Woman's Hour - Domestic abuse and brain injury, Calvin Klein advert, Exhaustion

Episode Date: January 16, 2024

Up to one in two survivors of domestic abuse in the UK may be living with an undiagnosed brain injury. That's according to a new report by the charity Brainkind. Emma Barnett is joined by Steffy Bechelet from Brainkind and Dr Annmarie Burns, a Consultant Clinical Neuro-psychologist.How often do you feel weary and depleted? Or perhaps just plain exhausted? Anna Schaffner knows these feelings well. Now a coach specialising in helping the exhausted, in her previous life as an academic, as a Professor of Cultural History at the University of Kent, she suffered from burnout. She has now written a book, Exhausted: An A-Z for the Weary.Since 1 January, working parents in England have been able to apply for a code to access new free childcare hours for two-year-olds, which will then kick in on 1 April. The scheme is part of a significant investment in childcare announced by the Government. But one campaigning organisation has found that parents are facing major challenges in securing a code. Joining Emma is Lauren Fabianski from the campaign group Pregnant then Screwed who carried out the survey.After the Advertising Standards Authority banned a Calvin Klein poster featuring the singer FKA twigs for presenting her “as a stereotypical sexual object”, we’re asking, what determines whether an advert is objectifying? Sarah Golding, the CEO of The&Partnership and journalist Rebecca Cope join Emma.Last week, Jade Robertson woke up to find that one of the dresses from her fashion brand Little Lies had sold out overnight – after Taylor Swift was spotted wearing it. Jade joins Emma to talk about what this means for her and her fashion brand. Presenter: Emma Barnett Producer: Lucinda Montefiore

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. Hello, I'm Emma Barnett and welcome to Woman's Hour from BBC Radio 4. Good morning and welcome to the programme. One of my guests today argues that the news cycle with wars, elections and pandemics can be causing feelings of exhaustion and then limiting your creativity. Well, I see it as my job to keep you awake throughout the programme as we navigate the latest I Shall Do My Best. But Anna Schaffner, a cultural historian and now a burnout coach,

having suffered from it herself, has some tips about how to heal from such exhausted feelings. One of her suggestions is a hobby, and the definition is that it must bring joy and nothing else no goals no parameters just doing it for doing its sake so how do you recuperate and find energy and joy when you have been truly exhausted I do want to point out there is a difference between exhaustion and burnout we will get to that but as we navigate a very cold January I'm in the market for any ideas and And also, if you relate on the feeling of exhaustion, why?

What's it doing to you? Why is it happening? And what have you found lifts it, if anything? On a personal note, I had a pure injection of pure joy last night through a very new hobby, a local pub quiz, which I entered with a new group of female friends that I met through my son's school. And to our huge shock and elation, we won. Obviously, that was brilliant. I don't want to point out that that was the goal, but because it's been joyful every time we've done it, and we definitely haven't won before, or even got in the top five. But it doesn't matter, because we're laughing as we try to find answers. My particular highlight last night was being able to answer what makes up the

citrus hybrid to form a grapefruit. I'm going to leave that dangling for the show and then you definitely can't go to sleep on me. Obviously, if you know, and I'm sure some of you do, you'll be getting in touch, but you can text me here to let me know how you deal with exhaustion and what gets you out of it. Whether it's winning quizzes through to, I don't know, playing some kind of instrument, singing, doing something in the house, doing something far from the home, whatever it is, let me know on 84844. We'll be talking about the state of exhaustion. I mean, it's fascinating today on the front of one of the papers talking about words of the year.

The worried children of today want serious words. Well, maybe we'll reflect on this. Asked a decade ago what their word of the year was. British youngsters opted for something predictably childish. This is on the front of The Times. Minion, a servant or unimportant person, probably coming from Despicable Me and those series of films. But now after Brexit, a pandemic and the death of a sovereign, it seems that children have much more grown up concerns. According to Oxford University Press, the children's word of the year for 2023 was climate change, followed in close second by war. Third place was coronation. So take from that what you will. We're living apparently in exhausted times, worried times.

What gets you out of it? Also on today's programme, is the government's new childcare plan working? We'll take a look at that. And if a woman feels sexy and amazing in a photo shoot, should it then be banned in an advert, especially when similarly sexual ones of men and other women are not? And finally, what happens if you wake up and find out Taylor Swift has been wearing your dress? All of that to come. But first, let me bring your attention to something important, to something serious and something that doctors are taking very seriously or should be perhaps taking more seriously indeed. Up to one in two survivors of domestic abuse in the UK may be living with an undiagnosed brain injury. That's according to a new report, Too Many to Count,

and it's published today by the charity Brainkind and shared exclusively with Woman's Hour. 55% of survivors that were spoken to screened positive on the Brain Injury Screening Index, suggesting a history indicative of a brain injury, which is compared to one in eight of the general population. I'm joined now by Steffi Bechelet, BrainKind's domestic abuse and brain injury researcher, and by Dr Anne-Marie Burns, a consultant clinical neuropsychologist. A warm welcome to you both. Steffi, if I may start with you, what are the main findings of this report? So the main findings of our report, as you've just said, are that one in two people who've experienced domestic abuse may be living with

a brain injury. And this has come about through a number of different ways. But our research found that over 80% of people that we spoke to had experienced at least one serious blow to the head. So thinking about injuries to the head, neck or face in their lifetime. And also three quarters of the people that we spoke to had also been held in a way that they couldn't breathe. And both of these are potential mechanisms for brain injury. So this is really saying to us that a lot of the experiences that domestic abuse survivors are having could lead to brain injuries, which is why this really needs to be explored further. And in terms of how you recruited the participants, who were the women that you heard from? So the women that we worked with and we spoke to came from a range of different host sites

across England and Wales. So domestic abuse refuges, but also community-based infuservices. And it was really important for us that people were recruited in a way that they were kept safe, because we realised that talking about this can be deeply traumatic for people. And we wanted to make sure that people were recruited in a way that they were kept safe because we realised that talking about this can be deeply traumatic for people and we wanted to make sure that people were safe in the process. Anne-Marie and in terms of there's been some research on this before but how does this differ what do we learn now? So predominantly the research that's happened before hasn't been in England and Wales it's been in North America some in Australia and those studies have predominantly been in emergency departments or in orthopaedic departments. And our research is with a community-based sample, women who are seeking support for domestic abuse.

