From self help

I’m making a radio programme about erection problems – can you help?

For the past two decades I’ve been researching people’s sexual difficulties, alongside offering them advice through my agony columns. Sexual problems continue to concern many people, who are often unsure what they can do to help themselves.

One way to give/get help is for people to share stories about their experiences. To that end, I am currently making a programme for BBC Radio Four with Loftus Media about erection problems.

The programme producers and I are looking for potential interviewees. We would like to hear your experiences so we can highlight something that is very common but not openly discussed.

The programme will be broadcast in June of this year (2017) and will be 30 minutes long. I will be interviewing contributors for the programme. If you were willing to talk to me, you would not need to reveal your identity.

We are looking to hear from adult men of any age who can talk about erection problems. This might be a current issue, or something you experienced in the past. We are keen to speak to men who have had erection problems related to physical illness (including as a consequence of clinical treatments), as well as those whose erection difficulties might have a psychological cause. Alternatively you may have erection problems but aren’t sure why.

Interviews will take about 20 minutes and will be a very informal conversation. They will be pre-recorded (not live) so you can go back and retake any answer you aren’t happy with or would like to clarify points you have made.

Questions we might cover include….
– What erection problems do you have?
– Do you know what caused your erection difficulties?
– How did having erection difficulties make you feel?
– How did your partner support you (or not)?
– In what way did you seek help yourself?
– What was useful and why? What wasn’t?
– What treatment (if any) has helped?
– How do you accept erection dysfunction if treatment doesn’t work and you don’t want/qualify for surgery?
– Do men find it difficult to talk about this subject? What is key to changing how we discuss erection problems?

If you are interested, or have any questions and would like to chat further before committing to an interview, please get in touch via email with producer Henrietta Harrison henriettaharrison@hotmail.co.uk

We look forward to hearing from you and appreciate any help you can give us and other listeners.

Practical help for you and your community during frightening and dangerous times

Are local or global situations causing you to feel distressed or anxious? Perhaps you’re at direct risk of social unrest, disease epidemics, terrorism, conflict, or police violence. This might be a recent emergency, or represent historic and systematic abuse and neglect. You may be being specifically targeted because of your race, gender, disability, sexuality, faith, or other factors beyond your control. You may have had some forewarning about events -or they may have come as a sudden shock. The threats you’re facing may be in the form of immediate financial, physical or emotional harm. Alternatively, it may be exposure to events via the media, through conversations with friends, or awareness of world events that are making you feel unhappy or afraid. If you already have an existing physical or mental health condition this may be exacerbated by knowing about other hazards that could be affecting you – or those you love. Maybe you aren’t even immediately familiar with people facing maltreatment but you are still distraught on hearing about their situation and wish to do something practical to help.

Below are a number of resources for you to use to help yourself, or to share with others who might benefit from them. All are designed to be adapted to suit different circumstances depending on where you are and what the problem(s) are that you are facing.

This guide to understanding and delivering Psychological First Aid (PFA) is created for all individuals and communities who are coping with disasters and crises (including the aftermath of war or terrorism) and includes free tools and resources for immediate use plus links to courses for training for those whose work as practitioners or activists may require longer term delivery of PFA. You may also find this guide from Jasmine Banks Brown on Self Care for People of Color After Psychological Trauma informative and comforting.

The Black Cross Health collective have specifically designed resources for those providing first aid during protests, demonstrations and periods of unrest. The BBC have produced these resources for First Aid in Hostile Environments, while the International Red Cross have produced First Aid in armed conflicts and other situations of violence available in multiple languages. Hesperian have a range of health guides in multiple languages on a variety of health and development topics for those who lack access to affordable and accessible services. Their most famous text Where there is no doctor may be essential to you or your community in emergency situations. Mental and physical health resources are also linked to alongside personal care and safety materials in What to do instead of calling the police (this is more of a US-focused guide but may still be adaptable to other country settings). In general the advice for anyone at risk of physical harm or with health problems is to call the emergency services (fire service, paramedics, police, or coastguard). Noting, also, that these may not be available – or that you may not feel you can trust such services.

