The Biggest Expert Of The Lot

Previous blog posts have described my concerns regarding the activities of some people associated with the north Wales mental health services and the way in which they have constructed themselves as ‘experts’, despite the dire state of the services with which they are associated (please see blog posts ‘Experts In Suicide Prevention??’,  ‘More Experts and Their Expertise’,  ‘Compassion, Intelligent-Kindness and Shame’ , ‘An Expert On The Betsi Board!’ and ‘Its’ Those Experts From The Betsi Again!’) One of these ‘experts’, who is employed as a psychiatrist at the notorious Hergest Unit, Dr David Healy, has become internationally famous for ‘bravely taking on’ Big Pharma. But no-one seems to have looked at what has been going on in the very unit in which Healy works.

There is however another ‘expert’ who is probably even more well-known – certainly to lay people – who now has achieved an international reputation for fashionable ‘pioneering’ work and who maintains that he began this work when he was Professor of Clinical Psychology at Bangor University. That is Professor Mark Williams of ‘mindfulness’ fame. Mark Williams has previously featured on this blog in the post ‘Experts In Suicide Prevention??’ However it was with mindfulness that Mark Williams really hit the big time.

Long, long ago, when the North Wales Hospital Denbigh was still in operation and when the Hergest Unit was newly opened, I first heard about mindfulness. There was a psychiatrist in the Hergest Unit, who, in about 1992-3, was telling his patients – including me – that a Professor Mark Williams was interested in something called mindfulness which was based on a Buddhist meditation technique and had been used in America for patients with chronic pain. This psychiatrist suffered from chronic pain himself and found that the painkillers normally prescribed were making him sleepy which was causing him a problem at work, so he was trying to use mindfulness to live with the pain. He told me and some other patients that Mark Williams was interested in using mindfulness with patients suffering from depression and he gave me a copy of Jon Kabat-Zin’s book ‘Full Catastrophe Living’ to read – Kabat-Zin was the man whose work had inspired Williams. After I read the book I was invited to try out mindfulness with a group of other patients. We were all herded into a communal room, along with a few staff who wanted to try mindfulness as well, and we were taken through the introduction to mindfulness that will be familiar to anyone who has undertaken a mindfulness course – the exercise of ‘mindfully’ eating a raisin. We didn’t ever see or meet Williams himself, this particular ‘class’ was taken by a woman who I think was an occupational therapy assistant. Most of the other patients hadn’t read the Kabat-Zin book and very obviously didn’t understand the philosophy behind mindfulness, but had gone to the group in the same spirit as they went to other activities, such as cooking, yoga etc – to do something with their friends. (In those days the Hergest Unit still had a day centre which offered activities.) I noticed the woman leading the group didn’t give a very clear explanation as to the rationale behind mindfulness either, so most patients were a bit mystified as to why they were chewing on a raisin. Although I was told that Williams was interested in using mindfulness with patients suffering from depression, I noticed that this group consisted of a collection of patients with a whole range of different diagnoses (a bit like the research’ conducted into Seasonal Affective Disorder with the light box that I described in my blog post ‘More Experts and Their Expertise’). I should stress here that the diagnoses that the Hergest Unit arrived at were often quite questionable – people would be given three or four different diagnoses over a period of time and they were frequently given completely different diagnoses again if they sought advice from psychiatrists outside of north Wales. There was very little consistency. These mindfulness sessions were supposed to take place weekly ever a period of I think it was six (or eight) weeks. The attrition rate was very high and most people – including me – gave up after three weeks or so. There was very obviously no structure to these sessions and no encouragement to continue or explanation of what was supposed to be achieved. Had I not read the Kabat-Zin book I would have been completely in the dark.