Okay. And I think it's important at this point to hear from one of the participants of your study, which is called Too Many to Count. We're calling her Faith. She described her experience, and I should say her words are spoken by an actor. I was very keen to take part as I was diagnosed with a brain injury 10 years ago. I never fully understood why I had the brain injury, although I did think it was down to the trauma

I'd gone through as a victim of domestic abuse and sexual violence for an exceptionally large part of my life. I was late having the diagnosis just before the age of 40. Health professionals even told me this was a peculiar age. Unfortunately, my lived experience of domestic abuse and sexual violence is vast and spread over many years. This includes domestic abuse of every nature, sexual abuse, sexual violence, coercive control, physical violence, gaslighting, also including post-separation abuse which is not talked about

enough. Can I add my main reason for not being able to talk live on air today as I'm still going through post-separation abuse which is a dangerous act that perpetrators use for years after separation. It's an important part of faith story as we're calling her and to protect her identity. To bring it back to the brain injury side of things, because there may be those who are listening who are trying to understand whether this has affected them. Anne-Marie, what are the symptoms? So I think the first thing, it's important to say

that not every head injury results in a brain injury. But if you have experienced a serious blow to the head with a loss of consciousness, or you've been held for a prolonged period in a way that you felt you couldn't breathe and maybe weeks or even months later you're experiencing difficulties with your memory or the speed at which you're able to process information or some people report that they have behavioral or emotional difficulties then that might be the time to speak to your domestic abuse support worker

or even visit your GP to discuss those symptoms a bit further. And in terms of what we should also be looking out for Steffi what would you like to say? I think it's just about being aware of the different types of experiences that so many people who have gone through domestic abuse will have experienced so thinking about those multiple head, neck and face injuries, thinking about being held in ways that they can't breathe, and that a lot of the signs and symptoms aren't immediate. There are some immediate signs and symptoms, but most of these are longer term, which is why we're really urging people to think about what their lived experience is. And as Anne-Marie has said, if they've got any concerns to seek advice from specialists that they can trust.

Let's have a listen to Faith as we're calling her. Describe her symptoms and diagnosis. Again, her words are spoken by an actor. I was diagnosed with my brain injury of epilepsy exactly 10 years ago this year. Firstly, I would suffer with blackouts with no warning. I was referred to a cardiologist to have a loop recorder fitted into my chest cavity to record my heart symptoms as they thought I had a heart problem. The findings revealed that my heart was completely fine. I then went on to continue having blackouts with seizures. Then things changed direction.

I paid privately to see a neurologist. I went through years of investigations with far too many admissions to hospital with multiple EEGs to find the root cause of my seizures. In 2014 I was given a diagnosis of temporal lobe epilepsy. My life changed dramatically. I was prescribed lots of medication with horrendous side effects. I gave up work, stopped driving and was isolated at home for 18 months. This is unbelievably difficult to say, but looking back, my life was over. The brain injury was diagnosed as epilepsy. It revealed that my left hippocampus was severely distorted in comparison to the right hippocampus although we know the brain is not symmetrical. There was evidence that there were abnormalities within

the brain more so to the hippocampus. There are reasons why the hippocampus can be smaller and distorted in shape and size. I am yet to find out the cause of this. I remember asking my neurologist, could this be the cause of any domestic abuse or sexual violence I've experienced in my life? They were not forthcoming in this question, unfortunately, so I still have many unanswered questions. A very difficult place to be and and also the description there of of getting a diagnosis and then the treatment I mean how how difficult can it be to to get a diagnosis Steffi? I think that would be best answered. So I think one of the complexities around diagnosis of brain injury is that the symptoms very much overlap with other physical and mental health conditions. So, for example, women might report that they're very fatigued or that they struggle to concentrate or organise themselves.

And those are also symptoms that we see with post-traumatic stress. So we know that from all the professionals that we spoke to that many people don't really consider brain injury in the context of domestic abuse so when women are presenting to their GP or other health professionals they're reporting these symptoms and brain injury isn't really being considered and so sometimes their symptoms might be being attributed to other things like mental health problems. So I think that's one of the issues. The other difficulty is that Steffi alluded to this earlier, is that if you have had a serious blow to the head, you've had maybe a brief loss of consciousness, but you recover, you get on with your day to day life. If say weeks or months later, you're then experiencing symptoms like memory difficulties

for example you don't necessarily link it back to that injury and so then when you go to your health professional it's hard to give a clear account so that's why at brain kind we're really clear that we need to raise awareness of brain injury in this context and do you think just having heard about the symptoms then or rather the side effects of the medication, that could also this morning put people off? Not all treatments for brain injury require medication. So there might be psychological therapies or rehabilitation therapies that might be helpful. It's not always medication that's required.

Let's just have a listen about Faith's experience of getting medical treatment. It's almost impossible to seek medical checks when going through abuse of any kind, as the perpetrator will control everything that is happening to you. Even going to the GP, if you get the chance, they will speak for you. In my case, they did. I was told by my perpetrator I was making things up in my head and that I was completely fine. On occasions, my visits were to the hospital. Not once was I asked what was going on in my marriage. This was over a period of 20 years where I would end up in A&E departments with an array of injuries. There were too many missed opportunities.

