Dr Gwen Adshead

Presenter0:00

Hello, I'm Kirsty Young. Thank you for downloading this podcast of Desert Island Discs from BBC Radio 4. For rights reasons the music choices are shorter than in the radio broadcast.

Presenter0:10

For more information about the programme, please visit bbc.co.uk/slash radio four.

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My castaway this week is the forensic psychotherapist Gwen Adsaid.

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She is one of the leaders in a very specialized field, trying to understand the behaviour of the most vilified people in society.

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and attempting to find ways of treating it.

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For more than a decade her office has been behind the towering walls of Broadmoor Hospital.

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The Victorian Built Institution in Berkshire is home to more than two hundred men, all convicted or accused of the most dangerous violent behaviour. She also works with young offenders, supports crime victims, writes academic papers, and is currently working on a book on the nature of evil.

Presenter1:11

Compared to that her life outside work seems well, almost impossibly normal.

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Bringing up her children, singing in a choir, and gardening fill her spare time.

Presenter1:21

Of her work, she says, Other people's minds are so fascinating I can't think of anything more interesting.

Presenter1:27

And I can't understand why everyone isn't a psychiatrist. Um fascinating, but I imagine at times also pretty.

Presenter1:34

Terrifying. There there must be moments when you contemplate what the people you talk to have done and and you are a little scared at least.

Dr Gwen Adshead1:42

Yes, well, not, I think, scared because of course I'm working in a very secure and safe environment. And so I think it's sad, really, because particularly in the hospital where I work, many of our people

Dr Gwen Adshead1:55

are are very disabled. I mean, not only have they

Dr Gwen Adshead1:59

done terrible things, but they've often been through terrible things as well, which has left them very psychologically disabled.

Dr Gwen Adshead2:05

And the rehabilitation process is a very slow one, so I think not so much fearful as just sad.

Presenter2:10

Uh

Dr Gwen Adshead2:10

And in terms of

Presenter2:12

Sort of day-to-day setup as as you go into your work. I mean, I noticed today you're wearing beautiful bracelets. I think you've got a necklace on.

Speaker 12:18

Uh

Dr Gwen Adshead2:18

Got it.

Presenter2:19

You know, w when you walk in, are you allowed to look and carry the sort of things you would in everyday life in an environment like that?

Dr Gwen Adshead2:25

Like that? Oh, yes. It's a although one I think one has to be very one has to be thoughtful.

Dr Gwen Adshead2:30

So it's not so much about feeling frightened, but about being thoughtful about risk and being aware that the people that we work with may not see the world as we do.

Dr Gwen Adshead2:39

I sometimes think that they're like survivors of a disaster, where they were the disaster.

Dr Gwen Adshead2:44

So what you and I might think of as being quite innocuous or harmless, they may see as being threatening or provocative. So one has to be thoughtful about that.

Presenter2:54

When you say survivors of a disaster, do you mean the disaster of the lives that they've had that have led them to the point of psychological breakdown? Or do you mean the disaster of what it was they did that landed them in Broadenware?

Dr Gwen Adshead3:06

Both.

Presenter3:06

Right.

Dr Gwen Adshead3:07

So

Presenter3:07

Yeah. Uh

Dr Gwen Adshead3:08

Many of our people have come from the most disastrous of lives in terms of abuse and neglect, real extremes of abuse and neglect.

Dr Gwen Adshead3:15

But also often for many of them what they've done is a trauma.

Dr Gwen Adshead3:20

And I think one of the things that's complicated about the work that we do is that people

Dr Gwen Adshead3:25

Uninformed people, unthinking people, see this attempted explanation and understanding as being somehow excusing people, and we don't seek to excuse people.

Dr Gwen Adshead3:35

But I think it's crucial to remember that these patients are people. They once had lives.

Dr Gwen Adshead3:45

albeit briefly some of them, that were quite ordinary lives.

Dr Gwen Adshead3:49

They were once small boys, they were once uh young men who were hopeful.

Dr Gwen Adshead3:54

and whose lives went terribly awry.

Dr Gwen Adshead3:58

Think King Lear has it best its ruined pieces of nature, and that's why it's sad rather than frightening, I think.

Dr Gwen Adshead4:04

And the most frightening place really to be is out in the community where, you know, you don't know what's coming in the door.

Dr Gwen Adshead4:11

At least in Broadmoor, we know where it is.

Presenter4:15

Let's have some music. Tell me about your first choice, then.

Dr Gwen Adshead4:18

Well my first choice is Give Me Shelter by The Rolling Stones. And it brings back very happy memories of going to a Rolling Stones concert. A friend of mine was roadieing for them, so I was backstage for the whole of the day. How exciting. Tell me what you saw. Oh well, the most exciting thing was sitting in the scaffolding behind the stage watching the Jay Giles band.

