects of CBT versus medication, I would
disagree people would think they are equal.

Again I appreciate your opinion, but regret not hearing the argument upon which your opinion is based. I can only engage with arguments. My argument was that there is no evidence that CBT produces side effects. Now, as Richard Gray’s claim is to the contrary, could you please request that he send you the relevant research on which this claim is based? You will appreciate it will be helpful for me to see this reference along with the others you have said you will check.

I have forwarded your email on to the team which handles comments to see if they can shed light on why they were not added.
Thank you.

The BBC Respond to my Antidepressant Complaint

The BBC have finally responded to my compliant regarding Professor Gray's article (see previous post for background). What is below includes the comments they sent to me, and my response to their comments which I have now sent to them. I have highlighted their comments in bold, and left my responses in normal typeface.
  The BBC write: "We are aware that Professor Gray lectures on behalf of pharmaceutical companies, and indeed we state that clearly at the end of the piece. However, Scrubbing Up is a forum for scientists and experts to put forward points of view challenging the status quo. We do not bar people with commercial links providing pieces - but there has to be a valid point being made which can inform debate. And we will always make clear what someone's background is so that those reading the piece can properly evaluate it".
 For obvious reasons, it is common practice in academic journals that all relevant financial links be declared. Gray’s article does not declare these links. All it declares is that he has lectured on behalf of drug companies, but nowhere does it indicate that he has received honorarium or consultancy fees for these lectures – information which makes all the difference. The fact that he has been paid for these lectures, means he has a potential conflict of interest that readers need to know about. In the absence of possessing this key information readers are not in the position of being properly able to evaluate the articles’ objectivity and integrity. You write at the end of the article: Professor Gray has written a book on treating psychosis with CBT, and has given lectures on behalf of a number of pharmaceutical companies. Would it not better serve the BBC’s intention of properly informing readers of any potential conflict of interest to rather say: Professor Gray has written a book on treating psychosis with CBT, and has received honorarium and consultancy fees from a number of pharmaceutical companies.
  The BBC write: "It is true that his piece advocated more use of medications. However, it is also true that despite extra funding it can still be difficult for patients to access talking therapies. It was for this reason that we accepted the piece from Professor Gray - he was advocating a solution, if a controversial one, to a recognised problem. In addition, he was not advocating specific drugs, rather a general approach."
Obviously you are entitled to publish Professor Gray’s solution to what is a serious problem (drugs can fill a gap left by poor therapy provision). His solution – more drugs rather than better therapy provision – I obviously find a little obtuse. But I am not disputing the BBC’s right to publish solutions. What I am disputing is the decision to allow a writer with potential conflicts of interests to enter the debate on the BBC without the BBC making it absolutely clear that he has these conflicts. By all means publish possible solutions, but if your writers have such conflicts let us know about them, or, better still, chose writers who don’t have these conflicts (an example of someone standing up for antidepressants while not having these interests would be Dr Clare Gerada who spoke on Monday’s Women’s Hour). Furthermore, the fact that Professor Gray did not advocate a particular pill is perfectly consistent with the fact that he has received consultancy fees and honoraria from at least 5 major pharmaceutical companies including Janssen-Cilag, Eli Lilly and Co., AstraZeneca, BristolMyers Squibb/Otsuka and Wyeth. They each manufacture different pills. If I were cynical I would say by keeping things general, he was in no danger of upsetting with declared pill preferences a potential source of income.