That's something that I know, Stephanie, you want to say something about, don't you, in the sense of how hard it can be to seek help? Absolutely. And I know for lots of people who are listening that might be experiencing domestic abuse, the idea of going to a medical professional doesn't feel like the safest option right now. And we fully recognise that. And I think what's important is that it's not going to be a one-size-fits-all not everyone is going to be ready right now to have those conversations when they need to but it's just about empowering people to have that information to know that if these things are happening this is something that they can look out for and when they feel ready to be able

to speak to a professional whoever that is whether that's a GP, domestic abuse support worker, an IDVA, that they know to mention the head injuries and being held in a way that they can't breathe. But we know it's difficult for people to access support and people are incredibly vulnerable by the situation of domestic abuse. But we really just want to empower people with what we found today and hopefully. I mean, it's a small study we should say 60 women in it and in terms of when people say how representative of that we talked about how we could be looking at a situation now with um you know the idea of up up to one in two survivors may be living with an undiagnosed brain injury but what would you say to that about representation we fully acknowledge it's a small sample but these people had a very broad range

of experiences from very different backgrounds. Ages ranged from 18 to 72. People were at very different stages of their domestic abuse journey. But what we found is that our results actually match a lot of international studies done with similar sample sizes. So what we're seeing is a really universal experience in terms of domestic abuse, terms of injuries to the head neck or face being held in a way that you can't breathe and the differences across the world are around our social structures in terms of health care and how we support people so yes it's a small sample and we fully acknowledge that there needs to be more research but we're really proud that brain kind of taken this step and acknowledge that that domestic abuse needs to be looked at in the context of brain injury.

And as a doctor, Anne-Marie, do you feel that because of what we were saying before about this nuance about when you might go to a health care professional, when it's safe to, might be a significant delay between the actual situation that put you at risk and where the violence happened and then going to see a doctor. Do you think that doctors also need to be made more aware of that gap and how that works? Absolutely. We've met with a lot of professionals across all different professional backgrounds in the course of this study. And nearly everyone has said we don't have enough awareness of brain injury and how to ask those questions. So I think given that we know these people are very vulnerable, that it's difficult for them to get to a doctor, it's so important that when they do get to that doctor, or they do get to that healthcare professional, the right questions to ask. And that's something

at BrainCime we're looking to doing is putting together kind of a resource pack for professionals that will guide them as to the sorts of questions they might want to ask. Thank you to both of you for coming in today. Steffi Bechelet there, Dr Anne-Marie Burns. I should say, if you're affected by anything that we've been discussing, there are links to support organisations on our website. But you've also been getting in touch while listening to this about exhaustion. Do you ever feel weary or depleted or plain just exhausted?

My next guest is the cultural historian and coach, Anna Schaffner, who knows these feelings all too well, but argues that they're present in every generation, despite every age thinking that they are the most tired. She's now a coach specialising in helping the exhausted. In her previous life as an academic, a professor of cultural history at the University of Kent, she suffered from burnout.

She's now written a book, Exhausted, an A to Z for the weary. Good morning. Good morning. Thank you for having me on the programme. Well, thank you for coming. And I should say we've been getting some very interesting messages from our listeners about exhaustion and how they start to deal with it and how they try to cope with it. But I did mention right at the start that there's a difference between exhaustion and burnout. Could you define that for us? Yes, I would say that exhaustion is a spectrum and burnout is at the extreme end of that spectrum. So when we suffer from proper burnout, we can often no longer function at work, we have to stop working completely. A lot of my clients actually have to give up the professions in the course of which they suffered that chronic stress and exhaustion. And burnout really means

that your body says, no, you can no longer function. Whereas exhaustion can allow us to, we can be exhausted in such a way that we can, what is called burn on, we can continue with very low energy reserves, but we can continue to function. So burnout is a diagnosis with very specific symptoms, and they include chronic fatigue that isn't curable by resting, and depersonalization, so a cynical attitude towards the institutions or people with whom we work, and also a sense of reduced efficacy that we can't really manage our workload anymore. And do you think, I mean, there have been numerous articles and studies about this, but the idea that it's worse than ever, that we're

living in an age of, you know, because of technology, because of the way we're structured, it is the very worst it's been? Or is that something that you've seen when you've looked back? Yeah, so I would say, I don't want to minimize the factors that cause our exhaustion today at all. There are very real reasons why we feel exhausted. And they include that we're constantly switched on because of new communication technologies. They include the psychosocial consequences of competitive capitalism. And we also live in very dark times.

We worry about climate change, political polarization, and so on. But I have also found that humans have always worried about exhaustion. So we can trace back concerns about the loss of our strengths and energy and speculations about its causes all the way to ancient China. We are not alone in worrying about the waning of our energy. And I find that consoling. And I do think that realizing that our energies are limited is also what makes us human. And I think we tend to have a nostalgic conception of the past. We always think that the

grass was greener on the other side of history and that our times and special challenges are the most wearying and difficult ever. But people have always thought that, you know, and for example, while we worry rightly so about climate change, people during the Cold War period had to live with the very real possibility of total nuclear war. So I think every people, every era struggles with its unique challenges. Yes, and also, you know know I was reading out what about the children and the words of the year I don't know if you heard me say that but the idea of what's in children's minds can be quite indicative as well of the time that we're in. What happened

to you because I mentioned that you you came to this by your own experience? Yeah so I actually realized at some point that I was becoming very, not just exhausted, but also irritable, bitter, I felt very sorry for myself. I just didn't enjoy work anymore. working environment. And I really noticed that, you know, that impacted on my whole being. And that, you know, the suffering at work sucked all the joy out of my life. And I think that's a very common experience, because we tend to overvalue work. Work holds a very, very special, dominant position in our emotional and social lives. And when we suffer at work, that suffering bleeds into all aspects of our life. And when I realized that, I sort of slowly started to prepare for an exit. And I also knew, luckily, I knew what I really wanted to do and what gave me joy and what made me feel alive. And I think that's also very important when we suffer