Presenter4:31

How exciting

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Oh well domestic

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That

Dr Gwen Adshead4:39

And I felt this movement to the left of me, and there was Mick Jago climbing up the scaffolding next to me. Did he try to chat you up? No, no, certainly not.

Speaker 24:45

Uh

Presenter4:45

Uh

Speaker 24:46

Uh

Dr Gwen Adshead4:47

Are you sure? Absolutely, absolutely.

Speaker 25:12

He's got the shadow, he's got the shadow.

Speaker 25:20

He's got the shot away!

Presenter5:23

That was the Rolling Stones and Gimme Shelter. I think it would be useful, Gwen Adza, to explain precisely what your title means. You are a consultant forensic psychotherapist.

Dr Gwen Adshead5:32

That's correct.

Presenter5:33

Night. What does that mean?

Dr Gwen Adshead5:34

Yeah.

Presenter5:34

Yeah.

Dr Gwen Adshead5:34

Well, what that means is that I'm a psychiatrist by training, so I'm a doctor, trained in psychiatry, and then I train as a forensic psychiatrist, so that means a psychiatrist who specializes in in mentally abnormal offenders and working with people who've been violent.

Dr Gwen Adshead5:48

And then a psychotherapist is someone who works psychologically with people to try and help improve their moods, reorganise thinking, make themselves function better. That's what a psychotherapist does. But a medical psychotherapist is someone who's trained in medicine, and that's important because if you're going to treat people who are very unwell and who've got very complicated disorders, you need people who are medically qualified to do that. Can you give us a.

Presenter6:13

As I say, there are around about two hundred and fifty men at Broadmoor. Can you give us briefly examples of the the kinds of things that these people have?

Dr Gwen Adshead6:21

Done.

Presenter6:21

Uh

Presenter6:21

Yeah.

Dr Gwen Adshead6:21

Well, you don't get admitted to a high secure hospital unless you've committed an action which is very violent or dangerous or threatening to other people. Murder, manslaughter, sexual violence.

Dr Gwen Adshead6:34

Those types of offences. You don't get to Broadmoor unless you've done something pretty frightening.

Dr Gwen Adshead6:38

And we have got two main efforts. One is to try and restore their mental health.

Dr Gwen Adshead6:44

And the other is to reduce their risk.

Dr Gwen Adshead6:46

They arrive in a high risk state. We aim to treat them and rehabilitate them sufficiently so that they can go on to a less secure place.

Presenter6:54

So the welfare of the patient and the safety of the public are the two things that are your concern.

Dr Gwen Adshead6:59

Are the two

Presenter7:00

Right. They can't they can't have equal status, though I'm imagining, do they?

Dr Gwen Adshead7:05

Uh why not?

Dr Gwen Adshead7:07

I'm not sure if I can do it.

Presenter7:07

Well, I suppose because the the public and the public listening might think, well, foremost in your mind must surely be the safety of the public.

Dr Gwen Adshead7:08

Republic

Dr Gwen Adshead7:10

They like

Dr Gwen Adshead7:14

Well, I think within the secure perimeter of a hospital, we know that we're working safely. We know that there's no danger to the public. So in that sense, we're not taking risks on a day to day basis.

Dr Gwen Adshead7:26

But nobody moves on from Broadmoor without the issue of the risk to the public being considered very carefully.

Presenter7:31

And it surprised me to learn that that most of the patients in Broadmoor do indeed move on. The proportion of the people that you treat, how many of them will go on to live in the community, not at another lower grade facility in terms of the security of it, but actually out day to day living in the same streets as the rest of us.

Dr Gwen Adshead7:48

I think very few will ever be living in the community in the same streets as the rest of us in that phrase. Because the truth of it is that most of our people haven't led independent lives since they were children. Many of them have been in care, gone from care to prison, gone from prison to secure hospitals. So the idea of independent living is not necessarily the most sensible goal.

Presenter8:10

Is is there any part of you that despairs that they haven't been

Presenter8:15

I suppose helped, if you like, before that. You know, in areas like infant mental health, if if these were once children who then ended up in the care system at the age of seven, eight, nine, ten, then maybe there could have been a point where people in your profession at different stages might have stopped the catastrophic events that have led them to Broadmoor.

Dr Gwen Adshead8:34

Yes, I think that's right. I think that is one of the saddest things.

Dr Gwen Adshead8:38

Our patients tend to be people for whom everything went wrong.

Dr Gwen Adshead8:43

All the opportunities for repair or rescue didn't happen, because of course there are many children who are abused and traumatized, who grow up in very dysfunctional households.

