Monday, 6 October 2025

Dominant and submissive relationships


by Meg-John Barker



Welcome to my website! You’ve found my most popular post, and in a second you can read more about Dominant/submissive relationships. If you want to find out more, check out my books and zines which cover this topic in more depth. If you like this, please do consider supporting my Patreon.

Why do people sometimes prefer Dom/sub relationships?

D/s is one aspect of the wider category of BDSM (Bondage and Discipline, Dominance and Submission, and Sadomasochism), sometimes also known as kink. Some people are into all of the things listed under BDSM, and some only some of them. D/s is generally distinguished from SM because it is more about power than about physical sensation (although some use these terms more interchangeably).

In D/s activities one person generally dominates the other, or has power over them, therefore people tend to prefer D/s if they find a power dynamic to be exciting in some way. Of course it is pretty common for sex and power to be mixed together in our culture. For example, a lot of romance fiction involves people being rescued from peril or being swept away by somebody more powerful, and a lot of people fantasise about having the power of being utterly desirable to their partner.

What is involved in a Dom/sub relationship?

If somebody identifies as being into D/s, or having a D/s relationship, then they probably include power play in their sex life, and perhaps in other aspects of their relationship. People can identify as dominant, submissive, or switch (which means that they are sometimes dominant and sometimes submissive). It might be that people stick to the same roles each time they play together, or that they take different roles on different occasions.

For most people, being D/s will be something that they only do some of the time (for example, just in pre-arranged scenes – often, but not always, involving sex). Such scenes could involve any kind of exchange of power. For example, the submissive person might serve the dominant one food, or give them a massage; the dominant person might order the submissive one around or restrain them or punish them in some way; people might act out particular power-based role-plays such as teacher and student, cop and robber, or pirate and captive.

Some people who are into D/s might have longer periods, such as a holiday, where they maintain their power dynamic. And a few have lifestyle or 24/7 arrangements, where one person always takes the dominant, and the other the submissive, role. However, even in such cases much of their everyday life will probably not seem that different to anybody else’s.
How does it differ to the traditional ‘vanilla’ relationship?

This depends very much on how important it is in the lives of those involved. Some D/s relationships would look very much like a vanilla relationship but just with a bit more power-play involved when people have sex. Others would have something of the D/s dynamic in other parts of the relationship. However, it should be remembered that most vanilla relationships have specific roles (e.g. one person takes more responsibility for the finances, one person is more outgoing socially, one person does more of the looking after, one person takes the lead in sex). In D/s relationships those things tend to be more explicit, but perhaps not hugely different.

So perhaps the main difference is in the amount of communication. Most people involved in BDSM stress the importance of everything being ‘consensual‘ so there will probably be much negotiation at the start about the things people do and do not enjoy, and the ways in which the relationship will be D/s. Checklists and contracts can be useful ways of clarifying this. So, for example, there may be limits about the kinds of activities and sensations people like, whether they enjoy role-play or not, and which aspects of the relationship will have a D/s element.

Why do so many people have misconceptions of this type of relationship?

The media portrayal of BDSM has tended to be very negative, often associating it with violence, danger, abuse, madness and criminality. Research has shown that actually people who are into BDSM are no different from others in terms of emotional well-being or upbringing, and that they are no more likely to get serious injuries from their sex lives, or to be criminal, than anybody else.

Often the media also focuses on the most extreme examples, such as very heavy and/or 24/7 D/s arrangements, rather than the more common relationships where there are elements of D/s. For these reasons people may well have misconceptions about D/s relationships. This is why it is useful to get a range of experiences out there in the media – so people can have more awareness of the diversity of things involved and the continuum (e.g. from light bondage and love bites to more scripted scenes and specifically designed toys).
How do couples go about beginning a relationship like this?

A good idea for all people in relationships, whether or not they are interested in D/s, is to communicate about what they like sexually early on, and more broadly about what roles they like to take in the relationship. Often people just assume what they other person will enjoy or how they would like the relationship to be.

For example, one good activity from sex therapy and from the BDSM community is to create a list as a couple of all of the sexual practices that either of you is aware of, and then to go down it writing ‘yes’, ‘no’, or ‘maybe’ about whether it is something that interests you, and sharing your thoughts. It can also be good to share sexual fantasies or favourite images/stories and to talk about whether (and, if so, how) they might be incorporated into your sex life (the Nancy Friday and Emily Dubberley collections of sexual fantasies can be helpful with this). It is very important that people only do things that they really want to try (rather than feeling coerced into certain activities) and that it is accepted that there will likely to be areas which aren’t compatible as well as those that are.

BDSM communities and websites are a great place to look for more information from those who have been involved in these kinds of practices and relationships. Also local fetish fairs and kink events often include demonstrations and workshops. There is more in my books Enjoy Sex and Rewriting the Rules about communicating about sex and relationships.
Some people have a BDSM relationship outside of an existing ‘vanilla’ relationship. What effect can this have on a marriage or couple relationship?

Again this varies. Although it isn’t always out in the open, many couples have arrangements where they are open to some extent (e.g. monogamish couples, the ‘new monogamy’, open relationships, swinging, polyamory, and ‘don’t ask don’t tell’ agreements).

Having different sexual desires is one reason why some couples open up their relationship to one or both of them being sexual with another person. If this is communicated about clearly, kindly and thoughtfully, it can work perfectly well. The important thing again is kindness and communication.