from exhaustion to remember what it was that made us feel good in the pre-exhausted time. But do you think you can come through that exhaustion rather than leaving? Yeah, that depends very much on people's circumstances. So I do think, you know, our exhaustion has both outer and inner causes. And outer causes can include toxic working environments, you know, where workloads are too high, where we have bad managers, a lack of community, you know, no boundaries, where we haven't always on culture and where we feel underappreciated. But they're also, you know, structural causes of our exhaustion that we, you that we live in competitive, individualistic times where we always have to achieve and be productive and we that we tend to internalize and they're

anchored in religious thought. And I think just existing in a modern world can feel exhausting, you know, with the kind of pessimistic outlook for the futures and the overwhelming complexity with which we battle. But we can also be exhausted because of inner causes, including perfectionism or a hyperactive inner critic, you know, an inner voice that drags everything we do into the mud and that berates us and judges us. And, you know, that's almost like a form of self-bullying that uses up our energy from within. And you said you knew what you wanted to do. I mean, you've got, did you know you wanted to be a burnout coach before you burned out or you burned out and then you realised you wanted to be a coach?

Which way does that come? Yeah, no, I realised that I've always been very interested in psychology and I wanted to help other people who are going through similar experiences. And I think, you know, the idea of becoming a coach became ever stronger and clearer in my mind when I, you know, got coaching myself and that my experiences and my insights into the longer history of exhaustion and its causes could be of help. Yes. I mean, there are just so many people, though, who are so terribly exhausted and obviously could never go for a coach,

can't leave where they were. You know, they're sort of in what they're in and there is no room for manoeuvre whatsoever. And I think that's why I turn to the bit of your book about hobbies and joy, because there can always be perhaps some room to find some space. You know, I'm very struck by a message that we've received around caring today. And there's a message saying, I care for my 97 year old mother at my home. I have no help. I also help my friend that has cerebral palsy, who has cerebral palsy rather,

as she can't get enough paid workers and helpers to cover the support she needs. I sometimes feel at breaking point my relief is doing jigsaw puzzles to just sit when I can forget everything but the puzzle. And I wanted to read that one out because of, you know, where there is little room for manoeuvre, there are other things that perhaps you can bring. Yes, absolutely. That's a beautiful example. And I just wanted to say that carer syndrome is very real. So often people who care for others are in great danger of neglecting their their own needs and um not being able to to take care of of their um you know what they need anymore so and hair syndrome is very real and you also talk about

parenting but if i may just very briefly on that point because you make a very good delineation in the book between the industry of self-care so the idea of getting yourself back up so you can do the things that you need to do and joy and hobbies. There's a difference, isn't there? Yes, absolutely. Because I do think when we're exhausted, when we lack energy, when we experience an energy deficit, we tend to reduce down our activities. We tend to cut activities out of our lives and our lives shrink our horizon of experiences becomes ever smaller and that is is kind of intuitive that we want to avoid expanding energy but it's also very dangerous because we cut out what has the potential to re-energize us to nourish us an example of doing jigsaw puzzles is very beautiful because I do think that when we are in that state, we need to do things for our soul, for ourselves that are purely joy-giving, that just serve the function

of making us feel alive, of giving us some respite, of allowing us a moment of peace and joy in our lives. And hobbies are unapologetically non-instrumentalisable activities, and they can really help us to re-nourish ourselves. So, you know, rather than just cutting everything out of our lives when we feel very depleted, we need to remember what makes us feel alive and what, you know, gives us peace and joy. And we need to try to bring more of that back into our lives. Yeah there are many messages coming in another one from Anna who says I'm a hospital doctor at home not working due to severe burnout you are describing me I love my work I love looking after my patients but the conditions are so horrible it's broken me I've gone back to riding horses, which I haven't done for many, many years. It's only once a month or so, but it gives me real joy. our idealistic expectations, and then what happens on the ground.

And when that gap between real and ideal becomes too big, this is also when we burn out. And that can happen in numerous scenarios. That can also happen with parenting. We're nowadays very, very influenced by high parenting ideals, and we have extremely high expectations and standards for parenting, which is a good thing. But these ideas can also become oppressive. And when we then feel we fall short of these ideals, we may experience quite a lot of shame and guilt.

A lot there. I was going to say, not that it's, of course, only women who are parenting, but how how does this impact women in particular the exhaustion point but perhaps you've started to to get there is there anything else you wanted to say about women in specific specifically yes i would say that um you know it is very well known that we perform more what is called emotional labor and unfortunately also still much more um household chores but i have also noticed the issue of mental load, you know, because often women tend to do a lot of planning. They tend to do a lot of, you know, tactical work. Oh, don't. Planning. Getting kids here and there. I'm on planning strike at the moment. I really am.

I just know I am. You know, everybody comes to me for an idea or what to do. I'm just that person. And also I have to just put certain, you know, WhatsApp messages to one side for a few days. I have to take a break each time from it because there are the people who plan and then there are the people who are planned for.

Yes, absolutely. And planning takes energy. And I think we tend to underestimate it because it doesn't seem like we're doing anything big and important. You know, it's just the daily tactical stuff that really takes our attention and that um has an impressively high mental load so when you notice um when you don't plan you notice just the toll that it takes on you and the mental capacity that can be freed up if you stop that kind of shepherding, quarreling, transportation planning and so on that can be incredibly exhausting.

