Woman's Hour - Anorexia, Rugby, Narcissism

Episode Date: February 8, 2020

We speak to Hannah Pearson who feels she's not getting the support she needs with her anorexia and bulimia. She’s been told she has to wait 18 months for an assessment because currently she's described as a "healthy weight". After Hannah, Dr Agnes Ayton, chair of the Eating Disorder Facility of the Royal College of Psychiatrists, describes some of the challenges when trying to get medical help.Catherine Spencer was captain of the England women’s rugby team from 2007 to 2010. She's now retired but has written a book called Mud, Maul, Mascara. Does she regret leaving the sport? Also on the programme is Danielle Thomas, who’s 32. Her mother is in the late stages of Huntingdon's Disease. Danielle has recently found out that she has the gene too, so what are her plans for the future? We talk about employing a cleaner and being a cleaner. And we find out what it means to be a narcissist, particularly in a relationship.

This BBC podcast is supported by ads outside the UK. I'm Natalia Melman-Petrozzella, and from the BBC, this is Extreme Peak Danger. The most beautiful mountain in the world. If you die on the mountain, you stay on the mountain. This is the story of what happened when 11 climbers died on one of the world's deadliest mountains, K2, and of the risks we'll take to feel truly alive. If I tell all the details, you won't believe it anymore. Extreme, peak danger. Listen wherever you get your podcasts.

BBC Sounds. Music, radio, podcasts. This is the Woman's Hour podcast. Hi, good afternoon and welcome to the weekend edition of Woman's Hour. This week we'll hear from the young woman who says she isn't getting the help she needs with her eating disorder because quite simply she isn't quite sick enough. More women than ever are working and more women than ever, more people than ever, employ cleaners. We look at the reality of domestic service in 21st century Britain and we ask why some women are a bit embarrassed about admitting they pay for someone

to help at home. The relationship is quite unstructured, ungoverned. You know, we don't really know, is the person cleaning a friend? Are they a bit like a family member? Should you be buying them Christmas presents? And from the perspective of the person doing the cleaning, you know, how do they have a conversation about something like the amount they're paid or the hours that they're doing?

It's very hard to know quite how to play it. And the former England rugby captain, Catherine Spencer, on why she thinks she might have quit international rugby a bit too soon. I made my own decision to retire while I was at the top of the sport. I didn't want to get injured. I didn't want someone else, some young whippersnapper to come and steal my shirt. So I made that decision. But then I've had to live with that decision ever since and think, did I did I do the right thing? And I'm not sure that I did. You can imagine, can't you? Catherine Spencer, the former England rugby captain on

Women's Hour this afternoon. Now, we've quite frequently, certainly recently, discussed the problems in CAMHS, Child and Adolescent Mental Health Services. It really can be a long wait for a child to get a specialist referral for any mental health condition. But what appears to be the case is that it isn't any easier for adults. In fact, it might be harder. You're about to hear from Hannah Pearson, who's 25, and she has anorexia and bulimia. She lives in Greater Manchester and has asked for help from a specialist NHS eating disorder service there. But she's been told she's got to wait. She does

acknowledge she is now what she describes as a healthy weight, but as you'll hear, she is frightened she's going to get ill again. I feel like I'm always battling with a smarter version of myself and it's always one step ahead. So sometimes I feel like I've got a grip on it, but it'll throw something else at me. Who was it who actually said to you that you do have an eating disorder and you need to get help? Originally, I asked for help from a GP when I was at university for help with my mental health because I thought I was just depressed or anxious. And she told me that every time that she tried to speak to me about food

that all of my body language changed and I just shut down. And she was the one who suggested that I might have an eating disorder. She pointed me towards the charity Beat and I read through a lot of their website and it was quite hard to read it because I was in denial that any of this was a problem but I recognised a lot of the signs and the symptoms that were on that website were things that I was doing but I didn't necessarily see them as an issue. At that point, I was struggling to eat with other people.

I was using exercise a lot to burn off calories. And were you being sick? Not at that point, no. I think that's come later as things have just carried on and just kind of been left to deal with it on my own. So how many years have now lapsed between that appointment with the GP and where we are now? Nearly four years. And Hannah during that four-year period have you had any medical intervention at all?

