Prevention: An angel you don’t know for the devil you do

The devil we know

‘Better the devil you know‘ we say. It’s ‘better’ than taking a risk with ‘the devil you don’t know’ who could be even worse.

We like the status quo. Evolution tends to select risk-aversion. Attachment is the safe-base from which we take-off. Familiarity breeds content not just contempt.

With minor gremlins our inertia doesn’t matter. But strangely, even the worst devil keeps us in its grip: “There’s no way out,” it whispers in our ear. “You have to keep fighting me.”

Helpers arrive to join the fight. They too can get locked in to the grim struggle. These frontline mortal angels of mercy offer essential rescue and repair. If that’s all there is, emergency help becomes an important job. It’s fuelled by compassion, gratitude, fame and payment.

It can be hard to separate the devil from the helpers. The whole struggle becomes the devil we know. With helpers weighing in, new strife grows when they don’t pull together. Conflict between helpers may mean they become extra devils to each other. Confusion follows over who is the main devil and who should be working together.

The point here is that the devil locks in and rewards the frontline struggle to discourage searching for an angel. So how do we break free enough to look for the angel we don’t know? Maybe it goes like this:

Treachery?

Someone, someone’s mind, needs to break free from the devil of a fight that’s in front of them. Sounds like a wimpy cop out, doesn’t it? Cowardice, desertion of duty, traitor. All hands are needed at the front line, now.

And what if there is no angel? What if the devil we know is all there is? What if the angel can help some but not all, and not a victim as bad as this one? What are the chances of finding an angel in time? At best, very slim indeed. The angel may only help future cases.

So we stay with the raging struggle. The more victims appear and the fewer the helpers, then no one gets a break from full-time frontline fighting.

But if the front-line fight doesn’t work, if more and more victims pile up to be rescued, at what point does someone have to risk being sensible? … to break free and say:

“Look. This isn’t good enough. We have to try to find that angel. Even if we can’t find one, we must keep looking. Even if the best the angel can do is prevent the devil’s work for other cases in future, someone must search hard to find it.“

Prevention, did you say? That’s pretty hard for those suffering now: They’ve to be left to suffer and wrestle while someone slopes off to find something that may not exist and certainly won’t arrive in time to help this one’s plight. All you can say is:

“Well surely you, the victim and helpers right now, would have wished someone before now to have found a way to prevent this happening to you?“

The devil you know may be your angel

So, the search for an angel holds no promises of ever finding one, nor when, nor how strong it will be for one or all situations. While the search goes on, the devil we know is still better than giving up. With no angel on the horizon, it is essential to keep going with the devil we know. The devil you know has to be your angel for the duration. It’s important for another reason too: Fighting the devil you know creates the essential clamour to let the world know there’s a scourge to defeat.

The argument here does not presume angels will be found. It seeks only for the freedom to search for them. Finding angels may take dedicated people years of time and effort. Already here our hopes have been downgraded from defeating the devil we know now, to preventing future similar devils. It’s a fair assumption to make: After years of rare success over the devilish troubles we know, the chances are poor of finding an angelic solution for them.

To use another metaphor we’ll come to, cure is better than prevention if that’s all you’ve got. Searching for prevention doesn’t mean we abandon the frontline fight for a cure. We need to do both.

Prevention: An angel we don’t know

OK. So prevention requires a search for an angel we don’t know yet. The devil you know will do everything to stop the break away to find the angel of prevention. Courage may be required to face down the taunts of traitor to the struggle

This gradual argument here is to respect the need for a strong case to free us to make new, more sustained searches for prevention. Let’s look some more at what it takes, why we need to find that angel.

Prevention is habitual and everywhere, preventing minor and fatal risks. Cleaning teeth, fire drills, pedestrian crossings, vaccination. Prevention is better – when it gets going – than dramatic intervention at the last minute. Prevention may be an annoyance, but it’s usually better even when there is a good cure.

The tension between prevention and intervention is well described by Hans Rosling in his book Factfulness (2019). On page 111:

“In these situations [bodies of dead children being pulled out of the debris] we must forget the big picture and do everything we can to help. The big facts and the big picture must wait until the danger is over. But then we must dare to establish a fact-based worldview again … make sure our resources are used effectively to stop future suffering.”

And pages 124-8 the story of how, in extreme poverty, community measures save many more children than hospital care does:

“It felt almost inhuman to look away from an individual dying child in front of me and toward hundreds of anonymous dying children I could not see.”

Note that imperfect prevention – prevention that is not 100% effective – may still be worth doing: We brush our teeth even though we sometimes need the dentist.