It’s common during and after a crisis to not know what to do or feel so weighed down by events you cannot concentrate or care for yourself or others. These two guides may help. The first is from me, writing in the Telegraph, about how to cope when life seems frightening and upsetting the other is by therapist Tania Glyde on When the world has changed forever – self care in a collective crisis. Both of these posts provide ideas for tackling loneliness, isolation, fear and distress – with links to additional sources of support and help. They are particularly focused on those who are living in times of uncertainty or unrest.

Meanwhile, regardless of wider social or cultural situations happening around you, other life events can also keep on happening. These might be positive or negative – but you may still require assistance in coping with them – in which case a list of support services and helplines can be found here.

Agony and Austerity

Jeremy Kyle Show

I recently made a podcast and wrote about how agony aunts can play a role in times of crisis, poverty and austerity to reflect back to wider society how these issues impact on people’s lives. This fits within a broader narrative of the advice column/programme being both a positive source of help and a place of activism and change.

Unfortunately, not all advice giving is like this. As with any medium it has its faults and limitations. Moreover advice giving may actually cause harm. Not just because the information shared is outdated or wrong. But because of how it represents treats already marginalized groups or individuals and plays into the hands of politicians and media outlets that wish to sideline and stigmatise them further.

This is explained very clearly in a paper by Dr David Hill from the Department of Communication and Media at the University of Liverpool entitled Class, Trust and Confessional Media in Austerity Britain that focuses on the UK television programme The Jeremy Kyle Show. Jeremy Kyle is part of a stable of what may be called ‘Talk Television’, ‘Confessional Television’, ‘Tabloid Talk’ or ‘Tabloid TV’ shows; that are popular across media particularly in the UK and US and include programmes such as Maury, Oprah, Dr Phil, Jerry Springer and more. (You can read more about these programmes within a wider global history of television advice giving here). Over the past 20+ years these programmes have moved from being discussion-based and issues driven, modeling a therapy session, and often aimed at individuals and audiences largely excluded from mainstream services; to a more confrontational, aggressive and shock-based format.

The general style for Talk TV currently, including The Jeremy Kyle Show, involves bringing members of the public together to discuss personal problems, relationship difficulties and family issues in front of a live studio audience. Where the host acts as referee and judge and where (for some programmes) additional support services/counseling may feature, delivered by a regular or occasional guest therapist, life coach, self-help guru or similar. Although possibly perpetuating some of the problems highlighted in Hill’s paper. This short clip that brings together popular narratives within The Jeremy Kyle Show for those who aren’t familiar with it.

Advice giving in print and broadcast media have been analysed through various lenses – including health, gender, media and cultural studies and history (see more here http://nostartoguideme.com/resources ). Hill takes a class-based approach to claim “the function of The Jeremy Kyle Show is inextricably bound up in a neoliberal agenda towards rolling-back state apparatuses and expenditure, while simultaneously shaming those who depend on it or have refused, for whatever reason, the mantra of self-help, in what has come to be called Austerity Britain – predating the financial crisis and yet prefiguring supposed solutions to it” (p.2).

As with other Talk/Tabloid TV programmes, The Jeremy Kyle Show utilizes ‘science’ as part of the means of addressing guest problems. These include televisually attractive and dramatic interventions such as lie detectors, drug and paternity tests. Hill highlights how these devices are used as “technologies of confession” (for example to root out those who have been unfaithful, or who have stolen from other family members). Hill argues that while Talk TV is “a training course in middle class culture, and in the case of talk shows this can be understood as training in the talking cure” (p.4) the additional inclusion of other technologies implies whatever guests say, their word alone cannot be trusted.

In turn, this reminds the audience in the studio and at home, to distrust people. Where liars can be exposed via science, and caught in their deceit. This is often noticeable when a person passes one question on the lie detector test but not the other – a situation that’s used to highlight the greater truth of the polygraph. As if the person who took the test agrees with one of the results they must accept them all. The test, we are told, cannot be right on one thing and wrong on the other. Arguing with the test results (and with Kyle) is taken as a further example of untrustworthiness. Since the majority of guests on the programme (and ones like it) are poor, working class, and in the case of US programmes Black or Latina, the underlying message is ‘these people cannot be trusted’.