Yeah. What kind of help have you had? I've become really depressed in the past and have required being admitted to hospital on three occasions and previously I was seen by an eating disorder service in Leicester but because my diagnosis was bulimia I had very limited treatment. And you're now in the Greater Manchester area aren't you? Yeah. And this is now where you're asking for help? Yeah. And when you ask for help what's happened? I spoke to my GP here and she took it very seriously from the start and referred me on to the eating disorders service here in Manchester. From that, we received a letter saying that there's an 18-month wait list to be assessed,

so not to be treated, just to be assessed. From that, there's not a lot that we can do in terms of accessing any interim support so at the moment my GP is just monitoring me physically and mentally and kind of like picking up that gap in between the services I just feel like I've been given a green light that this isn't bad enough that unless I'm well physically that this isn't anything that is an issue. Well that's the voice of Hannah I thought actually really really wonderfully giving us an insight into how she deals with what she's up against. Agnes Ayton is chair of the eating disorders faculty at the Royal College of Psychiatrists. She is a consultant psychiatrist based in Oxford.

How does the NHS decide who is a priority? I was very sorry to hear Hannah's description of her experiences. And unfortunately, what she has experienced is not unique at all. It's happening to thousands of people, particularly in adult services. I think we are experiencing a hidden epidemic, which is not really well measured in this country. The last time when NHS looked at this was in 2007, when they found that 6% of the population screens positively for eating disorders. And certainly working in clinical practice, we have seen almost a doubling of referrals.

And this is in the context of 80% of the patients don't seek help. So what Hannah was describing is very typical. People are ashamed, fearful of seeking help. So by the time they start seeking help, they are actually quite chronically ill. Well, Hannah did express her view that, in fact, if she were treated now, it might head off even more serious problems in the future. I absolutely agree. It's false economy because we don't have any evidence that people are on the waiting list get better by themselves in eating disorders. In fact, we have evidence of the opposite.

So when a patient receives a letter, well, you're not thin enough, you're not sick enough, it almost kind of gives them the permission to get worse. And early intervention in any other discipline of medicine is the way to go. So that early intervention helps with cancer, helps with diabetes, helps with any other disorder. So I don't think that eating disorders should be an exception for that. So the Dump the Scales campaign, which has come to prominence, the notion that BMI is just too crude a way of assessing who should get help, you'd agree with that, would you?

I think the Dump the Scales initiative is very helpful to raise awareness that eating disorders can affect everyone regardless of their BMI. It is important to recognize that eating disorders have the highest rate of mortality of any other psychiatric illness affecting adults. And intervening early is actually cost-saving on the long term. And it's obviously helpful for the individual as well as the wider society. However, we need to have sufficient resources, which we haven't got at the moment. I should say we do have some statements to read. This is from Greater Manchester Mental Health

NHS Foundation Trust. We receive an incredibly high number of referrals every month and the demand exceeds what we're able to provide. We have improved waiting times in other services such as crisis care and we have reduced the number of people needing mental health inpatient care out of the area. However we accept there are services such as eating disorders which need more capacity in order to be able to offer the care and treatment which is needed. And from NHS England, record numbers of children and young people are getting treatment for eating disorders and the NHS is expanding services for adults to meet rising demand. They point out there are around 400 beds for adult eating disorders.

400 beds is not very many actually, Agnes, is it? This is in England. Yes, I mean we have had the recent NHS digital publication we had 19,000 admissions for eating disorders and that is almost troubling since 2010. Dr Agnes Ayton who is the chair of the eating disorders facility of the Royal College of Psychiatrists and you also got the experience of Hannah Pearson. Some emails from you on this one. This is Gillian.

Interesting insight into treatment for adults. I'm 65 and I have anorexia. I've had it for over 50 years and I've had more than my fair share of in-out patient treatment at various units. I can honestly say that although I live with it as my crutch, I know that A, treatment offered wouldn't be applicable to somebody of my age, and B, I wouldn't want the funding. I manage it in my own way with input from my GP.

To throw any money into my care would, I think, be a waste and the young should get the opportunity over me. This from another listener, an anonymous listener. The greatest issue for me is that the longer a person with an eating disorder goes untreated, the more entrenched their thought patterns become and the less likely it is that they will make a full recovery. And I think that sentiment would be echoed by the contributors to our debate, Dr Ayton and indeed Hannah as well. Thank you both for those emails. There were many more on that subject, actually.

