Woman's Hour - Hormonal contraception, Ghost children, Narcissism, Mabel Constanduros

Episode Date: March 23, 2023

Taking any type of hormonal contraception could increase your risk of getting breast cancer, according to a new study by the Cancer Epidemiology Unit at Oxford Population Health, which is part of the University of Oxford. It’s one of the first big studies into this type of birth control assessing the risk of breast cancer. But headlines like this will be alarming, so, what do we need to know and do? Dr Charlotte Porter, Vice President of Speciality at the Faculty of Sexual and Reproductive Health and Karis Betts, Senior Health Information Manager at Cancer Research UK talk to Anita.More than 140,000 schoolchildren in England were officially "severely absent" in the summer term of 2022, according to official Department of Education figures, and the number of these pupils, missing at least 50% of classes, is growing. So what can be done about it, and how can the individual contributions of headteachers and teachers make a difference? Anita is joined by Caroline Walker a headteacher in Barrow and Alice Wilcock, Head of Education for The Centre for Social Justice.What are the traits of a narcissistic mother? In the second of a Woman's Hour series, 'Narcissistic Mothers,' reporter Ena Miller meets 'Louise' and talks to her about her late mother. Louise's sister 'Charlotte' thinks their mother was a narcissist, but 'Louise' isn't so sure.Mabel Constanduros was a trailblazing female broadcaster and comedian on BBC Radio in the early days of the corporation. She created the sitcom as a genre and brought soap operas to the UK. So why has history forgotten her? Anita Rani speaks to Mabel’s great-great nephew Jack Shillito and the academic Jennifer Purcell.Presenter: Anita Rani Studio manager: Duncan Hannant

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 Anita Rani and welcome to Woman's Hour from BBC Radio 4. Good morning, welcome to the programme. We were contacted by a listener, Jack Shillitoe, who wanted to tell us about a family member he discovered whilst digging around in his history during lockdown. His great-great-auntie Mabel, who, as it turns out, here's the Woman's Hour connection,

worked here at the BBC in the 1920s and was quite a trailblazer. Well, we'll be hearing about Mabel later in the programme. But I'd also like to hear from you this morning. Have you unearthed any interesting characters from your own family tree? Was there anyone intrepid or a rule breaker, a game changer, someone who did things a little differently? Or maybe you discovered something about a family member you had no idea about.

Any poets, artists or spies, any scoundrels, rapscallions of persons of ill repute or the pioneers, innovators or campaigners in your family. Tell me all about them. You can get in touch in the usual way, the text number 84844. You can contact us via social media. It's at BBC Woman's Hour. You can email us through the website,

or you can WhatsApp or voice note me on 03700 100 444. I discovered whilst making my Who Do You Think You Are that my maternal grandfather had written a memoir and his writing was beautiful, thoughtful and poetic, which was quite remarkable for an Indian man or indeed any man of the World War II generation. And as you can imagine, it absolutely delighted me. So tell me about the remarkable people from your own family tree. That text number once again, 84844. Also on the programme, we'll be discussing ghost children, the children who are severely absent from school,

meaning they're spending more time out of school than in it. The figures have shot up post-pandemic. We'll look into why this is happening and what can be done about it. Plus, the second part of our series about narcissistic mothers. A narcissist, for clarification, is an extremely self-centered person with an over-inflated sense of self-importance, often at the expense and the needs of others. So if you can relate to or have an opinion on anything you hear on the program, let us know. We actively encourage audience participation. That text number once again 84844. But first taking any type of hormonal contraception

could increase your risk of getting breast cancer. That's according to a new study by the cancer epidemiology unit at Oxford Population Health which is part of the University of Oxford. It's one of the first big studies into this type of birth control assessing the risk of breast cancer and it's found that being on the pro-estrogen only pill for five years increases a woman's chance of developing breast cancer by 20 to 30 percent the study also found an increased risk with non-oral hormonal contraceptives such as an implant headlines like this will be alarming so what do we need to do well to help us um get some perspective on what these figures actually mean and to talk us through it our Dr Charlotte Porter

Vice President of Speciality at the Faculty of Sexual and Reproductive Health and Caris Bess Senior Health Information Manager at Cancer Research UK welcome to the program to both of you Charlotte I'm going to come to you first if if I may. First of all, we're talking here about hormonal contraception. What does that mean? So hormonal contraception are hormones, oestrogen and progestogen, that we use in synthetic form to switch off the menstrual cycle and to prevent ovulation or, and thus pregnancy. So there are a variety of different methods. We have pills, we have patches, we have rings that contain oestrogen and progestogen. And we have pills, we have injections, we have implants, and we have hormonal coils,

so devices that go inside the uterus that work as progestogens only to prevent contraception. And I think the third thing is don't panic. Contraception by and large is safe. The progestogen-only pill is deemed so safe that it's available over the counter. And there are not many medicines which are available like that over the counter. So I think overall, this is safe. It prevents pregnancy. And the risks in terms of pregnancy are greater than the risks of taking contraception. However, for some groups of women, it may be sensible to discuss with your doctor if you have a family

history of breast cancer, or you're a carrier of a gene that increases your risk it's sensible to think about non-hormonal methods but by and large they don't confer the same benefits in terms of things like improved skin possibly improved mood and particularly menstrual control which is really important for us particularly in workplaces and i think that being able to be in charge of your menstruation is really important and we shouldn't throw away the baby with the bath water um if anyone's listening to this and they have felt alarmed you know what i've just told you about and the increased risk of breast cancer if you have a question get in touch with me 84844 and i can i can put them to charlotte and caris um and um and we'll see what what their thoughts are uh 84844 is the number to