I didn’t return to any more mindfulness groups at the Hergest Unit, but I was aware that they continued. Most patients couldn’t really understand what was behind it all and the most commonly heard comment was ‘well we all had to eat a raisin but very slowly’ – some patients were clearly baffled as to why they were being fed raisins. This suggested to me that most patients weren’t really getting beyond the first session. It very obviously made no sense to most of them. However, there was one group of people who really enjoyed mindfulness, embraced it wholeheartedly and even started going on little mindfulness ‘retreats’. That was the staff – but then the staff weren’t struggling with severe mental health problems whilst on low incomes whilst being on the receiving end of a chaotic, neglectful and abusive service which criminalised them if they complained…

I continued to hear rumblings about mindfulness, although I took very little notice of it. I did not ever meet another patient at that time who told me that they practised it or that it had helped them. I noticed that the psychiatrist who had been so enthusiastic about mindfulness continued to struggle, both with chronic pain and depression, and he eventually took early retirement. By the time that he retired, his relationship with his colleagues had become so sour that he requested that only patients attend his leaving party, not staff. By this time the Hergest Unit was obviously in trouble and staff relationships were clearly very dysfunctional (please see blog post ‘The Hergest Unit, Ysbyty Gwynedd’).

Mindfulness next touched my life in about 2002. A friend in a hill-walking group worked as a doctor for the North West Wales NHS Trust and his office was located in the same building as the Centre for Mindfulness Research and Practice that had now been established by Mark Williams at Bangor University. This friend was very worried about the activities of the mindfulness devotees and felt that mindfulness was being so ruthlessly promoted that it was almost like a cult. I remember that he was particularly irked that leaflets promoting mindfulness were being left around his part of the building, although he was nothing to do with this group. This friend was one of the many who found working for the North West Wales NHS Trust very difficult and he left his job after a period of serious depression and relocated to south Wales.

About a year and a half after this, I had a truly extraordinary experience with Judith Soulsby, one of Mark Williams’s colleagues, who was initially employed as a research officer by Williams and since then has been heavily involved in the Bangor University Centre for Mindfulness Research and Practice and still is today. Judith is a regular at the mindfulness retreats at Trigonos in Dyffryn Nantlle and I think she is classed as a mindfulness teacher or trainer, but I had never heard of her when I first encountered her. She has co-authored a number of papers with Mark Williams and others. At the time, I was recovering from a truly dreadful stay in the Hergest Unit during which I was assaulted by staff; my usual psychiatrist and key worker had been ordered off my case against their and my wishes by the awful Dr Tony Roberts, I had been discharged with no aftercare and was then arrested for ‘threatening to kill Alun Davies’, the manager of the Hergest Unit (please see blog post ‘Interesting Happenings In The Legal System’). I was then refused all care and treatment and Roberts also intimidated a number of other practitioners into not treating me. I could not get treatment anywhere, despite experiencing severe depression. My friends were incredibly supportive and kept me going, but I spotted an advert placed by a Judith Soulsby, for mindfulness for anxiety and depression. I remembered the mindfulness from the Hergest Unit from years ago and the Kabat-Zin book and wondered if I should give it another go – particularly as there was no other treatment options open to me. So I rang the number supplied in the advert and got through to Judith. A bizarre exchange followed. I explained to Judith that I had been diagnosed with bipolar disorder and was interested in trying mindfulness. I told Judith that if she wanted corroborating details of my condition she was welcome to speak to my former key worker from the Hergest Unit (that was the whistleblowing occupational therapist mentioned previously on this blog – he was sufficiently horrified by Dr Tony Roberts’s actions and Hergest’s attempt to stitch me up for a serious crime that he had stayed in touch with me as a friend). Judith asked if I was a Hergest patient. I explained that I had been but wasn’t any longer. She then said ‘oh I’m afraid we don’t accept Hergest patients on this course’. I was gobsmacked – after all, some ten years earlier, mindfulness had been robustly promoted to every patient in the place. I asked Judith for her reasons. She simply replied that mindfulness wasn’t suitable for Hergest patients. She was then kind enough to tell me that she hoped that I would find what I was looking for (whatever it was it clearly wasn’t going to be forthcoming from Judith and the Bangor University Centre for Mindfulness Research and Practice). I got the impression that Judith might as well have said that they didn’t take nutters. I rang the whistleblowing occupational therapist to relate this encounter and it transpired that he knew Judith. He told me that she had previously worked with the notoriously abusive Arfon Community Mental Health Team (please see blog post ‘The Arfon Community Mental Health Team’) and all he could remember about her was that she spent an awful lot of time off sick. I had never heard of Judith, but I presume that either she had heard about me from her delightful colleagues in the Arfon Community Team or that the Centre for Mindfulness Research and Practice at Bangor University indeed didn’t accept nutters.