And I just want to say that you are so welcome to tell us what you think of the programme, to give us an insight into your own life. If there's an experience you can add, email the programme via our website, bbc.co.uk forward slash Woman's Hour. Also, I should say that Frankie Bridge from the group The Saturdays was on Woman's Hour on Friday, who's written a book about her own mental health. It's called Open. And I think you'll find it particularly useful if you have adolescent daughters in particular who might be having a tough time at the moment. Here's Frankie on the time in her life at which she was so unwell that she had to go into a psychiatric hospital, but not until she'd shot a video. By that point, I no longer felt in control of my own body and mind.

And I'd got to the point where I felt like I didn't want to be here anymore. And that's quite scary. So I think for me, although I was terrified of going into a psychiatric hospital, it was a massive relief because I was almost handing over the responsibility of myself to someone else. And doing the video, luckily for me, it was quite a moody video, so I didn't have to pretend to be happy the whole way through it. But it was like okay I can get this last thing done I'd spent years of you know covering up my mental health so

I could do it for this last two days and then everything was going to hopefully get better when I got back. That is Frankie Bridge and if you'd like to hear that interview in its entirety you can find Friday's edition of Women's Hour on BBC Sounds, of course. Now, the Six Nations rugby is underway, of course. There are some televised women's matches, but there's no doubt the women's game does lag behind the men's in terms of profile. That's no surprise to Catherine Spencer, who was the captain of the England women's rugby team

between 2007 and 2010. She retired the following year year and here she is telling Jenny why she's called her memoir Mud Mall Mascara. I want it to be obvious that you can have a desire to put your mascara on in the evening or in the morning whatever time but you can still go and play rugby as well and that's absolutely fine this contact sport aggressive sport the two things can go together. Now, obviously, you started playing about with your brothers on the landing when you were very, very little.

And then in 88, started playing properly. But how easy was it for a girl to get going? It was not easy at all. You know, back in the 80s, girls did not play rugby. It was not the done thing. You know, rugby was a man's sport, you know, and then eventually it became a boy's sport as well

when mini rugby was introduced. But, yeah, girls were not for being on the pitch. So for me, fortunately, I had a very, very supportive family and the club was really supportive at Folkestone. My mini rugby coaches were really supportive. There was opposition, you know, parents and opposition coaches very shocked and mortified that I'd still be on the pitch when the starting whistle went. I don't know what they thought I was going to do. So yeah, really unusual. If it wasn't for my family, I doubt very much that I would have,

you know, carried on and continued. So what was it like to pull on the number eight for England? Oh, it was, it was incredible, Jenny. You know, it was, you know, these moments in your life that So what was it like to pull say the number eight shirt that that position to me um obviously i have to say the best position on the pitch but that position to me that number became really important to me as well and then and then later on in my career that the captaincy too and i hate to mention but you did lose two world cups as captain and you refer in the book to the scars you carry as a result of that. What do you mean by that? Rugby and World Cup cycle is a bit like Olympics. So World Cups come around every four years. So everything you do in that time is about that World Cup.

Now, England women, we were a good team. We were a good international team and there was every chance every likelihood really that we could we could win a world cup it was realistic for us so everything I did was about that was about winning the world cup the first one I went to in 2006 we lost in the final I was okay we could have won but New Zealand who we played against were just fantastic they were the better team on that day so next four year cycle starts and the next world cups on home soil in England I was capped in

that point expectation pressure building and we you know we were going to win this world cup there was no other option and we were good enough to win it and we didn't we lost by three points so everything you're working towards just shatters in front of you and and emotionally you have to somehow deal with that and manage that and as you say there's a lot of that in the book now here's something else I hate to mention as well the team won the next world cup after you'd gone what was that like for you really tough you know it's very light-hearted isn't it jolly to start with um yes it was it was really tough you know I finished playing I retired in 2011 and in my own words, I shattered my own dream.

