Three days of mild fever, successful male shoe shopping [boo], unsuccessful female shoe shopping [boo], shifting too much furniture, showering a lot, disliking local politics, disliking national politics [way to make a shitty situation really shitty, HMGovt], a Pakistan test win, Wagner reminding me of Bugs in drag, and the new Iron Maiden album – this has been almost the entirety of the past seven days for me.

In other words, you ain't missed much.

I did write quite a bit whilst I had a mildly inflated temperature, mostly on paper rather than on laptop, and it was all total and utter shite. This is fairly standard for me when I'm feverish.

Coincidentally [or maybe not], this entirely mirrors the days when I used to do far too much dope; I'd produce reams of stuff, all of it useless. [The few bits that remain now are far too embarassing to transfer to an electronic medium. One of the - alas - lost gems, though, is "Dissonance", the hour-long play in which two people on an abandoned Tube train recite Fish lyrics one word at a time and be silently pretentious inbetween. I wondered whether it'd get an Arts Council grant...]

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Upcoming Wonderment, though: on Wednesday I'm in the big smoke with a bonzerly amazing person, again wandering the streets in the eternal search for decent pizza and coffee at a reasonable price. "Trust those who look for the Pizza; be sceptical of those who say they've found it."

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One in three adults takes a soft toy to bed. Which might include me. Does a bat count?

[Interfauna link]

Random Facebook Status Generator. Those of you who are "friends" with me on FB *might* think that I use this. I don't. Honest.

[The way to tell is that I've clicked the generator 100 times and it's not yet mentioned Falkirk....]

Now, I know a lot of you don't care for sports – and one could hardly blame you, given its "evolution" from community activity to global corporate whore – but, very occasionally, in that small cross-section between politics and sport, an issue gets thrown up which sheds light on unexpected areas.

Unwittingly and, for her, unwillingly it may have been, Caster Semenya – finally cleared to compete again – has been one of these moments.

Finding herself on the receiving end of a "gender complaint" – she won a few races, she's got big muscles, therefore somehow she's not a 'proper' woman – she's had to go through a series of psychological, hormonal and physical tests – bad enough on its own, but worsened by the naivety of officials who decided all this could be done in public with the press poring over all the details.

Caster herself maintained a dignified silence throughout all of this – her talking will be done on a running track – and I applauded, applaud and will go on applauding her.

What it has thrown up, though, is the major difficulties in determining a fixed "gender" for a sizeable number of individuals. The IAAF [athletics governing body]'s own policy makes it clear that there are multiple issues in "verifying" gender, though their own criteria rest around "testosterone advantage".

At least the IAAF – unlike some "commentators" – recognize the complexities, rather than just want to classify people by the crude criterion of what "joy bits" they've got [or not got]. Complaints about "freaks of nature" are fairly redundant – all elite athletes are by definition freaks of nature, otherwise they wouldn't be brilliant at what they do. Maradona was, and still is, one. Serena Williams is one. George Best was one. Glorious [if, in the first case, utterly bonkers] sportspeople: and nobody questioned their genitalia.

Although some organizations have got better at recognizing the multi-faceted nature of gender and sexuality – tickboxes for "Other" have started occasionally appearing when declaring oneself on a form – anywhere where you have to separate "male" and "female" is a minefield. The charity I work for has a progressive gender policy, but it also occasionally employs workers for intimate care, advertising them for one gender only [this being exempt from the Sexual Discrimination Act]. What would happen if a complaint was made against a worker there for being "wrong"? These things are still to be tested post-Gender Recognition Act here.

I guess in the end, if you want to have a binary system – men compete/work over here, women over there – you're going to get anomalies and complications, because people are anomalous and complicated. And even beyond binary determinism, no system – whether self-defined or "three-gender" will ever completely cover the diversity of human experience, even if the options are preferable to what we have now.

The lesson that needs to be taken from Semenya, above all, is not to blame individuals for the shortcomings of systems;  and to recognize that no system, classification or organization will ever achieve 100% utility. The best one can hope for is one that doesn't penalize individuals for not fitting nicely into bureaucratic criteria.