When I later began my PhD I met people who were very cynical about the Bangor University Centre for Mindfulness Research and Practice – it seemed that it did not have much credibility with a lot of people, but I heard that they were running Masters degrees. It transpired that one didn’t actually need any formal qualifications to register for their Masters degree, so I decided to take an interest. I found that the Bangor University Centre for Mindfulness Research and Practice was growing and that Mark Williams had recently departed for a Chair at Oxford University but was still very involved with the Bangor University Centre for Mindfulness Research and Practice. I then read one of Mark Williams initial books on mindfulness  – ‘Mindfulness-Based Cognitive Therapy For Depression’; Segal, Williams and Teasdale (2002) – an account of how they’d developed MBCT (Mindfulness Based Cognitive Therapy). Although John Teasdale was based at Cambridge University and Zindel Segal was based at the University of Toronto, it was explained in this book that it had all started at Bangor and I also noticed that Keith Fearns of the Arfon Mental Health Team was mentioned in the acknowledgments. I was gobsmacked – here was a technique derived from meditation, being promoted as successful with depressed patients and involving such worthy sentiments as compassion, yet it seemed that Fearns, who was once described to me by a former social worker as ‘the most abusive professional that I have ever met’, was involved. There were also acknowledgments to Sheila Jenkins, another deeply unpleasant member of the Arfon Team, and of course to Judith Soulsby, who had refused to allow a former Hergest patient to join a mindfulness group. So a form of therapy was being promoted that had grown out of the chaos, neglect and abuse that was/is the north Wales mental health services and the Arfon Community Mental Health Team.

I wondered who had been in the original clinical trials. Had the trials been carried out at the Hergest Unit? If such success had been achieved, why had I not heard about it? I knew scores of patients who had been involved with the mental health services but I’d never met anyone among them who had been in a clinical trial for mindfulness or even said that they had benefited from mindfulness and practiced it. (Although by this time, I had become friends with someone who did practice mindfulness – but she had never passed through the mental health system. She was a member of a Buddhist Sangha and had spent a lifetime involved in alternative communities and had met Jon Kabat-Zin some years before.) I continued to wonder where the original clinical trials for MBCT had been carried out.

One of Mark Williams’s early publications regarding the success of MBCT, ‘Prevention of Relapse/Recurrence In Major Depression By Mindfulness Based Cognitive Therapy’; Teasdale, Segal, Williams, Ridgeway, Lau and Soulsby, Journal of Consulting and Clinical Psychology, 2000, 68 (4): 615-623, tells us that three sites were involved in a randomised clinical trial, the sites being Bangor, Cambridge and Toronto. 145 patients were recruited – it was stressed that at the Cambridge site, no members of academic staff or students from Cambridge University were recruited. The inclusion criteria state that patients met DSM-III-R criteria for a history of recurrent major depression. The exclusion criteria were, among other things, patients with a history of schizophrenia or schizoaffective disorder, current substance abuse, eating disorder or OCD, organic mental disorder, pervasive developmental delay, or borderline personality disorder and dysthymia before the age of 20. Read the paper here teasdaleetal

