Preface to a counter protest – Defence of the FCC
Oct. 19, 2011
The purpose of this paper is to establish the context for design of an intervention to change the outcomes for participants in the processes which occur here. It arises from our – Charles Brass and my - participant-observer experience at the FCC since early July this year.
The Fertility Control Clinic's front gate is a frontline of the struggle over life and death rights in Melbourne. There a group of Catholic protestors meet six days a week at 7:30am to protest patients' moral rights to a legal service authorised by elected representatives of the people of Victoria three years ago. Their protest expresses their unflagging commitment to expunging this parliamentary offence against the revealed word of gods.
Our goal is to improve the FCC patient experience by reducing the negative effects of the protestors' manner and methods. To do so we have to take into account all the players, direct and indirect, in the theatre of the public patient experience. Anything we do which increases patient stress is not a viable strategy. By chance, so far, the net effect of our presence has been an unintended positive for patients. Our presence appears to constrain protestors' harassing behaviour. We did not set out to do that at the start. We do now.
There is a set of regular players in this drama – the protestors, the security guards and large numbers of local residents and locally officed workers who pass through the frontline the five work days the FCC is open. The sixth is quieter.
The theatre of protest – a gauntlet to run
The typical 'facts' are simple. This is what you might see repeated perhaps twenty times a day:
The set: a two way black top with one lane access in the middle; one verge marked with a white line the other corralled by a 6 foot stone wall; midway is a recessed gateway with Fertility Control Clinic advised in large letters.
Onto this set six days a week between 7:30 and 10am a pregnant woman, with partner or family member(s) accompanying, walks along the footpath on Wellington Parade, East Melbourne, to the gated entrance of the Fertility Control Clinic. If she is coming for an abortion, she may be filled with conflicting feelings amongst which anxiety, shame and guilt may predominate. She may also have been told to expect watchers in wait for her – the 'pro-life' protestors whose aim is the reversal of the recently (2008) legalised practice of abortion in Victoria, and so they will explicitly and openly disapprove of her walk.
As she approaches, the protestors first appear standing on the curb side of the footpath. A couple, both men, have display boards dangling from their shoulders like spruikers for a year 8 sex-education class… 3D plastic portrayals of early stages in foetal growth and screen prints of ultrasound scans. A security guard, whom she perhaps has not even noticed, signals to her that she does not have to talk to the protestors.
Next, the patient encounters an 'offer' of help, often from a female protestor, to see her experience in the light of the only Catholic option – birth. She accepts it by stopping to talk or refuses by walking on by, sometimes with a verbal clarification on the way. Some protestors push their offer beyond the patient's refusal, to the point of attempting a verbal assault unless physically blocked. The patient's last message from the uninvited outside world may be "Don't kill your little baby…" as she's entering the inner world of the Clinic. Its door is always locked. Only a guard can admit her.
The 'set' – an emotional portrait
I have been a watcher, too, standing with the security guard for the Clinic, watching the watchers and at times explicitly protesting their protest by physically blocking their access to arriving patients who made it clear they did not want to hear from the protestors. The mood of this setting is just below the physical violence threshold. The guards and protestors have faced each other across the footpath for months (and years in some cases). Each day is a stream of boredom1 with sharp irruptions of rough water as a patient comes into view and a dance of offer and protection as in the theatre above is stepped out. The boredom produces a slow build of inexpressible energy which even the protestors occasionally fall victim to in moments of baiting the guards. For protestors and guards this is an experience of waiting with fear and anticipation. Fear roused by possible conflict runs from slight discomfort to irritability thru frustration on into anger and occasional rage. It is expressed in a running background struggle between protestors and security for judicial ascendancy: who can prove who is harassing who? Who can catch who fudging local short term parking rules?
Anticipation adds an edge of fight to the fear's possible flight - a situation poised for action; players waiting to take up their roles; the boredom of no patients being present holds them in suspension. This edgy experience fills about 2 of the 2 ½ hours each morning. The ½ hour of action is approximately 20 X 1 minute flurries, each event having its own specific, unique dramatic energy as the dance of entry plays out.The protestors and the guards both see the other as more powerful than themselves, and so threatening. The guards have physical and legal power on their side, though they have very limited right to use the physical – much less so than in other security contexts like night spots. The protestors have persistence, baiting and the niggling stretching of the notional behavioural limits of public protest on theirs. Both spend time trying to catch the other out in derelictions of roles. Hence the role of cameras in the daily drama, especially at moments of patient arrivals.
Patients walk into this set already tuned to potential assault from without by the assault from within of their own feelings. Refusing a protestor's offer is culturally more difficult for some than others, as it is psychologically more difficult for some than others. The simplest evidence for the acceptance which is not an acceptance is the number of protestor handouts given by patients to the guard as he accompanies them to the locked front door for which only he has the key. The guard's slow ritual shredding of the handouts in the protestors' faces completes the loop of patient refusal.Behind the scenes…
All of the regular players – protestors, guards, local residents and locally officed workers - are aware that this clinic is the symbolic centre of resistance to the Catholic, and other (religious) fundamentalist, "pro-life" protestors. It is not a political playground. A guard died here 10 years ago at the hands of a madman2, armed in part with the beliefs offered by the protestors to arriving patients. The protestor's case against the FCC sits, in part, on a thorough misunderstanding of what professional counselling's role is in clinics like the FCC. As has been explained to me first hand, that role is first to help generally with patient understanding of their fertility issues and second to help sort through the personal implications of a pregnancy, checking that all implications and options have been taken into account, including proceeding to normal birth.