Of course and a lot of women will relate to that I mean I think I think just to say so I do have some time to read out some of the messages as well thank you so much Anna Schaffner but I think you know you say this towards the end of the book and you made the point here around and the book's called Exhausted and A to Z for the Weary by Anna Shafna who you've been listening to um you talk you talk about harking back to a previous time when things were better I regularly say to myself how happy I am to be a woman today in this country um and not least with online grocery shopping because that is something that when you talk as a planner, they've just thought of it because someone's messaged in about the food shop, that it isn't always left to the women. I know that it's not.

But if it is on your list, on your particular list, you'll know what I'm talking about. I actually think regularly, be grateful for being a woman in this country today rather than many years before because of washing machines and all sorts of things. Anna Schaffner, thank you very much. And the ability to have jobs like this. And, you know, Annie Nightingale, we were thinking about her legacy and remembering on the programme yesterday. And we talked of husband substitutes. That's what we needed to be on the radio. So women weren't on the radio for so long. Never mind all of that. It was not better before in so many ways. Danielle from Birmingham's message to say, I was exhausted

working 12 plus hours a day for years as a teacher, but it was not until I became a first time mother, breastfeeding around the clock and then back at work full time that I burnt out. I quite literally collapsed as I attempted to do the food shop. I left the profession I once loved and I loved in order to have a sense of well-being. And my heart breaks for people who do not have the freedom to take an alternative path to preserve health and wellness. A leader of a brownie unit has got in touch. Hedwig, good morning to you. Every week I spend an hour and a half helping girls. Tell them and know that they can do anything.

I watch them discover their awesomeness. They recharge my batteries with their laughter and self-discovery. They are amazing. And very many more here. Jenny actually says they're in Oxford. Exhaustion robs me of the motivation to be active and to heal that makes things impossible uh whereas jackie says here never underestimate jack excuse me the power of art of journaling and art journaling writing and

painting in a journal no one needs to see it it's just your private thoughts i very recently lost my mother-in-law i'm sorry to hear, and I journaled about her passing, about the nurses who were to me actually real-life angels and about my feelings and feeling better now. And so it goes on, we've got knitting, we've got puzzling, we've got horse riding and painting and drawing as well in the mix. Keep them coming in. When you are robbed of those levels of energy you need to not just get through your life, but enjoy your life, what do you... I'm Sarah Treleaven, 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....turn to. Now, let me talk to you about one of the things you will need if you are a parent in order to access any of that is childcare. And since January the 1st, working parents in England have been able to apply for a code to access new free childcare hours for two-year-olds, which then kicks in on April the 1st. The scheme is part of an investment in childcare announced by the government back in the spring budget last year, recognising that childcare is one of the biggest costs facing working families today. But one campaigning organisation has found that parents are facing major challenges in securing a code that you need, with just one in 10 at the moment managing it. And of those parents they surveyed, only 55% have then found a childcare setting that will accept the government's new free, in inverted commas, hours for two-year-olds. Joining me, Lauren Fabianski from the campaign group Pregnant

Then Screwed, which carried out this survey. Good morning. Good morning. Have I explained that problem? Tell us a bit more. What's going on? You have. So parents have really been counting down the days to this scheme starting. As you already mentioned, we have one of the most expensive childcare systems in the developed world, with the cost of a full-time place for two-year-olds costing on average over £14,000 a year. So for many, this is more expensive than their mortgage. But it's clear that providers haven't been given the funding, the support, or the financial information that they need from the government to deliver this scheme. And also the portals that parents have to use to facilitate the scheme are not working as they should be. We are hearing from parents who are calling the helplines that

the government have put out, the childcare support helplines, waiting three or four hours at a time and then being hung up on. They're being given inaccurate information when they get through and that means that they're all flooding to our social media channels which is where we started to see these problems asking how they can access their codes, how they can find providers that will be running the scheme. So this is a huge issue and parents are really, really scared. We're seeing that thousands of providers have closed in the last few years because of underfunding of the previous schemes that the government have run, the three to four hours, 30 hours free scheme. And this really could be the straw that breaks the camel's back. There's 34% of parents that responded to our survey

said that their preferred provider doesn't yet know if they're going to be running this new scheme, even though it's supposed to start in April. And this is because they've not been given the information that they need from the local authority about how much money they're going to get. Look Lauren, there's two issues there, isn't there? So just separating them out is whether you've been able to get the code. Yeah. Okay. And that's one issue. I haven't got the government here to respond to this per se. I've got a statement I'll share in just a moment. But that could just be a teething issue, perhaps at the moment. The government statement says childcare application system is working as intended. Thousands of parents are replying for and receiving codes to access new free childcare entitlements every day we are working

to ensure all parents can access their codes in time to use the new entitlements in april and confirm childcare places as soon as possible let's stick with that for one moment before we get to the providers so do you see you you see some people being able to get it but a lot of people are not just 11 of the parents that we surveyed, parents who are eligible for the scheme as well. So this is not all parents, because many parents are not even eligible for this scheme. But just 11% said that they were successfully able to get a code.

So it's frustrating to hear that the government believe that this system is working as intended. And what needs to happen? People just being able to get through to somebody and actually unplug the system? Multiple things. So what happens when many people are applying for this code is they're told that if they've been using the previous tax-free childcare scheme, that they cannot even apply for the code right now.

And many have been told that they can't apply for the code until after the deadline to provide the code to providers. So that's one issue. Another issue is that the system is complex. Many parents don't understand how it works. There could be much better comms around it. And then there are some teething technical issues, which we have heard that the government are looking into. But in the first instance, it would be very, very helpful if the support line, which is supposed to guide parents through accessing this, was staffed better so people were not waiting three or four hours at a time. And when they do get through, that they're given accurate advice, because we've heard some completely inaccurate advice being given to parents who've managed to get through to the helpline.