Dr Gwen Adshead8:52

Who do get opportunities for rescue or repair, and they work. Sometimes the care system really works well. Sometimes people get the help that they need and they turn things around. That really happens.

Dr Gwen Adshead9:02

But our people tend to be those for whom everything went wrong.

Dr Gwen Adshead9:06

They not only do they have very deprived and abusive childhoods, but they develop mental illnesses, they develop substance misuse.

Dr Gwen Adshead9:13

And the rest. So yes, sometimes you can feel incredibly sad about the opportunities that have been lost.

Presenter9:20

Let's have some music. What's your second disc today?

Dr Gwen Adshead9:24

Well, my second is Pablo Cassas, playing Bach's first cello suite. It's just one of the most perfect pieces of music. I give this music to people that I care for. I don't know who it was who said that the cello is the voice of the heart, but I think there's no doubt that it is.

Dr Gwen Adshead9:45

Uh

Speaker 210:29

And

Presenter10:47

Pablo Casal's playing the prelude to Bach's cello suite number one in G major. You said there, Gwenad said, that y you give that piece of music to people y you care about, and I wondered if are you talking about people in Broadmoor that you care for?

Presenter11:01

as well as people on the outside.

Dr Gwen Adshead11:04

No, no, that would be a step too far in terms of being personal, rather.

Presenter11:08

Yeah.

Dr Gwen Adshead11:10

Because in as a psychotherapist, in a way, you make your mind available to somebody else to help them recover. And you can't be too personal.

Dr Gwen Adshead11:17

So you have to be personable?

Dr Gwen Adshead11:20

But not personal. And the dangers of being too personal are.

Dr Gwen Adshead11:24

Risk, danger, exploitation.

Dr Gwen Adshead11:27

I mean, one has to remember one's working with people who by definition

Dr Gwen Adshead11:31

Don't understand other people very well.

Dr Gwen Adshead11:34

And some of our people are predatory that's why they're there.

Dr Gwen Adshead11:38

It's quite subtle to explain, but it's I I

Dr Gwen Adshead11:41

Most of all, I guess, the risk might be for the therapist, too, that they lose their sense of risk.

Dr Gwen Adshead11:47

And let's look back.

Presenter11:47

Back a bit then, Gwen. You were born fifty years ago. Your parents were British, but your early years were spent in America. Wh why was that?

Dr Gwen Adshead11:55

Um yes, my father went to Harvard to do his PhD.

Dr Gwen Adshead12:01

And then he took a job at the University of Canterbury in New Zealand.

Dr Gwen Adshead12:06

and I lived there until I was eleven.

Dr Gwen Adshead12:09

when I then came to school in England.

Presenter12:12

Before you came to school then in England, which of course we will talk about, what were your memories of New Zealand and growing up there?

Dr Gwen Adshead12:18

Christchurch is a fantastic place. You have wonderful beaches, proper sandy beaches, and then an hour or two inland you have fantastic mountains where you can ski. It and we lived up in the hills above the city and we could look out to the sea. We had a most fantastic view.

Dr Gwen Adshead12:34

And your mother's

Presenter12:34

And your mother sh was she an academic too? Yeah, what did she specialize in?

Dr Gwen Adshead12:36

Yes, what did she specialise in? Ancient history. So both my parents were historians.

Presenter12:41

And they decided to send you, aged eleven, to Cheltenham Ladies' College, many thousands of miles away.

Dr Gwen Adshead12:45

The chill

Dr Gwen Adshead12:46

To many.

Presenter12:49

Uh was how was that? I mean eleven.

Dr Gwen Adshead12:52

It was young. There was an expectation, I think, that children went back to England to go to school.

Dr Gwen Adshead12:59

Also, my parents thought that they m I think they thought they might return to England in in time.

Dr Gwen Adshead13:05

But it was young it was young to go.

Presenter13:07

Can you remember? I mean, how did you get to England? Did you fly or did you fly nice?

Dr Gwen Adshead13:10

And where you with your

Presenter13:12

And were you with your parents when you were in the middle of the mm?

Dr Gwen Adshead13:13

No, no, no, no. I uh flew on my own from Christchurch to Auckland, Auckland to Hawaii, Hawaii to Los Angeles, Los Angeles to London. In those days, you know, it was a long, long journey.

Dr Gwen Adshead13:25

And you were very bright at school.

Dr Gwen Adshead13:27

Well it's very difficult for people to admit that, but um

Presenter13:27

Well it's very difficult for people to admit that.

Dr Gwen Adshead13:30

I don't know. Really, I don't. I was averagely able at school. I knew I wanted to do medicine. I'd always known that. I'd known that from quite a young age. Why was that?

Dr Gwen Adshead13:40

I was really, really interested in how people heal.

