Woman's Hour - Listener Week: Psychedelics, Peripheral friendship, Posthumous conception, Beach Guardian

Episode Date: August 24, 2023

For Listener Week, you, our listeners, decide what we cover on the programme.Listener Rachel asked Woman's Hour to explore the potential of using psychedelic drugs in medicine and whether these drugs might affect women differently to men. Academics have been researching psilocybin as a possible new treatment for depression, PTSD and anorexia, when used in conjunction with therapy. Anita Rani is joined by Professor David Nutt, Professor of Neuropsychopharmacology at Imperial College London; and Catherine Bird, Senior Clinical Trials Manager at the Centre for Affective Disorders at Kings College London.Helen, a listener, wanted Woman's Hour to highlight the importance of peripheral friendships. These are casual acquaintance relationships; the people in your life that you don’t see often, or your co-workers who give you joy, or kindness, but aren’t your close family. Anita meets Helen and they talk to Dr Gillian Sandstrom, a senior lecturer in the Psychology of Kindness at Sussex University, who has studied these relationshipsPosthumous conception is when assisted reproductive technology is used to establish a pregnancy and produce genetic offspring following the death of a parent. Listener, Lauren McGregor, wrote to Woman's Hour wanting to discuss the importance of having the legal paperwork properly completed and signed should you ever find yourself in a situation when you have to consider this. Anita is joined by Lauren and a family lawyer, who has experience of working with fertility law, Louisa Gheveart.Earlier this year, research from the University of Portsmouth showed there are 100 times more microplastics in the coast around the UK than there were six years ago. Anita talks to the marine biologist and PhD student Emily Stevenson who is on a mission to clean up the patch of Cornwall’s north coast where she grew up. Emily founded Beach Guardian in 2017 with her dad to try to empower local communities to combat plastic waste along the coastline.Presenter: Anita Rani Producer: Rebecca Myatt Studio manager: Giles Aspen00:00 Opener 02:28 Psychedlics 17:12 Peripheral Friendship 30:45 Posthumous Conception 46:18 Beach Conservation

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. Delighted to welcome you to another Listener Week programme. This is where every story we are covering today has been generated by you. So thank you for your brilliant suggestions and please keep sending us them. It's really important, I think, that we reflect the topics you want to hear about. And one story came in from Helen who simply wanted to know more about something she'd heard about. She said, I just heard about the concept called peripheral friendship.

The people in your life you don't often see or your co-workers, workers who give you joy or kindness, but aren't your close family would love to hear more about it. OK, Helen, we're going to find out more about peripheral friendships in the programme, but I'm also going to ask everyone listening about the importance of these friendships in their life. The casual acquaintances you might bump into on a dog walk or when you're out for a run. The person at work you see in the queue for the canteen. The woman at the bus stop. The lovely man who makes you coffee. The person who lives you see in the queue for the canteen. The woman at the bus stop. The lovely man who makes you coffee.

The person who lives a few doors down. People you don't know well enough to have their number in your phone, but you might find that you have meaningful conversations with. Who is that peripheral friend in your life that has helped you out in a time of need? What did the casual acquaintance do for you? Maybe they helped you move a piece of furniture, or maybe they gave a listening ear when you needed it most. Sometimes it's easier to share something with a

relative stranger than it is your nearest and dearest. So get in touch and tell me about your peripheral friendships and the importance in your life. The text number is 84844. You can email me by going to our website. You can drop me a WhatsApp message or even a WhatsApp note. It's 03700 100 444. And you can contact us via social media. It's at BBC Woman's Hour. Also on the programme today, psychedelics and the very new research into the potential benefits they have or could have for depression and other illnesses so new that the findings haven't even been published yet. We'll also be hearing from a very inspiring listener, marine biologist Emily Stevenson and her passion to keep our beaches clean of plastic waste and posthumous conception.

Lauren McGregor wanted to share her story of conceiving and giving birth to her son after her partner had died. That number once again is 84844. If you'd like to drop me a text about anything you hear on the programme today, please do let us know your thoughts and opinions. But first, one of our listeners, Rachel, got in touch with the programme and asked us to explore the potential medicinal use of psychedelic drugs and whether they might impact women differently to men. And she's tapped into something that seems to be in the zeitgeist right now.

In recent years, psilocybin, the active ingredient in magic mushrooms, has been researched as a potential new treatment for conditions as diverse as depression, PTSD, and anorexia when used in conjunction with therapy. So what role, if any, do psychedelics play in medicine? Well, to discuss this, I'm joined by Professor David Nutt, Professor of Neuropsychopharmacology at Imperial College London, and Catherine Bird, Senior Clinical Trials Manager for the Psychoactive Trials Group at King's College London.

Welcome to Woman's Hour to both of you. David, I'm going to come to you first. What are psychedelic drugs? Well, you've already mentioned psilocybin, the active ingredient of magic mushrooms. Other drugs in the similar class are drugs like LSD, DMT, which, of course, is usually taken in the form of ayahuasca. And it's been around for many tens of thousands of years, possibly, in Latin America. And also a drug like mescaline, which, of course, was the drug that Aldous Huxley took when he had the experience,

which really led to the opening of this whole new era of thinking about psychedelics in his book, The Doors of Perception. So they're powerful agents. It's work on the serotonin system in the brain, a particular subtype of serotonin receptors. It's very highly expressed in the very top level, most recently evolved parts of the human cortex. And they essentially work on those parts of the brain

which encode our ongoing sense of self, our ongoing ego, where we encode and think through the past, the future, and the the present and they change functioning in that circuit in the brain we call the default mode network and produce quite remarkable changes in attitude and often behavior as well how do they work how do they work on the brain so they stimulate a receptor the serotonin receptor is uh present in a particular cluster of uh of neurons in the brain the neurons which connect the brain you you're probably aware that you know your brain is the most complicated thing in the universe mine's pretty simple but um but that's a conversation

for another day but yes generally yeah your brain is made up of maybe 100 billion neurons each neuron is a little computer in fact the human brain has more computing power. Every human brain has more computing power than all the computers on Earth put together. And that is because it's billions of computers all linked up. But the linking up is the critical thing. The reason humans are so clever and so inventive and so creative is because they connect all the vast number of neurons in the brain. And the neurons which do that connecting have these serotonin receptors. And when you stimulate them, they change their function and they change the way you think.