And then the other side of this is whether providers of childcare, whether those settings are going to accept the codes. Do we expect that to be more in place by April? I'm not as optimistic about that. So there are some providers who may be running the scheme who are not currently sure. And that's because they haven't been told by their local authority about how much money they're going to get to deliver this scheme. And until they have that information, they can't decide whether it's financially viable for them or not. What we are hearing, though, is from parents who were using providers who thought they were going to be running the scheme they found out how much money they were going to get from the government to deliver it

and now they're pulling out of not just this new scheme but all existing schemes as well and they're no longer going to be running any government-funded child care schemes. We heard from one mother who said that this would mean that her child care bill would now increase to over two thousand pounds a month which is completely unrealistic for the majority of parents because of of not being able to use this code or because of the cost of child care and which providers are choosing to be part of the government schemes and not both so she won't be able to use this code for her two-year-old she won't be able to use this code for her two-year-old. She won't be able to use her code for a three-year-old because they're pulling out of all government schemes. And then as a result of that, she will have to fall into paying full price

in one of the most expensive childcare systems in the world. Important questions for those that we deem to be in charge of our money. I hope to be able to put some of them. We are into an election cycle, as it were. We don't yet know the date of it, but people certainly know the date of a new tax year and are trying to get access to codes where they're eligible. Thank you very much for talking to us,

bringing us to our attention today. Lauren Fabianski, the policy to the reality for some parents at the moment. We'll keep with that story. And as I say, I shared with you the Department for Education's statement. Now, I did ask about if you felt brilliant and beautiful and sexy in a photo shoot

and then you found out it was banned, how might you feel when there's still similarly beautiful and sexy photo shoots of others in a similar place still on billboards, buses and wherever else? Because last week, the Advertising Standards Authority banned a Calvin Klein poster featuring the singer FKA Twigs. place still on billboards buses and wherever else because last week the advertising standards authority banned a calvin klein poster featuring the singer fka twigs it first appeared in april

last year on the grounds that it presented her as a stereotypical sexual object i quote in it if you haven't seen it and on the magic of radio i'm going to try and describe this she wears a shirt drawn halfway around her body to show the side of her bottom and half of her breast. And the Advertising Standards Authority said the poster advertised the denim shirt, but the image's composition placed viewers' focus on the model's body rather than the clothing being advertised and that it was overtly sexual. She did not like this response and she posted on Instagram saying, I do not see the stereotypical sexual object that they have labelled me. I see a beautiful, strong woman of colour whose incredible body has overcome more pain than you can imagine.

On that last point, she's referring to allegations of domestic abuse at the hands of her former partner, the actor Shia LaBeouf. Allegations he's always denied, and I should say, is subject to an ongoing legal process. But she also pointed towards a double standard that's taking place, and others have pointed this out, not least the actor Jeremy Allen White's provocative underwear campaign for Calvin Klein, same company. Many women swooning about that.

You may have seen it. You may know exactly what I'm talking about. Some people said he broke the internet, that phrase that is deployed. And two other images of Kendall Jenner, again for Calvin Klein, which the same body said was also sexualised, the ASA that is deployed. And of two other images of Kendall Jenner, again for Calvin Klein, which the same body said was also sexualized, the ASA that is, but the level of nudity was not beyond which people would expect for a lingerie ad. Right, let's keep up with that. So which advert is objectifying and when is it objectifying versus beautiful and exciting? Sarah Golding, the chief executive of the Anne Partnership and Integrated Advertising Agencies here, and Rebecca Cope, a freelance journalist

who's written about this feature of the politics of the double standard. Sarah, if I could come to you first, what do you make of the banning, right or wrong, of this particular image? Well, there's two things here. I think it's really hard for the ASA. They're trying to do a good job. They're trying to police all of the messages and images that we put out there. It's really good

that they do that so that people can trust advertising in the UK. Personally, do I think she is the sexualized object of the advert? No, I think she's the powerful subject of the advert. I think she's absolutely in control. She looks superb, strong, athletic, beautiful. Like she says herself, she's in control. You know, she helped curate that image. She worked in partnership with Calvin Klein on it. And I think the ultimate test is, as a mother mother would I worry if my 13 year old obviously a tricky age 13 seeing that image on a billboard near her school because that was also brought in yes it was read every part of yeah it was basically level of nudity for product advertised and context where it appeared and you know posters aren't as regulated as, say, you know, some press ads or TV programmes.

So, you know, ultimately, no, because I think she is looking defiantly at camera. She's saying, look at me, aren't I great? And let's not forget who she is. She's a singer and a dancer. What do you make of this, Rebecca? I agree. Um, it's extremely obvious that obviously both Jeremy Allen White and FKA Twigs knew what they were signing up for when they were doing these ads. There's a very clear brand identity for Calvin Klein in terms of, you know, nothing gets between me and my Calvins. And I think on the one hand...

Other underwear brands are available. On the one hand, having, you know, Jeremy Allen White stripping off on a Manhattan rooftop and doing pull-ups and tugging at his waistband. That not being deemed, you know, drawing the viewer's attention to his physical attributes. I think you can sort of see his pubic hair. Exactly. It's highly sexual. Exactly. I think it's strange to argue then that the FKA twigs one does cast her as this stereotypical sexual object, because you could also argue, of course, that Jeremy Allen White is.