  The BBC write: "I am sorry you were unable to put your comments onto the piece. Comments are added to pieces for a limited time after publication, but such debates cannot be maintained and supervised for longer due to the sheer number the team handles."
My submitted comments were assessed by those responsible for selecting whether or not they should be posted. They chose not post them after their assessment – my question was why did they chose not to post them – I have still not received an answer.
  The BBC write: "With regard to the factual inaccuracies you refer to, if you give specific instances we will address them."
The following quote is central to the article: “Antidepressants are very effective in treating moderate to severe depression, quickly alleviating distressing and disabling symptoms in about seven out of 10 patients”. This point is misleading. We know from the work of Professor Irving Kirsch (2010) and many others that if antidepressants work for moderate depression they largely do so because of the placebo effect, and rarely do they do so quickly. Some of the details of this research are posted on the following BBC article: http://news.bbc.co.uk/1/hi/health/7263494.stm
Furthermore, Gray does not cite to which research he is referring……who conducted this research? - Who funded or sponsored it? - What antidepressants is he referring to?
 Gray also writes: “Yes, pills can have side effects but so does CBT”. Firstly, and I am no apologist for CBT, there is no compelling evidence that I or any of my academic colleagues know of that CBT has side effects. A claim such as this therefore requires support – what precisely does Gray mean? Secondly, by saying that pills have side effect but so does CBT, is Gray implying that the side effects are similar in severity for both treatments? Let us be clear, depending upon the research we consult, 50-70 percent of people suffer from powerful side effects when taking a popular antidepressant drug like Prozac. These include headaches (around 15 percent); dizziness/insomnia (around 10 percent) and nausea (around 15 percent). Does CBT have the same effects…? Or take a popular drug such as Seroquel. A recent enquiry showed that its maker, AstraZeneca, (one of the companies that pay Professor Gray) buried negative data from a study it commissioned of the drug. This study investigated whether Seroquel worked better than an older drug when treating schizophrenia. The results showed that Seroquel was only mildly better than the older drug in improving cognitive functions such as memory and attention. But in total it was far worse than the older drug. After a year patients on Seroquel had more relapses and worse ratings on various symptom scales. They also gained on average 5kg in weight, which put them at increased risk of diabetes. But AstraZeneca simply buried all these negative findings, and published only the positive results about improved cognitive functioning. This deception led to the drug being approved for general use. But by 2010 so many of these patients were suffering from awful side-effects that about 17,500 of them were officially claiming that the company had lied to them about the risks of Seroquel. These claims were finally vindicated in late 2010 when AstraZeneca lost a class action, and had to pay out in excess of a $200 million for defrauding the public.
 I could fill many BBC articles with similar stories, lawsuits and information, things that would undermine the view that antidepressants are safe or that the drug companies (who incidentally fund or sponsor most clinical trials into antidepressants), have always been honest about side-effects and efficacy.
 I regret having to push this point, but these matters are important to me and relevant to many patients. I am not saying that the BBC has done something wrong knowingly. I have much respect and admiration for the BBC. It is just that I feel you have overlooked declaring the precise extent to which your writer holds a conflict of interest. I feel readers and potential patients should know this given that the stakes for them are so high...
 Yours Sincerely, Dr James Davies