In regards to the hit book 50 Shades of Grey, many husbands have bought this for their wives and girlfriends. What does this say to them, and how would you help a couple who want to get more involved in this sort of lifestyle but don’t know how, or they are too shy to approach it?

The kinds of conversations and activities mentioned above are a great idea. One of the good things about 50 Shades of Grey is that it has opened up this kind of conversation for many people. However, it is important not to assume that the only form of BDSM is the one described in the book. In a heterosexual couple it may well be that the woman is more dominant, for example, or that both people switch roles, and the things that they enjoy may well be different to the ones which Ana and Christian engage in in the book.

If you want to read more about different practices and how to do them, then there are lots of good books available about BDSM. Dossie Easton and Janet Hardy’s books The New Topping Book and The New Bottoming Book are great places to start, as is Tristan Taormino’s The Ultimate Guide to Kink.

For couples who are really struggling to communicate about sex, or who have very different desires and are finding it hard to reconcile this, it might well be useful to see a sex and relationship therapist for a few sessions. The Pink Therapy website includes many kink-friendly therapists.


SOURCE:

Sunday, 5 October 2025

Considering digital change alongside planetary health



Sarah Lake and Dr Penny Trayner argue they are two sides of the same coin.

01 October 2025


The next generation of applied psychologists have a dual inheritance: a planet in crisis, with its profound psychological impacts, and a healthcare system in the midst of digital change. Against this background, the British Psychological Society (BPS) recently approved new standards for the accreditation of doctoral programmes in clinical psychology, with some notable updates reflecting contemporary clinical practice in these two areas.

The publication of 'Clinical psychology and planetary health: Changing course in the storm' (BPS, 2004b) is both a call to action and a resource for psychologists. It positions planetary health as fundamental to psychological wellbeing, offering evidence and direction for clinicians while urging the profession to take an active role in both mitigating and adapting to climate change.

As an aspiring Clinical Psychologist (Sarah) and a Clinical Psychologist and Paediatric Clinical Neuropsychologist, and Academic Director on the Liverpool Doctorate (Penny), these new competencies are highly relevant to us. We are involved in digital change through Kompass Health, a rehabilitation data platform that tracks patient assessments, goals, activities, and outcomes to support personalised recovery and service evaluation. To us, planetary health is intrinsically connected to digital change. Technologies have a material footprint, including energy use and data centre demands. This lens makes a response to the climate emergency feel immediate and practical: it is not only a matter of advocacy; it is about how we design, procure, and use the systems that underpin everyday healthcare.

Here, we summarise the BPS's position on planetary health, explore digital change and investigate the climate effects of different aspects of it.
Planetary health

We live in an era of unprecedented human-driven environmental change. Global temperatures have already risen ~1.1°C above pre-industrial levels, fuelling more frequent extreme weather events and posing threats to both physical and mental health. Whether that is the direct psychological impact of climate disasters such as hurricanes or wildfires, or the indirect effects of the changing climate on socioeconomic and political status and climate anxiety, the mental health impacts are both ranging and growing with the issue itself.

Growing awareness of climate change, though valuable for public knowledge and campaigning, is also driving climate anxiety, fear and hopelessness about the future shaped by the climate crisis (Boluda-Verdú et al., 2022). Younger generations are disproportionately affected, as those who will most directly face its consequences. Surveys report sadness, anxiety, and powerlessness, with 45 per cent stating these feelings negatively impact daily life (Hickman et al., 2021). Distress is compounded by a perception that governments are not doing enough. The BPS (2024a) recognises this anxiety as a rational response to an existential threat, but warns that without support it can become debilitating (Clayton & Karazsia, 2020). Without activism and change, which foster agency and social support (Schwartz et al., 2023; Stanley et al., 2021), young people are left with their rational worries, to see little being done about it.

The BPS publication also emphasises that the climate emergency's mental health effects are starkly unequal. Those in the poorest communities, who contribute least to emissions, experience the greatest burdens (Lobell et al., 2008; Pourmotabed et al., 2020). In lower-income countries, repeated trauma from climate-exacerbated disasters combines with limited recovery resources. In wealthier nations, disadvantaged groups, including low-income families, indigenous peoples, and individuals with disabilities, face higher risks due to barriers in adapting to heatwaves, evacuating from storms, or accessing mental health care (World Health Organization, 2023). Thus, climate change intertwines with social injustice: those least responsible bear the heaviest toll.

Underscoring the whole publication is the reality that human well-being is inseparable from the health of our planet. This is the principle of planetary health – the idea that human health depends on natural systems doing well. Clean air, safe drinking water, stable climates, and biodiverse ecosystems form the foundation for healthy communities. Their degradation directly harms mental health, whether through increased disaster trauma, food and water insecurity leading to chronic stress, or the loss of green spaces that normally support psychological well-being. Thus, the climate emergency calls psychology to broaden our scope to consider the larger ecosystems that support our collective health.

Consequently, the Standards for the Accreditation of Doctoral Programmes in Clinical Psychology (BPS, 2024a) frame sustainability and planetary health as integral to training. It is considered as both a moral and professional responsibility, tightly linked to sustainability, social justice, and health equity – and thus extremely important to future clinical psychologists.
Digital change

With the use of technology in healthcare steadily increasing across services worldwide (Rittenhouse et al., 2017), such innovations are set to play a pivotal role in advancing planetary health, simultaneously reducing the sector's ecological impact and promoting high-quality, effective care. This expansion reflects the broader reality that healthcare is constantly transformed by technological innovation, a trend set to continue at pace in coming years (Thimbleby, 2013). The regulatory landscape recognises this, with the Health and Care Professions Council's updated Standards of Proficiency (September 2023) requiring practitioner psychologists to 'use information, communication and digital technologies appropriate to their practice' (Standard 7.7) and to adopt digital record-keeping tools where required (Standard 9.3).