Dr Gwen Adshead13:43

And both my parents suffered from rather poor health when I was a child. My mother had had T B and was very frail. And my father had poorly controlled diabetes and would often

Dr Gwen Adshead13:57

pass out in public places.

Speaker 113:58

Place.

Dr Gwen Adshead13:59

And so I think I became quite sensitized to human vulnerability quite early.

Presenter14:05

Yeah.

Dr Gwen Adshead14:06

With a

Presenter14:06

Perhaps

Dr Gwen Adshead14:07

Some music.

Presenter14:07

Yeah.

Dr Gwen Adshead14:08

Absurd.

Presenter14:08

Quite a different sound throughout the last

Dr Gwen Adshead14:11

Oh, yes, this is Ian Dury and the Blockheads. Hit me with your rhythm stick. Chas Jankle, I think, is a musical genius, and this is one of his best. But Ian Dury was a wonderful singer, and I saw him when I was at medical school, and I saw him not long before he died. And everybody of a certain age in their jeans and T-shirts just dancing away was fantastic.

Speaker 114:36

Me with your rhythm steak, hit me, hit me.

Speaker 114:40

Shitano Ich Libani Hit me, hit me, hit me.

Speaker 114:45

Hit me with your rhythm stick. Hit me slowly, hit me quick. Hit me, hit me, hit me.

Speaker 114:53

Beep

Presenter15:02

That of course was Ian Jury in the Blockheads and Hit Me with Your Rhythm Stick. You were saying then, uh Gwynad said, that you play that to your sons and tell them that this is proper music.

Dr Gwen Adshead15:09

It is proper music. But then I realised this is a very ageing thing to say.

Presenter15:14

Um interestingly, uh before the last piece of music you were saying that as a child you became interested in in medicine because you were really interested in how things heal.

Dr Gwen Adshead15:23

Uh

Presenter15:23

Uh

Dr Gwen Adshead15:23

Mm.

Presenter15:24

The point of medicine that you are dealing with is where almost the sort of philosophical.

Presenter15:29

combines with the practical medicine, if you like.

Dr Gwen Adshead15:32

Absolutely. And you are entitled to bring into your work.

Dr Gwen Adshead15:37

Other intellectual disciplines criminology, jurisprudence, moral philosophy, theology, poetry they all in their different ways have something to say about the psychology of human experience, and particularly human experience faced with extraordinary events.

Presenter15:55

You worked for a time at the Institute of Psychiatry and and you were working there with um

Presenter16:00

Victims of trauma.

Dr Gwen Adshead16:02

Um

Dr Gwen Adshead16:03

Often people have been through events that are very unusual, very shocking and disturbing.

Dr Gwen Adshead16:10

I'm thinking now of a man who was on the Herald of Free Enterprise.

Dr Gwen Adshead16:14

who found himself in an air pocket.

Dr Gwen Adshead16:18

As far as he knew, the water was just rising and rising and rising, and he was going to die.

Dr Gwen Adshead16:23

And he, unsurprisingly, perhaps, became very disturbed by this experience. And I think because those types of traumas that come out of nowhere

Dr Gwen Adshead16:34

They take people to a peak of fear.

Dr Gwen Adshead16:38

And it becomes very difficult for them to come off that peak. That's what happens, really, in post-traumatic stress disorder. And what did you do to try to help?

Dr Gwen Adshead16:46

There's medication to manage the symptoms of anxiety and depression.

Dr Gwen Adshead16:50

And that helps because if you can get a handle on the physical symptoms, that helps people to think.

Dr Gwen Adshead16:55

And the whole point about the psychological treatment is to restore you to a sense of safety, so you no longer believe that you're about to be attacked.

Dr Gwen Adshead17:03

All the time.

Presenter17:04

But as you yourself said earlier, of course, unlike Broadmoor, the the world outside is highly unpredictable, and never mind just getting knocked down by a bus, you might be mugged by somebody, you might come home and your partner might tell you they're leaving you, there you know, there's all sorts of unpredictable things, both emotional and physical, that can happen to us. Do you think our expectations culturally right now are at a point where we expect too much happiness?

Speaker 117:10

No.

Dr Gwen Adshead17:12

Yeah.

Speaker 117:19

Or

Dr Gwen Adshead17:20

The motor

Speaker 117:22

Yeah.

Dr Gwen Adshead17:22

Yeah.

Dr Gwen Adshead17:28

Yes, I do. I I sometimes wonder whether we don't prepare enough.

Dr Gwen Adshead17:32

For the slings and arrows of outrageous fortune.

Dr Gwen Adshead17:36

Or rather, I think that we

Dr Gwen Adshead17:38

don't understand that pain and suffering and rage and distress are as normal a part of life.

Dr Gwen Adshead17:47

as the happiness and the joy.