Hill, again building on the work of other media scholars (cited within the paper) looks at how within the paternity/DNA testing the message is given that working class women not only deliberately mislead potential fathers but often are so feckless about their own sexuality they may not even know who the father of their child is. Hill’s focus on The Jeremy Kyle Show illustrates how working class mothers are portrayed as untrustworthy and sexually loose. While working class fathers are irresponsible sexually and financially – if they are not supporting any child they may have had. This may be more acutely observed on programmes like Maury that specialize in women coming back for multiple paternity tests where man after man is revealed not to be the father of their child. Men’s reactions to this news – often in the form of cheering and dancing reinforces, alongside the mother’s behaviour, the idea those who feature on the programmes are sexually immoral, lazy and irresponsible. Again as the majority of said guests are poor, and commonly Latina or Black the core message becomes ‘here are people who do not care enough about getting pregnant or supporting their children’. Views that are often reinforced by comments shouted by audience members or made by guests to each other as they argue prior to and after hearing the DNA test results.

Drug testing may be used separately or paired with either the lie detector or paternity testing. Its use, as argued by Hill and others (cited in the paper) suggests how drug/alcohol abuse is part of working class culture and as evidence of how working class people do not know how to look after themselves properly (see p. 7). In many cases having found someone has been using drugs or alcohol (and often after proving they’ve ‘lied’ about this) for additional televisual drama the person is requested to choose whether to accept help or not. On The Jeremy Kyle Show this is often illustrated by guests seeing a film of a car arriving at the back of the studio that they are told will take them to a recovery clinic. The guest with the drug/alcohol problem is begged by their relatives/friends/studio audience/host to get into the car and seek help. Often with the suggestion if they do not accept this they will not get the opportunity again. Guests who refuse help are made out to be irresponsible and uncaring about themselves or their wider family, children etc.

Although Hill’s paper doesn’t extend to other media, this kind of approach is played out frequently within media advice giving in print and broadcast formats where a ‘correct’ narrative of ‘staying healthy’ is rehearsed. Eating fresh fruit and vegetables, drinking plenty of water, exercising, ensuring you’re not overweight, not smoking, seeing the doctor if you spot any symptoms, taking your medication. All of these things are a set pathway to health. Straying from that pathway or doing things that might cause additional problems to your mental and physical health (e.g. staying in an abusive relationship, self harming, not talking to people about your worries) are all taken as examples of people not looking after themselves. Usually (and incorrectly) associated with the out-groups highlighted above. And coming with restrictions and caveats attached. You can have advice, but only if you act on it. You can get help but only if you follow it immediately and unquestioningly. If you take your time, relapse, or don’t do as you are instructed this becomes your fault for which you can expect to be blamed, shamed or in some cases sanctioned.

In the second part of his paper, Hill explores how the use of technologies fit within a climate of austerity. One area he discusses will be familiar to those who are agony aunts or uncles, which is advice giving within media is an alternative to existing, mainstream services. As services are cut and restricted and as demand for them increases, having alternative places to ask for help and get support – or in the case of The Jeremy Kyle Show have paternity and drug/alcohol testing and treatment – means the state (primarily in the form of the NHS) does not have to pay. Rather than this supporting existing, struggling, services Hill highlights an alternative reading of Talk TV programmes. “[W]ith the welfare system now deemed largely unaffordable and in need of dismantling…and volunteerism and private enterprise seen as part of the solution…this commercial television production can be read as a sort of perverse public service, auditing fiscally unviable bodies in order to shame them for their burden on the nation” (p.9-10).

The role of Kyle as presenter/host is also interrogated within Hill’s paper (which also cites other research that has performed similar analysis of the role and behaviour of Talk TV show hosts). Kyle takes on the role of judge and commentator, who is the cipher between the guests, audiences and any tests used. He not only delivers the results of any testing but passes comment on the results and people’s reactions to them. With follow-up questions that ask about people’s employment, income, mental health, physical wellbeing, sexual history and so on. All of which may be used to further shame or blame them for whatever situation has brought them to the programme. Where guests are using benefits but also have had children or are using drugs/alcohol Kyle makes a point of this as further evidence of people’s lack of trustworthiness, dishonesty and laziness: “[i]t plays to stereotypes of unemployment, alcohol or drug consumption and pregnancy as lifestyle choices for ‘feckless chavs’ who are ripping off Britain via the welfare system” (p.11). Within this “The Jeremy Kyle Show is simply about fire-fighting failure, where the narrative is not so much that everyone can be a success, but simply that everyone can and should be less of a financial burden to the state. The show, then, adopts state practices of roll-out, measuring the value of individuals, in order to promote the roll-back of state expenditure and apparatuses. So, it is that Kyle presents as an austere judge in a court of austerity” (p.11-12).