And that allows you to think differently. So, for instance, if you're locked into thought processes of depression, that you're a worthless person and that you don't deserve what you're getting that you actually feel that you're probably a burden on life you can disrupt those thoughts and people can come out and think hang on no it's not my fault i'm depressed it actually i didn't abuse myself i was abused by my my parents or i've suffered other traumas so it can help you recalibrate your thinking processes by disrupting its set maladaptive ways of thinking. Catherine, what are the types of conditions then that it can potentially treat, particularly for women? So psilocybin has been researched for the treatment of depression, particularly treatment

resistant depression. So people who have tried existing treatments and perhaps not responded or not gotten better. At the moment, there's a whole host of studies being conducted for different conditions that psilocybin therapy may be able to treat, like anorexia and PTSD. So we would say that this research is still in earlier phases. Depression has been kind of the first one that's been researched the most. And you design clinical trials that work with psilocybin, which the government have classed as a Schedule 1 drug, which means it can't be lawfully possessed or prescribed and can only

be used for the purposes of research with a home office license. So how do you make sure it's safe to use in your clinical setting? Also, and explain what a Schedule 1 drug is as well. I think we need to understand that. It's a very good question. I mean, people are more familiar with the sort of the Class A, the Class B classifications of drugs. Schedule 1 is the most restrictive classification for drugs that may be used in the medical sphere, where however, Schedule 1 says that the drugs that are in that classification have absolutely no therapeutic benefit at all. So it's a bit of a paradoxical situation we're in where we have funding from the government, we have funding from private bodies to

conduct research for the potential therapeutic use of these drugs, yet they are in this classification that states they have no therapeutic benefit at all and might actually be harmful. So this classification is actually very restrictive in terms of the administrative and financial costs on how we conduct our research. And there's other drugs that have potentially a lot of risk when used in certain contexts like heroin or morphine or ketamine, but they're in schedule two because when used in the correct setting, i.e. in certain medical settings, they can have benefits as well. So that's a useful way of thinking about it, that when psychedelics are given alongside psychotherapy in a controlled

setting with trained professionals, there is a potential for therapeutic improvement there. And what are the risks or the side effects that you make participants aware of? So quite common ones that people report can be initial feelings of anxiety, perhaps feeling a little bit nauseous. You might have a headache, but it's often found that these are transient. So they wear off as the drug wears off. And that's something that is very important to note that psilocybin and most classical psychedelics are pharmacologically safe. So on the body, they're not sort of toxic to the body. The risks are more to do with what might happen psychologically. And the steps that we take to mitigate that are making sure that people are adequately prepared. They've had time to acquaint themselves with the therapist that they will be working with when they receive the psilocybin treatment, educate them about what might come up.

Also prepare them for the fact that they may not have a pleasant euphoric experience, which is what some people do have. Others, you know, difficult material comes up and that can be distressing, but also a potential to work through those difficult things. And, you know, they may not be able to approach those things in other spheres without support. And it's also about managing expectations. So at the moment, you know, there's a lot of discourse and a lot of excitement and hype. And sometimes people come to the trials thinking that these drugs might be a chemical switch and easy fix. And it's kind of breaking down those expectations and creating realistic kind of approaches that we can work with. Tell us about your trial. How many people did it involve and what were you specifically looking at?

So we have a trial that's currently ongoing and we're aiming to recruit 60 people. And those are people with treatment resistant depression. There is another study that's being conducted at King's College by Professor Janet Treasure and Dr. Hubertus Hemrick looking at the use of psilocybin therapy for anorexia. We did complete a study last year or a couple years ago now actually looking at psilocybin therapy for depression. And it was found, so people were given three different doses, and it was found that people who received the higher dose had a more sustained response in terms of the reduction of their depressive symptoms in comparison to the people who received the lowest dose.

And this was sustained for sort of weeks after. How many? So for that particular trial, changes were observed up to 12 weeks. But again, it's a very variable result. So some people might have profound transformative experiences, whereas others may respond a little bit and some not at all. David, you've recently completed research into theucocilocybin for an anorexia patients with anorexia involving 21 participants so tell us about your trial what did it involve? Well it involved giving three doses of psilocybin different doses to see whether there was a dose effect and then monitoring changes in

largely an attitude that the trial was rather different to most studies of anorexia up till now people have tended to focus on body weight as their primary outcome, which, of course, is important because if you are very underweight, you are at much higher risk of dying. We decided to focus on attitudes to food and to body shape, etc., because we wondered if psychedelics could reframe the individuals, and they were women, attitude towards themselves, you know, to try to help them understand why they were denying themselves food, why they were trying to change their body shape and get a

different perspective on it. And I have to say, you know, we were very pleasantly surprised by the impact it had. Very many of them said it changed significantly their perspective on what they were doing it was a in a sense they were able to stand aside stand outside the um historic attitude that their brain had to themselves they were often they felt they were they were trapped in a behavioral thinking process which which they knew was damaging, but they couldn't escape from it. And the psychedelic trip, which they had at least one, allowed them to see things differently.