Presenter17:50

Let's have some music then. What are we going to hear next?

Presenter17:52

Speaking of the happiness and the joy.

Dr Gwen Adshead17:54

Speaking of the happiness and the joy, um the next record I've chosen

Presenter17:54

The joy.

Dr Gwen Adshead17:58

is the Weather Girls. It's Raining Men, and I chose this because it reminds me of the

Dr Gwen Adshead18:03

times at medical school when we would dance. Dancing has been a very important part of my uh enjoyment of my life and uh this weather was great fun to dance to.

Speaker 218:14

It's rising.

Speaker 218:16

I'm just getting low according to all sources to do.

Speaker 218:27

Lost tonight for the first time just about having

Speaker 218:35

History

Presenter18:44

That was the weather girls and it's raining men. And you said when I said that there was there was lots of dancing at medical school. I'm glad to hear it. You w you weren't then too dedicated to your your work.

Dr Gwen Adshead18:53

Oh no, I'm afraid not. No, I failed my second year medical exams and had to reset most of them.

Presenter18:58

Did you?

Dr Gwen Adshead18:58

Uh

Presenter18:58

Uh

Dr Gwen Adshead18:58

Oh yes.

Presenter18:59

Why? How did you feel?

Dr Gwen Adshead19:00

Too much partying. When I came to do my second year exams I had to blow the dust off my books. I danced a great deal in medical school and enjoyed every minute of it.

Presenter19:09

So that was what late nights, all nights? Oh, yes.

Presenter19:14

How did that go down with your highly academic parents?

Dr Gwen Adshead19:18

Oh, well they were far away in New Zealand.

Presenter19:21

Presumably you told them that you'd failed.

Dr Gwen Adshead19:23

Oh yes, yes, yes, yes. My mother wasn't terribly pleased. But uh Can you remember how the conversation went?

Dr Gwen Adshead19:29

Uh not happily.

Dr Gwen Adshead19:32

Not every memory is a happy one. Not every memory is a happy one. I think she was she was not very hopeful for me. But no, I passed my resets. And did you pass them well?

Presenter19:33

Yeah.

Presenter19:34

And that's where

Dr Gwen Adshead19:42

Did you sort of knuckle down? Enough.

Presenter19:42

Enough. Oh yes, enough with that.

Dr Gwen Adshead19:46

And when I came to do Sakatri, it just in a way felt so familiar. And I I love that I know I like that moment when you sit down with someone and you say, well,

Dr Gwen Adshead19:56

How d how is it that we come to be meeting here today? What where does this story start, do you think?

Presenter20:02

When you are at Broadmoor and you are listening to the stories and you know.

Dr Gwen Adshead20:06

Mm-hmm.

Presenter20:07

The result of the stories. How optimistic can you be?

Dr Gwen Adshead20:07

The result of the story

Speaker 120:08

Uh

Presenter20:11

that you will enable a patient there to find the tools to somehow recover. I mean, a lot of the time, don't you think, well, this might more be about me using the information to then work out with fellow professionals how we stop this the next time, rather than actually helping that individual.

Dr Gwen Adshead20:26

Well, I hope that they're not alternatives.

Dr Gwen Adshead20:29

I mean, the average length of stay in the hospital is about eight years still.

Dr Gwen Adshead20:34

And it's a mirror of the length of time most people spend in secondary school.

Dr Gwen Adshead20:39

And I find myself constantly wondering to what extent people are growing up.

Dr Gwen Adshead20:44

Psychologically.

Presenter20:45

Do you actually talk to your patients at Broadmore about the things that they've done?

Dr Gwen Adshead20:49

Oh yes oh yes uh very much so.

Dr Gwen Adshead20:53

Then it's always quite a moment, I think, when one does do that.

Dr Gwen Adshead20:58

When one says, well, when you killed so-and-so, when you actually use that phrase, it's always quite a moment. I heard.

Presenter21:06

Did you once say that one of your patients said, Well, you can be an ex-bus driver, but you can never be an ex-killer?

Dr Gwen Adshead21:12

Yes, that's right. You can be a little bit more.

Presenter21:13

The computer.

Dr Gwen Adshead21:17

That they know that, and um the people who've killed, you know, they know that. They know that they have to try and live uh with that. Because it I mean, it's existentially en enormous. It's like the Talmud says, you know, whoever takes one life takes the world entire. When you kill somebody, you've changed the universe.

Presenter21:36

We will certainly talk more about this in just a second. For now though, let's allow ourselves to pause with some music. What are we going?

Dr Gwen Adshead21:43

Well, my my next choice is Kiriti Kanua, singing Mithradi from Don Giovanni. And this.