Here devils and angels are impersonations of life’s most severe problems and their solutions. The devil is emotional hand-to-hand combat; the angel is cool strategic thinking. The reward when we find preventive solutions is that at least some severe problems simply vanish. In the future, that is.

Our fond familiar status quo

So far this is a picture of human beings attached to their familiar status quo – justifiably, fondly or miserably, but attached alright. The status quo bias is well-researched human nature: changing is twice as hard as staying with what you know. The science of personal and family attachment helps us understand the attachment to status quo:

Even if a parent or partner goes devilish on you, it’s hard if not impossible to give up on them. They’re your blood, your only family. They’re what you know, what you’re familiar with. ‘Familiar’ goes with ‘family’ which used to mean ‘household’ including servants. I was as attached to my Ayah in India as to my parents. She wept when I left.

Insecurity leads you to cling more to the only secure base you’ve got. So it can compel your nearest and dearest into enduring devotion to your well-being.  Coercively controlling relationships in families and in cults employ disturbed attachment patterns to achieve brain-washed mind-control, or just enough terror to entrap, but always to soul-destroying effect. You’re in the grip of the devil you know because it feels like you belong together.

Family attachment here is still just a metaphorical image of wrestling with the devil we know. Soon we will get to disordered family attachment patterns as the actual devil of a problem we’re grappling with. This slow build-up of the rationale of prevention is to help us think calmly about it – which you can’t do when you’re wrestling for your life.

Four more prevention metaphors

Here’s four more simple metaphors that make the same point about urgent intervention and prevention. Each has its own usefulness when we look at prevention. The devils in these metaphors are all potentially fatal. Three are on a short time-scale, one carries a longer one.

Ambulances at the foot of the cliff

Dangerous cliff. People stumble and fall to the foot of it. It keeps happening. Yes, ambulances are needed when it happens. But it is just stupid if all we do is keep ambulances standing at the foot of the cliff. Better to prevent people falling at all. A fence at the top, for example. That would stop a simple accident.

But what about thrill- and suicide-seekers who will climb over the fence? Preventing their falls requires less simple earlier measures linked to education, to helplines and mental health services, to safe cliff-climbing or safer alternatives for walkers and thrill-seekers.

This simple metaphor makes the simple point well about prevention rather than emergency services only. But many severe problems – family law cases, crime, the war on drugs – typically love vehicles with flashing lights as their solution.

Falling in a river

Rivers are often beautiful, safe and recreational. You can swim in them for fun. Often ‘being sensible’ is the invisible fence. But you can get out of your depth, get swept away, drown. As with cliffs, prevention for those less sensible includes warning signs or earlier education and appropriate earlier services. Unlike cliffs, intervening after falling in is also a prevention of a worse fate: drowning. We can imagine getting people out as soon as they’ve fallen in. Or we can imagine them half-dead being rescued downstream where we do need those ambulances.

Again, we see how ‘upstream’ is the obvious place for prevention. Prevention may be long before or just before falling in. A rescue shortly after falling in counts as prevention of the long rough ride downstream, and of drowning.

Of the four, this river metaphor best matches what a family faces with family law after they separate. There are some families who trustingly enter the river of family law, are welcomed rather than advised to get out, don’t realise how deep and dangerous it is, cannot get out nor find help to do so, float for months and years downstream just keeping their head above water, and (if they’re lucky and rich) they might be rescued way downstream when they are not much more than alive. All the adults involved pay lip-service to the priority of children’s welfare, but actually the kids may spend much of their lives carried along the dangerous river.

Car crash

The car crash metaphor makes the obvious obvious. We all know about car crashes, their serious dangers, and what it takes to prevent them or protect those involved –  driving tests, vehicle MOT, speed limits, don’t drink and drive, car seats, well-designed roads and strict enforced road safety rules. Oh – and ambulances for when crashes do happen.

We didn’t always know about all these ways to make cars and roads safer. But notice that the safety campaigns do not first have to tell us about how terrible car crashes are: We already know that. The safety campaigns can focus on ‘clunk click every trip’ or ‘don’t drink and drive’. A car safety campaign doesn’t need to call itself: Car Crash UK.

But when it’s an unknown scourge, eg a family relationship ‘car crash’ after parents separate, then the campaign might have to name and raise awareness of the scourge first.  Until everyone knows about the hidden scourge, nobody (else) sees the need for intervention and prevention.

Car crashes also illustrate how the most obvious prevention – doing without cars – isn’t acceptable: life and progress come with risks. We often have to find second-best kinds of prevention.

Epidemic illness

The classic models of intervention and prevention come from illness and epidemics. Take cholera: it’s a gut-draining infection. It is fatal in hours but quite easily treated at the frontline with fluid rehydration and antibiotics. Medical teams – arriving in ambulances – are essential for emergency treatment. The devil is clear – it’s the emergency illness. The roles of the other frontline players aren’t confused: the patient, the medical team, the treatment.

