From television

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 Not just because the information shared is outdated or wrong.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?

One step on from when you called me

Tree of Hands

In this month’s Lancet Psychiatry I’ve written a comment piece Agony, misery, woe: a new role for media advice columns about the history and purpose of media advice giving, the changing role of the agony aunt/uncle, and the agony aunt as witness to the crisis around austerity and poverty and the harms these bring.

Expanding on the comment piece I am joined by Lancet Psychiatry Editor Niall Boyce and journalist Anna Raeburn in a podcast where we talk about how advice giving has changed (or not), what it can deliver, and why practitioners may be missing this important media resource and the tools and experiences it may hold.

Anna starts the podcast talking about how advice columns have developed, with a particular focus on radio and the power of the voice in reaching out to others. In addition Anna touches on the problems posed to modern media due to financial cuts and a lack of investment in community programming/features and particularly local radio and press. Explaining that the need for advice and information is higher than before but the opportunity for advice givers to work effectively is “significantly less”.

From this Anna moves to talk about advice giving as storytelling, sharing experiences, and how it’s okay to say you aren’t sure about a person’s situation. While discussing the strengths and weakness of advice giving on television, newspapers, magazines and new media.

When asked what role agony aunts fulfill, Anna replies:
“I would describe myself as a bridge….I have a very modest idea of what I can do. I want you to walk over me to the next stage of your life….I want, very modestly, to move you one step on from when you called me”

This is helpful in the context of advice giving as it sets out very simply what advice giving can achieve. And highlights where it may be a bridge between individuals and services but also part of a wider chain of help seeking behaviours people engage in. We don’t assume agony aunts have all the answers, or advice columns can solve all our problems, but if we consider it as a small step forward it reminds us that advice columns should never be excluded or forgotten about in wider conversations on physical or psychological health, help seeking or behaviour change.

In the second part of the podcast Niall asks me about evidence and whether we can we be evidence based around advice giving? This echoes other questions I’m increasingly asked about how agony aunts know they are doing a good job – something I’ll be returning to in future blog posts.

I reflect in the podcast on what agony aunts and audiences think evidence means when it comes to media advice giving. Plus what we already know about media advice giving, what we don’t know, and where we can draw parallels of evaluated work on self-help and public health campaigns. I have a bit of a grumble about how academic and journalistic snobbery can lead to advice giving being overlooked or denigrated – and why this is improvident.

For me the crux of the podcast focuses on the issue of how cuts to benefits, austerity measures, poverty and funding problems within the NHS are leading to staff and patients/service users feeling increasingly pressured, distressed and excluded. This may be an area where agony aunts and mental health services might work together, particularly in poor communities who are far less likely to be able to access and use mental health services. Another agony aunt Denise Robertson had previously suggested to me one role of the agony aunt in modern times was to bear witness to the damage caused by poverty, inequalities, and the blaming and shaming of those in need. The podcast explores more on why this has happened and whether there is a role for advice columnists and NHS staff and patients to work together to highlight theses issues and consider possible solutions.

This brings us to what form advice might take and how the traditional focus of the advice column has often been to refer people to a charity or a GP (Family Practitioner/Doctor), or helpline. But how in these cash-strapped times people are arriving at their conversation with advice columnists by telling them what services they have already tried – and failed – to access. The podcast reflects on why this is and what we might do about it in ways that do not further denigrate either those in need or health/social care staff who are also under huge pressure and struggling to do their job.

Rather than just seeing advice giving as asking for help, reaching out or being supported by others the podcast considers advice giving as advocating models of activism and resistance using the example of Focus E15 Mothers campaigning for housing and rights.

By contrast examples from the global south where advice giving through radio, TV, text and newspapers has had particular success are shared as examples of good practice. Particularly around the ideas of citizen journalism and self-care. I talk about trailblazers such as Hesperian and BBC Media Action within this context (although other examples of good practice can be found within this site).

The podcast ends with a reflection that if services across media, health and social care and the third sector are massively stretched. And where there is no immediate change to the current climate then we need to think about ways to help ourselves

“No-one is going to help us at the moment. That’s quite obvious. So how do we help ourselves and what do we do together to make things a bit easier for those in need where there may not be immediate help available?”

The resources below are ones I use myself within these limitations, and may help those who want to know more about working effectively where barriers exist.

Although broadcast after this podcast the actor Michael Sheen also picks up on some of the problems around the NHS and ways for us to defend and stand up for it.

Further Reading
Psychological First Aid
In or Out?
Community Psychology
Augusto Boal
Paulo Friere
Kerry Frizelle 2011 What is critical community psychology?
Carolyn Kagan et al 2011 Critical community psychology. Critical action and social change

 

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….