OK, well, it seems you both agree on this, although you come from different backgrounds on this. It'll fall to me to play ASA and perhaps other roles. No, but just to say, you know, the context, again, of women versus men and who has the power in society and how we look is something I know you've written about. So what do you say to that? Yes. And I think, obviously, there are hundreds of years of sexism and discrimination behind these kind of objectifying of women. And there's always that threat of violence there. And I can understand why someone like the ASA is keen to kind of, you know, protect women from this sort of thing. But as FKA Twigs herself said, you know, she felt empowered by it. So who are we to kind of argue or anyone to argue that she is being objectified? Because that, you know, the very definition of objectification is that it's degrading and I think minimizing her role in that and the agency over her body but saying that Jeremy Allen White is you know it's just a fun yes chef uh you know moment for him to sort of

you know cavort in his pants is fine but I suppose how a model feels who is presumably being paid handsomely or how a singer feels in this and then how it comes across are two different things you know and within adverts so you have to think about that, don't you? You know, the poster doesn't speak, Instagram might. And, you know, it being near a school and all of that, you know, not just to do with women and men, but how it comes across and what it can't say beyond is what the ASA is, I suppose, trying to grapple with. Yeah. And I think it's really important that they do grapple with this stuff. But you both think they've come out wrong? Personally, yes.

But, you know, as you said, context is everything. And, you know, it's not just ads for lingerie, it's ads for gambling, smoking, alcohol. Thinking about where ads are placed, really important for the advertising industry. I think the advertising industry takes that duty of care very seriously. You know, there are...

Does it? Yeah, there's a whole industry of research. Well, it looks like it does. No, it doesn't. But there are still adverts for... I mean, you're from the ad industry, but there are still adverts for all of those things placed often where children can see,

in the middle of, you know, things that are family events sometimes, even if they've been couched within couched within couched? Listen, I believe, and having worked in the industry for 20 years, that the industry takes it very seriously. I do think they do think about context. I think there's a lot of due diligence, duty of care. There's a whole research industry out there talking to the public consumers

all of the time to understand how they feel about things images messages also as an industry we have got probably the best gender balance of any creative industry in probably any industry in the UK between men and women therefore whenever an ad is created the images and the messaging is absolutely looked at looked at again and again by as many women as men. Women can get things terribly wrong. No. I could give you a list of them. But that will be something I do whenever the final show are for me presenting this time. So let's start get to that now. And what is also happening, some may say, Rebecca, and I know you've looked at this, is a race to the bottom. So the idea of the sexualisation of men now being equal to women,

to celebrate that, to talk about that, because you've talked a bit about the idea of a male thirst trap. Let's, first of all, define that. And secondly, you know, there have been some, you've obviously been talking about a particular male actor model here, who've had the experience of them being asked questions at press conferences and on the red carpet just about their bodies. And you can do well now you know how it feels but is that really where we should be going exactly do two wrongs make a right um i do find it interesting and i watched that entire

golden globes um press conference with jeremy allen white after winning for the bear and i was really struck by how strange it was that three questions in a row all reference number one, the Calvin Klein ads, and then two of them directly sort of said to him, how does it feel that everybody in here and on the red carpet is just thinking about you in your pants? And were a woman to be asked that, obviously, you know, it would be really shocking. And you can see that he's visibly uncomfortable with the questioning, but I think he probably knows that he can't really uh argue very much because of the fact that you know people do get upset if men speak out about you know feeling objectified um there's been various cases

he feels he can't argue because he stripped off to very little on the top of the rooftop and got handsomely for it 100 just saying what i'm actually thinking yeah i mean yeah um but of course i think the other point of view is that there's a time and a place for talking about that and i suppose for him you know it's like a a pivotal moment in his career his second globe yeah um so to then you know he and he's very careful to say oh you know i'm proud of both things but you know it's not that's not what he's there to talk about and then and the thirst trap so I mean that's more to do with uh the reaction on social media of people saying things like what a wonderful day to have eyeballs and and stuff like that and it being uh you know it's okay for us to react like that to

you know a sexy man um but you know would it be okay for us to react like that to, you know, a sexy man. But, you know, would it be okay if we reacted like that to a sexy woman? I don't know that we would. So the thing is, when there are those reactions, we police them when it's of women now in some ways, but we don't of men. So do you come out feeling, I don't know, pessimistic about that situation? Or where do you come out? I think it sort of

puts us in a funny state of where feminism is that I suppose in terms of you know if you're empowered by your body um why you're not allowed to share it and also the kind of implication that a woman's body is you know dangerously sexual or That kind of implication is, I think, slightly unfair and maybe backwards thinking too. We've walked such a long way though, haven't we? Although one of the Kardashians was allowed, Jenna here, to carry on in her particular textos. So it's not just men and women, is it?

And I think on the point with Kendall, Jenna as well, I think what's really interesting is that I wonder if that advert, which ostensibly is for underwear, gets away with it from the essay. That was the reason, wasn't it? It was for underwear and she's showing less bottom and breast. Because she's a stereotypical model physique, right? Whereas FKA Twigs isn't a model. She's a singer and she's got more of a kind of curvaceous body

and therefore a curvaceous body is more dangerous. Kendall's still in control. She's looking at camera. She's the subject of the advert, not the sexualised object. And I think, you know, today's, I think, Kate Moss's 50th birthday. If you think back to her ads for Calvin Klein in the 90s, in the 90s when she was wrapped around Mark Wahlberg's body, you know, it was playing on her innocence. And she talked, didn't she, on Desert Island

Discs about how uncomfortable she felt about that shoot, how she was embarrassed, how she felt she was objectified in the advertising campaign. And if you look at that image, compared to the images of FKA Twigs, and Kendall Jenner, they're totally different. The power has shifted. Your view of that. A message here says, how depressing that now this kind of advertising is being, now that it's being properly policed in favour of women, we are confusing the argument. There is a huge gap between how strong or empowered the model might feel and how it lands, especially with male viewers, it is still an invitation to objectify. Reads a message that, as I say, no name on that, but an interesting response to your discussion.