I'd never be able to achieve that, but I retired for a number of different reasons. So actually watching the team win in 2014, I was in the studio working as a pundit. When that whistle went, just emotion came over me, but actually absolute devastation that that didn't happen in 2010 and it wasn't me as captain lifting that trophy with my with my teammates around me it was you know as much as it was fantastic that England won the world cup for the sport for me personally it

was a really really tough time how easy was it to cope with your retirement because I mean you'd always had a job because you had to to earn a living because rugby didn't pay for you in those days but how did you cope with having to give up the playing the game? I loved playing rugby so as you say Jenny we were female so we didn't get we didn't get paid things are starting to change now thankfully but really this was my this was my primary focus I worked because I had to pay bills but my life my main reason for being really was to play rugby and to play rugby for England but I made my own decision to retire while I was at the top of the sport I didn't want to get injured I didn't want someone else some young whippersnapper to come and steal my shirt so I made that decision

but then because I made it myself I've had to live with that decision ever since and think did I did I do the right thing and I'm not sure that I did and especially when they won in 2014 it made that decision even harder but there's so many people that go through transitions in life whether it might be getting a different job or parents with kids flying the nest and moving to university all these transitions that are really difficult you know we feel that we have this identity and and suddenly it changes suddenly we need to find a new path and we're having to deal with this in our in our life emotionally as well as practically you say in the book that you don't think you have the right people leading the game what changes would you like to see i think there's been sort of natural growth in the women's game,

particularly since I started, and it's been easy to see that. But I think there's time now that we need to be aiming higher in our game. So to give you an example, one of the home games for England in this Six Nations is going to be up at Doncaster. Now, it's really good to take the game around the country. You know, I'm a supporter of that, but the stadium has a capacity of 5,000. In France this weekend we had nearly 18,000 at the game, football seeing 30 plus thousand at club games. We should be aiming higher I think and we should be having tougher questions and we should be a bit more challenging about how we push our game.

That was Catherine Spencer and Scotland play England tomorrow in the Women's Rugby Union. Now Huntington's disease is a progressive brain disorder, there's no cure and the symptoms include involuntary movements, depression, personality changes and problems swallowing, speaking and breathing. If a parent has Huntington's, there is a 50% chance that each of their children will develop the condition. Well, Danielle Thomas is 32 and she runs a cafe in Hertfordshire. She's just got married. Her mother, Lisa, is in the late stages of the disease. Danielle has made a film for BBC Stories in which it's revealed she has the gene for Huntington's as well. That's correct yeah my

CAD count is actually on the lower end which means that I won't develop any symptoms for at least 10 years hopefully. Medicine is coming such a long way and the developments are unbelievable even in the last 10 years there's so much has happened that isn't available for my mum unfortunately but even my mum wasn't able to have any of these things. What you do know is that your own mum lost her mum when she was very little. Yes my mum was four when her mum passed away which is why my mum didn't know that it you know run in the family. You have taken the test. Your sister has decided not to. Yes, my sister is very adamant that she doesn't want to know. We've both been complete polar opposites in our decisions.

I've always wanted to know. I said I'd make a decision by the time I was 30, whether I was definitely going to have the test or not. And I wanted to wait for my sister to see if she changed her mind at all so we could do the journey together. Sophie's still quite adamant that she doesn't want to have the test done. And it does make things a little bit more difficult for her now because she has my niece, who was a surprise.

But it makes things a lot more difficult for my sister. So I completely understand why she doesn't want to have the test. Why were you so certain that you did want to have it? I think it helps with planning for the future and it was it was always at the back of my mind you know I think about it at least two or three times a week and in regards to planning a family for us in the future we can go down the route of something called PGDId ivf um where they actually test my eggs um to see if the the eggs carry the gene right um so they can make sure that my eggs don't carry the gene and then re-implant them and you are you're being helped along the way here i know that before you even had the test you were were counselled, people were with you, because this is, well, it absolutely must change the way you think about your life.

It definitely does. And the counselling was unbelievable that I received. I actually went to an outbuilding at Great Ormond Street in the neurological department. And my doctor, she was fantastic. And you can stop the process at any time so you know once you start your counselling that doesn't mean that you still have to go forward and have the test you can stop the process at any time up until you know the day of your blood test once you've had the blood test you have to receive your results but I was made to feel so at ease and

because I have got quite a good knowledge of Huntington's disease you know we had some really good conversations about it as well so it really did help me. And shortly after you found out that you did indeed have the gene did you speak to your sister did you did you tell her very quickly what you'd found out about yourself? My sister was actually there with me on the day yeah we did some filming here at the BBC and she came with me on the day along with my husband. And she did wait outside to start with, but I wanted her there. So, yeah, she came in and she was with me when I got the results. I had the pleasure of meeting your dad actually before we started the programme today. And he was talking about your mum and about how I think you've been on a night out.