So we're hoping that that alteration in attitude and perspective will persist. It certainly persisted for a month, and we are now doing the follow-up to six months to see whether it can produce long-lasting alterations in the way they view themselves and therefore hopefully change their behavior. And you also carried out similar studies on depression. What are the long-term effects? Did the depression

return after six months or more? Yes, we've done two depression studies. The first was resistant depression. There we had 20 subjects. Interestingly, four or five of them have done extremely well. It's almost like a cure. They've been well for up to 10 years. For the vast majority, the depression crept back.

But it was still, that first single trip was way the most effective treatment for resistant depression that there's ever been, because half depression scores at six months, which after one, just one administration. But depression creeps back because for many people, it's become a way of thinking. Again, emphasize childhood trauma does leave its scars and they may be very hard to shake and the second trial was a head-to-head comparison with what is one of the most conventionally used antidepressants an ssri called estetalopram and there we showed again that that a single um cytosibing dose produced profound reductions in depressive scores uh but also improvements in well-being, which rather exceeded those of the acetylopram. So it does look as though psilocybin is not just working faster than traditional antidepressants, but working very differently. And in fact, our brain imaging work shows that they're very characteristic.

You can image fundamental differences in the way these two different approaches work, which is exciting. It's fascinating stuff of course i should have i should i should state that the benefits that we're talking about in the program today have come from taking psilocybin under strict medical supervision with carefully controlled doses with therapists and medical professionals on hand um katherine what are the limitations of these studies because so far most have been quite small we're talking about very small number small sample of people what what needs to happen next in this field of research well you can't you kind of just said it you know that a lot of the studies that have been done are quite small and we need to do larger studies to understand whether these results are generalizable whether

they will work for more people and also work in different places rather than a study that's conducted in a single center where there's a team of highly specialized people. And we want to understand if it can be scaled up and done in different places. So I think it's very important that we kind of, despite all the positive research that's coming out, be a little bit kind of careful with what we say and um wait to see what happens when we do bigger bigger studies um at different sites with with more participants in those studies and david last month australia became the first country to allow psychiatrists to actually prescribe psychedelics to patients with depression or ptsd how will that inform future studies? How is that going to impact what happens here, if at all? Well, I think it's a major breakthrough, because this is compassionate access. Australia said, because it has such a high suicide rate in people, first responders, it said, if people have failed on two treatments, it was sensible

for compassionate reasons to allow them to use something like psilocybin. And the great thing is that over the next year, we will be able to collect a lot of data. We call real world evidence data on people who have not responded to traditional approaches. If psychedelics like psilocybin work, the Australian data will be really very, very helpful in informing countries like ours that we should change the scheduling like they have. I would like to thank you both for joining me to talk about this, both to you, Catherine, and to you, David. And if you would like to get in touch and tell us what you think, 888 is the number, 8, oh my goodness me, my number, the number has completely left my mind.

It's a really basic number, 84844 is the number to text. We would love to hear from you on this. Lots of you getting in touch with various things. Oh, I must read out the Home Office spokesperson. We did get in touch with the Home Office to give us a comment on this. And they said there are no plans to review the scheduling of psilocybin. The government responded last December to advice from independent experts on how best to reduce barriers to research with controlled drugs.

In June, we wrote again to seek views on removing licensing requirements for research with clinical trials approval. Now, what do you think about when I say the word friend? Does a certain person or group of people spring to mind? But what about the people you casually know who aren't on speed dial, the ones you might see every day and ask how their week was, but don't actually spend time together? Well, listener Helen wanted to explore this casual acquaintance relationship. And she wrote to us and said, well, actually, Helen, it seems strange to read out your quote when you're sitting in front of me.

Why did you want us to discuss this? I just read an article and it was about someone who'd been through a really difficult time. And they were saying that difficult time and they were saying that their friends and family were like critical in that but they'd also had these little experiences where people had been kind made a cake taking them for coffee not talked about the difficulty that they were having and I thought that's really interesting because we often put a lot of boundaries and rules around friendship and what if we didn't what if we were just nice to people when we could be when we knew they needed a little bit of something without feeling like we had to do everything for them well how brilliant

that you got in touch to say can we talk about this because we've also got dr jillian sandstrom who's senior lecturer in psychology of kindness at sussex university who has studied these relationships to join us to talk about this and so many of you are getting in touch to tell us about your own experiences of these peripheral friendships I'm going to read out a message from Karen Christian Wakefield who says my mum has had very limited life for years due to my stepfather's full-time carer her peripheral friends she meets each day while walking or shopping have kept her sane during a most difficult period in her life. She's now a widow and she's told me that she will never

be lonely due to these friendships from her hairdresser to shop owners, dog walkers and neighbors. They all brighten my mum's day and in turn, I think she brightens theirs. So Gillian, there are various levels of friendships, aren't there? What do we know about the importance of what Helen has brought to women's peripheral friendships? I love the question. And yeah, I've been studying for more than a decade now, what I call minimal social interaction. So, you know, up until this point, most of the research that had been done was focusing on our close relationships, which are obviously really important. But I had experiences like the ones that you just shared, where I was realizing that there were so many people in my life, and it wasn't just the close ones that mattered. So that's where I've been focusing my research attention on, on what we call about a sociologist coined the term weak ties, which are basically acquaintances. And I think that means someone

that you recognize, who recognizes you. And it could be someone you feel close to and would call a friend, but not someone that you feel that same level of intimacy with as you do with your strong ties. Is it sometimes easier to confide in these casual connections rather than people who are closer to us? Yes. There's research showing that people often choose to confide in someone that they're less close to for various reasons. Sometimes it's just because of who is in the right place at the right time. You know, we have so many more weak ties than we have strong ties. So, you know, the person that if you're at work and something, you know, you just need to talk right now. Maybe it's maybe there's no one who's really close to you at hand and you confide in someone just because they're there at the right time. Sometimes, you know, if it's due to a specific topic, like if you're going through, I don't know, like, let's say you had a miscarriage.