In clinical practice more broadly, emerging technologies are advancing far faster than is often appreciated, requiring clinicians and policymakers to think 'exponentially' and 'expansively' about how to integrate them into both pre-clinical and clinical interventions (Hategan et al., 2019). This growth has also been driven by significant financial investment in health technology (Chandra & Skinner, 2012), and was further accelerated by the Covid-19 pandemic, which exposed the need for rapid digital transformation (Clipper, 2020; Hammers et al., 2020). However, the pandedmic also revealed enduring gaps in digital skills and confidence, often due to limited time and structured support amidst competing clinical demands.

In rehabilitation, technological developments have expanded the scope and effectiveness of the discipline (Anderson et al., 2019; Schreyögg et al., 2006), while adoption of such tools has been linked to policy initiatives aimed at tackling healthcare inequalities (Chishtie et al., 2022; Joynt et al., 2017). Policy mandates, such as the forthcoming NICE 2025 rehabilitation guidelines, reinforce this shift by embedding digital care pathways into best practice, aligning with the UK government's aim to achieve full digital maturity within the NHS by 2025 (UK Parliament, 2023). At the same time, digital tools are increasingly recognised for their role in empowering patients (Fitzpatrick, 2023).

The Standards for the Accreditation of Doctoral Programmes in Clinical Psychology (BPS, 2024a) therefore recognise the need for psychologists to adapt and lead digital change, being able to understand and utilise digital platforms and methods within their work. Digital competency is embedded not just as a practical skillset but as a fundamental shift in clinical governance, communication, education, and research.
Technology and its effect on planetary health

The Health and Care Act 2022 made the NHS in England the world's first health system to legislate for a net zero strategy. This sets two milestones: achieving net zero by 2040 for directly controlled emissions (with an 80 per cent reduction by 2028–2032), and by 2045 for supply chain emissions (with an 80 per cent reduction by 2036–2039). Operationally, this embeds net zero into procurement, infrastructure, care delivery, and travel. Suppliers are now required to consider carbon footprints in the tendering process, cascading an environmental responsibility across the entire supply chain.

This shows how planetary health and digital change also represent two sides of the same coin. Operationally, they have to be considered in tandem. And the workforce are open to this: conversations with clinical psychologists and rehabilitation professionals highlight a strong openness to innovation, underscoring the broader shift toward digital solutions (Hategan et al., 2019; Trayner et al., 2023).

Here are some areas that need to be considered as part of that shift.

Electronic patient records

Electronic patient records (EPRs) are replacing paper systems in contemporary practice, offering environmental benefits such as reduced paper use, less physical storage, and more efficient information sharing (Clarke et al., 2018; Kwon et al., 2024; Turley et al., 2011). Cloud back-ups also strengthen disaster resilience, ensuring data is preserved during events such as floods or fires.

Unfortunately, EPRs are not impact-free. Their footprint lies in energy use: powering servers, data centres, and networks requires significant electricity, while the manufacture of hardware involves resource-intensive mining and processing, contributing to pollution and depletion. In some cases, EPRs may even produce higher greenhouse gas emissions per patient than paper records, largely due to server demands (Eyesustain, 2025; Kwon et al., 2024). However, if powered by renewable energy, digital records retain their eco-efficiency.

Telerehabilitation

The Covid-19 pandemic rapidly accelerated telehealth across medicine and psychology, with video consultations, app-based condition management, and online appointment systems becoming routine. This shift came with a compelling climate benefit, the lack of transportation required. Studies show that the small emissions from data use are negligible compared to the savings from reduced journeys (Hantel et al., 2024; Nordtug et al., 2022; Rahimi-Ardabili et al., 2022; Vidal-Alaball et al., 2021). At scale, widespread telehealth adoption could reduce national healthcare travel emissions by nearly one-third, preventing tens of millions of kilograms of CO₂ annually (Nordtug et al., 2022; Vidal-Alaball et al., 2021). With this climate benefit, comes accessibility benefits too.

Digital care does, however, carry an energy cost: running video calls, transmitting data, and powering servers all consume electricity. While per-appointment use is minimal, system-wide adoption increases demand on data centres, and if coal-powered, some travel savings are offset. Encouragingly, many centres are transitioning to renewable energy, and streaming efficiency continues to improve. This positions telehealth as a strong example of digital change that advances planetary health.

Artificial intelligence

AI is increasingly integrated into clinical psychology, from clinical decision-making and conversational tools to administrative tasks like minute taking and record management. However, unlike telehealth, the environmental cost of AI is substantial, particularly in the training of models (Strubell et al., 2019; Truhn et al., 2024). While deployment has relatively low emissions, training is energy-intensive (Truhn et al., 2024), and as AI applications expand and become more complex, training demands and their climate burden will grow (Morand et al., 2024). At the same time, AI could mitigate healthcare's environmental impact by streamlining processes, reducing waste, and enabling low-carbon alternatives such as virtual care (Ueda et al., 2024). This duality highlights AI as both a potential climate solution and a significant environmental risk.