What I'm really anxious for people to understand is that your mum is still with you. She's still there and she's still living a life, not least because of the fantastic care she's had from your dad and the rest of the family and the carers you have. Yeah, mum is... She's always been very outgoing. She loved the film crew coming to the house and filming her. She was completely in awe of them um and very

well behaved all day um but yeah she was always the last one at the party and that's that's the case now you know it is more manageable for us now it sounds awful but now she's in a wheelchair and we can manage her movements because at one stage she was falling over all the time she wouldn't go in a wheelchair she was so determined and so strong to carry on living an independent life but it's so difficult with Huntington's disease you know we had to watch her 24 hours a day but now you know we go to parties and she still wants to be the last one there and she has the best time so yeah she's still living a very full life. We know that one of the symptoms is personality changes. And can you tell me, can there be bouts of anger and sudden flare-ups

that perhaps were not characteristic of the person that used to be there, if you see what I mean? Yeah. Through my teenage years, looking back now, we didn't know at the time that mum had Huntington's disease. But looking back, we see that, you the time that mum had Huntington's disease but looking back we see that you know that was part of her condition you know the flare-ups and the anger that she'd show towards me and my sister for no reason but that wasn't her you know that was that was just the condition coming through and she used to um fall over quite a lot she'd have a lot of

angry outbursts um she fell down the stairs a couple of times. And there were so many things that happened that probably couldn't be prevented because of the condition. But now, as I say, things are a lot more manageable with her. Yeah, it was really lovely to meet Danielle and her dad and to hear about her mum, Lisa, as well. We wish the very best to Danielle. And you can see that film, Just Look for BBC Stories. She's a very impressive young woman. Are you a cleaner? Have you ever been one?

Do you have a cleaner? More women, obviously, are working than ever before and many more households than ever before employ somebody to clean the place up. This week, Jenny talked to Dawn Nicholas, who's a nanny and a housekeeper in Dorset, and she also employs a cleaner for her own flat. Julieta Adame is an artist and a cleaner, and Dr Lucy DeLapp is a reader in Modern British and Gender History

at Cambridge University. Jenny asked Lucy how many people work in the domestic service industry right now. I'd like to say that we know the numbers, but we don't really, because one of the transitions of the 20th century is that domestic service or cleaning goes from being a formal sector to an informal sector. So we can have a stab at saying what kind of size sector it is in terms of its economic worth. We know that it's worth about £4 billion annually by the end of the 20th

century. And there's no evidence that it's got any smaller since then. So it's a very substantial sector. But we don't know how many people work in it in the way that we did in the past. What about men? How content are they to become cleaners, domestic workers? Well, historically, there has been a sector of male cleaners or domestic workers. And I would say that that has grown in recent years. And one of the reasons for that is because we start to see the rise of agency work. So that is where we do get formal cleaners. And agencies are more ready to employ men and women in those roles.

So I do think there's been a transition away from what's been mainly a female sector into a sector which is more gender mixed. Julieta, what made you become a cleaner? I think a little change. I'm originally trained as a graphic designer. I did my in print making and then things changed. I was out of work for a very, very long time. I called a friend during her pregnancy for a cleaning job and I thought, well, I need money. And I wanted to also have my own printmaking studio. So

that's how I started funding it. Do you enjoy cleaning? Yes and no. As an artist artist you are always cleaning the tools, the presses, everything needs to be perfectly clean. For me it's another skill and it also gives me kind of a good space to think about things that probably I get too sort of overwhelmed when I'm trying to solve a print or a design for a client. So it is a good thinking space too. Dawn, why do you keep house for a family and then employ your own cleaner?