I note that the patients at the Bangor site were described as being patients of a community mental health team in Bangor. So that would have been the notorious Arfon Team then, which would explain the acknowledgments to Keith Fearns and Sheila Jenkins. (Many years later, after numerous complaints against them, the Arfon Team were investigated for neglecting patients and a number of them, including Keith Fearns, were removed from their posts.) Now for all I know, Mark Williams and his colleagues may have carried out such a randomised clinical trial and may have achieved the results that they published. But people who were familiar with the practices of the Hergest Unit and Arfon Mental Health Team at the time remember the very elastic diagnoses that patients were being given and the very poor care which sometimes constituted neglect and abuse. There is a very real possibility that patients in this trial would have received a different diagnosis – or indeed a number of different diagnoses – before or after the trial. For example, during the period that I was involved with the mental health services in north west Wales I received at different times all of the following diagnoses: depression, personality disorder, schizophrenia, schizoaffective disorder, paranoid personality disorder, bipolar disorder and borderline personality disorder. I concluded back then that these people simply had no idea what they were doing, but over the past few days I have been reading documents from my medical records that I have only recently acquired and what strikes me is that the diagnoses tended to depend on whether and to what degree I needed discrediting at the time, or whether the ‘service’ needed to find a reason not to treat me. I was by no means alone in north west Wales in my collection of different diagnoses. So where does this leave the inclusion and exclusion criteria used in this trial, at least for the Bangor site? And if there was a new treatment available in Bangor for relapsing/recurring depression why did this news not spread like wildfire? I didn’t hear a thing – the mental health services continued to be dreadful and the suicide rate in north Wales remained one of the highest in the UK. One would have thought that if Bangor had been an experimental site with enthusiastic committed practitioners, the mental health services would be of the highest quality. But no-one seems to have noticed this.

In the years that followed, mindfulness generated enormous interest. Mark Williams established the Oxford Mindfulness Centre within the Department of Psychiatry at Oxford University. Patrons included one Lady Lavender Patten of Barnes aka Mrs Chris Patten. Chris Patten aka Lord Patten of Barnes was then and still is Chancellor of the University of Oxford. Mark Williams has now retired and the website of the Oxford Mindfulness Centre has recently been revamped, listing different Trustees. One of the current Trustees is Chris Ruane, a former Labour politician from north Wales who was the driving force behind alerting Parliament to the miracle of mindfulness. Chris Ruane too would have known how bad the mental health services were in north Wales. He went to school in north Wales and for many years his constituency was the Vale of Clwyd, just down the road from the notorious North Wales Hospital Denbigh.

At one point some three years ago a friend and I found a You Tube clip of Mark Williams explaining that he wanted to establish a foundation to ensure that mindfulness would continue for generations and generations to come – what was he planning, a Thousand Year Reich? Mark Williams was also very keen that MBCT should acquire recognition from NICE (National Institute for Health and Care Excellence) as an effective treatment for depression. There was an awful lot of research being done by then in the field of mindfulness generally, but a lot of the research and analyses on MBCT and whether it was effective had been done by Mark Williams and his colleagues or people whom he had trained or who were networked with him – ‘true believers’. At this point I’d like to introduce readers to a paper from the British Medical Journal that I came across recently, ‘Conflicts of Interest and Spin In Reviews of Psychological Therapies: A Systematic Review’; Lieb, van der Osten-Sacken, Stoffers-Winterling, Reiss and Barth, 2016, BMJ Open http://bmjopen.bmj.com/content/6/4/e010606.full

This paper raises some important issues which seem to have been largely overlooked and is worth reading in full. Conflicts of interest involving researchers receiving funding from pharmaceutical companies are extensively discussed even in the lay press, but Lieb et al raise the issue of a different sort of conflict of interest – researcher allegiance regarding psychological therapies, ie. the belief of a researcher in the superiority of a psychological therapy when reviewing outcomes of this therapy. Allegiance may be due to a special training in one specific psychological therapy, the involvement in previous efficacy research about this psychological therapy or the involvement in development of aetiological models via basic research. Williams and his colleagues developed MBCT, published the initial research into the efficacy of MBCT and his co-authors like Judith Soulsby and Rebecca Crane had received special training in MBCT. Lieb et al maintain that empirical studies show a strong impact of researcher allegiance on outcome in psychotherapy studies…