Maybe you don't know anybody who has, which is unlikely, because there's so many. But you know, you need to talk to someone who has the right expertise, since that might be someone who you're less close to. But also, they're just more objective, you have that that psychological distance, you don't have to worry about managing the other person's emotions, as well as your own own, which is something we feel we need to do when it's a strong tie or a close relationship. Oh, that's really interesting. The psychological distance from them. You're nodding along, Helen.

Tell me about your peripheral friendships. How have they helped you? I was thinking about a couple of instances in my life which have been really difficult. And I think though my friends and my close family were obviously amazing it was my co-workers who just gave it that little edge because as the um researcher was saying. Gillian. Yeah Gillian sorry Gillian. It's all right. They're there they see you sometimes every day in the way that you know your really close friends and your family don't and they can just sense a

little off moment and go actually ellen how are you doing how's that going for you and i think for both of the things i'm thinking of one was a work thing one was a more of a life thing they were the ones that made the real difference because they kept me going when i really needed that little push come on helen you can get through today you can do it i really liked what julian said about the psychological distance as well. You don't have to think about their needs. Yes. Which sounds very selfish, but actually it's quite a nice little unspoken contract.

You don't need to worry about what they're... And you don't have the baggage either. And I think sometimes when you've offered that friendship to someone, a work colleague or someone who you've just bumped into at the bus stop, you know you can just be with them for that moment and then go on with your day and do what you were going to do. So I think it's, it works both ways when you're the friend or the person in need. It sounds like these weak ties are very important for our well-being, Gillian.

Yeah, so the research suggests that, you know, having these kind of interactions with weak ties, it just puts us in a good mood. So I ran a study where I got people to keep track of how many weak ties they talk to on a given day. So I got them to carry around these little clickers and count how many people they talk to in the course of the day. And the more interactions that people had with weak ties, the happier they tended to be. So people, on average, you have more of these interactions on a daily basis tend to be a little bit happier. And on days when you have more than you usually do, you tend to be a little happier. But I think it's not just mood. It's also these

feelings of connection, which are so fundamental for humans. And, you know, the smallest thing can help us feel connected to another person, you know, So it can be a little chat, it could just be a hello or even just making eye contact with someone makes us feel connected and human. And so having this network of people can just make a huge amount of difference for mental and physical health, actually. See, I am that person who walks around London smiling at everybody

and they just think, oh, she's a little bit peculiar it's like no just northern just northern well I'm not northern Anita and I do it too you do it too I do it and have you been important in other people's lives as a peripheral friend it's always hard to know isn't it Anita particularly when you only do something little um I've got a friend at the moment who's having a difficult time she's a colleague and at the moment my job seems to be making cake I am making cake some of them are healthy and I am putting food in front of her

and that's all that's what I can do I can't make her problem go away but I can make cake and give her a bit of a smile around that It's a really thoughtful beautiful thing to do for somebody isn't it and is there something Gillian more important in fact that we're just more touched when someone we don't know so well

does something for us like that yeah I think there's some research on on gratitude and how you know we sort of expect the people that we're close to to to be there for us and to do things for us and we still appreciate it but it's it's not surprising. And I think when someone that we don't know as well goes out of their way to do something, even if it feels really small to the person who's doing it, it can, it feels really surprising and then we're extra grateful for it. But, but yeah, I love what you're talking about to think about that pro-social aspect. And I think, I think you're right, Helen, that often you don't know how much of a difference you're making.

And if we keep doing these little things, they really are appreciated. Julia has texted in to say, recently I was sitting atop a mountain in the French Pyrenees in thick fog. This sounds great already. A female hiker came to sit by me and we struck up a conversation.

She told me she had to make a life-changing decision, finding herself single in late middle life and unable due to injury to continue her career as a ski instructor. She was being persuaded by her daughter to move from her long-term home in the Alps to live in Biarritz on the Atlantic coast. I hope our chat helped her in some small way. What do you think, Helen? I think it probably did. I'm sure it did because sometimes you just need a bit of space to chat and talk it through.

You were also interested in the rules and boundaries that we place on friendships. Why? I've always tried not to because sometimes your friends come in and out of your life. They get busy with, you busy with family or something happens, and then they kind of wander back in, and I've always tried not to be weird about that and say, oh, you haven't spoken to me for three months, and therefore we're no longer friends. I think once I've made a friend, they will be a friend forever,

and that's how it works. You can come back after five years and say, Helen, I'm in your neck of the woods, let's have coffee and I'll I'll do what I can and I'll meet you for a drink yeah I'm the same don't put too much expectation on but not everybody's like that they're really not and I think that's why I wanted to talk about it today was to just give ourselves a little bit of permission to do as I said be the friend you can and not put too much burden on yourself to be a perfect friend or to have perfect friends people are human and and they will they will come to you when they

need you or when you're the right person I was single for too long Anita too long in my life most of my 20s most of my 20s and people popped in and out because they were single I think that was a real thing like they needed someone to be single with. And we'd come out on the speed dating and, you know, hit the town. And then they would find a boyfriend and I'd be like, oh, they've gone. And I think I was quite cross about it at the time. But now I think that was what we needed to be friends for. And it helped both of us.