Dr Gwen Adshead21:50

reminds me of many things. Well, first that I heard Kiri when I was ten years old in our local town hall, but also because she was one of my father's favorites. And my father taught me about opera, and this was the first piece of opera music that I really got when I understood why people love it.

Presenter23:07

Kiriti Canawa singing That Ungrateful Man Betrayed Me from Mozart's Don Giovanni with the orchestra of L'Opera in Paris conducted by Lauren Moselle. And you said it, intriguingly, the first time you were aged ten and you heard Kiriti Canawa singing in your local town hall. In my local town hall? That must have been the very beginning.

Dr Gwen Adshead23:21

So that

Dr Gwen Adshead23:24

It must be the beginning of her career. Yes, it was my tenth birthday. And she was wonderful.

Dr Gwen Adshead23:30

It it might be a good time.

Presenter23:31

To talk then about, it's a very loaded word, of course, as you will know more than any of us, the nature of evil.

Dr Gwen Adshead23:37

Hmm.

Presenter23:38

How do you characterize it?

Dr Gwen Adshead23:38

How do you characterize

Dr Gwen Adshead23:39

Well, uh my my supposition is that

Dr Gwen Adshead23:43

Anybody can get into an evil state of mind. Anybody. Anybody. I think one of the fascinating things f for us to think about is what sort of state of mind do you have to be in to tie up and stab an elderly man, which is um can kill him over the course of about three days, which was

Dr Gwen Adshead24:02

A story of one seventeen-year-old girl that I saw.

Presenter24:05

Uh

Dr Gwen Adshead24:05

And this was

Presenter24:05

When she had taped up his mouth with seller tape and taped his eyes shut, she glued his eyes glued his eyes shut, in fact.

Dr Gwen Adshead24:11

Come on.

Presenter24:11

And over a period of three days she intermittently snapped him.

Dr Gwen Adshead24:13

Yeah.

Dr Gwen Adshead24:15

Boom.

Dr Gwen Adshead24:16

Yeah.

Dr Gwen Adshead24:17

Um

Dr Gwen Adshead24:18

And I guess that would be a paradigm case in a way of sustained cruelty, which I think most people would think is a feature of evil. But then against that we have to put accounts like Guita Sereni's account of Frantz Stangel, who was Commandant in Treblinka, who oversaw the deaths of nine hundred thousand people.

Dr Gwen Adshead24:39

Gotta be of interest to a forensic psychiatrist, someone who oversaw the deaths of nine hundred thousand people.

Speaker 224:43

Yes.

Dr Gwen Adshead24:44

How do you compare those states of mind?

Dr Gwen Adshead24:46

There must be some connecting link between these states of mind.

Dr Gwen Adshead24:50

But they're clearly but similar and different. Because actually evil is one of those things like

Dr Gwen Adshead24:54

time and hope in elephants, which is quite hard to define.

Presenter24:58

Let's have some music then. What are we going to hear next?

Dr Gwen Adshead25:01

Well, my my next choice of record is uh is a piece of me that means an enormous amount to me. It's James Taylor's Shower the People and

Dr Gwen Adshead25:09

I used to listen to this all the time at school. James Taylor's greatest hits was Our Record that we played in the Juniors' Common Room all the time. And my children like him, and this is a song which I think

Dr Gwen Adshead25:20

really exemplifies everything that I think is important about relationships.

Speaker 225:24

Shower the people you love will love

Speaker 225:29

Show them the way that you feel

Speaker 225:34

Without work, I'll find

Speaker 225:38

Only will.

Speaker 225:41

Do as I said Shower the people you love will love Show them the way you feel

Presenter25:53

That was James Taylor and Sharo the People. Of course, there are, Gwenat said.

Presenter25:58

There are mistakes that are made, that are people released back into the community who go on to perpetrate.

Presenter26:04

appalling crimes and and have been judged.

Presenter26:07

By psychologists and so on, to be at a state of. Hmm.

Presenter26:12

A function that allows them out into the community.

Presenter26:16

An incredible responsibility for people in your profession to bear.

Dr Gwen Adshead26:19

Um

Dr Gwen Adshead26:21

And I think the the the complicating thing there is that human beings are not machines. You can't you can't put them in a certain setting and then they g and say they're going to stay there.

Dr Gwen Adshead26:32

We can help men and women to get to a state where they are psychologically quite secure.

Dr Gwen Adshead26:36

But we can't promise, we can't guarantee that they're going to stay that way because human beings are dynamic, they move, they change.

Dr Gwen Adshead26:42

And I can think of one man who we really did do good work with, and had really, I think, become much safer and more secure in his mind, but he was rehabilitated out to a hostel, where he was left alone for long periods of time, and he became very agitated.