text caris i'm going to bring you in let's get into the figures because they are alarming they sound alarming don't they developed an increased um woman's chance of developing breast cancer by 20 to 30 percent by taking the the pill what what are the figures let's get into these figures how many people actually actually get cancer from their contraception yeah so that's that's the the scary thing sometimes about numbers is they can make things look really big but when we put them in in proportion things aren't as bad as they might initially seem so kind of studies that we have on on combined pill, that about 400 cases of breast cancer a year caused by the combined pill. And to put that into perspective, 4,400 cases of

breast cancer are caused every year by alcohol. So if people are worried about their cancer risk, and they want to cut down, there are much kind of easier changes they can make in their daily life, like cutting back, maybe don't have that second glass of wine on Friday night and changes like that. They stack up, they make a difference and they're going to be just much less disruptive to your life than changing your contraception. So so the main thing really to take away here is exactly what Charlotte said is don't panic. And this research is it hasn't kind of changed anything. We don't want anybody to change what they're doing with their contraception and the risk is small and the risk goes away after

you stop using contraception so once you stop using the hormonal pill or coil whether it's oestrogen and progesterone the combined pill whether it's the the mini pill pressure only after you stop taking it, your risk starts to go back down. And it depends, obviously, on the person, on the type they're using, how long they've used it for. But after about 10 years, we know with the combined pill, your risk returns back down to what it would have been if you'd never taken any sort of contraception. Charlotte, the reason this study is being done is because of the rise in people taking the Prostagen-only pill in in recent years why has that come about? I think it's partly

because we have some newer contraceptive methods and it's partly about a change in choices and a promotion of long-acting methods which have lower failure rates in terms of preventing pregnancy than the daily methods. Having said that, more than 60% of women in the UK still choose to use pills. And, you know, I think that although I'm probably a little bit old fashioned as a family planner, I've been around as all men for a while and I've used contraception. I think it is always a bit of a balance you know your you you take something that will have some small effects potentially on your mood on your skin on your weight but it's about the reason that we're taking medication is to prevent pregnancy

and so that we have control over our fertility. The three things you mentioned there, because we had a chat about this in the office this morning, and everyone who had taken the pill said, yep, we discussed with our GP mood, skin, weight, but cancer just didn't come up in the conversation. So is it for us to be bringing this up with our GPs? No, I think we have a responsibility as clinicians to talk about risks and benefits.

And I think we think very clearly about medical risk in terms of the combined pill and oestrogen-containing methods and the worries about blood clots and potentially about raised blood pressure. I think probably, and I've done contraception for a while, we don't see very many women with cancer. And I think probably, therefore, you know, I've done contraception for a while, we don't see very many women with cancer. And I think probably, therefore, as clinicians, it doesn't leap into our minds as something which is a particular worry. And there's a very small increase for women, for younger women in their

kind of 20s and early 30s. The increase in risk around 18 eight in a hundred eight and a hundred thousand and that is statistically speaking a very small risk that your risk of breast cancer is far more likely to be influenced by your alcohol intake or your weight than it is um by your contraception and i don't want to go about about maternal mortality but you know the risk this is the right place to do it the risk of dying relating to pregnancy in the uk is something that again we don't really think about but the risk is from dying from the pill is far lower than it is from dying from a pregnancy. So that perhaps feels a little bit third world in terms of that's really not what we're thinking about. We know that women who take contraception or hormonal contraception,

they are no more likely to die at any age. The pill's been around now for 50 years. It's not a new medicine. The women who've never taken the pill you know this is a safe um medicine the studies about the pill have included millions of women um over the years and it probably is the most widely researched medicine that we have and to me it feels a little bit misogynistic that we have these regular scares in terms of in terms of cancer and this this scaring women away from using contraception particularly in the teeth of

a financial crisis where unintended pregnancy has even greater consequences than normal. Karis what do you think about that? Yeah I absolutely agree I think that that point that Charlotte's that's made about balance is really true. Nothing, nothing in life is all good or all bad. And we have to weigh that up. And, and we know that the contraceptive pills and hormonal contraception are very effective at preventing pregnancy. And when it comes to deciding whether or not to take contraception and what type you take, it is a very, very personal choice. And, you know, it's about what works for you, what works for, you know, the practicality of your life and how your body accepts it. And I'm sure Charlotte can talk more to that than me. And that's why, you know, cancer risk is a small part of the decision to take contraception.

It's only part of the parcel you need to have something that works for you and if people are particularly concerned they they can talk to their doctor about it their gp can give them some advice um and if if women have experienced breast cancer before the options might be slightly different so whether you've had a family history or you know if you've experienced breast cancer these results are not looking at people who have had breast cancer so the options might be slightly different there depending on what type of breast cancer you've had what type of treatment you've had if that breast cancer itself sorry was kind of um estrogen responded so talk to your doctor um if you are concerned but

but like charlotte said these these medications are safe um and and these risks are balanced so nothing nothing in life is is free nothing comes without a risk but overall we know they're really effective for preventing pregnancy and they do a lot of good um and to consider all the things that you you need to personally about what you need in your life in terms of is it something more long-term going to be better? Is something taking a pill or something every day that's easy? Is that something that you can do? Or I'm particularly forgetful, so I don't work well on the pill. So those kind of things are really important to consider.