I needed someone who was single too. My friends are off getting married and having babies. So I just keep reflecting like if you're my friend for a reason that's brilliant and if it's just for that period of time that's totally fine and actually if you come back five years later and go oh Helen do you remember when we used to do that I'm up for the reminiscing and and just you know being who we are Helen you sound like a great mate to me I'm not sure yeah she sounds brilliant um do we put too much pressure on having close friends Gillian and the expectation that we need to keep up and like message each other all the time and I mean of course you need to check in on your friends and all that but just too much sometimes

yeah I really resonate with what Helen's saying and I I don't know about any research but but like, just personally speaking, I think, you know, I've thought a lot about about weak ties and how people, I kind of like that word permission, because I think we often feel like we have to turn it into something else, like that it's not okay to just have someone be a peripheral tie and someone that we talk to, and we see them, but we don't make an effort to sort of, you know, turn it into something bigger than it is. And I really love what Helen's saying about sort of being flexible about, you know, being okay with whatever sort of level of closeness and interaction that happens and not feeling like we have to hold on really tight and just let it be a little bit more fluid. When does a peripheral friend or a weak tie or an acquaintance move into something more? Because once you've shared something really personal with them, you've opened yourself up, you've trusted them, you've made yourself vulnerable. Isn't this how we sort of forge our closest friendships? Definitely. Self-disclosure is sort of one of the biggest ways that we create intimacy with someone

and I think often it can having self-disclose can lead to that deeper friendship but I think also it doesn't have to like you might just appreciate the person for being there for you in that moment when you needed them and and not have it continue as a close relationship that's okay too too. So I like the message that Helen's saying, like just about giving people permission to let things be what they are. Yes, we've had a lot of interaction on this, Helen. Someone else's message is saying, I'm an older man living near a river. I often walk along the river path and a great joy is the many dogs

of all kinds who accompany their owners. Oh, I can relate to this. I've chatted to the latter and made friends with their dogs. Peripheral maybe, but what a wet nose gift. Often, and all dog owners can relate to this, you know the dog's name, not the owner's name. Yes, I know all of the names of my work colleagues' cats. Yes, very important. Judith has been got in touch to say peripheral friendships. This rang so many bells for me, having even bereaved of my husband and younger daughter within eight months.

I'm so sorry about that. I found so many acquaintances were so supportive from bringing me home, baked cake, an invitation to tea or just a hug in the street. When we met, the links are so important to me. And Gillian says, I'm 77, live alone and have no family. My many peripheral friends are crucial to my wellbeing. It's a brilliant topic. I'm so glad we brought it to us, Helen. Thank you so much for that. And Gillian, thank you.

Pleasure. Keep your thoughts coming in on this. 84844 is the number to text. Peripheral friendships, very, very important. 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's 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. Now, posthumous conception is when a pregnancy is achieved using assisted reproductive technology to produce genetic offspring following the death of a parent. A Woman's Hour listener, Lauren McGregor, wrote to us wanting to discuss the importance of having the legal paperwork properly completed and signed in case you're ever facing a situation where you might want or need to start the posthumous conception process. In a moment, I'll be talking to Louisa Gerhart, who is a partner in a family law practice and has experience in dealing with fertility cases. But first, I'm joined by Lauren herself. Lauren,

welcome to Woman's Hour. And thank you for getting in touch to want to share this story with us. Start by telling us what happened to you and your husband hi Anita um so me I met my husband um back in 2012 and we'd actually known each other as children and but kind of grew apart as we got older um within nine months of us being together he sadly got diagnosed with a brain tumor um which led on to him needing some surgery and then a couple of years later it was when they offered chemotherapy now with Chris only being still within his early 30s at that point it was offered that we could bank some of his sperm which we agreed to because we'd always been under the impression that we would um you know have a child together chris has a child from a previous relationship and it was um it was

that whole process we banked it in with our local clinic um and when he'd done the testing after he completed the chemotherapy his sperm had actually increased four times and so we didn't ever think that we'd need it and it was just by chance that they said you know we'll keep it anyway just in case he has to have chemotherapy again and it was uh just before a lockdown started his um headache started again and he knew something could change slightly in his head and a scan unfortunately showed he had grew a second brain tumour. We did some therapies ourselves and managed to get rid of the second one. But due to COVID, they stopped his chemotherapy and I lost him in July 2020. I'm so sorry about that.

Thank you. Did you talk about, tell me about the decision to have the baby then? Was that a conversation that you had together and was it a difficult decision for you both to make? When we were in the clinic banking the sperm back in 2017, thankfully part of it was because he was doing it for chemotherapy purposes. They did include the after-death paperwork and we were quite blasé about the after death part of it

and he said you know if you're brave enough and you wanted to go ahead that you've got mine we joked we laughed and he was like go for it and he also asked could his name go on the birth certificate which they said it could as long as he signed and that was about as far as it went because once the once it came back that his spain was four times stronger after we never ever thought we'd need it um but for me looking back now especially i'm ever so grateful that we did bank it because it gave me the lifeline i needed after losing him did you ever question the decision to go ahead um with the ivf after you'd lost him no and i still don't regret my decision um i still think it's been the most perfect journey

for me I don't I can't imagine my life now without a little piece of Chris in it and he's like him in so many ways he looks just like him as he was a small child so I've got that reminder but it was you know pregnancy is hard and fertility going through the fertility itself, the IVF is extremely hard. And I was very blind, I think, as somebody who didn't need the treatment prior to what's actually involved with the amount of drugs that you take. And emotionally, it's, you know, the women who are going through this, it is torture. Well, exactly what you say, Lauren, it's such a tough process for anyone to go through. So how did you cope going through it having just been widowed so how did you deal with the sort of emotional and the mental challenge of it yeah I think um I think I was on a little bit of a one-track mind it was that end goal of having a little bit of