This metaphor is powerful because we now know that something quite different is the best solution for cholera. Cholera epidemics only happen in areas that don’t have clean water systems. Sanitation is the best prevention of cholera, illness and deaths, not hundreds more medical teams. And sanitation prevents lots of other diseases too.

And with this dangerous devil, cholera, that requires brief wrestling at the frontline, the medical teams celebrate when they lose their jobs to prevention by sanitation. The right attitude to solving a scourge like cholera is prevention – make sure the world knows how terrible it is, work tirelessly to find the angel of prevention that works, and finally the medical teams celebrate the loss of their frontline jobs. There should be no grieving, no holding onto the devil you know, when a devilish scourge meets its avenging angel – sanitation in cholera’s case.

Mapping metaphors together

The formal framework for prevention of illness talks of primary, secondary and tertiary prevention (of morbidity and death). In fact secondary and tertiary are more intervention than prevention. Primary prevention seeks to prevent a disease happening at all. Secondary prevention aims for prompt treatment from the pharmacist or family physician as soon as symptoms appear. Tertiary prevention is when specialist intervention is called for, maybe as an emergency, when symptoms continue, the condition is complex or gets worse.

These formal concepts and actual examples can be mapped onto the metaphors: devil/angel, cliff, river, car-crash, cholera and medical prevention. Thus, for families and family law, not falling in the river is primary prevention; getting helped out where you fall in is early treatment or secondary prevention; being dragged out way downstream is specialist treatment or tertiary prevention.

Sometimes the river of family law and family courts takes parents and their children for a long harmful scary ride. A few get tertiary prevention (that is, prevention of drowning) way downstream. Others get nothing. If this system is the only way, then it is a case of better the devil we know.

Here we’re simply negotiating permission to check out alternative prevention. And there are some courts in Europe and Israel that focus on secondary prevention by getting people out of the river as soon as they go in.

Does this devil help or hinder a search for an angel?

This example of a legal process framed by a medical prevention model leads us to focus on the specific case of families going through family law. For example, medicine and its allied professions are now required to be evidence-based in scientific method, research and service delivery. Rigorous transparent studies carefully define diseases and sufferers so that we can precisely see what treatments produce what effective outcomes. There is none of this rigorous research for children and families going through family law. Evidence means something quite different in the adversarial legal context.

When we come to search for the angels of prevention for family troubles after separation, there is a fair question about whether family law and its allied professionals is the right system for the job. But that’s for another time. Here we are asking a smaller question about how a system may have the best intentions, may be all that there is (for now or even forever), and yet it can lock us into wrestling with it like the very devil that stops us breaking free to even think of looking for angels.

Mostly we have not put our minds to, nor come up with, universally effective preventive angels for the worst devils after families separate. So we are left – by default not choice – with the devil we know. Across the Westernised world the system everyone typically heads for is family law.

How family law behaves may be reasonable, rule-bound and required within that system. Those running it may well be just doing their job.  But the high status, independence, power and trust the law is given, means that it is liable to operate unchecked in its own bubble.

If you know anything about family law, you can apply your own experiences here to answer these pointed but neutral questions. The focus is solely on how far the current river of family law does or does not invite us to begin to search for the angels of prevention. What do you reckon?

• Does the world know – what does the world think – awaits the child and family after they separate and head for family law?
• Are the worst troubles well-known like car crashes are? Does the world know what a terrible scourge it can be?
• How far do legal people recognise that things may sometimes not go well in their hands? How many lawyers speak out about their system and their clients?
• Could it be that it’s all too complicated for non-legal non-specialist outsiders to understand, that legals just know best? Or might there be ways to describe what is happening in ordinary language so that everyone immediately understands what’s wrong?
• Does family law operate more like those ambulances at the bottom of a cliff or like there’s a fence at the top of it?
• Are there effective warning signs anywhere about the risks of bathing in the river of family law?
• How well are separating parents pointed to or required to use the alternatives?
• How well does family law warn people against jumping in that river?
  • Why would a lawyer deter clients when their firm’s contract requires them to generate income or lose their job? Or
  • when they don’t have the training or code of conduct that every other helping profession has to learn to manage concerns for risk and child protection? Or
  • when they do what the whole of their profession has always done and thinks is good practice?
• Once welcomed into the river, does anyone else try to warn or pull the client back to shore? Is the river more powerful than someone waving on the shore?
• Once caught up and rushing downstream, how easy is it to get to the shore and pull yourself out?
• Does anyone on the bank know how to throw a line to someone in the river?
• How actively do family lawyers or courts encourage and advise their clients to catch that line and get out?
• Do or don’t lawyers reassure that it’s best to trust them, go with the flow, that somewhere downstream – by keeping faith and paying the bills – this mystery ride will end with even a chance of what a client hopes for?
• Where health services and helping professions hold to reliable standards of professional care, service and safety, how far does the family law system do that? How often is the assurance that ‘in some places it sometimes works quite well’ – which would never be acceptable for, say, a paediatric service?
• Does the client get given any information or statistics about what their chances are downstream? Is there any data there anyway – such as there is from health service staff about proposed treatments?
• How much does a client get told about that rare last option of expensive emergency ‘ambulance services’ way downstream?
• Does the legal profession – and the other heroic professions who help them to rescue bodies way downstream – look like they are ready to celebrate losing their jobs when the problems that come to them are prevented upstream?
• How far do your answers to these questions give you a picture of family law welcoming the search for angels? If you found some angels, how far do you get a picture of readiness to make the changes the angels require?