Which brings us back nicely to the post a couple of days ago on benefits and the never-ending "crackdown on fraud"…

10 Reasons I Cheered For Each Germany Goal:

1. I'm Scottish. That's how I identify my "ethnic heritage"; the fact I was born and brought up in Dagenham, a particularly insalubrious area on the edge of East London, is an unfortunate fact of geography I prefer to overlook in favour of cultural continuity.

2. Scottish does not equal British. English does not equal British. Given that Scotland and England have been officially politically united for around three centuries, and that for most of that time the Scots have had the impression – rightly or wrongly – that they've had the raw end of the deal, it's traditional in my cultural heritage to be dubious of England and things English.

Okay, political devolution may have, at least partially, settled the grievances, but the cultural rivalry remains. We do not support things English – we may support things British, and every time the media south of the border assume that we'll be backing England it only makes it worse.

Even in today's BBC commentary there was Mark Lawrenson; "Seventy million people will be on the edge of their seat." 70,000,000 is the [projected] population of the UK; 50 million was the figure he wanted. You'd think an ex-Republic of Ireland player would know better.

3. "We can win the World Cup!" Scotland are a fairly crap football team; we've not qualified for a major tournament for a couple of decades, and although there's been a few bright signs and a couple of talented players [most notably...], we're pretty much going to stay fairly crap. We're used to it. We only complain when they're utter crap rather than fairly crap.

England – here I'm talking about the media and a subsection of the fans – seem to somehow believe they have an inalienable right to be one of the top contenders, even though they haven't been for about as long as Scotland haven't. Every major tournament is accompanied with [I'm looking at you, Radio FiveLive, here] journalists sitting round in a studio asking "Can they win?", analyzing in great detail the possible failings of the England team, then somehow forgetting all that and answering "yes".

4. Overkill. Which is a brilliant Motorhead album, a brilliant NYC punk-thrash band, and just the word to use, following on from number three, as to the coverage England get. I heard that ten million people watched the Eng v Slovenia match the other week. Doesn't that leave forty million or so English people interested in something else? I like football, but I don't want to force it on anybody nor for it to dominate at the expense of everything else.

5. England fans. I know that the yob is a small minority, but the problem is that it's a very vocal minority. Staying out of pubs helps minimize the time I'm subjected to them, but they still exist. And despite the campaigns, there is an undeniable crossover between the hardcore England following and the extreme right.

During the 1996 tournament, when England met Germany in the semi-final, I had the misfortune to be "looking after" P., a very difficult – read racist, homophobic, misanthropic cnut – client. His language whilst we were watching was what mainly made me cheer the eventual German victory on penalties.

The England-Germany "rivalry" takes it to another level, with tedious World War II references every time the two teams meet. Again in 1996, in Ipswich several German exchange students had the shit kicked out of them by "patriotic" England fans, for – well, the reasons weren't clear, since they were a mish-mash of things that had happened when none of those present were born. FFS, grow up, fuckers.

6. Other Countries Exist Too. I'm a football fan. I want to hear what's going on in the World Cup – y'know, the other 31 teams – as well, rather than having six-page analyses every time Wayne Rooney farts. England's elimination from the tournament means that journalists will have to look a little wider for their stories. Maybe now we'll hear about how and why Uruguay are impressing the non-blinkered, how Ghana is carrying Africa's hopes, or – thanks, Guardian/Observer – how corrupt the whole FIFA setup is.

7. My Friends: Maxine is half-German, and Birgit is full-on-German. They're lovely.

8. Contrariness. Something in me wants to go against the flow. I'm never comfortable in large groups – metaphorical and real – and mass movements scare the fuck out of me, from Diana Grief Syndrome to the more recent Hate Gordon Brown Syndrome, even though I'd no great dislike for Diana nor any great regard for Mr Brown.

Robert M. Pirsig, in the [even better] sequel to Zen and the Art of Motorcycle Maintenance, "Lila", reports an American Indian tribe in which those who had thought they had suffered a wrong became contrarians, and started doing everything backwards as a sign of protest and "otherness" until it was settled.