Moving forward, the focus must be on sustainable AI: reducing the energy required for training, using renewable power, and demanding transparency from vendors about carbon footprints and offsetting practices. For psychology and rehabilitation, aligning AI adoption with planetary health is essential.
Practice points

Considering the effects, both positive and negative, that digital change can have on our planet, the discipline must act. Consequently, psychologists must embrace digital innovation in ways that actively protect and promote planetary health, ensuring technology is a tool for sustainability, not a new source of harm.

Some practical ideas of how to do this include:Adopt sustainable digital systems: Choose electronic patient record (EPR) platforms hosted on renewable-powered servers, implement device recycling schemes, and extend hardware lifespans through repair and refurbishment rather than replacement. Evaluate platforms not only for clinical utility and usability, but also for energy efficiency and supplier alignment to NHS carbon targets.
Align with policy: Prepare for NICE's digital maturity targets (2025) by embedding environmental criteria into procurement, service design, and commissioning. Psychologists should advocate for sustainability to be built into the digital standards their services adopt.
Embed equity and climate justice: Ensure digital health solutions do not widen inequalities (such as by perpetuating digital exclusion) and design interventions that specifically support vulnerable populations affected by climate-related crises.
Teach sustainable digital literacy: Incorporate training for psychologists to critically assess the environmental costs and benefits of digital tools, helping the workforce see sustainability as integral to clinical effectiveness. Build in protected time for digital upskilling and reflective discussion within teams.
Make positive everyday digital choices: Reduce the hidden carbon footprint of digital work by sharing files via cloud links instead of email attachments, regularly deleting old emails and clearing spam, avoiding unnecessary printing, and using digital notepads and secure recording systems. Where clinically appropriate, use low carbon defaults such as remote supervision and paper-light workflows. Even small changes, such as streamlining email habits, can have measurable impact. Using a carbon calculator can make these savings visible, motivating behaviour change across services.
Far-reaching transitions

The challenges of climate change demand that clinical psychology 'change course', rethinking our practices, priorities, and use of technology in light of the planetary emergency. Both digital change and planetary health are key changes affecting our discipline, and should not be considered as isolated factors, especially as they both directly contribute to the discipline that future professionals will inherit.

Technology will undoubtedly be a part of the path forward in tackling the climate emergency. Its potential to shrink healthcare's carbon footprint, whilst present, must be tackled thoughtfully to avoid unintended environmental consequences. Thus, a mindset of sustainable innovation is required, embracing digital change whilst considering the full lifecycle environmental impact and ways to mitigate any climate downsides of developments. This is why the two considerations are two sides of the same coin, as they must be acted on concurrently. Psychologists are well positioned to advocate for this, bringing a human-centric lens to ensure that technology best serves human well-being without undermining environmental health.

Finally, a tone of advocacy and reflection is fitting. There is no denying that both the climate crisis, and the rate of digital change can feel overwhelming, and it is easy for healthcare providers to feel that their individual actions are a mere drop in the ocean. Yet, as the BPS (2024a) paper emphasises, collective action and leadership from professionals are indispensable for the 'far-reaching transitions' required, and digital change is no different.Sarah Lake is a Research Assistant working with Kompass Health. Sarahlake@kompass.health
Dr Penny Trayner is a Clinical Psychologist and Paediatric Clinical Neuropsychologist, and the Founder of Kompass Health, a rehabilitation data platform that tracks patient assessments, goals, activities, and outcomes to support personalised recovery and service evaluation. Penny is also joint Academic Director of the DClinPsy at the University of Liverpool.

Inspired by:

British Psychological Society. (2024b). Clinical psychology and planetary health: Changing course in the storm. Leicester, UK: British Psychological Society.

See also the 'Climate and the environment' collection.
References

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Tuesday, 30 September 2025

‘Attachment research gave some indication where we could start in trying to parent our seriously unwell daughter’




Robbie Duschinsky (University of Cambridge) reflects on parenting a profoundly unwell and disabled child whilst undertaking research and writing about attachment.

01 August 2025


Ibegan conducting research addressing child-caregiver attachment relationships in 2012. A few years later, things settled down for my wife Sophie and I in our jobs, and we felt it was time to start a family. I felt positive about becoming a dad, and reassured by what I had learnt from attachment theory and research. I understood about the importance of being available to offer support for a child when they wanted to explore (a 'secure base'); and to offer them help and comfort when they were distressed (a 'safe haven'). This is what attachment researchers called a 'secure attachment'. I doubted I'd be anything like a perfect parent, but that did not seem to be especially the point. Someone my child could trust – I thought that sounded possible.

The next few years were hard. Sophie and I celebrated the start of three pregnancies, only for each to end in miscarriage. Miscarriage is not so uncommon, and I remained hopeful, though these losses weighed on both of us.

In 2019, following a fourth pregnancy, our daughter A was born. However, it soon became clear that she was seriously unwell. We received news of our daughter's diagnosis of a very rare and serious genetic condition over the phone the day that lockdown began. The severity of the condition can vary. For A it has meant profound intellectual disability, long-term struggles with nutrition, and impairments in communication and mobility. Most immediately, she was in pain 16-20 hours a day for her first few years. Coinciding with the pandemic, lockdowns and huge healthcare backlogs, Sophie and I were largely on our own with our sick daughter, with limited access to help.

In 2021, A began having seizures, which did not respond well to medication, and since that time she has needed continuous monitoring day and night. At that time, she lost the ability to vocalise, eat, drink, walk, play with toys, smile, or even routinely recognise us. Now, heading towards her sixth birthday, some of these skills have returned, such as her smile and increasingly her ability to recognise us. Many skills remain partially or wholly lost.