Mindfulness has truly taken off in the last few years and after Chris Ruane – whilst he was still an MP –  vigorously promoted it to colleagues in Westminster, the Mindfulness All-Party Parliamentary Group was established and in October 2015 their report ‘Mindful Nation’ was published http://www.themindfulnessinitiative.org.uk/images/reports/Mindfulness-APPG-Report_Mindful-Nation-UK_Oct2015.pdf The Preface to this report mentions that the Parliamentary group heard from ‘some of those who experienced the transformational impacts of mindfulness’. The Parliamentary Group were deeply impressed by mindfulness and wax lyrical about the near-miracles that they seemed to believe that it can achieve  – among many other things, they recommended that MBCT should be commissioned in the NHS in line with NICE guidelines for patients with recurring depression and funding made available to train mindfulness teachers. The Parliamentary Group’s whole-hearted embrace of mindfulness is so uncritical that it is worth readers taking the time to read this report themselves. But I am interested in who contributed to this All-Party Report. Firstly, Jon Kabat-Zin – he writes the foreward to the Report. But read the Appendix 1, List of Expert Witnesses – there are some very familiar names here from familiar institutions. Again and again people who already have what could only be described as vested interests in mindfulness were relied upon as ‘experts’ – there are names of people who have been part of Mark Williams’s network for years, including a number from Bangor University eg. Sharon Hadley, Rebecca Crane and Jo Rycroft-Malone. Sharon Hadley is the Manager of Bangor University’s Centre for Mindfulness Research and Practice and Rebecca Crane is a mindfulness trainer, has been a leading light in Bangor Mindfulness for many years and is now Director of the Centre for Mindfulness Research and Practice at Bangor University. Jo Rycroft-Malone has featured on this blog before (please see posts ‘An Expert On The Betsi Board’ and ‘Conflicts Of Interest – and Some Very Big Salaries’) She sits on the Betsi Board and in 2103 received a grant of £448,000 from the National Institute for Health Research’s Health Service and Delivery Research Programme to investigate the ‘accessibility and implementation in UK services of an effective depression relapse programme: Mindfulness Based Cognitive Therapy’. Her collaborators on this project were William Kuyken (then at Exeter University, who has now succeeded Mark Williams as Director of the Oxford Mindfulness Centre at Oxford University and who is a long-standing collaborator of Mark Williams and his team) and Rebecca Crane. I note with some surprise that Jo’s Bangor University web page also describes her as the Director of the National Institute for Health Research’s Health Service and Delivery Research Programme, ie. the body that funded her research into MBCT https://www.bangor.ac.uk/healthcaresciences/research/people/jorm.php.en

So a number of the ‘experts’ that the All-Party Group relied upon stood to personally benefit in a substantial way should mindfulness find its way into Gov’t policy. As for the All-Party Group recommending that MBCT should be recommended by NICE – well Jo Rycroft-Malone is Chair of the NICE Implementation Strategy Group. I believe that MBCT has now been recommended by NICE…

The mindfulness bandwagon continues to roll on. Mark Williams has developed an enormous international network and his books on mindfulness have been translated into many languages. Interestingly enough, his ‘life changing best-seller’ ‘Mindfulness, a Practical Guide To Finding Peace In A Frantic World’ was co-authored with Danny Penman, who is a former Daily Mail journalist, rather than an academic psychologist. This book – and Williams’s work on mindfulness – received a further boost when endorsed by Ruby Wax (who had previously endorsed the charity ‘Kid’s Company’….). Ruby Wax has famously undertaken the Masters in mindfulness at Oxford University with Mark Williams. At one point Wax was stating in interviews that she had a Masters in ‘brain science’ from Oxford University but I see latterly that she is describing it as a Masters in mindfulness – presumably a real ‘brain scientist’ contacted her and pointed out the difference. I have also heard Ruby give interviews in which she stated that she had no previous qualifications and had always believed that she was stupid until Oxford University accepted her on a Masters course. One assumes then, that as at Bangor University, one does not need any formal qualifications to enrol for the Masters in mindfulness. Mark Williams obviously spotted Ruby’s huge potential.

Mark Williams has now retired and has almost vanished from Oxford University’s  Oxford Mindfulness Centre website (Chris Patten’s wife has also disappeared). But he is still listed as a Principal Investigator of one of the Wellcome Trust funded research projects that the Centre is running, a project promoting mindfulness in schools, again based on MBCT. The website boasts that the Centre has netted research funding of nearly £7 million.