And if you are concerned, do talk to your doctor. They do want to know. Charlotte, we've had a message in from Heather who's been in touch to say her 15-year-old daughter has just been put on progesterone-only pill to manage her endometriosis, which she's just been diagnosed with should we be worried about breast cancer as she may well be on the mini pill for life well not for life but i would hope that it will um that using her hormonal contraception will significantly improve her quality of life in terms of managing her menstruation

and should prevent progression of her endometriosis which is really important in terms of preserving fertility so I think in the in in the short to medium term it's the right thing to do I think I'm always slightly cautious about using combined contraception within 18 months of MENARC for young women and actually would regard using the progesterone method in terms of long term effects on the breast, because the risk of having breast cancer at 15 is incredibly small. The risk of breast cancer in your 20s is around one in a thousand but the risk of getting breast cancer in your 50s is around i need to go back to the things i wrote down earlier around one in 65 so it's really important that we that we sort of stratify risk and a 15-year-old is at low risk in terms of breast cancer, but at higher hopefully using this pill for her now will

reduce the chances that fertility will be problematic later on. And then she can make a decision about non-hormonal contraception before her increase in breast cancer risk becomes appropriate. So it's about trying to make decisions appropriate to different ages and looking at the whole picture. And your whole lifestyle. A single. Heather, that hopefully answered your question very thoroughly. Dr Charlotte Porter and Caris Betts, thank you very much for joining me to talk to me about that this morning.

Keep your questions and thoughts coming in on anything you're hearing on the programme. 84844 is the number to text now. The term ghost children is used to describe the pupils who've fallen out of the school system, many of them during the pandemic and after Covid. Pre-pandemic in the autumn of 2019, the number was 60,244. That has jumped post-pandemic to more than 140,000 school children in England who were officially severely absent in the summer term of 2022, according to the official Department of Education figures. And the number of these pupils missing, at least 50% of classes, is growing. So what can be done about it? And how

can the individual contributions of headteachers and teachers make a difference? Well, to discuss this, I'm joined by Caroline Walker, a headte teacher in Barrow, and Alice Wilcock, head of education for the centre-right think tank, the Centre for Social Justice, whose report, Lost and Not Found, is out today. Welcome, both of you. Alice, I'm going to come to you first to give me a proper definition of who ghost children are. What does it mean? Yeah, thank you so much. So ghost children has been used quite a lot over the last year or so.

And when people talk about ghost children, they're normally referring to two different types of children. So it's children who are severely absent. And that's the cohort of children we're talking about today. So they are children who are still in their school roles, but they are missing 50 percent or more of their time in school. That's equivalent to being off about two and a half days a week. And the Centre for Social Justice has done a lot of work looking at how many children are severely absent and what's happened post-pandemic. There's another cohort of children, and these two cohorts are linked, but they are children who are moved after, often into home education. And it's worth stating that there are a lot of children who are in home education who love it and have made that choice freely. But we are increasingly concerned about a group of children who are in home education who love it and have made that choice freely but we are increasingly concerned about a group of children who move into home

education and because they don't think their needs are being met in state schools and we've seen a massive increase in the number of children who have also been moved into home education post pandemic. Yeah I sort of read some of those figures out it seems like a big jump it's 134% the jump has been since post pandemic How did you arrive at these figures? Yeah, so it's a massive jump. And I think it's fair to say that this was an issue before the pandemic. It just was unnoticed. So when we talk about absence, we're talking about children who are severely absent here. That's missing 50% or more of time in school.

The DfE has collected data on this for quite some time, but people haven't been talking about it. So even before schools closed, it was 60,000 children who were severely absent when schools returned that number went up to nearly 100,000 and we saw that in the data but this wasn't really published on the Department of Education's website now they are publishing data and we can track what's happening term on term and what we've seen is that number has continued to climb and so some people wondered when schools reopened and things normalised, wouldn't these children just return to the classroom? But what we found is that's not happened.

In fact, disengagement has continued and absence has become a feature of school life. And now we're seeing that over 140,000 children were severely absent in summer 2022. That's the highest number on record. Before we find out what the main reasons are that you found, Alice, I'm going to bring Caroline in here. Caroline, you're a headteacher in Barrow. Do these stats surprise you? No, not at all.

I think the pandemic brought a change to the family unit and it brought a lack of routine and structure and freedom for families. So they created their own structure in the families and then when we reopened school the social contract between parents and school was completely broken the social norms were broken and people were asked to come back to school as a fear already still epidemic and and the disease and the spread of covid and we had to really really work hard to rebuild that contract with parents to give them that confidence to bring the children back in. And also families damaged by furlough, losing their jobs, and then to substance and alcohol misuse, which then completely destructed

the routine of the family. And then that routine of getting back to school was really difficult because they'd been absent for such a long time. Alice what did you find what the main reasons? Yeah I totally echo that I think one big finding is that social contract between schools and parents has been totally broken from school shutdowns and I mean the reasons behind absence are complex and multifaceted but we spoke to a lot of local authorities and charities and schools working on this space and they said that the biggest driver and post-pandemic has been an increase in anxiety and in mental health needs and some children had mental health needs before the schools closed and

then going into lockdown gave them a welcome respite but there's also a group of children who didn't have anxiety issues before the pandemic and since schools have returned they find it really difficult to go back and We also heard about children with special educational needs and whose needs weren't being met in school and or at least they won't be perceived to be met and that was a big problem because children their parents don't want to send their children into school if they don't think they're going to get the support that they need and to access education. We also heard about a group of children who during lockdown there were really complex issues going on at home so substance misuse, domestic abuse and you know caring

responsibilities and that really magnified and school was a place of sanctuary for those children and their family needed support to get them back into school and to resolve some of those issues but that just went totally unaddressed and then post pandemic the cost of living crisis has put so much pressure on parents and on their incomes and you know we're hearing about things like children who um are starving and they turn up to breakfast clubs and they find that they haven't eaten for days or children who haven't got the ability to have a hot shower before they go to school so they're not turning up because they don't want to be bullied. And also beyond that, we did shift the way that people thought about school. You know, school is largely consent based.