How can we use research like this?
We can use papers like Hill’s to help us see more clearly how programmes are constructed, perhaps noticing for the first time ways that people might be helped or disadvantaged by broadcasting styles and formats. It might enable us to question who is included or excluded by Talk TV (or advice giving more widely) or to notice that agony columns or programmes very often sit alongside or support particular views about life, help seeking, care and problem solving. Identifying this and considering how it might impact on our own lives or professional practices can be very useful.

Therapists and health care providers may well notice how their patients may have incorrect beliefs about what therapy, or drug/alcohol care or paternity testing might entail having watched programmes like The Jeremy Kyle Show. Being mindful that this may frighten away would-be patients who might benefit from help/care, or give them the view that therapy will be instructive, judgemental and revolve around scientific testing (which may or may not be what a client might want) could help people access care more effectively and realistically. A useful exploration of this can be found via Jonathon Tomlinson’s blog post Who is the NHS for? Not me!

If you are an agony aunt or uncle or work in media advice giving
You may want to consider whether the advice you give also fits within the kind of format outlined by Hill’s piece. What role do you occupy as an advice giver? Are you presenting yourself as a judge? Do your editors and/or audiences want this – and if so how does this help them (and you)? Do you use advice giving to discourage people from seeking particular sources of help, blame them for doing so or suggest if people have problems in one area (e.g. they’re an alcoholic) they do not deserve help in another (e.g. access to healthcare or benefits)? Perhaps like many other people you’ve taken on board a lot of the messaging within Talk TV about self-reliance, associating state benefits with shame, or judging those who do not ‘help themselves’. If so, how might this affect the advice you offer others? At what point do discussions around self-determination, self-care and personal empowerment become messages about scrounging, and problematizing the use of benefits people are entitled to. Given some of the political strategies around the shaming of those who have disabilities or claim benefits in order to make cuts to services and support, where is your advice fitting in? Are you inadvertently or deliberately ensuring that some people are demonised by the advice you give, and do you encourage your viewers/readers/listeners to side with you against them? (For more on what the extreme consequences of this can be, reading more about radio and advice giving during/after conflict may be necessary).

It may be you disagree entirely with the analysis presented in Hill’s paper or how I’ve interpreted it here. Perhaps you agree with the interpretation of Talk TV programmes but simultaneously think there is a role for shock media where people’s problems are performed as entertainment and where those who do not fit appropriate behavioural models deserve to be given a ‘wake up call’. You may favour ‘straight talking’ advice in your columns or programmes. In such a case can you reflect on what services you are offering and think about if your approach is still helping people seek appropriate care when needed?

Because of the framework of analysis used within Hill’s paper, it does not concern itself with whether or not the approaches taken in The Jeremy Kyle Show ‘work’. For all the tests, technologies, a focus on ‘telling it like it is’ and referrals to aftercare, there remains little evidence of the effectiveness of Talk TV programmes around addressing people’s problems with their mental or physical health, addictions, relationships problems, financial or childcare worries. Whatever kind of advice we are offering, how do we know it is right? How do we know it is effective? Are we working to a standard of ‘first do no harm’? If so, how can we be sure that we aren’t directly or indirectly causing problems? And if not, why are we wanting to adopt a model of advice giving that is potentially harmful? Although Hill does not ask us these questions, my reading of his paper suggests that we should still be thinking about them.

Applying this work
There are several ways in which papers like Hill’s can be used. They can help us reflect on the television we watch, to think about how it is made, how it encourages us to respond, and what can happen as a part of that process.

They can show us how programmes that present as a source of help and care may not always be doing this. And in fact may be causing indirect harm by presenting unhelpful and biased views about people in crisis. Not to mention taking advantage of those who may be vulnerable.