Chris and when I'd sat down after I'd lost Chris and um kind of evaluated my own life what did I want from life now because my life had been very much evolved around Chris for for eight years and his brain tumor and I didn't want to go out and meet somebody else and I was 32 and so for me I'd always wanted to be a mum and we'd only recently sat down just before he died and got diagnosed with the second one to say we were gonna start trying for a family ourself and it was put on hold because of his treatment so the next step for me was to have a child too Chris I just I couldn't really find anything if I was honest there's not

very much out there at all to say that this can be done. Why did you want to get in touch with us to talk about because you specifically said you want to talk about the legal paperwork properly. Why? Yeah, so I set up an Instagram page anonymously at first just to reach out into the IVF world because I didn't really know anybody who'd done fertility treatment. And then that has slightly grown and now I speak to a lot of widows and a lot of people who are just going through IVF as a couple or as a single person.

And if you're just going through IVF or ICSI treatment, the after death is not part, it's not a general part of the paperwork in most clinics. They only offer it to you if it's somebody who's having chemotherapy. But as we know, you know, illnesses and life is just extremely short and extremely unpredictable that you don't know if you're in a happy loving relationship at the moment whether your partner could leave for work tomorrow and something happened to him and you have absolutely no right to those embryos or that sperm if he's never ever signed that

paperwork. I'm going to bring in Louisa here because Louisa is a partner in a family law practice and has experience in dealing with fertility cases Louisa welcome to Woman's Hour is Lauren's situation an unusual one have you dealt with many people in this situation I have dealt with people who are thinking about and who've gone through post-tendency conception and it's always a very sensitive and personal decision. Lauren's case really brings into focus just how precious fertility and biological legacy is and how fragile it is and that it can be lost through illnesses, you know, like brain tumours or through accident, medical negligence and unexpected death and particularly for women through age and so it makes it really really important for people to take proactive legal and practical steps to protect not only their own fertility but that of a loved one so that family building plans can happen and it's not all left to chance.

And the thing is that posthumous conception law is prescriptive in the UK. In other words, a person has to give their informed, written and signed consent to the storage and use of their eggs, sperm and embryos in fertility treatment in life, and if they choose, after death. And for that to happen, they need to be completing sets of HFEA consent forms at a UK fertility clinic to give that written and signed consent to posthumous conception and for their wishes to be fulfilled. And they have to meet the legal requirements for storage terms, use of fertility treatment and if needed, surrogacy. And when those forms are not completed, it causes real issues, complicated issues, and it can lead to really difficult and complicated court cases. Why is the law so complicated around this area? The law is very black and white and it is black and white because

giving what's termed informed consent is seen as a cornerstone of fertility treatment law and for you to bring about a child, a biological child or otherwise through fertility treatment law. And for you to bring about a child, a biological child, or otherwise through fertility treatment, there has to be clear written consent to bringing that child about and to parentage. But the issue with the law is that that consent to things like posthumous conception and the arrangements for that to happen aren't always there when life and situations happen. You know know people are very focused on the fertility treatment they're busy places at clinics with treatments and protocols and scans and people don't always think through all of the risks and things that can happen in life and these types of

legal situations and it happened in a case that I dealt with in 2018, where there was a sudden death before the consent forms had been signed at the clinic, I was contacted by a wife who was in the early stages of IVF treatment with her husband. And they'd been to the fertility clinic and the husband had given a sperm sample for testing and they'd signed some forms and they'd booked their next appointment for fertility treatment but really tragically a few days before that appointment the husband had a catastrophic brain injury in a road traffic accident on the way to work and he was on life support and the wife got in touch to make an application to court to try and get legal permission to extract his sperm and for that to be stored so that she could continue with the fertility treatment that they had talked about and wanted and we brought an urgent application to the court of protection and we had to provide very careful very thorough fact specific information real life evidence that they had discussed the post-tumor misconception and they had they'd

talked about it at home you know what would happen if something unexpected happened and the husband had told her i would really want you to be able to go ahead and have that baby that that we plan to have and the court of protection stepped in on this particular occasion and authorized the third party to sign the consent forms on the husband's behalf. And then his sperm was collected. And then 12 hours later, the life support was switched off. And it's a really important case because it shows that inappropriate circumstances,

in places like the Court of Protection, will step in because they recognize now the importance and significance of fertility. You know, not just assets and houses and property, but not everyone goes to a fertility clinic. And that's one of the issues I wanted to highlight, you know, you might never go near one. And this, I think, was really brought to life in quite a sad case last year, was a 22 year old man who was busy playing sport, and he suddenly collapsed. And he ended up on life support. And his parents brought a case to court to try and save

his firm for posthumous conception but that case wasn't granted and the court said although the parents had provided evidence that their son had wanted to be a dad and he talked about being a dad and he'd even say some toys and some of his sporting equipment to hand on to a child. It wasn't the same thing as having given consent to posthumous conception, to bringing about a child after death. And like Lauren, your story, which the consent was given, which is why you wanted us to talk about this on Woman's Hour. And now you have Seb, 15 months old. What's he like?