I'm not sure I'd go that far, but I certainly recognize the urge. I wanted to laugh on the day of Diana's funeral, but didn't dare. I might have voted Labour last month, just because everyone said they'd lose, if they weren't so crap on certain things. And when people assume that I think a certain way – whether they think I'm a lefty or a righty, whether they think I'm gay or straight, whether they think I'm English or whatever – I want to say exactly the opposite just to shut them the fuck up.

9. David Cameron was "backing England", and flew the flag from 10 Downing Street. Okay, this one's childish, I freely admit. But if that smug cnut came out of the house one morning and said that murdering baby seals with chainsaws was a bad thing to do, something in me would go "hmmm, maybe there is another side to it…"

10. Germany were by far the better team. In the final analysis, that's what it boils down to. Defensively they were wobbly, but going forward they rocked in entirely the way which England didn't.

I have my own theories as to why England never managed any sort of a performance in their four matches – mostly in terms of successive managers picking the best players rather than the best team – but, hey, I'm not the manager. Yes, I'd like his pay packet, but with the media in the frenzy it is, no way would I take the job for all the money in the world…

Last night's biopic of John Lennon in his most turbulent period, "Lennon Naked", was an absorbing and productive watch.

From roughly when the Beatles started getting all drugs-and-Maharashi to when he left England for good in 1971, it showed an angry man, a flippant man, as well as a problematic and vulnerable man.

Two things stood out in the production; the first was the brilliance of Christopher Eccleston in the lead, and the "often-mentioned-in-this-blog in a "squee" manner when she was in Torchwood" Naoko Mori as Yoko.

Although when these two actors reprised John and Yoko's famous naked photographs, part of me was going "woooooot!" at Ms Mori, and the other part was going "…hey, am I really looking at the Ninth Doctor's knob?"

[It's lucky I'm not with Butterfly any more. Given her ecstatic - almost orgasmic - reaction at seeing Mr Eccleston's botty in Elizabeth, I can hardly imagine what the sight of his frontal banana would have done to her...]

The second, more serious, issue which the programme certainly didn't shy away from showing was the casual racism which Yoko Ono has always had to deal with from the English psyche.

Yoko's never been "liked" by the media here – not for her art, not for her choice of husband, and certainly not for her defence of what she regards as the legacy of Lennon since his murder. I don't want to go into whether she's right or wrong in what she's done, especially in the past thirty years; just to say that even at the time, at a young age, I picked up the strong impression that racism played an unspoken part in the very strong criticism of her.

It wasn't that she was a woman who was uppity, brittle and screamed a lot; it was that she was uppity, brittle and screamed a lot contrary to English expectations of [East] Asian* women. But – even worse than that – it was that she'd somehow usurped an English "icon" into her clutches, using a [very East Asian, apparently] low cunning.

I've noticed this in a few other things. I noticed it back in 1988 when I went out with a Cantonese-origin woman for a short time; I attracted low-level racist abuse from some acquaintances – though they never actually said anything in her presence; I got the abuse for "choosing" her.

I notice it still on the couple of occasions when someone's clocked a couple who's white man/Asian woman, and said once they're out of earshot "I wonder where he ordered her from?" This from people who would certainly shy away from direct racist abuse, but who see nothing wrong in the facepalm-inducing stereotyping they've just bought into.

It seems to me that they have little problem with people of non-white origin when they're "over there", hanging out with each other, but once they start mingling with the decent white folks and infecting our gene pool [or something], then, well…. It's a form of "soft" racism that still has an underbelly in Western culture. As late as 2009 we've still got interracial marriage being refused…

On the other hand: at least, though, the direct racist abuse John and Yoko suffered is much less prominent than it was in those days, certainly much, much less fashionable except amongst the noticeably stupider and badly misspelt end of Facebook groups. We've come a long way since 1971, and programmes like this do a great service in reminding us that "the good old days" were in many, many ways very bad…

Poor Yoko. She's helped change the world for the better, but not necessarily in the way she thought she might….

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* Usage note: "Asian" in the UK primarily refers to people of Indian sub-continent origin, rather than to people from the Pacific rim.