You do have to send your children to school, but that does rely upon getting your children out. And the routine was broken. That contract was broken. And now we're seeing children disengage from school. And when there's concerns about illness and viruses, like Strep A, for example, a lot more children just being moved out of school altogether because school has been seen as somewhat optional over the last few years. So many different factors.

Caroline, how many of your children have not come back? How many ghost children do you have at your school? So initially we had around 50% attendance returned to school we're now at 97% overall so we're doing really well but the battle of getting that up over the last year has been huge so we did see that I think we've done lots of things to increase that attendance and now we don't have any ghost children in our school. So what did you do? I think first of all understanding our families and understanding the issues and the crisis they were dealing with and trying to reintegrate them into a new school system which

wasn't a social come with their friends and meet outside the school bringing your child wearing a mask staff wearing a mask getting them used to the new risk assessments and what's offering children I think we were looking at dealing with increasing emotional demand, increasing academic demands of their children, addressing family. So what we did was we had to work with the adults in the families and bring services to them to give them the confidence and the courage to bring their children back to school

and deal with whatever issues they were dealing with. During lockdown, we were having around three to five calls from the police a week due to domestic abuse and domestic incidents in families. So it was dealing with those situations and generally getting people to have more confidence, reconnecting with them to have the confidence about them and their children.

But you're quite a remarkable headteacher though, Caroline, I would say. I've read about the bits and pieces. You're going to find out. You're going to tell the listeners. You're going to tell the listeners because you're a superhero. You actually got onto the streets, knocked on doors. You even climbed through a window of one of your pupils to get them to school.

Tell me about that. Yeah, I think during lockdown, we brought more children in. And what we found was we needed to go and get them get them in have a positive experience to take back to the family encourage them to come in every day and for some children that did mean that we out to the parents and encouraged them and one day i did go into a home where the parent had been um alcohol and was at law so i climbed through the window to um get the child access into house, to get the child out, and then get services in to help the parents get back on his feet.

So it's those kind of things. We needed to get the children through the school gates, and in general we wanted to do anything to make that a positive experience and get that routine back for our families. Is that going above and beyond the call of duty, doing that? I'm trying to imagine other teachers listening to this who may have, you know, this is an issue up and down the country, thinking, oh, is this what I have to do?

I mean, you're bringing up your own kids. You're also, you know, head of a school. You have your own form that you look after. And you're on the streets bringing children into school. It's a lot of pressure it is a huge pressure but i think and it felt we had this moral obligation to these children to get them back in and recover from that lost learning issue they were dealing with at home and also to support the adults back into some kind of functioning normality so yeah it is

above and beyond but we felt it was a need to get those structures and to get those girls back into school and in some kind of formal education and also to deal with the emotional demands that they were feeling and struggling with. Alice, we're just going to... Caroline, we're just going to sort your line out for a second because it's really important that we hear you nice and clearly,

but you're kind of cutting in and out. I'm going to come back to you, Alice, and just talk about which groups are more likely to be severely absent. Is there a gender split? What's the demographic? Yeah, absolutely. So when we look at the data, there's surprisingly not a gender split. And we were surprised about that because we heard about the drivers being anxiety and mental health.

And we know that mental health conditions are very prominent in females. But actually, if you look at the rate of severe and persistent absence is largely the same across different genders. What's different is the drivers. But one thing that we did see is that you have a much higher rate of severe absence if you are low income. So if you're eligible for free school meals, the rate of severe absence is about triple and in fact areas and schools in areas of high disadvantage are 10 times more likely to have an entire class worth of children who are severely absent and also children who are eligible for special educational needs support have much higher rates of severe absence and in particular children who have social or

emotional mental health and needs who are identified have some of the highest rates of severe absence. And so that's a massive concern for us. I would say whilst these are the groups that are most likely to be affected, it's quite a permissive issue across the school system. So one thing that we found that really shocked me was that over a thousand schools have an entire class worth of children who are severely absent. And whilst those schools are largely concentrated in areas of disadvantage and that came through time and time again we also heard about schools that weren't that disadvantaged but did still have massive problems with attendance what are your recommendations so i agree with you that caroline is remarkable and if we could have a head teacher like caroline in every single school we would and the difficulty we found is that most schools can't put that level of support in place. You know, we were saying that a lot of the schools that are worst hit are those in those disadvantaged areas.

And they are grappling with whether or not they put a teaching assistant in place to get that catch up academic support or whether to offer pastoral support. And what we heard is that there's some amazing people out there who are knocking on knocking on doors trying to find these ghost children but that is a postcode lottery and so what we're calling for is a national program of attendance mentors to support these children back into school and to support the families to get the support that they need to get their children back into education how much is that going to cost can the government afford it good question we recommend and it would cost about £80 million. And we think that funding should come from the Supporting Families programme. So it's existing funding.

The government has said that attendance is a massive priority for them. And they have started to roll out some pilots of attendance mentors, but it's really small scale. It's about one local authority with the intention to scale up. There is no way that is going to reach the 140,000 children who are severely absent. And as we're seeing, every single term that we don't act, the number of severely absent children continues to climb up. So there is funding available in the Supporting Families programme. And we think that should be, we prioritise the focus on attendance because it's become the issue of our age.