Hello. I've nearly always on and off employed a cleaner because I've always had a really busy life and it's more a kind of two, three week person who has always come in and just done the fundamentals and I think strangely I've always really liked keeping other people's houses clean the job I'm in now which I adore I mainly went for as it's a nannying job but part and parcel of it is to keep on top of a large four-story house and all the laundry what do you mean when you when you talk about the essentials i mean uh communal areas really i i'm

also an airbnb host in my own flat so that's you know paramount to me that i get lots of uh reviews saying it's sparklingly clean uh which i do um and i just find somebody coming in and doing uh the oh i don't know really the foundations uh every maybe fortnight or three weeks really makes a massive difference to my life i think it's what my grandma used to call doing the bottoming. It's getting right down to it and making sure everything is done properly. Exactly. Yes, skirting boards, architraves, that kind of thing, really. Lucy, people used to employ what they called servants,

but I doubt anyone would ever use that term now. Why has that changed? Well, the term servant really falls away just after World War II when you get a wide variety of other jobs available to the mostly women who were going into domestic service. But I would say it's not that the job itself goes away, it just becomes informal and people have new terms for it.

Margaret Thatcher talked about having a treasure in your house. And that was a very deliberate kind of tiptoeing around of the term servant, avoiding that term. There's a term mother's help that becomes really, really, really common in the 1960s and 70s. That's the fastest growing category of domestic worker nanny i think uh keeps its positive connotations but maid servant housekeeper um you know that carries with them a whole load of baggage of stigma the work that that that dawn was talking about there that the fundamentals that used to be called the rough and the people who undertook it were also you know stigmatized as as dirty people, unrespectable people. Why though do so many women now say oh I feel so guilty about employing a cleaner or even a nanny? I think that you know the person who comes in and cleans your house if you have somebody doing that they know a lot about you. They know about your social life, your habits, they might know something about your health, they might know something about your sex life.

So they have intimate knowledge about you. And yet the relationship is quite unstructured, ungoverned. We don't really know, is the person cleaning a friend? Are they a bit like a family member? Should you be buying them Christmas presents? And from the perspective of the person doing the cleaning, how do they have a conversation about something like the amount they're paid or the hours that they're doing? It's very hard to know quite how to play it. And that actually isn't new. You see that in

the, you know, the early 20th century when, you know, a quarter of all women were working in domestic service, you still get those senses of embarrassment. It's only really in the great houses, the country houses, places where figures like Churchill's cook would have been working, that you have, I think, a lack of embarrassment. And that's because you have a sort of sense of a professional structure, a career, and that offsets the embarrassment. Julieta, what's your experience of this very complicated relationship,

of being a cleaner and people throwing strange expectations on you? There was something to do with a bed, wasn't there? It was like more, for me, it's just like, I can put together a bed, yeah, of course I can. But it was more down to sort of, oh, well, you have nothing better to do. You can come an extra hour because, of course, you're poor or you're in desperate need of this money. It's things for me that you could do yourself if you give yourself five minutes. Is the relationship difficult with an employer? Sometimes it is extremely difficult because there's expectations, especially on time and normally

it's people that tell you oh it's going to take you a couple of hours and you get there and it's it's a six day six day job I think my feeling is it pairs up with what you only deserve I don't know 20 pounds for for these two hours and you're a cleaner you're supposed to be able to do it on on time for that money and that's good enough for you dawn as a cleaner and an employer how embarrassed or guilty do you get at having someone do your i mean effectively dirty work i'm not personally embarrassed but i have found a reticence in me to maybe mention it to other female friends there is certainly some stigma in it it's interesting I don't have any stigma personally about my job and I adore it and I always take a lot of pride in it and say

that but I can find myself hanging back in letting people know. You know, people will say, you've got such a busy life. How on earth do you manage? And certain people I don't then say, oh, but I have this wonderful woman, Rachel, who's really flexible, who comes in maybe fortnightly, three weeks, and I know all the foundations of being done, done you know and I don't know that's a strange one isn't it really I can't quite explain that and Lucy very briefly how much exploitation do you reckon goes on now it's hard to know but I I would say we've been emphasizing embarrassment

but I would say there's other emotions uh and forms of experience going on in that relationship, which are about snobbishness and mockery and trying to get a bit more work out of your cleaner. So it's, you know, I don't want to dwell too much on the embarrassment and forget about the fact that actually there's a lot of employers who try to cut corners. So a common practice, for example, is not to pay your cleaner when you go on holiday. That is just exploitation. And a lot of cleaners say that is just the norm that people go off on their skiing holiday or their summer holiday, and they don't leave any money because they assume that somehow the cleaner can afford it.