Is the BBC Really Advertising Antidepressants on its Website?

Three months ago an article appeared on the BBC News website extolling the virtues of antidepressants: http://www.bbc.co.uk/news/health-12716742 I thought this article was heavily biased in favour of antidepressants, suggesting that more people should take them. I also thought it made some erroneous claims about antidepressant efficacy without supporting these claims with any evidence. When reading the article I therefore felt uneasy. But my unease only increased once I read at the bottom of the article that its author, Professor Richard Gray, has, and I quote, ‘given lectures on behalf of a number of pharmaceutical companies’. Now, for those of you who don’t know, these companies pay speakers considerable sums to deliver lectures on their behalf. And I have direct evidence that Professor Richard Gray has received such funds. For example, in another article in the Journal of Pharmacology (2008), he declares he has received consultancy fees and honoraria from many pharmaceutical companies including Janssen-Cilag, Eli Lilly and Co., AstraZeneca, BristolMyers Squibb/Otsuka and Wyeth. After I found this out I sent professor Gray the following email: “I read your article about antidepressants on the BBC with interest. If I may, could I ask your source for the statement 'Antidepressants are very effective in treating moderate to severe depression, quickly alleviating distressing and disabling symptoms in about seven out of 10 patients'. At the end of the article it states that you have given lectures on behalf of a number of pharmaceutical companies. I am conducting some research on these matters, and the conflict of interest issues they may raise. I wondered whether you would be happy to disclose to me the number of lectures you have given, the companies you have spoken on behalf of, and the amount of revenue received for these lectures.” Professor Gray did not respond. I contacted him twice more but he did not respond. I also contacted his secretary, and left the details of my question, but again I have still not received a response. I have also contacted the BBC. Firstly, I wrote comments on their website on the 25th March under the article drawing attention to Gray’s financial associations. I further commented on whether the article could be considered to constitue a kind of surreptitious form of pharmaceutical advertising, unbefitting for the BBC. The BBC then proceeded to remove my comment from its website, without giving me any explanation why. I then lodged two further complaints to the BBC complaints department about professor Gray’s financial associations, and whether a man who is being paid by drug companies to speak on their behalf should be extolling their virtues on the BBC. They did not respond. So two weeks ago on the 15th June I called the complaints division and asked them why they were not responding, and that by not doing they were raising my suspicions. I was told I’d be contacted within 10 days – two weeks later (now the 1st July) they have still not responded. Exasperated, I sent them an email today (1st July) …let’s see if they continue not to respond…. Rest assured, I will keep going until I receive a response and will keep you informed as to the outcome. -------------------------------------------------------------------------------------------------Update (July 4th 2011) - After not responding again to my last email, I called the BBC complaints division today. They admitted I should have received a response by now. So they have contacted the relevant parties again at Newsonline to urge them on. I am sure a response will drop in to my inbox soon. When it does, I shall post it below.–------------------------------------------------------------------------------------------Update (July 20th 2011) - After still not receiving a response, I called the BBC complaints division once again today, and told them this. I was told that I was in a queue. I informed them that their complaints website states that complaints are answered usually within 10 days, and that I had been now waiting for a response for nearly 4 months (my first complaint was late March!). They then admitted that this was highly unusual and that they will now do everything to get my response prioritised. Once it arrives. I'll post it below.

A Lost Speech Written by One of Obama's Team for Ed Miliband.

The following is an exert from a speech written by President Obama's speech-writing team for Ed Miliband. Apart from its nationalistic tone, which I find difficult to digest, the rest is rather good: - - - "Britain's greatness is not located in its ability to compete economically with nations of 260million, 340million, or even 1000 million people. It is not our economic power that makes us a serious player on the world stage, but our symbolic and our moral power. For generations we have been a nation globally admired not essentially for our love of liberty and fairness, or for our tolerance for diversity of person, belief and opinion, but for the integrity of the institutions that maintain and transmit these noble qualities from generation to generation. But recently we have seen these virtues threatened from many directions: from misguided politicians who have stained our global reputation for justice and legality with the crimes of an unjust and illegal war; from selfish bankers who exposed the corruptness of our system by feeding greedily from our tables while leaving us to pay the bill; from self-interested politicians who behind parliamentary privileges exposed their unfitness to lead by claiming expenses no decent British person would ever claim. And now from a tribe of ideological politicians, who, in the name of saving us from economic ruin, unnecessarily unravel our greatest institutions in the hope they may save a few extra pounds, win the next general election, and thereby maintain the power their schooling told them would always be theirs. But as we read closely the book they are writing, it turns out that the pounds they save are not from the pockets of the wealthiest in society, but from the pockets of the poorest and most needy. We read that under their policies it will soon be more expensive than in any recent decade for middle and working class parents to raise a family and put food on the table, more unlikely for an ambitious middle or working class girl to enjoy a university education, and more hopeless for the unconnected but hardworking youth to create for himself a brighter future. For these reasons, and many more besides, we find ourselves bemused when they say their current policies will make Britain more fair, more just and more mobile. Let us be clear - their policies will do nothing of the kind. All they will do is increase the likelihood that the types of people who lead us today will end up leading us tomorrow. I believe that what makes this country, this Britain, this Great Britain, deserving of its special name, is not the stubbornness of politicians to stick to their guns when they have got it wrong, not the vested interests of those with power to ensure their power remains, not the people who enjoyed the best university education making it harder for those who can’t, but the capacity of our institutions to uphold the moral foundations – fairnesss, justice, tolerance, equality of opportunity – that secured our place among the great nations of the world. But once these institutions, built by the labor of generations, begin to crumble at the hands of an irresponsible few, we lose far more than our current hope and our birthright of opportunity - we lose the keys to our future. If ever we were a United Kingdom, then let us Unite this Kingdom tonight in our opposition to the unraveling we see around us. Let us unite in saying no more and no way to what they intend to do..."