Be careful what you wish for. For fifteen years I have spat fire and brimstone at successive Governments and their "partner agencies"; it's about that long that I have been involved, in one way or another, in helping disabled people to fill out the complex forms for their extra welfare payments ["Disability Living Allowance"]. The process is long and time-consuming; the language that has to be used to prove one's disability is flowery and jargon-heavy [which is why any claimant who thinks they can fill in the forms themselves is making a big mistake]; the whole process can take about twenty professional person-hours. Which ain't cheap, as well as wasteful.

But today the Government as part of its budget has announced that by 2013 the entire process will be replaced by one medical assessment.

Ostensibly, this is a good thing. Your condition will be assessed by medically competent doctors rather than Benefits Agency lawyers looking for the slightest mistake in your wording; a two-hour appointment will replace twenty hours of work; people won't be disadvantaged by not having access to a DLA specialist professional.

Until, of course, one thinks about it a bit further. The paraplegic who turns up in his/her wheelchair and shows no response in his/her limbs is fairly sure that they won't be assessed as being able to walk. The problems come when more nebulous conditions are presented.

It amazes me that even these days we still have – and are still allowed by the doctors' regulatory body to have – practising medical staff who "don't believe" in various conditions. Depression? Pah. Get a job, you lazy workshy shite. Autism? You're just trying to be difficult. CFS/ME? They're just making it up. If I wasn't strictly controlled by all sorts of confidentiality clauses I could give you several examples of each.

Lawyers may be [with some very honourable exceptions] the bottom-feeding scum-sucking arses of the planet, but the one good thing about them is that they are challengeable, and therefore unlikely to take up positions it would be difficult to defend. A Benefits Agency lawyer can't, and won't, argue that autism doesn't exist, because they'd get laughed out of any legal gathering. A doctor, sitting on his lofty position as "sole defender of the Hippocratic ideal", isn't subject to such "adversarial" process – unless they kill lots of people or rape their patients [and sometimes not even then].

The experience of the past twenty-five years of the modern mental health system applies here. People released from psychiatric hospital are given aftercare in what's known as the "care plan" approach – agreed by a nurse, a social worker, a psychiatrist, and [theoretically] the patient – as to the sort of services they should receive as part of going back into the community – sometimes very high levels of 24-hour care, sometimes just a day service drop-in and a visit from a nurse once a fortnight.

Anyone who's ever attended a "care plan" meeting will know how the psychiatrists [again with very honourable exceptions] think they're king of the whole damn process, no matter who's appointed to be the "co-ordinator". One goes against them at one's peril. They have a title whereas you only have letters after your name.

This professional ivory-tower-sitting is not only, of course, confined to the more arrogant end of the medical profession. It's one of the areas which has never been challenged by either "radical" [Blairite] left or "radical" [Thatcherite] right, both of whom shied away from targeting middle-class socially-influential doctors whilst they screwed those lower down the ladder…

Of course, I'm only talking about a few doctors – the majority are very sympathetic to all sorts of conditions. But I can certainly foresee a Benefits Agency with a lot of pressure on its budgets actively seeking out "sceptical" medics for this job…

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So the questions one needs to ask after this announcement, which I may put in an email and send to the relevant minister if I manage to keep all the swearing out, are;

1] Which doctors will do these assessments? The fairest choice would be the person's own GP [family doctor], but the Government's not going to give them the task since they're already overburdened. What chance the Benefits Agency finds a bunch of ex-military doctors who don't believe any illness/condition exists?

2] Will the assessments be challengeable? Will the person be allowed to bring in their own "experts" [social worker, nurse, other competent person] or written evidence from above to the assessment to challenge/question what the doctor says? Will the GP's opinion count for anything? What is the appeal process?

3] Will the doctors have management-led "targets"? "Oh, by the way, Sir Barry, you've passed nine people already this morning, so make sure the next one's a fail." [Is this one too cynical? Long, long experience, I'm afraid.]

4] What special provisions, if any, will there be for people with mental health problems – who are noticeably very bad at turning up for important, official appointments, and who are noticeably very bad at explaining their condition properly when they know how crucial it may be?