It is professionally unethical to promote a particular patient conclusion as much as to hide a medically understood, socially viable and legal option. Those charged with the welfare of patients do neither3, if they can. There is no complaint book suggesting the FCC's counsellors have compromised their role. Fulfilment of that role does not include any assumption of what the right resolution is for any patient, other than that patients' unintentional ignorance of factors and options may produce sub-optimal resolutions.
Reality photo shoots??
Think of yourself being paraded by fate before an avowedly prejudiced audience which seems likely to judge you as falling short in some painful regard – an audience which will record your shame and give it a life by reciting it as end of day stories to their families and friends. And, they'll have a photo record of it, too!! Welcome to celebrity health in the name of the lord.There is always a hidden camera in the dress of one protestor capturing the daily comings and goings. This occurs in other protested sites in Australia and the US. That the cameras are hidden means they are ashamed of their actions because there is no legal reason to hide them. They know it is an unwarranted intrusion. Private photographs of anyone are just that until they are made public at which point pay-for-use and defamation concerns arise immediately. They know this, too. We've discussed this explicitly with the protestors.
The bigger picture
We guess that for protestors the patients are both individuals making their personal way through life challenges and symbols of mistaken pathways at the same time – that is, representations of big ideas, not people. I know that some protestors label patients, and us4, as evil. In their symbolic form for protestors, patients are bigger than their own reality and so open to any influence process, and righteously so in the minds of protestors. They, the protestors, would not present any assaultive materials if they wanted to maximise low-emotion responses from patients. High emotion responses express automatic defensive reactions, likely to elicit an automatic rejection of the protestors' offer – the reaction of someone feeling punished by unreachable others.
Because they are confused about their aims – helping the patients vs. helping the church achieve its mission of repealing the law – they assault as often as they solicit. One could say that any offer by a "protestor" under such circumstances is always a potential assault.
Larger struggles of this sort surround us in increasing numbers and depths. They take tangible shape in the human scale of face-to-face settings like the Clinic entrance on Wellington Street. That's just fine. However, this protest is executed through invasions of patient privacy in the open space between their transport to the Clinic and its front gate. They feel harassed, and 14 once-a-week participant observations by both of us support this claim. These are palpable harassments of visual, verbal and physical sorts. Research makes this observation more than a passing or stereotyped perception of ours5.
Onto this stage patients appear solo or in couples, in widely ranging states of disarray from the wholly contained to open crying. The core cast of protestors (in bunches of five or more) and guards (always only one at a time) can see them coming 100 meters away. The guards almost never mistake a patient for an in-transit local. The protestors, though more experienced than the guards (some being on deck at this site for 18 years) often propose their offers mistakenly. And if rebuffed by an actual patient, they are too likely to persist with a plea like "please save your little baby…" and follow them to the gate (unless blocked by the guard) repeating the plea over and over. At the same time, in the background, a visual assault is on offer. We know from the guards and patient reports that protestor actions are more invasive in our absence.
Disapproval and disenabling are the weapons of moral intimidation. The disapproval is obvious. The disenabling, more veiled. The agent of disablement is shame, with a backdrop of guilt. Shame is the public face of guilt and the passage from transport to clinic aggravates its power. Patients arrive in a context in which they are at best amateurs and are confronted by a working practice, an established order of things whose role players are thoroughly at ease with their purposes and moves, though not with each other!
Vulnerability and intimidation – the harassment equation
This makes the very presence of the protestors – physical, visual, and verbal – potentially invasive. It is especially so for those patients most affected by the experience of unwanted pregnancy. They are the most vulnerable and the least able to defend their vulnerability. In my most recent conversation with the most articulate and sympathetic of the protestors, there was no recognition of the immense power imbalance that patient vulnerability gives to the protestors, perhaps because they are so often unheard themselves.
They are aware that harassment is a matter of perception, but not that some perceptions of harassment have ethical priority over others. Clearly in counselling, patients' perceptions of their own vulnerability always comes first at the beginning of any work. This is also the medical rule. How else can we find out what they think/feel is wrong?I know the protestors are open to moral intimidation because I have quietly threatened to threaten them morally twice and the reaction was faster than the twitch of an eye offended by a wandering mote. So, they should appreciate their effects on patients, but the powerful seldom do appreciate their effects except as benefits to themselves. When I aim an openly held camera at them they shy away, while training a hidden one on me. Shame is a wondrous thing.
We are in the early stages of negotiating an agreement between all the players. Whatever form an agreed result might take, it will have to respond to the factors above. Keep posted.
1-boredom is a high energy state expressing one's frustration with a context with no accessible action opportunities, no way to focus an interest into anything.
2- see Dr. Susie Allanson's Murder on his mind (2006); Wilkinson.
3-declaration of interest: I am an AHPRA registered psychotherapist with a broad caseload of biopsychosocial disorders in which degrees of danger to patient viability are common; they are in danger from others or themselves.
4- "Fear the lord…" - In one of my more effective patient shielding efforts recently I earned the attention of a candle wielding, female, septuagenarian protestor's ire : "Fear the lord" she said drawing a roar out of her 4'10' body. I asked her later what she meant and she said (roughly) "…because it's written in black and white, thou shalt not kill and what you are doing is evil and the lord will come and take you away, snip, snip, just like that (with a snip of her fingers as if pinching off a wayward stem)."
5- see Hilary Taylor's Parliamentary Intern Report "Accessing Abortion – Improving the safety of access to abortion services in Victoria", June 2011.