The Difference Between Cameron and Obama (the artist and the bureaucrat)

Perhaps it is unfair to place these two men side by side. They are entirely different kinds of men, almost different species. But if pressed to summarise the heart of the difference I would say simply this: one man is self-made while the other is a product of a system. Obama defined for himself the man he wanted to be, his own identity, the direction he would take. The answer to his life's riddle was not given ready made. He had to sweat and bleed for the answer. But from the struggle the answer finally came, that is, after years of searching, reading, living alone, getting sidetracked, sometimes getting high, often falling deep into introspection. For Cameron things were different - in his biography we detect no struggle at all, no strain or self-inquiry beyond the pedestrian, or even the superficial. He knew who he was from the outset; his family in the Cotswolds told him; a message consolidated by his schooling, by his university trajectory, by his choice of friends, lovers, associates and employers. Cameron, unlike Obama, is an entirely predictable creation of conventional circumstances - he is an untarnished and faithful product of where he is from. A polished artefact of the upper-middle-class establishment. His values, aims and beliefs are not exactly his own, they were not creatively fashioned by himself, they were simply inherited by default, as were his range of choices, which were narrow: Eton or Winchester, Oxford or Cambridge, the Civil Service or Chambers, Kensington or Notting Hill, Sally or Samantha. In the end, all lines tend in the same direction. For Barack, however, his choices were as complex as they were diverse: State College or Private College, basketball player or novelist, Junky or community activist, college professor or journalist, corporate lawyer or politician, writer or teacher, white wife or black wife. The path was not already lain, the range of possibility far from circumscribed or provincial, as it was for Cameron. Each step for Obama was uncharted and experimental - each step for Cameron had been walked by a thousand others before. Each conviction for Obama was gradually, individually and thoughtfully fashioned, each conviction for Cameron was predictably and communally instilled. It is in this sense that we can say that one man is largely a product, while the other, comparatively speaking, is his own creation; a creation that could have gone any way. One therefore seems curious and exotic, the other commonplace and entirely known; one intrigues and surprises us, while the other is someone we have seen before, who stands next to someone we have seen before. For me, one difference between the two men with respect to their characters, their passion and their the capacity to inspire is that in one we sense the inspiration born from true individual searching and experiment, while in the other we sense that oddly dogged and old-fashioned conviction that their upbringing was true and right. The fact that one man thought individually, while the other followed faithfully, can be illustrated by the following contrast: at Columbia Uni Obama spent his spare time reading the core works of the Civil Rights Movement and writing poetry, while at Oxford Cameron spent his spare time watching Neighbours and the game show Going for Gold!? If anything captures the difference between the activities of the 'self-made man' and 'the product of convention', it is this illustration. For a man who follows the well-travelled road does not need to search in his spare time. But it is precisely what Cameron lost from not searching, from always being the prefect, if you like, that I feel constitutes the heart of their difference - and which more broadly always seems to constitute the difference between the artist and the bureaucrat.

Failing at School (does it matter?)

The following is an exert from my book, "The Importance of Suffering: the value and meaning of emotional discontent" (to be published by Routledge 2012). Those of you who did not do too well at school should consider the following - you are in excellent company:

 Emile Zola, the great French novelist, at school received a zero in literature and also failed in German and rhetoric. D.H. Lawrence, whose novels rank high in English literature, came thirteenth in his class of 21 students and at graduation was placed below average. Sergi Rachmaninoff’s grades at the music conservatory were so low that he altered his report card to hide his failings from his mother. Puccini fared even worse than Rachmaninoff, as he consistently failed his school examinations. The same can be said for John Lennon who did not pass one final school exam, and only barely got accepted into Art College. Marcel Proust as an adult continually complained that his school teachers thought his compositions odd and disorganised, and graded them accordingly. Stephan Crane, Eugene O’Neill, William Faulkner and F. Scott Fitzgerald all experienced failure at college because they did not like the content of their courses. And when Cézanne eagerly applied to the Beaux Arts he was flatly turned down.