I know of people at Bangor University who worked with Mark Williams many years ago who are not particularly complimentary about mindfulness or Williams’s management style – but many of them until recently still used him as a referee for research funding or had previously co-authored with him. These people also knew the reality of mental health care in north Wales. But no-one has breathed a word…

More recently, I know of one man in Snowdonia who followed one of Rebecca Crane’s mindfulness courses ‘in the community’ after experiencing terrible problems with prescribed anti-depressants and who became very interested in mindfulness and wanted to follow it up after the eight week MBCT course. I was told that although the promotional literature advertised that follow-up would be available, he did not find this to be true. However he persisted, followed up himself and became very committed to mindfulness meditation and practice, gaining much experience. I would have presumed that this man would have been a brilliant ‘advert’ for – and addition to – Rebecca Crane’s Centre in Bangor and I asked him if he had ever thought of trying to get a job as a trainer or teacher with them. He told me that he had approached them but gained the impression that paid work at the Centre was the preserve of a small clique.

Mindfulness has gripped much of the western world, but voices of dissent can now be heard. Academic critiques are being published and some people with a longstanding commitment to Buddhist meditation are raising concerns regarding what has been done in its name. Whilst casually perusing google scholar last year I came across extracts from a highly critical edited volume, which included a chapter by a practising Buddhist. This man maintained that he had attended a mindfulness course at Bangor University led by Mark Williams and had been ostracised by the rest of the group for daring to question Williams. He also observed that he gained the impression that the version of mindfulness meditation that Williams was promoting seemed to have been developed with a view to gaining research funding.

There is undoubtedly a group of people who do enjoy mindfulness meditation and maintain that it is indeed transformative, but they tend to be well-educated, with a previous interest in ‘alternative’ medicine or spirituality. Interestingly some of these people are also very uncomfortable with what is now happening – they do not feel that mindfulness should be ‘sold’ to the US military establishment or  to global corporations to improve workers’ productivity. But then the beauty of mindfulness as devised by Williams et al is that neoliberalism can use it to prop up toxic work environments or support the retraction of welfare services. A dreadful employer only has to give staff twenty minutes a day to practice mindfulness and the employer can thus show their enlightenment and ‘compassion’ as well as tell the staff that they should be able to cope with their work environment – after all, it’s their reaction that is the problem not the environment. And I was interested to hear Ruby Wax interviewed on Radio 4 recently in which she plugged one of Mark Williams’s mindfulness volumes as being the book that changed her life. Towards the end of the interview, Ruby spoke about how she had spent years consulting mental health professionals but hadn’t found the solution to her problems, but the good thing about mindfulness was that you don’t need anyone else – ‘cure yourself!’ Yes Ruby, that is the only choice that so many people in north Wales have been left with for so long – but they aren’t millionaire celebrities, so their lives and options are somewhat more constrained than yours.

Somebody recently drew my attention to an article in the Guardian in which Rebecca Crane was quoted as expressing concerns regarding the quality of some mindfulness training and the quality of some trainers. Well this is a fairly obvious consequence of the large scale rolling out of a business model that involves charging people to undertake a Masters degree requiring no previous formal qualifications that then qualifies one as a mindfulness trainer/teacher, enabling the said trainer/teacher to transform the world and resolve any personal problems – and of course to then charge others to do the same. I think it used to be called ‘pyramid selling’.

Even if one accepts that some people find mindfulness helpful and that Mark Williams and his colleagues may have genuinely believed that MBCT was an effective ‘treatment’ for recurring depression – and I fully accept that there are problems with medications used for depression and that many people have been and are prescribed these medications when they do not want them and do not find them in the least bit helpful – I cannot help but wonder at the claims now being made regarding mindfulness by Williams et al. They are maintaining that a mindful approach has the potential to transform virtually every area of society. Did no-one think to look at what was happening in that cradle of mindfulness, the mental health services in north west Wales, in particular the Arfon Mental Health Team and the Hergest Unit? These services have remained highly abusive and neglectful, patients continue to die and the Betsi, the Health Board concerned, is now mired in scandal and in special measures – and one person acknowledged in Williams’s initial work was later removed from his job under after an investigation into patient neglect. (I note that references to Keith Fearns et al have disappeared from Williams’s later books and the second editions of the early books.) Yet the language of mindfulness is that of compassion. Readers of this blog will be well aware that there was and is very little of that to be found in the Hergest Unit or in the Arfon Mental Health Team. Mark Williams was working as a clinical psychologist at Bangor University whilst the mental health services were centred around the North Wales Hospital Denbigh and he remained there whilst the Hergest Unit descended into madness and chaos. He has remained silent about all this and clearly was not able to use mindfulness to bring about any sort of transformation at all in north west Wales. What he did do was escape to Oxford University and leave it all behind….