He's a little whirlwind, as most 15-month-olds are. But he's definitely brought a joy back into, like, mine and my family's lives. And it's nice seeing the relationship that he also has with Chris's son, who's 19. So it's a large age gap, but just so that they have kind of the common ground of you know they're both growing up without a dad and Chris was a fantastic father that was something else that you know I didn't I couldn't really picture meeting somebody else who could fulfill such a fantastic role as being such a good dad regardless of whether they were here or not um but now he's um he definitely keeps me on my toes and keeps me going on a day-to-day basis with his antics.

And helped you through the grieving process? Yeah, I think people thought after I had Seb that the grief had kind of lifted or gone. The grief is still very much there and there are still days I'll be driving along and I find myself just bursting into tears over the slightest thing like a memory or something I've seen but overall he has done a fantastic job of um yeah mending part of the heart of that I was definitely missing Chris in and and I know I was reading about your story and Chris was very much present when you were giving birth to Seb, wasn't he? Yeah, so due to they thought Seb was going to be slightly larger than what he was, I opted for an elective C-section.

So they allowed me in the theatre room. The staff were absolutely fantastic. They allowed photos on the pillow where I was and they let me keep Chris's ashes in my necklace around my neck until they had to get to a certain part and then it was removed while they stitched me up but he yeah very very much so and right through the whole fertility journey the ladies who'd done the egg collection they brought in a spare chair and when I asked them what it was for I thought we were expecting somebody else and they said oh no we

just thought we'd leave it there for Chris and so it was little touches like that just to acknowledge that you know although technically I am a single woman going through it I am married to you know the most wonderful man and um he would have done a fantastic job helping me raise Seb so yeah it's it's little things like that of bringing him up and we have a specific photograph in the living room and Seb waves waves to it and he understands it's Dada he does say dada to the photo and um he'll blow kisses to it of an evening before going to bed along with the dog so you know chris is there on the same level um but no it's i am hoping to carry on that of just dripping chris throughout seb's life so he knows who his dad was it's a beautiful story lauren thank you so much for coming and

sharing it with us this morning thank you and. And thank you as well, Louisa, for all the information you've provided us with. Lots of you getting in touch with various things we're talking about in the programme. Lots of peripheral friendship conversation is still going on. Danny's texted in to say, friendships can be for a reason, a season or a lifetime.

So believed my late wife, Diana, who I'm lost, Diane, who I lost to cancer. I'm so sorry to hear that. And posthumous conception, we've had a message in saying, why no discussion of the right of the as yet non-existent child growing up without your biological father as I have, though I'm different, circumstances can be very painful.

And another one here on peripheral friendships, Laurie texted in to say, a recent pilgrim walk to the Camino Way, the walk was amazing and you met so many interesting people and shared very deep thoughts and issues that we had with the fore knowledge that we would probably never meet again the support was amazing as was the walk and we had a very interesting conversation at the beginning of the program about psilocybin and psychedelics Nina has texted in to say really exciting research on psilocybin at last some

hope for treatment for resistant depression she says in brackets i hate that term i love this research keep your thoughts coming in now earlier this year research from the university of portsmouth showed there are a hundred times more microplastics in the coast around the UK than there were six years ago. My next guest was nominated by a Woman's Hour listener to take part this week and she's been on a mission to clean up the patch of Cornwall's north coast where she grew up. Emily Stevenson is a marine biologist studying for her PhD and she founded Beach Guardian with her dad to try to empower local communities to combat plastic waste along the coastline. Emily, welcome to Woman's Hour.

Good morning. Lovely to be here. Lovely to have you here. As I mentioned, you grew up in Cornwall. So tell us about your life in Cornwall. How old were you when you first became aware of the level of plastic pollution on your local beaches? Whereabouts in Cornwall are you, by the way? Let's get specifics. So I was really privileged to grow up in one of the most beautiful parts of Cornwall in Padstow. And I think it's because of this, because I've been, you know, all of my most treasured childhood memories are times on the beach with my family. When I look back through those memories, they're all polluted with plastic. I remember being eight years old, so over 20 years ago now, and building sandcastles on the beach and decorating them with plastic. So

I've always been exposed to plastic, but it's because of this that I'm now determined to dedicate my life to tackling plastic waste. And you set up Beach Guardian with your dad so what was the inspiration behind that? Well you know because I've had this exposure to plastic waste and determination to tackle it I then went on to study marine biology at Plymouth University and when I was coming to the end of my degree I basically needed something to keep me out of trouble and keep me busy and my dad was finishing his role at the time. So we were both very inspired, very passionate about tackling this problem. And we knew that there was a drive within our community to want to tackle it too.

So we started Beach Guardian back in 2017. And Beach Guardian was really born out of this community desire to tackle the problem of plastic in our local area and it's now because of that community that we continue to grow Beach Guardian and achieve incredible things. So what do you do? Well the work we do at Beach Guardian is incredibly varied so the backbone of Beach Guardian is beach cleaning, getting people, you know, that frontline conservation, grassroots conservation, getting people to connect with the environment, protect the environment, but connect with each other and themselves too. Well, we've just been talking about peripheral friendships on the programme, haven't we? So it's probably a nice way to go and just

have a nice little catch up with somebody and do some good. Absolutely know beach cleaning is as much of a social initiative as it is environmental when we first started beach cleaning six years ago those volunteers that joined that very first beach clean still now come to every single beach clean since we're all now you know almost like a family we know each other we know each other's lives and stories and histories and it's developed into this very rich friendship and and what do you do with the waste when you pick it up well this is an excellent question because this is what makes beach guardian a little bit different because you know we know that a lot of groups are litter picking and beach cleaning now and really starting to tackle this problem of plastic but when we first started beach cleaning now and really starting to tackle this problem of plastic.