 Many other creative individuals’ temperaments were highly misunderstood by teachers who privileged types of personality that honoured the common standard. James Lovelock, one of the greatest scientists of the modern age, was frequently hit with a cane at school. And when he won his school’s general knowledge competition, this infuriated his teachers so much that he was called a freak rather than intelligent. Albert Einstein’s teachers complained to his father that he was mentally slow, unsociable and adrift forever in his foolish dreams. At school Pablo Picasso would stubbornly refuse to do anything but paint, and at the age of 12 was finally removed, as it seemed there was nothing else to be done. Nietzsche continually provoked his teachers’ annoyance by asking questions they could not answer. Hugh Walpole wrote long historical novels as a schoolboy, which nobody wanted to read. Carl Jung was branded a ‘dreamy child’, and when writing on a topic that fascinated him, produced an essay so utterly brilliant that his teacher did not believe it was his own. He was then punished severely for plagiarism.

 Among famous military men and politicians we also find our casualties. Gamal Abdel Nasser spent two years in grade two, failed grade three, and was twelve before he passed his primary school examinations. Thomas Edison was always at the bottom of the class and felt his teachers could not sympathise with him and thought he was stupid. Lord Randolph Churchill was a problem student at Eton and failed his Oxford examinations. His son, Winston Churchill, one of the greatest orators of the twentieth century, when at school at Harrow was thought so poor in English grammar, spelling and composition that he had to forgo his Latin and Greek classes to attend remedial English classes.

 More generally, Thomas Mann, Ernest Jones, Leon Trotsky, Pear Buck, Isadora Duncan, Willa Cather, Sigrid Undset, Susan B. Anthony – all intensely disliked school; whereas as William Randolph Hearst, Paderewski, Brendan Behan, William Osler, Sarah Bernhardt, and Orville Wright were so unruly that they were all expelled.

 There is no need to labour the point by accruing further examples (and there are many more), for what is important is that these illustrations belie a powerful idea that incompetence at school is not only an index of personal failure or obtuseness, but a portent of grave things to come. What these illustrations teach is that failure at school may be rather due to rigid criteria of adjudication, lack of insight into creative temperaments, over-valuation of the judgements of school-tests, or just bad luck with one’s allotted teacher, than to any inherent failing within pupils themselves. The unfavourable judgements these children received we now realise in the light of their adult successes to have been misplaced and short-sighted. But teachers do not possess the benefit of hindsight; and their present judgements cannot be challenged by outcomes that do not yet exist. Furthermore, limited time and resources, as well as today’s huge governmental pressure to obtain high results, do not give teachers the time to make critical distinctions between children who fall below the norm and children who surpass it.

The Pultizer Prize winning psychologist, James Hillman, to whom I am grateful for many of these examples, has argued that it is precisely because creative children are forced to adapt to the norm, that they become maladjusted. He takes the view that creative people often ‘do not allow compromises with standard norms’ even if ostracism and unhappiness is the result. In this sense their maladjustment acts ‘as a kind of preventative medicine, holding…[them] back from a false route.’ He proceeds to remind us, ‘that school for teachers was once called ‘normal’ school, the goddess of school is the Roman Minerva, the great normalizer, the great weaver into the social fabric.’ 

A Great Woman at Your Side

I am reading at present a biography by Andersen entitled Barack & Michelle. I am gripped to learn of the central role michelle played in her husband's ascent. Firstly, she was the main bread winner for many years, while Barack made almost nothing establishing his career. Secondly, she changed jobs frequently, and often strategically, in order to make highly valuable political contacts for him in Chicago (where they lived). Thirdly, she constantly networked on his behalf, introduced him to the right people (including Jesse Jackson), and was such an excellent host at their political dinner parties that guests just wanted to come back. She secured his campaigns more money than anyone else, she forewarned him that he would fail before he failed, and knew where and when he would succeed before he succeeded. And all the while she predominantly raised their two kids and kept the household afloat.  Oh, and to cap it off, she came up with the phrase 'yes we can'. Well, yes, she certainly can!

After reading this book my admiration for barack, while remaining undiminished, has been joined by a deepened admiration for her, not because she served her husband, but because she served through him a far greater cause, and for a while, was willing to take the risk of almost losing herself in the process.