There is one very sad  individual story among all this. Readers may remember that at the beginning of this post, I described how there was one psychiatrist at the Hergest Unit who was enormously excited about mindfulness, who had begun using it himself, who lent me the Kabat-Zin book and who was encouraging his patients to use mindfulness. Did it work for him? I don’t know what his thoughts on this were because after he retired I lost contact with him. Some four years ago I was told that he had killed himself.

I have been musing over all this with my friend Brown recently. What fascinates me is why Mark Williams ever went to Bangor in the first place. He arrived there in 1991 from Cambridge University. The north Wales mental health services were so bad that they constituted a major political embarrassment (nothing has changed) – Dafydd Alun Jones and Denbigh were notorious throughout Wales. I wondered if perhaps Mark Williams really knew nothing about what was happening there. I think before he worked at Cambridge University he had worked in Newcastle. Maybe he didn’t know Wales at all. But then I found out something very interesting. John Teasdale, Mark Williams’s close colleague and co-author of the MBCT work who worked with Mark Williams when they were both employed at Cambridge University, had previously worked as a clinical psychologist in Cardiff, at the University Hospital of Wales. Teasdale will have therefore known about north Wales. I had a friend who was a medical student in Cardiff University in the 80s and in 1984 as her cohort were all beginning their clinical placements she told me that they all dreaded being sent to Bangor because the tales that returning medical students told were just so grim. And that wasn’t even Denbigh. I think it very unlikely that Teasdale had not mentioned the appalling reputation of the north Wales mental health services to Williams when Williams was offered the Chair at Bangor University. The first thing that anyone does when they apply for or are offered a senior position in a university or the NHS is to ask all their mates and colleagues what they know about the place and the people that they will be working with. Why on earth would a promising young psychologist already establishing himself among a network of credible people leave a highly regarded unit in Cambridge University to come to a service dominated by Dafydd Alun Jones? North Wales has of course always attracted a group of people who come here because they are Welsh and want to return home, or because they are keen climbers/outdoor activity enthusiasts or ecologists. Mark Williams is none of these – and it seems that people in Bangor University knew a long time ago that Mark Williams’s ultimate goal was a Chair at Oxford University. North Wales was not an obvious career move. The only thing about Mark Williams and his interests that fits in with people attracted to north Wales is the ‘alternative spiritualities’ bit – the Bangor area, along with mid-Wales, since the late 60s/early 70s, has been a magnet for people seeking alternative lifestyles. The region is full of ‘old hippies’ and there were many communities of people with interests in things like alternative medicine, Buddhism and meditation. I know some of these people and a lot of them know about and have been very impressed with the Centre for Mindfulness Research and Practice at Bangor University. Most of these people are originally from middle-class backgrounds and are usually quite well-educated but few of them are academics or have received an education in science. Mark Williams’s attraction to a Chair at Bangor University remains a puzzle. But Brown – as he so often does – pointed out something very salient. On arriving at Bangor University, Williams would have found that the most senior posts in the region were log-jammed by people like Dafydd Alun Jones and if Williams had really had his ear to the ground he may even have heard that a paedophile ring was operating across north Wales in Gwynedd and Clwyd Social Services. Opportunities for advancement would have been very limited and he would have realised that Dafydd Alun Jones et al had such a grip on the region that they were not going to go anywhere and were very difficult to negotiate around. Patient care was appalling and was obviously going to remain so all the time that Dafydd et al were in place, so there weren’t going to be any improvements there.  But Dafydd et al knew nothing about research and weren’t interested anyway – and I bet there was no research governance in place. So mental health practitioners claiming an interest in research would be able to do pretty much what they wanted, publish it as well and there would be nobody to question what they were doing or ask for the evidence. What an opportunity! I only know one person who has ever questioned Mark Williams about his research. That was a former Hergest Unit patient who, along with so many of us, was having terrible problems with both the Hergest Unit and the Arfon Mental Health Team. He was at one point referred to Mark Williams because of his serious self-harming. He has always described his encounters with Williams in very negative terms and maintained that Williams’s techniques ‘didn’t work’. These were not mindfulness techniques, but techniques to supposedly deal with self-harm. Sometime after he decided to stop seeing Williams, this man told me that Williams published his book ‘Cry of Pain’, an investigation into self-harming and suicide. After reading this book, this man became convinced that Mark Williams had used him as research for this book without his consent. I have no idea why this man believed this, but about four years ago this man called in all his medical records via lawyers, and like me, found the most extraordinary things had been documented by staff at the Hergest Unit and the Arfon Team. He then wrote to Mark Williams and cc’d his letter to the Vice-Chancellor of Oxford University, asking Williams if he had ever been part of a research project and would Williams be willing to give him access to the original research data. Williams wrote a very polite letter back, assuring this man that he had not been part of any research project, but saying that he could not give him access to the data because he no longer had it. Which is interesting because even I still have most of my research data and I haven’t held successive Chairs, established research institutes and built an international reputation on my data. In my experience, people keen on writing do tend to keep their data, because you never know when it might come in useful for another publication or follow-up project. Shortly after my friend received Williams’s letter, a notice appeared on Williams’s Oxford University profile announcing that he had retired and would not be accepting anymore PhD students.