But when we first started beach cleaning, we were collecting such vast quantities. It didn't feel right to just put that plastic into the bin on the beach because we'd have no idea where it's going. It could very well end up back on the beach or dumped at sea. So we decided to use that plastic as a resource and keep it. And ever since, you know, our very first beach clean, we have kept every single piece of plastic that we have collected. We have a fantastic facility in Padstow at Trevisca Garden Centre. And we have this massive haul of waste, tons and tons of it. And we use it for educational workshops to bring more people together to raise further awareness. So one thing that we've used it for is to create a giant eight meter long humpback whale sculpture that's called Cetus, named after the constellation of the whale. And if any of your listeners have been to Glastonbury Festival this year, they may well

have seen Cetus as she was there spreading our message. I was there. Did you see Cetus? I don't remember I saw so much I saw so much. Now you're very good at raising awareness because there was a great story with you and a packet of crisps you found a packet of crisps from 1997 didn't you on a beach clean and that is the year of your birth and And you use that in such a brilliant way because you changed something, didn't you? Tell the listeners about what you did. I'm really pleased that you brought this up because, you know, this is a really important story for my journey into conservation. It's also an important story around power to the people as well

because I think sometimes people feel powerless in this war against plastic. But you tell the story and then we can um we can talk about power. Thank you yeah so um as you said rightly one of our very first beach cleans I found a crisp packet a walker's crisp packet ready salted on a beach called Constantine Bay and on that beach clean we had the Daily Telegraph join us and I found this crisp packet it was it had the use by date of 1997 meaning that crisp packet had been on the planet the same duration that I had and I held it up and it was on the front page of the Daily Telegraph the very next day the same day that Theresa May and the government at the time announced their 25-year action plan to tackle plastic waste. Now, because I found this crisp packet, and we have found a whole host more

since then, the oldest crisp packet that we found is from 1966, the year that my mother was born. So this really shows that plastic does not degrade. Any litter that gets dropped today will still be here in decades, if not centuries, years time. So I wanted to raise awareness of this. I couldn't believe that we were finding these ancient packets on our beach cleans. And I thought, you know, I am a young woman in Cornwall. How am I going to get Walker's attention? Walker's is owned by PepsiCo. PepsiCo is the second largest food and drink manufacturer in the world. Also in the top three most plastic polluting organisations in the world. So what did you do? Well, I decided to use plastic as my resource. This seems to be one of the best things that we can do at Beach Guardian. So I decided to create a dress out of Walker's crisp packets

and wear it to my graduation from my marine biology degree back in 2018. And it's a very, very clever, brilliant stunt. But what did it do? Did it achieve anything? Well, it did exactly what I needed it to do. It got Walker's attention. PepsiCo knew who I was. So said all right emily fine by the year 2025 we will make a hundred percent of our packaging recyclable compostable or biodegradable which is great but by then they'll have produced 28 billion more packets of crisps so i had some

great opportunities i went live on b on BBC News and the reporters fair enough to them they said look Emily you've done what any conservationist any person can do you've raised awareness of a problem what's the solution so I said TerraCycle can already recycle crisp packets so there's lots yeah I'm sorry so there's companies out there who can and can recycle crisp packets. Absolutely. Yeah. And so you achieved it because you got a response from them and they said, fine, we will get on board. But what about people listening who might think, I mean, you go out there and you beach clean and Beach Guardian is doing great work and you have people who come every week.

People who feel powerless in this fight against plastic. How do you encourage them that they need to keep on the good fight? You're still there. I'm still here, absolutely. So plastic pollution as a problem is completely unique. When we're looking at different environmental issues, plastic pollution is unique because it's so easy to feel that sense of reward, that sense of achievement. You go to a beach, you see the rubbish, you may feel that feeling of hopelessness,

but then you spend five, ten minutes doing a beach clean. Instantly, you see the difference that you've made. Instantly, you feel that sense of empowerment. And it's always then, what's next? And it's that ripple effect that starts with something as simple as cleaning the beach. I have to say that we don't have walkers here to say what their policy is after you spoke there. But yeah, so the ripple effect. But it's a huge battle, isn't it? It absolutely is. And, you know, you just commented there that walkers aren't here. Credit to walkers. As a result of that whole campaign, they launched the very first crisp packet recycling scheme nationwide. Over 50 million crisp packets have been recycled since as a result of all of that engagement. So credit to them. They took action.

So what's next for you? Well as you said at the beginning of the interview I'm now currently studying for my PhD and what I really hope to achieve with that is link environmental pollution to human health specifically microplastics so how does human action, anthropogenic activity affect the environment and in turn how does that affect our health

and maybe you can come on and tell us all about it on another program emily stevenson thank you so much um emily stevenson who was nominated by people to come and talk to us about the work that she's doing down there in padstow in cornwall as and she set up beach guardian uh thanks to all of you who've been in touch messaging me about your peripheral. I was a troposist for 25 years. Some patients have been with me from the beginning. I listened to their problems, hugging when necessary, knowing the names of their families without meeting any of them. I know it helped.

When my son was killed, the same people did the same for me, helping me cope with the most dreadful time of my life. They kept me going. I'm so sorry to hear that, but thank you for getting in touch and sharing that with me. I'll be back tomorrow. That's all for today's Woman's Hour. Join us again next time. From BBC Radio 4, a new fiction podcast. I want you to hold something for me.

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