The answers to these questions do no more (here) than tell us how far private family law is or is not enabling us to look for alternative solutions. Remember that once we have gained the fullest freedom to break free and search for angels, we may still find that family law is the better devil we know. Or we may find that family law in general isn’t actually interested or capable of changing its ways in the face of the better angels we find – or the ones we already know about.

What can prevention offer post-separation trouble?

Our metaphors help us see how a prevention focus may be really challenging and even annoying. It cannot provide reliable solutions to things that are past, or current, or even in the near future. Changing systems and cultural beliefs can take a long time, decades even. Yet we know that a specialist prompt effective court in Israel changed the expectations of the community in that legislature within months.

We wish someone had sorted prevention out before, so that we didn’t have to suffer so badly and work so hard. But no one has. So we are the people now who need to work on prevention for the children and families of tomorrow. Patience is required when we all want answers yesterday. It is easy to be pessimistic when no part of the current system functions well because the whole system seems to be struggling and dysfunctional. In other words, a comprehensive solution will only work when we have worked out a preventive plan thoroughly in principle and got it working in practice. So the best prevention plan will be both attractively efficacious and quick to set in motion. But more likely it will take time, money and doggedness.

Prevention aims to create a functioning system that stops in its tracks as much trouble as possible upstream. Prevention often prevents a wide spectrum of troubles. That may include preventing or lessening the severity of the worst cases. But it might not. We won’t know this until we’ve tested out the chosen prevention. Like brushing our teeth, prevention is still worth doing even if it doesn’t prevent the worst cases. For the worst cases, the skills of later intervention will still be needed.

The attraction of early or primary prevention is that it will promote a world where family ties are automatically safe, sustained or repaired after separation because everyone expects it automatically, just as everyone expects kids to get schooling. That would mean prevention would be self-sustaining. The need for any systems of support or intervention would be minimised.

There are two kinds of social impact campaigns targeting this change of culture. And both are valid:

1. Those that seek to raise awareness of the scourge using a special label (because it’s not known like car crashes are). Examples are Good Egg and PA Europe.
2. Those that promote awareness and social change in ordinary language and ways that will prevent the scourge (without special labels). Examples are Erasing Family and For Kids Sake.

Searching for good prevention is like any thorough problem-solving process. As well as out of the box thinking (like sanitation for cholera), the factors that hinder family ties after separation can be systematically explored and adjustments tried out.  For example, three general hindrances are:

1. The general assumption that children are fine with only one parent;
2. The new sensitivity to abuse and harm to children that exposes our need to learn more about ’emotional abuse’, ‘coercive control’ or ‘psychological maltreatment’ everywhere as well as in family law;
3. The widely held assumption that a parent who abuses should be immediately evaporated when even abused kids seek and need the best safe relationship with both their parents to be skilfully supported and repaired where possible.

And the good news is …

With the help of metaphors this slow unpacking underlines the obvious – the importance of prevention in general. And it shows why we have to understand and work our way out of some strong resistance to do it. Prevention requires dedication, hope and patience. Quick solutions are possible but cannot be assured. We have applied the prevention framework to the troubles that children and families can face. We have asked questions about the most common system of help after separation – private family law – in blameless terms only, of how easy or difficult it is to break free to search for an angel of prevention that we don’t yet know for this devil that we do.

The good news is that there are lots of good prevention ideas and pilot projects around the world for troubled separated families. In fact there’s a whole conference on this topic: Protecting Family Ties After Separation NOW! It has had to be postponed into 2021 because of the COVID-19 pandemic. Sign up for email updates on the website here.

Protecting Family Ties After Separation NOW! Click for more

Nick Child, Edinburgh