5] Do you actually give a crap about what disabled people might think about this?

The history of my profession – specifically the mental health aspect, rather than the social work aspect, is not a glorious one. And there was a programme last night which highlighted a lot of what went wrong -

BBC Four: "Mental: A History of the Madhouse"
[should be available to watch again for UK users in that link until 25 May.
Warning: contains some disturbing scenes of experimental/harmful surgical procedures.]

Starting out in the early twentieth century rather than at the beginnings of asylum in "Bedlam" times, it told of the large Victorian institutions which were both the sanctuaries and sole carers, but also the prisons and occasionally torture chambers of those deemed "unfit for society".

It moved from the "Poor Law" age, where asylums were places of incarceration, through the new NHS age in the late forties where they became misguided capitals of psychiatrist power, into the sixties and seventies where they became unfashionable to the eighties and nineties when the last major institutions closed down.¹

In harrowing testimony and archive footage, it told of the injustices of the systems; of people forcibly admitted for "actions against society" [one person in Ipswich I got to know in the early nineties had been admitted and kept for decades for the shame of being a single parent as late as the fifties]; of the institutional abuses carried out in the name of keeping order; of the sheer horror of some of the misguided experimental attempts at providing a surgical "cure" for mental illness; and finally of the system's decline because of its huge running costs, its dismantling, and the ramifications of the mass closures.

For those of us who have a direct interest in the mental health system – and that's just about everybody, unless you're an undiagnosed sociopath – this piece of history is a harrowing watch, but also one with hope; the issues are still red-hot live, but we're not dealing with the same level of abuse, of degradation, of needless suffering as we used to. It's a stage in our acceptance of the past, and hopefully our path to the future.

I urge you, so long as you're not in a place where it'd be bad for you to watch such things, to have a look. It's not only horrible – there are also good stories – but it's also so revealing about the cultural thinking, not only about mental health but about society in general, that was going on at those times.

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There's a couple of aspects I particularly want to mention -

The first, and still germane to our times, is the idea of power without responsibility. The major example of this was where the old institutions were perfect examples of where a government said "here, you deal with this problem, I don't care how, just do it so we don't have to see it". In essence, they were perfect Stanford Experiment models even decades before the experiment actually happened – and the results, sadly, were as predictable even then as they are now in our modern versions of the "total prison".

Below the major abuses, though, was a more subtle expression of power, that of utter primacy of the professionals. The psychiatrists which ran the place did so, I'm sure, through the highest motives originally, but became as institutionalized as the patients; they had come to believe in their own moral superiority.

The credos and dogma they spouted came from rational language, ostensibly miles from the Victorian Xian paternalism of their forefathers, but in reality was as good at shielding itself from the negative effects of its actions as any circular-logic theology.

To take one example; for some time, the dogma was that insulin shock therapy is a good thing; therefore insulin therapy is what we do; and if the patient doesn't respond that's the patient's problem, not the therapy's or the psychiatrist's. It took several decades for the realization that this therapy was actually severely harmful to filter down through to the ivory-towered psychiatrists.

Those days have long gone. Or have they? Consider these days, where "treatment" for anxiety-stress-depression is governed not by the dogmas of Xianity or medical paternalism, but by the constrictions of NICE. They've deemed that the best – by which they mean the most cost-effective as well as backed by the most scientific evidence – treatments are the cheapest SSRI drugs, and cognitive behavioural therapy if need be.² GPs which prescribe more costly treatments will either have to justify doing so or get a right bollocking off their health authority.

It's not quite like before when actively harmful treatments were meted out³; but, like before, we see a situation where mental health problems are treated as if they were physical ones; the "best" treatments must always be applied because the dogma is that the stress-anxiety-depression is separate and distinct from all other issues; so there's no need to take other factors into account when deciding which treatment will work "best". Just dish out the Prozac, put the patient on the [months-long] waiting list for CBT, and shout NEXT!

This doesn't sit well with "patient experience" which always points to a more "holistic" view of their difficulties – each individual having their own particular complex set of problems, therefore needing a particular complex set of solutions – but there's no way a holistic approach is going to get properly funded in the current environment.