Caroline, how are you doing it? How are you affording it? I know you feel it's your responsibility. You're obviously, you know, fighting the good fight. But how do you afford to run these wraparound services? We're very fortunate that we're in a trust with another six schools who we all put our funding in, a top slice funding, and we direct the funding to what we need. So we've been able to fund a social worker family support worker and a school counsellor so that's where our priority has gone also we are funded by magic breakfast to help get breakfast club with 70 children attend every day so it's trying to find the best streaming funding for our schools to work across our trust so we have those positions but actually now with the cost of living crisis and

the increased pressure on school budgets we are looking at whether we can actually continue with those kind of funding for that pastoral care which we know is so needed and I think we were underfunded in the recovery with narrowed government funding for English and maths and actually the biggest issue was the health crisis and that functional support that we needed families and the children. I've got to bring in one of your key parts of your pastoral care Dougie the puppy how successful is it having a school dog at getting kids into school? Right now and he's he's had a huge impact in our school and it came from an idea my friends are principal in Australia and they quite they value dogs education and she suggested that i used him to um develop the morale of school and to help support with social and emotional needs and what i found is if i end up at home with dougie he he

stops any emotional stress and and and kind of calms children down and encourages them to come to school when they're in school he'll sit with them to come to school. When they're in school, he'll sit with them. He sits on the desk while they're working. They'll read to him. He offers that emotional support that somehow humans can't do. So he's had a huge impact in our school for a year now. Alice, add it to one of your recommendations, please. Every school dog mandatory.

Caroline, does Ofsted look at attendance records of a school? Absolutely. We were Ofsted post-pandemic. And how much of an extra strain is that? It's a huge strain. The overwhelming strain of a school leader post-pandemic, it was horrific. And I think to then be looking at attendance and looking at how you're improving attendance while we were still in a pandemic is a huge pressure on us. I want to thank you both for speaking to me this morning Alice and Caroline and we do have a statement from the Department of Education a spokesperson said to us attendance rates since the pandemic have improved and the vast majority of children are now in school and learning we're continuing to work with local authorities on their voluntary registers of

children not in school and remain committed to introducing a statutory system so that no child falls through the cracks. This is on top of targeted support to pupils who are at risk of becoming or who are persistently absent. And if you want to understand more about ghost children, then there's a new podcast from BBC Radio 5 Live. It's Terry Waite, Finding Britain's Ghost Children, and it aims to investigate the causes and consequences

of children missing from school. You can find it on BBC Sounds. 84844, that number to text. Lots of you getting in touch about remarkable people in your family. My grandmother, who was imprisoned for bigamy, was captured on the continent posing as a Belgian countess. She sounds amazing. She disappeared from the lives of her four children

when they were young, and only one of my aunts is still alive. We've been looking for her for years, this mysterious romantic figure. She was called Winifred Fitzell, though what she called herself later is unknown and only adds to her mystique. On to my next item now. Keep those family stories coming in, though. On Tuesday's programme, we heard from a listener we're calling Charlotte. She contacted us after a revelation that she had in therapy

when talking about her childhood. One memory in particular stood out. I must have been eight or nine and we were sat around the table on a Saturday early evening in the summer and she'd said something and just one or two words came out in a really Merseyside accent. And I said to her, you sounded really Liverpudlian then. And she completely flipped, instantly flipped. She got up, her chair fell backwards. I'm not from Liverpool, I'm from Birkenhead. And went stamping and screaming upstairs. And I looked at my dad and I said, what have I said?

What have I said? And my dad and I got up and went to the foot of the stairs and mum was on the half landing. And by this time she was just in her underwear and her bra and pants screaming and ranting. And she pointed her finger down the stairs and says, look what you've done to me and I thought she was pointing at me and the next time I saw her she'd had electric shock therapy and she was slumped on her bed almost dribbling out of one side of her mouth and for 40 years I thought that was my fault and that's what I had done to her so that alone just talking through that with my fault and that's what I had done to her. So that alone, just talking through that with my therapist, was amazing because I could rationalise that it wasn't my fault, but I didn't understand what was going on

until I knew that Mum was a vulnerable narcissist and she wants to portray to the world one image and if I break through that image, she will hate it. Well, feeling sure that her late mother was a narcissist to portray to the world one image, and if I break through that image, she will hate it. Well, feeling sure that her late mother was a narcissist made Charlotte determined to unpick the ways that have shaped her life. One major source of tension was the fact that after her parents' divorce, she stayed in touch with her father. You can find the whole interview on BBC Sounds.

Look for the 21st of March. Well, today we hear from Charlotte's sister, Louise, not her real name, who's the youngest of three sisters brought up by the same mother. Sadly, the other sister died. As you'll hear, Louise's take is a bit different. Our reporter, Enna Miller, began by reading out some of the classic traits of the narcissist mother. Love is conditional. Mother wants to be in control, belittles the child, manipulates them, won't or can't validate feelings,

unpredictable, volatile, above the rules. I mean, the list goes on. Now, Charlotte identified with a lot of that. Do you? Not as much as Charlotte, if I'm honest. Is Charlotte influencing your train of thought now with regards to what she's learned and your memories of what you had with your mother?

If anything, it's made me feel a little bit more sympathetic. To? To my mum, because she had these traits and she didn't have the mental capacity to reflect and realise. And that's not necessarily her conscious fault. I already get the sense, very quick into this conversation, that you obviously both have different perspectives of the same mother. And Charlotte's very clear, having gone through therapy,

my mother was a narcissist and all these traits have impacted me in certain ways. A, did you see those traits? And B, did they have an impact on you? I did see them to a slight extent, although I didn't know the term narcissistic at the time. When you think of your mother, describe her for me. Proud. Slightly domineering on occasion.