Through A's early years, and still today to an extent, I faced a daily battle with feelings of hopelessness and heartbreak. In this context, something that made a profound difference was my work on attachment theory and research. Thinking about, researching and writing about attachment helped me retain a sense that whilst the situation could feel impossible, it did not mean that it actually was impossible. Sophie and I couldn't stop A being ill. But attachment research gave some indications of where we could start in trying to parent our daughter.

A lot of well-meaning nonsense and hazy generalities are circulated about attachment. Inaccurate information is so much easier to come by than accurate information – it's wild. But attachment theory and research has also generated some recommendations for parents, supported by researcher consensus as well as experimental evidence from attachment-based interventions. My experiences have given me an urgent sense of the value of some of these key messages. I have tried to make these accessible in my books, and especially in one for students and general readers called The Psychology of Attachment, written with my friends and colleagues Pehr Granqvist and Tommie Forslund.

The challenges A faced were extreme and rare. But the recommendations of attachment theory and research still had bearing for Sophie and I, maybe even more so given our daughter's suffering and need for comfort. The focus of this article is on the ideas I found helpful in giving some sense of how to proceed with A's care. I close by bringing the reader up to the present, thinking about what I have learnt from these experiences, and how these lessons have shaped me as a parent to A's little sister, as a co-parent with my wife Sophie, and also as a researcher.
Providing a safe haven

An early and important source of help for Sophie and I as parents was the idea of the caregiver as a 'safe haven'. By this attachment researchers mean that when a child is distressed, they are disposed to seek a familiar caregiver with the expectation of help and protection. Touch and comfort from a familiar adult, these basic things, help an infant to re-find equilibrium. Older children can get the same reassurance by other indications of the caregiver's availability. Even as adults we are still disposed to look for comfort when we are distressed, unless we have learnt that this will backfire.

In being available when a child is distressed, a caregiver gradually helps the child learn to trust, and to cope with difficult feelings (Ainsworth, 1985). The extent of security of each close relationship makes an additional contribution to a child's development in these regards, highlighting the importance of caregivers supporting one another in their provision of safe haven availability to a child (Dagan et al., 2021).

Sophie and I could not protect our daughter from pain. However, we could remain with her through it, holding her, and walking her up and down our little flat for unending hours. We could reassure her that she was not alone. We could try to teach her the expectation that when she was distressed, her mum or I would be completely there with her, even if, to our sorrow, we didn't know how to make things better. We could try to support one another with the grief we were feeling.

Attachment theory suggests that caregivers are most readily able to offer a safe haven to their child when they feel themselves supported by their family, community and society (Supkoff et al., 2013). Due to the pandemic and the severity of A's illness, at times we have felt quite abandoned by community and society, with exceptions. We have found it tremendously difficult to access support from health and social care services, who have often been hell-bent on reducing costs or trying to pass responsibility to other services regardless of what this means for A's safety or our family's ability to cope. Some professionals have gone above and beyond to help us. There's been almost no middle ground. Likewise many friends from before we became parents ran in horror at A's suffering and what our lives looked like. But some friends really stepped up to try to look after us, acting towards A like extended family. And since 2024 A has started attending a specialist primary school, which she absolutely loves, and which has reduced pressure on us too.
Attending to our child's signals

Attachment research has a premise that a lot goes on at the level of behaviour that mostly does not get noticed. On this basis, a second recommendation made by the attachment literature was the idea that caregivers can consider their child's actions as having 'signal value' for their experiences and needs (Ainsworth, 1977). The caregiver can be on the look-out for behaviours and vocalisations that might give relevant clues. This will allow the caregiver to accurately identify the child's motivations, and respond to them appropriately and in a timely way. For instance, being able to distinguish signals of tiredness from hunger or pain can be helpful in ensuring that the caregiver is available as a safe haven when needed.

It was very hard to discern A's experiences and needs. For her first years, other signals were often drowned out by pain. Then, with the seizures, she lost much of what capacity she had to communicate her experiences and needs. At times it felt that A was inaccessible to us, for all that she was physically present and required care.

Yet the idea of the child's actions as having 'signal value' suggested that signal might still be found, even if most of A's means of communicating her experiences and needs had been overloaded, blocked or damaged. We began keeping a moment-to-moment diary of everything we thought might have signal value, day and night: what A seemed to pay attention to, when she was capable of attention; bowel movements; coughs; when she fell asleep and woke up; changes in her breathing. Sophie and I worked together to try to interpret these signals.

This level of attention was, and remains, costly. It is exhausting, and comes at the expense of other things. But over time it has helped build our understanding of A's experiences and needs, allowing us to respond to them. We searched for A in these small signals, and in this way, over time, began to identify critical factors for her care, including triggers for pain and for seizures, and other indicators associated with better days for her. We discovered, for instance, that she loved cheesy '90s pop music (e.g. Spice Girls, Aqua), and given the lack of access to medical care, this was what we had available as pain relief for A for her early years.

Sophie and I feel that A acts like someone who believes that we are trying to interpret her signals and to help. On her better days she reaches out for contact, she smiles, and she rarely resists her medical care; she readily forms new relationships with people who are responsive to her cues. A knows we are listening out for her signals; and Sophie and I know that A's signals can be found and trusted. Despite all that we have to bridge in order to achieve this understanding, this sense of mutual trust makes a huge practical and emotional difference to every day of interaction and care.
Avoidance and Emotional Defence

A third point raised by attachment theory and research is that a child's signals of their experiences and needs can be obstructed by the caregiver's own defences (Main & Hesse, 1992), or when a caregiver feels chronically overwhelmed (Cyr et al., 2010). So when a child signals to us, our defences or feelings of overwhelm can hinder us from recognising or responding to these signals.