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The other aspect of this history I want to mention comes with the closure of the asylums, and the introduction of "Care In The Community".

Nowadays it seems ironic, even perhaps absurd, to think that the first great champion of closing the institutions and freeing the patients within was the grand Conservative politician, then destined for high things but later derailed by being a paranoid racist twat, Enoch Powell.

Nor does it seem quite right that the government which finally bit the bullet and fully implemented the policy was a Thatcherite one at its mid-eighties height.

Were they right to do so? Unquestionably. Anyone who suffers from "asylum nostalgia" has never been near one.

Should they get the credit for doing so? Absolutely, but with this proviso. Powell and Thatcher's instincts were libertarian; they had very little concern for the treatment or "freedom" of any of the asylum inmates – they just wanted the big drain the institutions made on the public finances halted and staunched.

When the inmates were released, few went into situations where they had any proper support or rehabilitation into the "community".

Some thrived – and Powell and Thatcher deserve the credit for allowing them to do so. Some struggled – with housing, money, community stigmatization, and all the other easily predictable problems. Some went straight from asylum to prison and have stayed in and out ever since. Some fell into the "charity sector" – Salvation Army hostels became their new institutions, with no abuse but lots of enforced bible-thumping. And quite a few didn't survive.

The late eighties and the early nineties were marked by a long series of scandals in which patients released with little or no support committed murders and violent crimes; the killing of Jonathan Zito caused the most outcry.

[Another I remember was when a patient in a psychotic state managed to climb into a lion's cage at London Zoo. The joke at the time was that afterwards he received the best tip-top care and round-the-clock therapy - whilst the patient was shoved back on the street with a bottle of pills.]

It took the ousting of the Conservative government in 1997 for reforms to be made which strengthened the obligation for authorities to provide support for vulnerable sufferers in the "community". The libertarian ideal of patients completely free outside of asylums was tempered by new laws such as "medication orders" which forced people to take their pills, and eventually a new Mental Health act. The arguments about the balance between personal freedom and community "safety" are still raging. The problems with "community care" are ongoing, and very rarely spoken of by those in power in public [in case the bill for it frightens the outraged-taxpayer middle Englander].

I take all the above as evidence that although libertarian instincts are in a lot of ways okay, in practice they lead to some pretty shitty outcomes if you've not got the money and personal power to cushion yourself.⁴

Of course I wouldn't say that the outcomes were worse than the history which preceded them – I can imagine little worse than lifelong incarceration without appeal – but must we really have suffered from the lesser of two evils? Was it necessary to go through the laissez-faire approach of those who were mentally ill and unable to cope with life outside sleeping rough on the streets, frightening or attacking people, and, even still today, filling our prisons – in order to get rid of the old institutions?

To those who are powerless, to those who are in need, giving these people a set of theoretical "freedoms" and "choices" works great for a few, but works very badly for an equal set of few, who'll impact extremely heavily on the rest of society. The lie of Thatcherite libertarianism [and its even scarier American cousin] was – and very much still is – to pretend that others will pick up the pieces, that somehow it'll evolve into its own balanced solution – ultimately, that those negatively impacted can be safely brushed under the carpet where the so-called "hardworking, decent families" beloved of populist politicians won't have to notice them.

By wanting psychiatric patients to "hide away" and not bother anybody, the Thatcherites in the end were guilty of the same crime as the Victorian paternalists.

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1 The programme said they all disappeared – not quite true; Broadmoor, Ashworth, Rampton and Carstairs "high-security hospitals" are still with us.
2 If available, but that's a whole other can of worms.
3 although some, eg Ben Goldacre, maintain that SSRIs have little therapeutic value for a lot of side-effects. My unscientific observation is that they have a lot of value for long-term sufferers, and very little for those who have just temporarily fallen off their metaphorical horse.
4 This sense of "nice theory, pity it won't actually work" is not the only thing libertarianism shares with Marxism; also comparable is the way their followers are unshakeable believers, resolute arguers and utterly annoying as frog.