Dr Gwen Adshead26:56

And he started drinking again and no and luckily there wasn't a disaster this time, but there could have been. So the idea of people are cured or not cured, that dichotomy simply doesn't work at all. I I would

Presenter27:08

imagine that most people would feel that, you know, spending a an enormous amount of time and indeed taxpayers' money trying to understand them and improve the standard of their life is is maybe

Presenter27:20

Time and money that's ill spent.

Dr Gwen Adshead27:21

But I suppose the counter argument to that would be that if you want to really make them safer, you're going to have to try and understand them, if only because you need to understand the nature of the risk. There may be some people who will be unhelpable.

Dr Gwen Adshead27:37

So time

Dr Gwen Adshead27:39

Invested in understanding them is time invested in safety.

Presenter27:43

Unless of course you always just keep them locked away, in which case everybody's safe from

Dr Gwen Adshead27:45

And

Dr Gwen Adshead27:46

Except that you can't do that. There is no there is no legal framework in which we lock people away forever, except in a very few in a very few circumstances.

Dr Gwen Adshead27:55

Um if you're going to lock up everybody who's potentially dangerous, you're going to have to lock up a lot of people who will never be crim who will never do anything violent. In fact, uh I have a colleague in Chicago who's a very famous professor of forensic psychiatry who used to say that if you really want to make a city safe you will lock up every single man between the ages of fifteen and thirty-five, and that will make the c streets completely safe.

Dr Gwen Adshead28:17

which is counter argument is of course, but who will mow the lawn? But she's right. So you could detain people indefinitely, but that would be fantastically unjust.

Dr Gwen Adshead28:29

The other thing is, is that, contrary to what people think, violence is quite rare.

Dr Gwen Adshead28:35

So you'll be talking about detaining people on the basis of something that may is fantastically rare and often very unpredictable?

Dr Gwen Adshead28:42

And we think of it in terms of a bicycle lock.

Dr Gwen Adshead28:45

that you've got to have four numbers come up before the lock opens and for the violence happens. So you could have people wandering around with three numbers down who'll never get to the fourth. Now statistically you might lock everybody up

Dr Gwen Adshead28:57

Who's got those three clinical risk factors?

Dr Gwen Adshead29:00

But you'll be locking up an awful lot of people, and what will you do with them?

Presenter29:05

Time for some music. Tell me what we're going to hear now.

Dr Gwen Adshead29:07

Well what we're going to hear now is something which is very important to me which is I sing in a choir in my local church and we sing with another choir and we often get together and sing evensong in cathedrals around the country and it's an enormous pleasure. And every year at Candlemas we sing this motet which is a 16th century motet by Johannes Eckhard called When Mary to the Temple Went and these are our two choirs singing together.

Speaker 229:51

Share.

Speaker 229:53

Lord Preci.

Speaker 229:58

May children

Presenter30:34

The choirs of Saint Peter's in Caversham and Saint John's in Mortimer, conducted by Ian Wesley, singing When Mary to the Temple went, Could you hear your own voice in there, Gwen?

Dr Gwen Adshead30:43

No, I hope not. The art of choral singing is to be able to hear other voices coming together to make that melody. It would be disastrous if I could hear my own voice above the others.

Presenter30:54

Um, your Christian faith then, how important a part of your life is it? And indeed of your work?

Dr Gwen Adshead30:59

Oh, very important.

Dr Gwen Adshead31:02

I think all the world's religions provide an account of how people struggle with uh the four last things, good and evil.

Dr Gwen Adshead31:10

death and judgment. And those themes are so

Dr Gwen Adshead31:14

Present in my work that it would be very difficult, I think.

Dr Gwen Adshead31:19

to to do this work without being.

Dr Gwen Adshead31:23

At least interested.

Dr Gwen Adshead31:24

In religious theological ideas, and indeed ideas of moral philosophy.

Presenter31:29

Is redemption possible for for many of the people that you work with, do you think?

Dr Gwen Adshead31:33

I hope so.

Dr Gwen Adshead31:35

It reminds me of that line from Richard the Second, in which uh

Dr Gwen Adshead31:40

Richard says May I live in hope.

Dr Gwen Adshead31:42

And Anne says All men, I hope, do so.

Dr Gwen Adshead31:46

Hope is a very important part of the work that I do. I always think that there's a duty to be hopeful.

Presenter31:51

You were married for thirteen years no longer married. The things that you've heard are worse than than most of us, surely listening, can imagine.

Presenter32:03

Where do you unburden yourself? Do you go and talk to somebody about that in a in a clinical sense? Do you unload the horrors that inevitably must they must be in your head, are they?

Dr Gwen Adshead32:13

Yes, yes, taking care of our own psychological health is an important part of being a professional. It's not, as I say, it's not about being.