Attachment theory is sometimes perceived as about categories, putting people into boxes. That's a stereotype and simplification. In reality, we all have tendencies towards particular kinds of defence or dysregulation, tendencies that will be elicited particularly when we are under stress, and shaped and reshaped by the training our life continues to give us in how to cope. Parents, including those of children with additional needs, have our own histories. For me, A's additional needs have confronted me with the limits of my defences, not least from watching them buckle at times from the pressure placed on them.

A's quality of life is frequently not good. But with the passing years it has been generally getting better, and when she is not in pain or dazed by seizures she is a remarkably happy and resilient little person. Even so, perhaps the hardest challenge for me as a parent, my most pervasive defence, has been to bear to try to see things from A's point of view. Whilst able to cognitively attend minutely to signals of her experience and needs, I nonetheless find it aversive to imagine what A's life might be like for her. To go beyond A's signals and what they mean for what I need to do, and try to fully imagine her mind behind those signals.

Attachment theory and research teaches that avoidance is a strategy, one that can be protective when the alternative would be getting overwhelmed and dysregulated. It isn't bad. But avoidant behaviour by carers is penalised by the contemporary health and social care system: our experience has been that unless you are telling professionals repeatedly that you are not coping, help gets stripped away, even when this is manifestly unsafe. Additionally, attachment research regards avoidance as emotionally impoverishing when it is stuck in place. When we barricade ourselves off from the experience of others, this can help us cope, but also risks leaving us feeling empty (Slade et al., 2023).

Over the years I've given this challenge a lot of thought; I've talked about it with Sophie; I've had counselling through our local children's hospice. Though it is hard, I am learning how to use avoidance more flexibly, and try, where I can, to feel out what A's experience might be. The more I do, the more pleasure and pain I receive in being A's parent. As I do, the more A seems to respond to me and engage, even if her forms of engagement remain limited. This would be in line with the idea from attachment theory that exploration is facilitated when a child feels their caregiver's engagement with their experiences (Fonagy & Target, 1997).
The present

In 2022, Sophie and I had another little girl, L, who has been healthy and hilarious. The weight of past experience and day-to-day pressures of A's care has certainly affected me as a parent. As someone who generally thought of himself as quite silly, I can at times barely recognise myself in my parenting behaviour, which can sometimes be flat and exhausted, lacking playfulness.

I struggle especially with the rough play L enjoys, and requests most days: even faced with our firework of a toddler, my hands expect A's vulnerability, and it requires intense concentration to adjust. But Sophie and I also have an intensified sense of the preciousness of L's communications, and confidence in our capacity for teamwork as parents.

I continue to try to learn from attachment theory and research to inform me as a parent. Indeed, I sometimes talk in my head to the attachment researchers I have read or know about my caregiving responsibilities for A; I find this can help with making sense of it all.

In turn, my experiences as a parent have shaped how I have interpreted and undertaken attachment theory and research, and informed my writing about the topic. This has included a sense of wonder at the power of some of the levers available to caregivers: touch, noticing signals, provision of a secure base. I've also gained greater tenderness in considering the challenges caregivers may face in thinking about the mind of their child.

Experiences as A's parent have also given me additional questions. For instance, whereas attachment researchers generally treat 'safe haven availability' as a single thing, I've been brought to think about its different aspects, such as a caregiver's response to indications of pain, distress, fear and incomprehension. I have also become more critical of the limited way that attachment theory and research have addressed the wider context of family life, even when the data was available to do so. I cannot unlearn what I have learnt as a parent about the power of social isolation and failures of health and social care systems, and this has left a decisive mark on me as a researcher.

In Cornerstones of Attachment Research, written before A was born, I wrote of a sense of affection for attachment theory and its 'genuine insights into the strange, drunk-dialling human heart'. For all that I am more critical of attachment theory and research now, I couldn't have possibly known then how precious some of those insights would prove to me when I became a parent.Dr Robbie Duschinsky is Professor of Social Science and Health and Head of the Applied Social Science Group within the Primary Care Unit.
See also our 'parenting' collection.
Key sources and further reading

Ainsworth, M.D.S. (1977) Social development in the first year of life: Maternal influences on infant-mother attachment. In: J. M. Tanner (Ed.) Developments in Psychiatric Research (pp.1-20). London: Hodder & Stoughton

Ainsworth, M. D. (1985). Attachments across the life span. Bulletin of the New York Academy of Medicine, 61(9), 792-812; Goldberg, S. (2000) Attachment and Development, London: Routledge.

Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2025). Attachment in pediatrics: No such thing as a child. In M. H. Bornstein & P. E. Shah (Eds.), APA Handbook of Pediatric Psychology, Developmental-Behavioral Pediatrics, and Developmental Science (pp. 205–226). American Psychological Association.

Cyr, C., Euser, E. M., Bakermans-Kranenburg, M. J., & Van IJzendoorn, M. H. (2010). Attachment security and disorganization in maltreating and high-risk families: A series of meta-analyses. Development & Psychopathology, 22(1), 87-108.

Dagan, O., Schuengel, C., Verhage, M. L., et al. (2021). Configurations of mother‐child and father‐child attachment as predictors of internalizing and externalizing behavioral problems: An individual participant data (IPD) meta‐analysis. New Directions for Child and Adolescent Development, 2021(180), 67-94.