Thank you very much to both of you for coming on today. Thank you. Sarah Golding and Rebecca Cope there. I read you out a range of the responses to do with why the ASA, the Advertising Standards Association, made its decision. And a statement from Calvin Klein said, in our view, the ads did not overly sexualise Kendall Jenner or FKA twigs and are not irresponsible. Both, they say, have collaborated with Calvin Klein

to produce the images and approved them before publication. And there you go, there was also, they say, interviews alongside to give more context about how they felt about it. But of course, getting more publicity for Calvin Klein and dare I say, doing very well at advertising at the same time, which I'm not going to fall into here. No, I'm not. Let me tell you about something as I start to end the programme that I promised you. How would you feel if you woke up one morning and found that Taylor Swift had been wearing your dress? Well, not quite your dress, but one you had created. The Scottish fashion designer, Jade Robertson,

had that experience. The founder and creative director of the fashion brand Little Lies found out that Taylor Swift had been photographed in one of her dresses. And I'm sure the next 24 hours and perhaps ever since have been quite interesting. Jade, hello. Morning.

What did you find out? What was she wearing? Where was she? Tell us more. So she had been out for dinner with blake lively zoe kravitz in new york and the next morning we yeah just casual we woke up to um uh one of our design team her brother is a mega taylor swift fan and he had seen on twitter this image and instantly recognized the dress sent it to us and was like no way like is this yours

and yeah did some digging realized it was ours and was like, no way, like, is this yours? And yeah, did some digging, realised it was ours. And the, yeah, the internet went wild. You've been breaking the internet as well as an actor showing his pubic hair. It's all going wrong this morning. All right, depending on who you are. How much is the dress? Key information or how much was it? £58.

£58. Excellent bargain. Can't get it anymore though, can you? Well, we've had it on pre-order um but we're about to close that now so yeah it's gone it's gone a little bit wild but the taylor swift effect did she buy it herself she did yeah we didn't know um so it's not been like a press or gifting situation we've not sent it to a stylist we've not been you know posting stuff out in the hope that it would happen. She literally just placed an order under the radar and wore it.

So you went back. Did you have a little look on the system and see who'd ordered it? Does she have a great, come on, is there a pseudonym like Pocahontas? What's going on? There absolutely is. I won't reveal it just in case, but yes, there definitely is. How do you feel about it? I don't know if you're a so-called Swifty. So I'm a lot more of a kind of 70s rock and roll kind of gal, but I can absolutely appreciate Taylor Swift. I love what she stands for. All of her kind of values are very much aligned with mine and the brand's.

So, yeah, I mean, she's like the most famous person in the world right now. So of all the people to wear it, she is the absolute best. Jay, I know I don't know. I was justay and i know i know i don't know i was just gonna say i know i don't know you but i love the fact you're like well i'm not actually a fan but it's great that she's my fan but yeah well yeah you have to just ride the wave i i just think you know especially with with a scottish accent you can deliver that better than anyone else just keeping it real um is it is it something now though like with can you see with the with the website traffic with all of that stuff that you're

getting a whole load of other people yeah it's gone absolutely wild absolutely bonkers how are you gonna are you gonna you know do anything with that what do you do next when you're in that situation right now we're kind of in the midst of processing everything so you know answering customer service questions and answering the phone to press because it seems it's gone so wild I think just because it's such an affordable dress and people are so pleased it's like a little bit of positive news you know that somebody so famous has bought something so affordable and from an independent brand so the press the internet has gone crazy so we're kind of just wading through dealing with that at the minute. Maybe next week we'll calm down

and figure out what to do next. Have you got the dress? Personally, no. I didn't even manage to get one. Next you're going to tell me you don't even like the dress. Never mind Taylor Swift. I love the dress.

Well, there you go. We've been talking throughout the programme about how you deal with energy levels and exhaustion and you've certainly given us, I'm sure this has certainly woken you go. We've been talking throughout the programme about how you deal with energy levels and exhaustion. And you've certainly given us, I'm sure this has certainly woken you up. Absolutely. Yeah, definitely. Hopefully I won't have to speak to your burnout coach anytime soon. No, I hope you don't either. Have you got a hobby to take you away from all of this? 70s music and running after my toddler. OK, those can count. I recently met someone who's the second best air guitarist in the world.

So I didn't know that was a thing. But, you know, for rock. Yeah, that's a talk to your hobby. All the best with that. Jade Robinson, thank you so much for talking to us. The founder and creative director of the fashion brand Little Lies. Just talking about what you do, giving yourself energy. Carrie says, I used to be a full

time nurse i'd regularly come home feeling uh you know down but also exhausted i would pick up my guitar staying with the music here and bang out a few tunes sing at the top of my voice i fortunately lived in a detached cottage and i would pretend i was amy winehouse lily allen and liam gallagher etc i didn't sound like any of the above, but this cheered me up no end. And I would go to bed feeling lifted and uplifted. I'm sure some of you could also relate to that. A lot of you've been thinking about different things. Another one here saying, I took my children ice skating at our temporary ice skating rink two years ago.

I had a go and was wobbly. Last year, I improved and really got into it. It's such fun simply gliding around and doing the odd twirl. And this year, I couldn't wait for the rink to arrive and sometimes went on my own whilst the children were at school. I'm 53 and next year I'm going to get my own skate and maybe have a lesson.

Yes, you should. Lovely messages. I'll be back with you tomorrow. Thank you for your company. Back tomorrow at 10. That's all for today's Woman's Hour. Thank you so much for your time. Join us again for the next one. I'm John Ronson and I'm back with season two of Things Fell Apart,

my show for BBC Radio 4 that unearths the origin stories of the culture wars. This time around, the stories are all about the battlefronts that engulfed us during lockdown. The stories twist and turn until each one ends with the explosion of a new, far-reaching culture war. If you tell me that my nephew had superhuman strength, if you tell me that he didn't feel any pain, well, he's dead now. That's Things Fell Apart, Season 2. Listen on BBC Sounds. I'm Sarah Treleaven, 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.