Vulnerable at times. Volatile. Yes. Wanting to make sure that situations centred around her when they needn't necessarily have done so. Yes. Charlotte feels and believes that your mother was a narcissistic mother.

What did you see? I saw a mum who felt that life had not delivered in her childhood, in her marriage and in later years. And so there was a frustration there. I sensed that. I wonder why you feel the compassion for your mother and she doesn't. I'm just interested how you are on different spectrums. Because I never had that viciousness,

the vitriol for being in touch with Dad. Now, that's because I wasn't. Because I took the easy path, I suppose, looking back on it, being honest. And good for her, that was the right thing, that was the adult decision to make. I had more manipulation, which came up later. I started working in London after university

and there was that sense of her wanting to control and if I didn't call at a regular time, it was a big issue. And I agreed to meet up with her halfway. We had a lunch and it was fine and I tried to address these issues. You know, I don't need to tell you every detail of my life. I'm now a young adult forging my own career. All hell broke loose. I mean, she slammed the cutlery down, the plate broke.

We were in a restaurant. It was quite awkward. Everybody went quiet. And she stormed off and got the next coach home. And it was a while before we spoke again, which again just reinforces that, ooh, don't go there. You tread on eggshells, avoid the big drama, rather than being able to have a frank adult-to-adult conversation. I've had to stand up to her, my mum,

and every time it's just been a disaster. There was a horrific, horrific phone call. My husband could tell that I was getting agitated so he switched the switch and put it on loudspeaker so he could listen in I was actually breastfeeding my first baby at the time so I was a bit bound and she just started questioning why I was with him I'd rushed into having a family I wasn't doing the right thing and you know husband could hear all of this so he ended up

just picking up the handset and giving a what for down the phone and slamming the phone down and that was awful because it put me in the position where she's my mum but I suppose for the first time really I saw her through somebody else's eyes and he just said that's not what a mother does that's not what a caring mother new grandmother does try to split up and sow seeds of doubt and distrust between people who are just starting out as a new family um and he called her out on it and they did have a difficult relationship as a result because every time she's called out or was called out, it never went well.

She couldn't take it on board, she couldn't reflect. It was us being vicious and nasty and manipulative. I do recognise traits. Again, I didn't know the label to put on it at the time. All these traits, having spoken to Charlotte, she says have had a massive impact on her self-esteem, her self-worth, she's been depressed, she seems to have gone to quite a bad place. Have any of these traits had an impact on you? Not to the same extent if I'm honest and I feel

bad about that in a way because Charlotte was was the middle one of three but the first to go to university and go away and sort of start to break away have her own life that bit older that bit more savvy maybe and having had the contact with our father it gave her an extra lens to look at things through our mumented that. I had no direction whatsoever, no encouragement, no discouragement, just got on with it. Looking back, probably could have done with a bit more involvement,

but then, you know, you can't go back, can you? Charlotte is looking back in order for her to go forward. But when she started getting interested about narcissistic mothers, it would be literally until every other day she'd ping me, oh, yes, and she did this, oh, yes, she did that. And whilst I recognised the anecdote she was referring to, I didn't feel the need to ping back and, yes, I remember this too, because it's obviously had a bigger impact on her than on me.

There came a point also where where what good was this doing and I think Charlotte needed that process far more than I felt I needed it so my husband had already recognized these traits in her so I felt I could at least talk about that with him. So I've got that sounding board, whereas Charlotte hasn't. It's good to revisit it, but I don't want to dwell on it either. Our mother died a few years ago, which in one way is bad. She has no right to reply, but at the same time, it allows us the freedom to talk things through. I'm influenced by her, but I've also had a number of years without her I've had a number

of years in a marriage and a number of years with four children which keeps kind of busy so there are other things to think about and look forward because the influence was greater on Charlotte she made some decisions which weren't the right decisions and then she had to sort of end one marriage, move on, live on her own, working mum. You know, that's an extra burden, and I haven't had to face that. When my mum did die, I did have a huge weight of grief and loss, but there was a sense of relief as well her influence it was started to rub off onto my children and I was getting wary of that and there was one Christmas where

my children got really upset and one of my children came through and sort of said all the pictures of granddad have been turned around and that's my dad and I said what do you mean because all the pictures of granddad have been turned around. And that's my dad. And I said, what do you mean? He said, all the pictures of granddad have been turned around. So I went into our other sitting room, and my mum had literally just been in there, and any photograph, which included my father, she had turned around. So it was just the back of the frame you could see.

And A, I think that's a weird thing to do. Extremely weird. B, it's my house. Thank you. You are a guest. guest and c the grandchildren are shared he is their granddad whether you like that or not that's the way mum was and it's impacted on charlotte hugely it's impacted on me less so but we've still got lives ahead of us fascinating stuff and next time And next time, Charlotte and Louise speak together about how two adult children can have such different views on the same mother, her impact on them,

and what it's done to their relationship. And lots of you got in touch after you'd heard Charlotte's story. Someone said, I was moved by the piece this morning on Woman's Hour on narcissistic mothers. It's not easy to recover from growing up with a narcissist primary caregiver. Both myself and my sister felt like bit players

in our mum's drama. My mum died in 2019 and the legacy of her departure has been complex, grief, anger, sadness and a ton of guilt and confusion. Thanks for broadcasting stories on the subject. And Caitlin has been in touch this morning to say I had a narcissistic mother and it had a disastrous effect on the

whole family but especially me the damage has taken years to unpick even after her premature death I understand why she was she as she was terrible attachment issues in her infancy but the damage she inflicted was immense recovery however is possible your Your thoughts, 84844. Now, does the name Mabel Constantinouris mean anything to you? Do you know who she is? Well, not many people do until now. It's all about to change.