Doodeman, T. W., Schuengel, C., & Sterkenburg, P. S. (2023). Effects of the Attune & Stimulate‐checklist for caregivers of people with severe and profound intellectual disabilities: A randomised controlled trial. Journal of Applied Research in Intellectual Disabilities, 36(5), 1136-1149

Dozier, M., & Bernard, K. (2019). Coaching Parents of Vulnerable Infants: The attachment and biobehavioral catch-up approach. New York: Guilford Publications

Duschinsky, R. (2020) Cornerstones of Attachment Research, Oxford: Oxford University Press – free to download from the Oxford University Press website

Duschinsky, R., Granqvist, P., & Forslund, T. (2023). The Psychology of Attachment. London: Routledge.

Duschinsky, R. (2025) Developments in Attachment Research, Oxford: Oxford University Press – free to download from the Oxford University Press website

Fonagy, P. & Target, M. (1997). Attachment and reflective function: Their role in self-organization. Development and psychopathology, 9(4), 679-700

Foster, S.L., Schofield, G., Geoghegan, L., Hood, R., Sagi-Schwartz, A … Duschinsky, R. (2025) Attachment theory and research: What should be on the core curriculum for child and family social workers?. Social Work Education, forthcoming.

Main, M. & Hesse, E. ([1992] 2021). Disorganized/disoriented infant behaviour in the Strange Situation, lapses in the monitoring of reasoning and discourse during the parent's Adult Attachment Interview, and dissociative states. In Tommie Forslund & Robbie Duschinsky (Eds.) Attachment Theory and Research: A Reader (pp.108-132), NY: Wiley.

Mucha, L. (2025). Please Find Attached: How Attachment Theory Explains Our Relationships, London: Bloomsbury

Schuengel, C., & Oosterman, M. (2019). Parenting self-efficacy. In Bornstein M. H. (Ed.), Handbook of parenting: Being and becoming a parent (654–680). London: Routledge

Slade, A (2009). Mentalizing the unmentalizable: Parenting children on the spectrum. Journal of Infant, Child, and Adolescent Psychotherapy, 8(1), 7-21.

Slade, A, Sadler, L. S., Eaves, T., & Webb, D. L. (2023). Enhancing attachment and reflective parenting in clinical practice. Guilford Publications.

Supkoff, L., Puig, J., & Sroufe, L.A (2013). Situating resilience in developmental context. In M. Ungar, The Social Ecology of Resilience. (pp. 127-142). New York: Springer

Berástegui, A, & Pitillas, C. (2024). The family keyworker as a critical element for attachment resilience in the face of adversity. Journal of Family Theory & Review, 16(1), 106-123.

Vandesande, S., Bosmans, G., & Maes, B. (2019). Can I be your safe haven and secure base? A parental perspective on parent-child attachment in young children with a severe or profound intellectual disability. Research in developmental disabilities, 93, 103452.


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Wednesday, 24 September 2025

Feeling accepted versus tolerated



A recent study finds that embracing differences, rather than being ‘identity-blind’, leaves LGBT+ people feeling more truly accepted in the workplace.

16 September 2025

By Emily Reynolds


Diversity and inclusion have become central priorities for many organisations, with a wide range of strategies emerging to guide how differences are recognised and valued in the workplace. Yet we know less about the subtle, lived nuances of more complex experiences — such as the experience of feeling 'tolerated' in these contexts, a state that goes beyond exclusion, but falls slightly short of feeling like real acceptance.

In the British Journal of Social Psychology, Kshitij Mor and colleagues explore these feelings, asking how different diversity approaches can shape the experiences of LGBT+ people at work. They find that 'identity-blind' approaches, where everyone is treated the same without highlighting differences, are more likely to cause feelings of being 'put up with', rather than truly accepted.

For the first study, the team looked at data from 462 LGBT+ adults collected for a previous investigation. The characteristics of these participants were quite varied, though the vast majority were White. Participants were randomly assigned to read a diversity statement from a fictional company, either framed in an identity-blind way (downplaying differences and emphasising similarities) or an identity-conscious way (highlighting and valuing differences). They were then asked how much they agreed with the statement "I anticipate being tolerated at this company, meaning that people will not really approve of my identity but rather will endure and put up with me at work."

Overall, those in the identity-blind condition anticipated feeling more tolerated; around 30% moreso than those in the identity-conscious condition. In other words, more of those who read that the company encouraged employees to embrace their similarities rather than their differences felt they would only be put up with rather than approved of.

After an additional analysis looking specifically at demographics, the team also found that multiple marginalisation increased concerns about being tolerated overall. In both conditions, transgender participants reported about 19% higher anticipated tolerance than cisgender participants, for example, and non-White participants 16% higher.

Next, 445 participants answered a range of questions about their own workplace, including how diversity was approached by both their organisation generally and their direct supervisor specifically, whether they felt tolerated at work, and whether they had any intention to leave their job.

Similar to the lab experiment, when actual organisations and leaders took an identity-conscious approach, employees reported feeling less tolerated than identity-blind ones: on average, for every 10% increase in how identity-conscious an organisation or leader was reported to be, perceptions of being tolerated fell by around 5%. Unlike the first study, there were no significant differences between White and non-White employees, though transgender employees reported around 30% higher feelings of being tolerated than cisgender employees, suggesting that multiple marginalisation still played a part.

