A Denial Or Not

At last a reply from the NHS to our MSP’s letters (see here). The reply doesn’t address the main points of the MSP’s letter and we will respond fully through the MSP in due course. There is one aspect I want to highlight now: the NHS reply contains the weakest denial I have ever seen. So weak is the denial, in fact, that it doesn’t act as a denial of Mrs Carr’s claims but actually confirms them.

The MSP wrote:
“I do not believe that your letter [NHS first response] addresses the main point of my letter of July 2007 [MSP’s first letter], which is that Mrs Carr is in urgent need of care. There appears to be a view that Mrs Carr's behaviour is as a direct result of the ending of the therapeutic relationship with Dr X. Mrs Carr was told by Practitioner A at assessment that her behaviour was part of a cycle of escalation to secure a response from Dr X. This view, however, doesn't seem to appear in any case notes . Mrs Carr strongly denies that this is the case. However, even if it is the case, not dealing with her behaviour, including her suicide attempts is not addressing the problem. Can you confirm whether or not clinicians, apart from Practitioner A, believe Mrs Carr is deliberately escalating the situation and is that the reason why NHS therapy is being denied totally?”

The NHS reply does not address the issues of Mrs Carr’s urgent need of care and of whether other clinicians believe Mrs Carr is deliberately escalating her behaviour but attempts to deny that Practitioner A said anything about Mrs Carr’s escalation. The attempt is so weak as to be meaningless in terms of a denial but rather it confirms what it seeks to deny.


The NHS reply states the following:

“Dr Z advises, that during psychotherapy assessment and treatment that a therapist may often explore motivation behind a person's behaviour. Dr Z confirms that motivation can be conscious or unconscious i.e. within or not within the person's current awareness. Dr Z advises that during this assessment process that Practitioner A may have explored the motivation behind Mrs Carr's behaviour but does not feel it is accurate to say that she advised Mrs Carr "that her behaviour was part of a cycle of escalation to secure a response from Dr X".


Let's look a little closer at their quoted paragraph. The reply states:
“Practitioner A MAY have explored the motivation behind Mrs Carr's behaviour.”
Either Practitioner A did or didn’t explore.

“but DOES NOT FEEL IT IS ACCURATE TO SAY that she advised Mrs Carr ‘that her behaviour was part of a cycle of escalation to secure a response from Dr X’".
Why not write “did not say”? Because she did say.

Why use a quote from the MSP’s letter? The MSP did not state that Practitioner A had actually used these words. Therefore it is much easier to deny specific words which weren’t even used …… except that it isn’t even a denial.

Why have Dr Z saying what she thinks Practitioner A may or may not have done or said or meant? Why not state what Practitioner A did and said and meant?

Instead of all these weak words a genuine denial would say something like:

“Practitioner A made no comment to Mrs Carr about escalation and believes that Mrs Carr’s behaviour was not escalation”
or
“Practitioner A explored the motivation behind Mrs Carr’s behaviour but made no comment to Mrs Carr about escalation and believes that Mrs Carr’s behaviour was not escalation”.


If the NHS could correctly state that Practitioner A had not suggested to Mrs Carr that she (Mrs Carr) was escalating her behaviour they would have said so very strongly. That they use weak words means that they cannot make a formal denial. Therefore, the NHS reply is not a denial; is nothing like a denial; it’s the weakest denial one could write; it’s a non-denial denial. It is confirmation that Mrs Carr and the MSP are correct!


Will Practitioner A please take the stand?

Do you promise to tell the truth, the whole truth and nothing but the truth?