Dr Gwen Adshead32:20

tough and uh pretending that you don't have feelings about this, that would be disastrous. I make a very clear distinction in my mind between my work and my home life. So I very rarely think about uh uh about my work when I'm not there.

Presenter32:35

You talked about hope, and I'm sure

Presenter32:37

It must be incredibly rewarding at times, but but to do what you do week in, week out must

Dr Gwen Adshead32:39

Screwdon.

Presenter32:43

I mean, I don't know. I think as a parent I would I'm I'm not sure I'd want my my daughter to do it.

Dr Gwen Adshead32:49

Well, it's it is a demanding job, but it it is um the most interesting job anybody could have.

Dr Gwen Adshead32:59

You do get to deal with the big themes of life.

Presenter33:03

Your father died last year. Your mother is is still alive. What did they make? What does your mother make of this remarkable and unusual career that you have?

Dr Gwen Adshead33:12

Oh well, I think she finds it rather baffling. Um it's not a world I think that she understands or or knows.

Presenter33:20

You're a mother of of two your yourself. Uh did it become harder your job when you became a mother?

Dr Gwen Adshead33:26

Yes, I think it did.

Dr Gwen Adshead33:28

It became a bit sadder recently.

Presenter33:29

Really, yes.

Dr Gwen Adshead33:30

Because I began to see all these men as the small boys that they once were.

Dr Gwen Adshead33:36

And about

Dr Gwen Adshead33:38

how they might have been with all that promise that children have.

Presenter33:42

Yeah.

Dr Gwen Adshead33:43

And when you're on

Presenter33:43

On the island then, of course, you're going to this island.

Presenter33:47

The value of human relationships will be something you can think about, but it will no longer be practically accessible to you. How are you going to deal with that?

Dr Gwen Adshead33:55

Very badly. Very badly. Very badly. I don't wish to be on this island for a minute longer than I have to be.

Presenter34:01

You will have some comforts, as we will find out in just a second, but for now tell me about disc number eight. Go ahead.

Dr Gwen Adshead34:07

Well, my last choice is from Mozart's Requiem, and it's the Lachrimosa. Again, this is a piece that I've sung, and it has a memory for me of being in New York in two thousand and two, the first anniversary of 9-11, when I went to the Juilliard School of Music along with hundreds of other people with my own score, and we came together for a spontaneous singing of Mozart's Requiem to commemorate 9-11. And this, the Lacrimosa, with its great Amen at the end, was one of the most powerful pieces of music I've ever participated in.

Presenter35:38

The Lachrymosa from Mozart's Requiem performed by the Academy and Chorus of Saint Martin in the Fields, conducted by Sir Neville Mariner. So we come to the point, then, Gwynnette said, where I will give you the Bible and the complete works of Shakspeare.

Presenter35:51

What's your other book going to be?

Dr Gwen Adshead35:52

Can I have the

Dr Gwen Adshead35:54

Biggest possible volume of collected poetry that we could find on the planet. If I'm going to have to sit and wait to be rescued, I'm going to need poetry and the consolations of poetry while I wait. So the biggest book of collected verse that we could find would be helpful. You can have that and a luxury.

Dr Gwen Adshead36:11

Um well, I don't suppose I can take the Top Gear team with me to the island. Well they're definitely useless, but I mean I think Oh, that's very unkind. They would be entertain they would be entertaining.

Speaker 136:22

I think that's a good thing.

Dr Gwen Adshead36:24

They would be very entertaining in different ways, and I think potentially useful. That's something my sons introduced me to, and um I think they would be very entertaining.

Presenter36:32

Is there one?

Dr Gwen Adshead36:32

In particular

Presenter36:33

Like you have in mind?

Dr Gwen Adshead36:33

Yeah, yeah.

Presenter36:35

No, you can't have them anyway. I'm just interested. So what are you gonna take?

Dr Gwen Adshead36:39

Whose fantasy is this?

Dr Gwen Adshead36:42

Well, what I I think I would be lost without pen and paper. So I or some sort of writing device. Because I'm going to be needed to be writing. A writing device.

Presenter36:47

I'm good.

Presenter36:49

We'll just give you pen and paper. It's not that I don't trust you with the computer, but it seems somehow more straightforward. And one record of the eight discs, if you had to choose just one, what would it be?

Dr Gwen Adshead36:58

Uh

Presenter36:58

Uh

Dr Gwen Adshead36:58

Oh, I think I

Presenter36:59

But it James Taylor.

Presenter37:00

Shower the people. It's yours. Gwen has said thank you very much for letting us hear your desert island discs. It's been a real privilege for me.

Presenter37:53

You've been listening to a download from the BBC. You'll find more information on the Radio Four website bbc. co dot uk slash radio four.