Leadership was also important, with employees of identity-conscious leaders felt less put-up-with regardless of how their wider organisation was perceived. The strongest effect, however, emerged when leaders and organisations aligned. In workplaces where both leaders and organisations took an identity-conscious approach, employees reported the lowest levels of feeling just tolerated, suggesting that consistent messaging can make a big difference to marginalised employees.

As ever, there are some limitations to this investigation. In particular, the team notes that their single-item measure of tolerance may not have captured the complexity of the experience, and that future research could look at its nuances: whether tolerance means acceptance under certain conditions, subtle exclusion, or something else. Capturing emotional factors which influence the feeling of just being tolerated could also have been useful, including wider mental health measures or motivation at work, as well as looking at a more racially-diverse sample.

Overall, the findings suggest that approaches that downplay differences, even when well-meaning, can leave LGBT+ people feeling as if they are not really accepted for who they are. To ensure that employees are genuinely benefitting from workplace diversity initiatives, organisations need to invest not only in their policies, but also their leadership, ensuring that workplaces move beyond tolerance and cultivate a real culture of acceptance and inclusion.

Read the paper in full:
Mor, K., Seval Gündemir, & van. (2025). "Are they just putting up with me"? How diversity approaches impact LGBTQ+ employees' sense of being tolerated at work. British Journal of Social Psychology, 64(4). https://doi.org/10.1111/bjso.70006


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Monday, 22 September 2025

Kindness

 (part one)

https://megjohnandjustin.com/relationships/kindness/

This time on the podcast we discussed kindness. Here on our free feed you can listen to our overview of what kindness is and why it’s so important. Then please check out our Patreon to listen to the rest of our conversation about how to be kind.


Listen here in the embedded player, or go here, or download the soundcloud app, or simply find us in your podcast app on your phone.

Our jumping off point for the conversation was these two quotes.

Kate Bornstein: ‘Your dreams are not dangerous. Your desires are not damned. Do whatever it takes to make your life more worth living. Anything at all. There’s only one rule to follow to make that kind of blanket permission work. Don’t. Be. Mean.’

Michael Brooks: ‘Be ruthless against institutions but be kind and forgiving towards individuals.’

In the podcast we wanted to reflect on what being kind – or not being mean – actually looks like in practice, and also on how we can be kind with individuals while being ruthless with unkind systems.
Watch our video here
Why now?

We see starkly the degree of meanness and cruelty in our wider world right now: the hatred and fear of difference, the desire to keep safe by policing and building walls against the most marginalised people – excluding them or imprisoning them. The pandemic and the #BlackLivesMatter uprising have both shocked people into greater awareness of all of our complicity in the current state: our histories steeped in colonisation, genocide, slavery, and exploitation, and the long shadows these cast over our current situation.


The question becomes ever more urgent of how we can find kindness for each other in our own communities, networks, and close relationships. This could provide some buffer against a wider world which feels mean and cruel. If we can find some different ways of being we might be able to invite others into this, or offer it outwards: another way of being where one person’s safety and comfort doesn’t rely on another person’s pain and alienation. Where people of all bodies, lives and labours can really be equally valued.
Kindness as praxis

Capitalist systems – particularly neoliberal capitalism rather than social democratic capitalism – are built on the idea that humans are fundamentally unkind and need regulation. The philosopher Hobbes’s model of the Leviathan was the idea that humans needed a monster to keep them behaving well. This is echoed in the popular book Lord of the Flies.

This can be juxtaposed with Rousseau’s idea that humans are fundamentally decent, cooperative, and friendly. Rutger Bregman’s recent book Humankind considers the evidence to support this idea that humans have capacity for kindness and it is the systems we’re in which make it very hard for us to be kind with ourselves and others. One part of the book involves finding the ‘real’ Lord of the Flies and noting that the shipwrecked boys actually developed practices and systems of kindness.

To act kindly and expect kindness in return (even if we don’t get it) is radical. It’s anti-capitalist. As philosophies from Buddhism to intersectional feminism have emphasised, kindness is essential because we’re fundamentally all interconnected.
Niceness or kindness?

Kindness can’t just be a veneer of ‘niceness’ or ‘harmony’ which covers over people’s pain, fear and rage, tone-policing all the difficult feelings away.

We distinguished between niceness and kindness on the podcast. Niceness responses often come from wanting to appear kind, but may not actually involve acting in the kindest way in a situation.

Author of Fucking Law, Victoria Brooks, talks about how real kindness requires work and effort. She distinguishes between talk about ethics (in research, law, medicine, etc.) which is often really about avoiding complaints or protecting ourselves or our institutions, and real ethics which is about asking what’s best or kindest for everyone involved.

Sarah Ahmed talks about how institutions often hire an individual – or bring in a trainer – to address diversity or sexual harassment as a way of looking like they are tackling racism or sexual violence, but actually leaving the systems and structures which enable those unaddressed.

Niceness could be seen as something like these examples: the veneer of kindness which actually enables cruelty to continue – on whatever level.

We finished this part of the podcast reflecting on how this happens in much sex and relationship advice. ‘Nice’ sex and relationships advice imagines we could tweak our current way of doing sex and relationship to be kinder, more consensual, and better for people. ‘Kind’ sex and relationships advice – in our view – recognises the impossibility of kind, consensual, fulfilling sex and relationship under the current – normative – cultural system, and endeavours to offer alternatives to that system and its way of doing sex and relationships. This is both why our sex advice book is so good, and why it doesn’t sell very well!

Sign up to our Patreon to listen to the rest of this conversation about kindness. There is gold! There may or may not be blow-job tips at the end.

© Meg-John Barker and Justin Hancock, 2020

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