Using media for advice giving is more than offering help/signposting/support to those who’ve immediately reached out to us. Agony aunts and uncles could consider how our messaging, the problems we choose to focus on, and the way in which we offer advice/solutions all inform  wider audiences and political landscapes about who deserves help and who does not.

The Jeremy Kyle Show and others like it portray a particular set of problems/situations, familiar narratives of easily identifiable ‘goodies’ and ‘baddies’ and an extreme form of self-reliance/individualism where those who are unable to cope alone are constructed as failures. Yet for many people who do not have access to health or social care, for whom counseling is alien and unaffordable (or at the end of a 6 month waiting list) Talk TV is a desirable option. If you cannot access or afford care, if you do not know what it might look like, then you may well reach out for a programme that offers scientific solutions and definitive judgements. Plus a trip away from home, the chance to be on television, and being put up in a hotel. If we are offering any kind of advice giving, noting why it may be attractive is important. As is recognising that because we provide advice, or a hotel, a fee, or a resource this doesn’t excuse people being maltreated on our watch or render what we do beyond reproach.

What Hill’s paper has reminded me is the importance of noting if services are not available, rather than using advice giving simply as an alternative to overstretched facilities we should be using it as a campaigning device to identify not just the needs of people currently unmet by health or social care, but to look deeper at the root causes of their problems and begin to try and address those directly.  The next question, then, is how do we do this?

Can soap operas solve our problems?

Mark Fowler in Eastenders who was HIV+

The UK television soap opera Eastenders celebrates its 30th anniversary this week. Which is a good an excuse as any to look at how soap operas can be used to give advice.

What’s a soap opera?
I’m guessing you’ll be familiar with, and perhaps a fan of, soap operas. But if you’re not sure what they are they’re a drama on radio, television, or more recently online. Where interlinking stories show the lives of different characters. Often, although not always, based around a particular town, business or area. The name ‘soap opera’ originates from these early dramas being sponsored by soap manufacturers.

Arthur Fowler struggled with mental health problems

What can soaps offer us?
Aside from entertainment and distraction from every day life, the often unrecognized role of soap operas includes company. The characters in a soap opera and their regular scheduling on TV or radio can either fill the role of family or be an addition to your family. This may be of particular benefit to those who are socially isolated, including stay at home parents, carers, older people, or those who are housebound.

When it comes to advice giving, soaps can play an additional role of education, and outreach. They have been used worldwide through television and radio serials to cover anything from farming advice to dealing with landmines or information about immunization programmes and safer childbirth.

 

Teenage pregnancy and paternity issues in Eastenders

The way advice giving via soap operas has developed is either as a serial specifically developed to raise awareness, usually funded by an NGO or charity – for example New Home, New Life in Afghanistan (radio) or Soul City in South Africa (television). Or where an existing soap opera links with a charity or organization to bring in a particular storyline where an issue is focused on.

This can result in highlighting issues that may not always be noticed or talked about. For Eastenders some storyline examples have included:

Mental distress, mental health problems and break down
Gay and lesbian relationships
Teenage pregnancyLittle Mo is a victim of Trevor's abuse
Drug and alcohol abuse
Domestic violence
Historic child sexual abuse
Infant death
Assisted suicide

 

How are issue-based storylines assumed to work?

The reasoning behind covering a particular issue within a soap opera is primarily to raise awareness. Viewers with a problem may feel less lonely or isolated if they see another character going through what they have experienced. It may alert people that help is available and encourage them to make use of support services, charities or healthcare. Particularly if programmes signpost to other sources of help (websites, telephone helplines etc) at the close of each episode.

Kat Slater was abused as a child

People may also be able to model their behaviour based on what they see characters in soaps doing (or decide to do the opposite). While a storyline may make others aware of issues and problems and give them ideas on how to support friends/family who may be in need.

Having characters that audiences relate to going through problems in life may reduce stigma, as viewers or listeners will want their favourite characters to be okay (for example a character to escape a situation of domestic violence). Or familiarize audiences with individuals or issues they may have previously been intolerant about. Such as a gay or lesbian couple, a character with disabilities, a Transgender character, or an ethnic minority family.