Dawn Nicholas, Giulietta Adame and Dr. Lucy DeLapp. And actually that conversation sprang from an interview I'd done with Dr. Annie Gray, who's the author of a really fascinating book about Winston Churchill's cook, Georgina Landermeier. The book is called Victory in the Kitchen, and if you're interested in the history of food and in social history generally, that's a really interesting book. Victory in the Kitchen is the name of that. Now, to your emails, this is from Lynn.

I have always had cleaning ladies, and the way I look at it is that I'm giving employment. The lady I have now has become a real friend, and I love to see her on a Friday when she comes to me. We also go out for a curry together sometimes. She's called Jo, and she's the best. I trust her with my life, she works hard, and genuinely, I don't know what I'd do without her.

I run my own business and so having her gives me a little more time for myself. I am not ashamed to say this and honestly I treasure her above all else. That's Lynn talking about Jo and this is from Jane. My parents moved to a different town when they retired. 34 years later, the lady who cleaned for them all that time ago came to my mother's funeral. When I thanked her later for coming, she said to me, you know, your mum was a real lady. When she had visitors and we all stopped for elevenses around the kitchen table, she always introduced me as my friend, Elaine. In our series about breaking free from potentially rather damaging relationship

patterns we heard a moving account from a woman we're calling Sadie who now knows that her previous partner was a narcissist. So at first you're not doing anything to earn this adoration but then they start halving that and then you start working twice as hard to get half of the reward. So manipulative. Did you have any fun together? Well, that's the other thing, isn't it? It's the love bombing. So after the argument, then you get love bombed.

So, yeah, unfortunately, quite a lot of our relationship was made up of her, you know, making it up to me. You know, she was up for adventures. She was fun. But but of course you're living for the the good moments they're renowned for being very sexual and good in bed and yeah but yeah towards the end I think I was so worn down well that interview got a really interesting response from many of you so we brought in Baldwin, who is an expert in love and dating and relationships. I asked her to define what a narcissist is. So a narcissist is someone who is very much in love with themselves. So it comes from Greek mythology. Narcissists loved his

reflection in the pool, but they have a real difficulty caring for anyone else. So having any concern for anyone else's feelings. They'll be selfish, they'll be arrogant, they'll also be very charismatic, but a high degree of self-importance. But everybody surely is somewhere on that spectrum, if such a spectrum exists. Absolutely. Like many personality traits, narcissism is on a spectrum and we're all there somewhere. Right at the far end, you've got the pathological narcissists, but that's very rare. But then, you know, we're all there somewhere. We all have, we all have underneath narcissism is often a low sense of self-esteem. So we all have, we all struggle with that. But the problem is when it starts damaging

relationships and when it starts damaging other people and when a narcissist preys on someone with low self-esteem and you end up with an abusive relationship. Now in that description, Sadie really, very brilliantly actually, I thought, brought to life the love bombing, the intoxicating early stages of a relationship with an individual like this. Tell us a little bit about that. So a narcissist will, in the early stages, they will flatter you, they'll be very persuasive, they'll probably hurry things, it will happen very quickly, very charismatic, lots of texts, lots of messages.

She mentioned that they started sleeping together really quickly. But then once they get what they want, once they have you, then they might lose interest. And they might also start to undermine you and belittle you. Because their own low self-esteem, they start projecting it onto you. And also, if you challenge them in any way, they don't like that. So the relationship can become quite toxic. How different is it to coercive control? There are similarities, aren't there? There are similarities, yes. I'd say narcissists will probably exercise coercive control over their victims or over the people they're in relationship with. So if we are vulnerable to being controlled, to being

manipulated, then we're going to get into that troublesome relationship. Also, the issue of codependency, I think that that's a tricky one, because almost all relationships have a sizable chunk of codependency about them, surely. So where the codependency becomes a problem is if i as a codependent really struggle with low self-esteem and insecurity and fear and then i get myself in a relationship with someone who initially seems so amazing and it really boosts my self-esteem because they want to be with me because they have told you you are that you you alone are the solution to all their problems exactly so that boosts my self-esteem, but then I get trapped. And that's also quite addictive, you know,

that being told that you're amazing and wonderful, especially if you have low self-esteem. But I can get trapped in that relationship, and then it becomes unhealthy, and it's very difficult. It can be very difficult to get out of. And are the narcissists doing this knowingly, or are they unable to help themselves? So underneath many narcissists doing this knowingly or are they unable to help themselves? So there's underneath many narcissists is a vulnerability and a low self-esteem.