She was a trailblazing female broadcaster and a comedian on BBC Radio in the 1920s, 30s and 40s. She's believed to be the creator and pioneer of the sitcom as a genre. She brought soap operas to the UK and she was widely known as the mother of the BBC. In other words, she was a national treasure and yet she's become largely forgotten. Here's the woman herself talking about being one of the UK's first ever broadcasters. I was a member of the first radio repertory company ever formed in 1925

when the personnel at 2LO numbered only 70 people. And I think my interest in drama is as great if not greater than my interest in variety. Oh, how fantastic. And here she is performing in one of her sketches that she wrote and starred in. This is London Corley. Here is Mabel Constantouris

in her sketch entitled Grandma Buggins at the Zoo. Coo, here we are at the zoo at last. I don't care much for monkeys myself, do you, Grandma? When you've got husbands, you lose your taste for them. I want to use your anky, Grandma.

Use your anky, quick! Love that. This is London calling. Well, Mabel even appeared on early episodes of Woman's Hour, but despite that, here in the Woman's Hour office, we had never heard of her. That is, until we received an email from her great-great-nephew, Jack Shillitoe. Contacted Woman's Hour after lockdown, after a lockdown project, to look into his family tree that led him to discover his great-great-aunt

and ignited a desire to find out more about her life and career. Welcome to Woman's Hour, Jack. What was it like hearing her voice? Hi, Anita. Yeah, thanks for having me. That was quite surreal, actually. I've heard the comedy sketch before, but actually hearing her voice is quite strange. It kind of sends a bit of a shiver down your spine,

like you're touching, like, history. Yeah, because you went on this journey of discovery during lockdown. Tell me about that. Yeah so just as lockdown hit I lost my job. I started working for myself but then as a kind of as I was saying to you earlier kind of like a cathartic project with being faced with a pandemic and redundancy, I decided to look into my family past. I knew there was some interesting story around the Tillings, who was my great-great-grandfather, and he ran a horse bus business in London. So pre-motorised transport, basically the Uber of the Victorian age, you could call up, you could hail a horse cab and that kind of thing.

And then as I was looking at the Tillings i saw that um the name constant jurist and i thought who is who is this person that shillito is quite an unusual name constant jurist quite an unusual name but i thought i don't i couldn't see the connection uh and then i discovered she was actually the sister of my great granny my great granny was still alive when i was born so i was four when my great granny died uh she and she was um mabel was my uh great granny sister so she when my great-granny died. Mabel was my great-granny's sister, so she was my great-great-aunt. And what did you discover about her? Well, as in your introduction, she was a trailblazer, pioneer. She was extraordinary, and it's quite strange.

I felt a bit, I was thinking about this on the way in this morning. If you've ever seen Coco, the Pixar film, he discovers that his great-great-grandfather is a legendary musician. I felt a bit like that. I felt a bit like Coco. I discovered my great-great-aunt was a legendary broadcaster. She was amazing. She was kind of the first of her kind.

As you know, last year BBC celebrated 100 years. Her career started shortly after. She was 45 when her career started. She was not divorced but yeah all intents and purposes basically separated from her husband which was not a done thing in the 20s um so yeah she was basically supporting herself and her son michael um and her career started late so there's so many what i discovered was that she was extraordinary um even in today in like the 21st century but when you look back back, you go, hang on a second,

it was 90 to 100 years ago. She's even more extraordinary. She's doing things well ahead of her time. And I was just completely bowled over by it. And then that led me to meet the likes of Jen, who's also researched Mabel. Well, let's bring her in because you started your own podcast called My Aunt Mabel.

And one of your guests was indeed Professor Jennifer Purcell, Chair of History at St. Michael's College. Jennifer's areas of expertise include the social and cultural history of 20th century Britain. She's written a book, an entire book about Mabel of all the other fortuitous things that could have happened. You discover Jennifer and the book is brilliantly entitled Mother of the BBC. Very early good morning to you, Jennifer, because we know you've woken up very early in the States to speak to us. So how did you first come across Mabel? Good morning and thanks for having me. I came across Mabel about 12 years ago. I had just finished a project called The Domestic Soldiers, which was about housewives during World War Two. And I was sort of casting around for another project. And my publisher said, well, why don't you look into the BBC? Because you talked about that in your first book. And so I said, okay. And I did some research, as you do as a historian, and started reading these books. And in the books,

there's lists of entertainers. And that's what you read about. You read about lists and lists and lists. And Mabel kept showing up in those lists, but nothing more about her until I found one book on the social and cultural history of the early BBC, which was written in the 1990s. And it's the only one that really touches on the subject. And here she was in two paragraphs, not a list, but in two paragraphs. And in one paragraph, I was intrigued to learn that this woman was indeed, as Jack was saying, an amazing woman, an amazing performer. She could voice seven different distinct voices in one go. In that clip that we just heard, that was only two of the seven voices that she could do.

And she fooled everyone. Every, you know, the BBC listeners at the time thought there was a cast of seven actors doing this work. And I thought, wow, somebody has got to have written about her. And they hadn't. And then later on in the book uh there's this little um mention from val gilgood who was a storied uh bbc um staffer producer and so on who attributed um soap opera coming to the to the bbc and to britain um from america through mabel constadurus and i thought okay i'm on to something here. Yeah, she's a character. And she started really late. This is the bit that jumped out at me.