Couple Colin and Barry

A storyline on a particular problem also allows charities or other organisations to talk to other news and entertainment media which both raises the profile of an issue and/or those who are best placed to offer support if it affects viewers. Which in turn might also increase support and donation to charities.

 

Yes, but do soap operas really manage this?

Criticisms of soaps are they mix so many issues, cliffhangers and melodrama across storylines that particular problem based themes can get missed out or perhaps not taken as seriously as they should be. It’s no coincidence that all the very worst crises in soaps seem to coincide with important holidays or peak viewing times (in the case of Eastenders the Christmas episodes are usually particularly eventful). And with soaps competing between each other for viewing figures, the pressure to find different problems to bring into storylines can mean audiences are fatigued by or inured against topics they may benefit from paying attention to.

Ethel asks Dot to help her end her life

The impact of soap opera problem-based storylines on our daily lives has mixed results. Some stories appear to have more of an impact than others. Which can be partly based on how they are portrayed, the popularity of the characters, how convincing the actors are, and how sympathetically audiences respond to characters and issues shown.

Some have argued performances can reinforce, rather than challenge stereotypes For example in Eastenders, Arthur Fowler’s breakdown was greeted with mixed reactions as some felt it showed an overly dramatic and frightening portrayal of mental distress, while others believed it realistically showed someone in crisis.

Or in order to boost ratings, storylines can be embellished in ways that could harm those affected by the very issue they’re trying to raise awareness about. In Eastenders this was most recently shown in the storyline where the character Ronnie Branning experienced the death of her child to SIDS later responded to this trauma by abducting another character’s baby. Unsurprisingly viewers, many of them affected by cot death themselves, angrily reacted to the idea that bereaved parents were unstable, dangerous and a risk to children.

Ronnie and baby

Overall the impact of issue-based storylines tends to be short term. These stories will raise awareness during the time they are being aired, but may not be recalled once the drama has moved on. Moreover knowing that an issue has been covered in a soap does not always relate to any meaningful behaviour change. We might be able to say which character’s been through which problem but we don’t necessarily use that to make any useful changes in our own lives.

Driving attention to charities and services can be a beneficial aspect of issue-based storylines but can also increase the burden on services and charities from people wanting their help. While bringing them no additional financial benefits.

Where charities and NGOs are involved with soap opera storylines they may assume this partnership is enough of an activity and do no further work to evaluate impact or sustain public attention or engagement. They may have the noble idea of ‘increasing awareness’ but have no sense of what that awareness might entail, how to measure its impact, or how to support people once they are more aware of a topic.

Phil Mitchell struggles with alcohol and drug addiction

When are they effective?
Although issues-based storylines don’t always ‘work’ it would be wrong to dismiss both the popularity of the soap opera generally, and the impact some storylines have had.

While some organisations and media outlets may prefer short-term storylines and impact, for major issues the best way to bring about greater awareness and behaviour change is through ongoing, sustained messaging. Soul City in South Africa is an example of how this can work. It is highly effective both as an entertaining soap that has run for decades but keeps within it core messaging around HIV. One-off storylines can be effective in the short term but don’t tend to have long-term impact.

If you’re working in media, healthcare, or for an NGO or charity and want to introduce an issue to a soap opera you’ll be more likely to make a difference if you:
– diligently research audiences before storylines are introduced to identify specific issues they might be helped to know more about
– develop characters and storylines to appeal to viewers or listeners so audiences can relate to characters going through/representing particular issues and engage more actively with story lines
– make careful links between those with expert understanding of an issue (patient groups/support networks/charities) and those able to translate this into a believable storyline
– support stories with additional materials – a website, cartoon, links to helplines etc
– have clear outcomes for impact from the outset. What behaviour do you want to change and how do you want to change it? If you want to raise awareness how do you want to do this and for what purpose? How can you build this into programming, enable it further through multimedia platforms, and most importantly how will you assess whatever work you do to see what effect storylines have?

As mentioned previously on this site, bad advice giving tends to tell us what to do not how to do it, which is the trap I’ve fallen into above. So, in the tradition of all good soap operas, all of the ideas on how to actually make an issues-based soap opera will be covered in a future episode….

25 reasons why advice columns fail

Stock photo to illustrate 'depression'

Recently I blogged about 25 reasons why advice columns are amazing.