Whilst searching for Mark Williams’s early work on mindfulness in the library the other day, I came across a book written by David Healy in 1993, ‘Images of Trauma’. David Healy published some work with Mark Williams years ago and Williams has also published with Helen Healy, Healy’s wife. ‘Images of Trauma’ contains an eccentric but fascinating piece under ‘Acknowledgments’. Healy describes this book as a ‘joyride’ and ‘as with any joyride there is a certain disregard of convention’. He reminds readers that a reviewer of his last book ‘complained about the cavalier approach to references and facts’. Healy quips that ‘as regards the references, the approach here may be less than a law-abiding Sunday driver might like’. He was ‘happy enough with the reviewer’s qualms about my brushing up against the red reference cones on the edge of the motorway’ and had ‘announced beforehand that some disregard for established facts seemed inevitable’. Healy compares the plot of this book to progress along a multi-laned motorway and that ‘switching from lane to lane inevitably make drivers who stick to one lane nervous’ but he states that ‘it is difficult to know what to make of appeals to stay in lane’. David Healy then goes on to state that ‘as in most cases of joyriding I have had passengers in the back. Some have been hijacked; these include Ian Rickard…’ (Ian Rickard was formerly a senior nurse at the Hergest Unit, one of the many who failed to investigate my complaint about Dr Dafydd Alun Jones trying to bribe me into dropping an earlier complaint about him. Brown heard the telephone conversation in which Jones tried to do this and wrote to Ian Rickard. When I received no reply, Ian Rickard told me that he ‘hadn’t received’ Brown’s letter. A few days ago when I received some newly released documents regarding my medical files, there was a copy of Brown’s letter to Ian Rickard. Ian Rickard more recently has joined the disgraced Keith Fearns on the committee of the North West Wales Branch of the BABCP, the British Association for Behavioural and Cognitive Psychotherapies.) David Healy continues ‘Others have been there before and have come along again for the ride, perhaps partly out of a fascination at the possibility of disaster…they have individually or collectively screamed from the back seat….Another group of back-seat passengers have been the patients…The book is in many ways an apology for my/our abiding inability to get them much further towards where they want to go than they could get under their own steam.’

Many years ago David Healy was prosecuted and fined for dangerous driving in Menai Bridge.

So whilst Mark Williams established himself as a guru and David Healy carried on revelling in joy-riding despite listening to the screams of other people, I nearly went to prison for something that everyone knew that I didn’t do. And a great many people died.