She started her career in her 40s. Yeah, late. So she was 45 when she went into broadcasting. So obviously we're like sat in the studio now. But as we know, radio has been around for about 100 years. I know what a microphone is. I know what a studio looks like kind of thing. But she was just thrown into a studio. And her her instruction was, well there was a sign on the wall

when she went into the studio that said, no jokes about Scotsman, Welshman or clergyman don't sneeze into the microphone, off you go now you're live. We've still got that sign but you know there couldn't have been that many women working at the BBC at the time, certainly not women of her age, I mean we're only just kind of speaking about

how 45 isn't past it, you know and she's's starting her career at that age. What a trailblazer, Jennifer. Yeah, yeah, she is. And I think what's so fascinating about her is, as you said, you know, her age. But what really is intriguing about her is how she negotiated her way through the BBC, created a career. Not only did she create a career on the BBC, but she expanded that career into multiple media, which is just amazing to me. How did she do that? She would take her BBC sketches, the Bugginses,

which is what we just heard, and she novelized them. So in the 1930s, she wrote multiple novels based on her characters. Eventually, she wrote soap operas, which became the predecessor for Mrs. Dale's Diary, which everyone knows. She was going to write Mrs. Dale's Diary, but there were some contract negotiations that went south in the war. And so she's never been attributed to that. So she went into various different genres. She was in film. And she was, I call her a jobbing actor and writer, because how I got to know her was through the BBC with the written archives. I could see all the letters that go back and forth between her and the BBC. And she was constantly pitching ideas. Here, I want to do this. Can I do this? And it's a measure of the respect that she

had from the BBC that most of those ideas in the 30s and 40s were picked up on. And she was given a contract to do that work. And she was working hard. So she's 45, but she was working hard on this career, raising her child, who at the time was around eight years old, Michael, her son, who she was very close with. So she was managing all of this, being a mother. As Jack said, she's got this relationship with her husband, too, that we're not really sure about. So, yeah, she's amazing.

She is amazing. And she fought for equal pay as well, Jack. Yeah, yeah, she did. And she was very kind of, I think in the office, she was quite shy and kind of very polite and very modest. But she was also pretty determined and persistent and resilient as well. And so she got on, as Gemma was saying, with the likes of Val Gilgud, who was one of the BBC execs at the time. But she would send pretty stern letters to the BBC saying, I think you'll find that I deserve the same pay as what you're paying my male colleague

who's written the same sketch. Or actually, I'm the same pay as what you're paying my male colleague who's written the same sketch. Or actually, I'm the lead writer. Why is my male co-writer getting paid more? Or if I'm on my own, why do I get paid less? Like today, you can still imagine an email like that being sent. Like, why am I not being paid the same as my male colleague? But she was doing it 100 years ago. And the BBC was saying, yeah, here you go.

Here's your equal pay. So it's actually, she wasn't just sending a letter and it was falling on getting actually the BBC was saying yeah here you go here's here's your equal pay um so it's actually she wasn't just sending a letter it's falling on deaf ears it was working and has it changed you discovering that you have this ancestor uh yes um uh yeah I kind of it it was really interesting to discover her um but also there was kind of like a sense of inadequacy as well because you look and you wow, like she started when she was 45. As Jen said, she was essentially a single mum. She was a writer, actor, performer. She was on stage. She was in films. She was hugely productive and busy during World War Two as well. She led the Kitchen Front programme, which was helping families basically make meals out of their rationed items. So she was doing all that. I kind of looked and thought,

right, I better get cracking. At least I need to make at least a podcast. Otherwise you feel really inadequate. Yeah, so yeah, exactly. And it was, yeah, it was just really nice to discover someone like that and know that she had such an impact on those around her as well. As Jen's book suggests, she was mother of the BBC. and know that she had such an impact on those around her as well. As Jen's book suggests, she was mother of the BBC.

She was very encouraging to her colleagues as well at the time. Yeah. What was her legacy, Jen? I think her legacy, I think, is the sitcom and the soap opera. The more I looked at her, she would never have been credited. And the BBC would never have been credited with early sitcom. And in fact, most scholars in this field wouldn't say that the Americans got to sitcom before the British did. And the only reason why they would say that is because here in America, we serialized our programs because everything was commercialized. And so we needed to do that. But the BBC fought against that until 1936.

So in the 1920s, she knew her audience. And she was also a creature of radio, too. She understood audience. She understood how to do slapstick, visual slapstick on the radio, where you could imagine somebody falling down a chimney for instance yeah amazing stuff she's amazing she sounds absolutely wonderful and it's been such a pleasure to be able to bring her to life today on woman's hour there there is her legacy right there jack and jennifer thank you so much lots of you getting in touch about various things you've

heard on the program i must read this message about the first item. I just listened to your report on birth control and breast cancer as an endometriosis and endometriosis sufferer. I was surprised to hear your expert refer to endometriosis as just painful periods. It's a debilitating disease

and should be acknowledged as such. We've been dismissed by health professionals for far too long. Join me tomorrow for another Woman's Hour. I'll be back on air, live at two minutes past ten, thank you to all

my guests and to Rebecca Meyer for producing the programme. That's all for today's Woman's Hour, join us again next time and maverick thinkers. It includes Bill Gates, Greta Thunberg and Sir Ian McKellen, as well as Novak Djokovic, Billie Jean King and Nile Rodgers. Nothing is off the table and all give an insight into their remarkable worlds.

You can subscribe and listen on BBC Sounds. Thank you. 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.