As an agony aunt it’s obvious I’m going to defend advice columns. They’re not just a popular source of entertainment, people do find them genuinely useful. Sometimes even life saving.

However it would be completely wrong to suggest advice columns are all benign or even helpful. It’s worth supporting them when they get things right, and being aware they can get things very wrong.

Here are some of the ways that happens.

1. The advice given tells you what to do but not how to do it. While “luggage label” (very short) replies don’t give enough information to help do anything about your situation.

2. You may write or call in for advice but receive either a standardized answer that doesn’t address your situation. Or get no response at all. Leaving you anxious about whether you’ll ever get reply and potentially feeling rejected and afraid to reach out again, not just to advice columns but to other sources of help and care. This also means a media company is making a profit from your problem.

3. The advice given may not suit your culture, circumstances or situation. For example recommending a relaxing bubble bath as an answer to a serious problem and to someone who has limited access to affordable/hot water. Or recommending someone must immediately and publicly come out as bisexual, lesbian or gay when they’re living in a country where this is illegal and potentially punishable with prison or death.

4. Advice may be outdated, wrong, or dangerous. For example suggesting those who’re depressed just need to ‘think positive’. Or stating those with mental health problems are possessed. Or claiming masturbation causes infertility. Or encouraging people on medication for chronic or life limiting illness to stop taking it. Or recommending people don’t vaccinate their children.

5. Advice can fail to account for difference or diversity – e.g. recommending sex positions unsuitable to someone with mobility problems or chronic pain. Or telling people to make individualistic choices while not noticing they’re in a situation where state, faith or familial control would make this difficult and dangerous, if not impossible.

6. The tone of the advice, or the format of the advice giving column or programme can shame, blame or ridicule those seeking help. If the advice columnist seems judgemental, unsympathetic or overly harsh this can lead to similar reactions from wider audiences towards those in difficulty.

7. The advice columnist may be more interested in promoting their products and services than offering realistic and useful advice for you. While their messages may be commercialized and focused on solutions that are reliant on you having the money to be able to pay. Whether that is in the form of healthcare, therapy, or purchasing products to enhance your relationship (date nights, trips away, sex toys, designer lingerie, expensive bedlinen).

8. The advice columnist may not be paid nor adequately supported or supervised to do their job.

9. Those seeking help may be treated as passive recipients of expert-led (top down) advice rather than giving them tools to find their own solutions to problems or peer-led approaches that actively engage with any advice being given. A focus on all problems as being a huge crisis in need of multiple support interventions may overlook how some people perhaps don’t feel the need for solutions that automatically include follow-up care or to talk widely and in-depth about their experiences. For example the woman who’s had multiple miscarriages that have all upset her to a greater or lesser degree and who wants to share that experience but does not necessarily feel the need to see a therapist about it nor join a self-help group.

10. Examples may be used in advice that are triggering or upsetting (e.g. talking about child abuse recovery by using graphic anecdotes about child sexual behaviour). While images used may reinforce, rather than challenge, problematic ideas about people’s issues. For example the image used at the start of this post is a stock ‘head in hands’ image for ‘depression’.

11. Cases featured, particularly on television (and especially on tabloid talk shows) can demonize those who are poor, from particular racial or tribal groups, who are socially disadvantaged, inarticulate and who may have additional physical or mental health problems or learning difficulties. Rather than offer support for people they may serve to reinforce wider cultural and political views of those in need of assistance as being feckless, immoral, scroungers.

12. Problem pages can change identifiable information but they may not always get this right and potentially you could be identified. For advice programmes on radio and particularly TV you may be easily identifiable if care is not taken to avoid this.

13. Tabloid talk programmes (Maury, Jeremy Kyle etc) may encourage guests to ‘act out’ in ways that may be regretted during and after the programme. Guests may be exposed to stressful, abusive and violent situations, or forced into making choices they don’t feel included in (e.g. ‘choose now to go into therapy or we won’t help you any more’). While aftercare for advice columns and programmes is mostly non-existent and where it does exist it varies in quality and has never been evaluated for effectiveness. Services used within programmes may compound people’s difficulties. For example using lie detectors or ‘interventions’ (where friends or family confront a person to tell them how much of a problem their problems are causing).