There are others who aren't at all aware of what they're doing and they actually do believe in their self-importance and in their value and their worth. But I believe that narcissists can change. We can all develop, you know, we can all develop you know we can all develop personally so if they start to if somebody can help them to see that underneath they are vulnerable and weak something that they hate and if they can be vulnerable then they can change but if you're in a relationship with a narcissist you have to ask yourself how am i feeling is this good for me or have i been lost have i lost myself? Yeah.

So you will, people will lose themselves. Yeah. Here are some emails. This is from a listener who's anonymous. Sadie is admirable in that she was able to see the reasons why she became a victim. These people are predators who seek out empathic people and push them to their limits. And she beautifully described the carrot and stick they use in their abuse to keep you hooked into the relationship, abusing your sense of decency and your caring qualities. You lose all sense of self in such relationship. It's akin to an addiction. They literally change your brain chemistry. You're nodding.

That's right, is it? Well, you will become very, imagine somebody is belittling you, manipulating you, undermining you. And because you don't have a healthy self-esteem, you start believing it. And then your self-esteem gets worse and worse. So you become drained. You have no energy left.

And you do need help to get out of that relationship. You need people to support you. You need your friends. You might need a coach or a therapist. You need people to remind you of who you are and of your value and your worth. And, you know, that's the work I do. It's all about building our self-esteem, having healthy boundaries so that we don't fall into those relationships with people who are going to manipulate and control us. And are you more vulnerable if you've come from a particular set of circumstances, if your parents have behaved in a particular way, for example? As a victim of narcissism? As a

victim. Yes, because you don't have a strong sense of self, you haven't had a secure base, you don't believe in yourself, so you are more vulnerable. So that's why all the work I do is about building up your sense of self-esteem, your sense of confidence, your sense of your own worth and value. And also knowing, connecting to your intuition and noticing those red flags. OK, that person, they might be love bombing me. This feels a bit much or hang on, they're coming on really strong and then they're pulling back. And talking to your friends or talking to a professional and saying, you know, something isn't right here and trusting yourself. Does this, your wisdom, does it come from personal experience?

It comes from personal experience of not having strong, healthy self-esteem and being in relationships with people who weren't right for me or who were emotionally unavailable. And obviously the narcissist is emotionally unavailable at the extreme. Catherine Baldwin, who's an expert on relationships. If you are around on Monday morning at two minutes past 10 I hope you can listen to the programme. We are discussing on Monday loneliness and the impact of loneliness and how hard it is to actually acknowledge that that is indeed what you're feeling and we have some really interesting interviews with people who've been brave enough to acknowledge their own loneliness.

In particular, women who might very well be at the centre of family life. They've got partners, they've got children, but they still really miss a connection with other people. So that's Monday morning, Women's Hour on Loneliness, two minutes past ten. If you're listening to some other podcast, then stop now and listen to a good one. Because the Infinite Monkey Cage is back for a new series. And we're doing loads of things, aren't we, Robin? We're going to be dealing with the science of laughter, conspiracy theories, coral reefs, quantum worlds, and finally UFOs. I love UFOs.

It's also, by the way, the UFO one available to watch on iPlayer. In fact, all of the series that we've done are available on BBC Sounds. I must say that I wouldn't bother with the first series. I don't think it's very good. I wouldn't bother with the first series. I don't think it's very good. I wouldn't bother with the first two. Yeah. But we were played by different people then, I think, weren't we? Yeah, yeah.

Melvin Bragg was you. You were Debbie McGee. Debbie McGee. Bragg and McGee. Now that is a 1980s TV detective series that I will be making. I'm Sarah Trelevan, and for over a year, I've been working on one of the most complex stories I've ever covered. There was somebody out there who was faking pregnancies.

I started, like, warning everybody. Every doula that I know. It was fake. No pregnancy. And the deeper I dig, the more questions I unearth. How long has she been doing this? What does she have to gain from this? From CBC and the BBC World Service, The Con, Caitlin's Baby.

It's a long story, settle in. Available now.