14. Some agony aunts are more interested in being famous and/or talking about their own issues than those of their audience.

15. Increasingly advice giving happens via email, online, or through smart phones. If you don’t have access to the right technology you may not be able to ask for the help you need.

16. Problems can be individualized through advice giving. Solutions offered are around the person with a problem either seeking further care or looking to improve themselves. Rather than encouraging audiences to look at wider cultural, structural or social issues that are causing or exacerbating their problems. You may well feel unhappy and a course of counselling might help, but it won’t change much if you are still living in a damp home where you cannot afford food and are struggling with breathing difficulties.

17. Supporters of advice columns argue they challenge or subvert the status quo. In many cases they may maintain it, or worse still present a commercialized and aspirational view of the world where those in crisis are there to be laughed at, pitied, shamed or punished.

18. If you’ve literacy or communication problems reading or contacting advice columns may be particularly difficult.

19. Searching for information or asking for help on taboo topics may be highly risky in some cultures – for example asking for advice about sexuality, or abortion, simply trying to access reproductive health services if you are a young person or unmarried, searching for information about domestic violence, or trying to get help without your husband or in-law’s permission.

20. Writing about your experiences or expressing them on radio or TV may leave you feeling more upset or anxious than before you asked for help.

21. You may simply not have the reserves, energy or confidence to act on the advice given. Which in turn may leave you feeling more helpless and hopeless.

22. Although it’s often recommended, particularly when justifying the importance of advice columns, passing your secrets on to someone else doesn’t always make you feel better, nor lead to anything changing in your life.

23. You may feel cheated if the person you ask for help from doesn’t give you the answers you want. And sometimes there are no immediate solutions to problems.

24. Problems are often presented in a narrative of hope and recovery where audiences are expected to ‘get better’ or ‘change’. But where no notice is given to how difficult this may be, and how other social, cultural and historical factors may prevent this. For example the person upset about being single is expected to try harder and transform themselves into dating material. The alcoholic or drug user is expected to want to stop using immediately and get sober. The person in an abusive relationship is expected to recognize abuse and to leave, quickly. Where people resist or find this hard they are seen as being difficult, weak or unwilling to want to help themselves. And therefore completely to blame for their situation.

25. If your situation is not represented in advice giving (because it often doesn’t deal in diversity) you may feel more alienated and afraid.

25 reasons why advice columns are amazing

Doodlecats card by Beth Wilson http://www.doodlecatsshop.co.uk
Doodlecats card by Beth Wilson http://www.doodlecatsshop.co.uk

1. They’re a place where you’ll be heard.

2. You can tell someone your problems in confidence.

3. No matter where you are in the world if you can write, text, email or use a phone you can reach out for help.

4. Advice may be free or only cost you the price of a phone call or postage stamp.

5. Print, online or broadcast media has a massive reach. If you need help, chances are you’ll find it somewhere.

6. Writing or talking about your experiences can be therapeutic.

7. If you don’t want the burden of a secret or story you can pass it on to the advice columnist to take care of.

8. They’re a place to confess.

9. Or somewhere to get a second opinion.

10. You can help other people by sharing your own story.

11. Reading about other people’s problems can make you feel better about yourself.

12. They’re somewhere that reminds you that you are not alone.

13. If you don’t have access to or can’t afford a therapist or other health services, you may be able to get some temporary help or advice from an agony aunt or uncle.

14. They’re somewhere to help you reflect on your situation and give you ideas about what to do next.

15. A place to rehearse what you’d like to say to your lover, boss, relative.

16. Or where you can express feelings you might not feel able to share anywhere else.

17. They provide someone to talk to if you don’t feel safe or able discussing issues with others.

18. Plus a resource to help you build escape plans if you are trying to exit a difficult or dangerous situation.

19. They may be a step on a journey to seeking help or recovery.

20. And a place where taboo topics can be mentioned.

21. Or an introduction service – where you can find out other books, websites, helplines, charities or organisations that could assist you.

22. They can help you put your worries in context.

23. Be a place for reassurance.

24. Where someone will pay you attention and make you feel special.

25. And who you can keep coming back to if you still need help, or if you want to report your progress.