The author of this piece was a patient at the Peter Dally Clinic for five years and David Britten was in contact with her for over 11 years in full. She wishes to remain anonymous for the purposes of this article.

Britten – From Victim to Survivor

I first became unwell with Anorexia and Bulimia in my late teens and was admitted to an eating disorder clinic in the early 1990’s weighing just five stone. I was seriously ill both physically and mentally, and an admission to the clinic was thought to be a life saving measure. I was not to know however that this was only the beginning of over a decade of being caught in the clinic’s dysfunctional web.

From my early days on the unit staff and patients alike talked about David Britten (DB) with almost awestruck reverence. He was certainly ‘King Pin’. It was as if no decisions could be made without him as he was the ‘expert’ and always had the last say; even overriding the decisions made on occasions by the doctors. From an early stage it became apparent that one was considered to be privileged and special if DB demonstrated any interest in you. Initially I found him to be intimidating, not surprising given how much he had been hyped. Despite those initial feelings however he quickly and cleverly engaged my trust, for example by overriding treatment decisions that I felt unable to cooperate with but making it clear that he was doing this for me at the cost of being reprimanded by his colleagues. He said that he would risk this only because he thought I was special.

No-one challenged him
Early on he would make comments about my physical appearance, saying he found me attractive and would touch me or kiss me. When I recoiled he told me that accepting touch in this way was part of my recovery and that I was avoiding anything to do with being a woman. As my contact with him increased so did the nature and extent of his sexual advances and intrusive sexualised questioning.

There was a great deal of competition amongst us patients for DB’s attention and any number of us would be waiting to see him. One was certainly considered to be very special if he saw you for individual meetings even by staff. He saw a number of us individually and would conduct these meetings in his locked office, saying that unless his door was locked our meetings would be frequently interrupted as he was in such high demand. Staff did quite often knock on the door and find it locked even on occasion asking for me when I was in there. However no one challenged him as to why I was locked in there with him.

I had no reason to doubt him
Eventually I was referred formally to DB for psychotherapy. He told me he was well qualified, and that I was very fortunate as he only saw a favoured few for therapy at the clinic; that he usually saw patients for therapy privately. I had no reason to doubt him or to question the nature of what I thought to be a clinical referral. I lived for our meetings and trusted him implicitly. However if I rejected his advances or indicated in any way as to how uncomfortable they made me he could become quite cruel for example by cancelling our sessions or having another patient in with him when I was due to see him. By this point I had become completely dependent on him and was devastated and felt punished when he wouldn’t see me. I would beg to see him and he had me believe that no one else understood me as he did and this prevented me from discussing my difficulties with other staff. He said that he understood eating disorders like no one else and it was rumoured amongst us patients that he himself had suffered from Anorexia.

We would often meet outside of the clinic; he would take me to bars and restaurants and visit me at my home. He persuaded me that we were having a relationship and that he loved me, but always on his terms. Over the course of time, DB told me many details about his personal life: that his mother had died when he was a teenager; that he had a disabled brother who was an alcoholic; that his fiancé had died on their wedding day; and some most devastating news that he himself suffered from Non Hodgkin’s Lymphoma, a form of cancer. This had a huge impact on me and I became very depressed as one would when faced with the impending death of someone so significant in your life. He would often use the cancer as an excuse for periods when he would go away with no contact leaving me distraught, and as the reason why our relationship could not become permanent in the way that I wanted it to be. His disclosures about his illness became more and more convoluted, and far fetched, but I truly believed that he was dying. DB’s brother was also in contact with me and I now suspect that he too was involved in his illicit activities.

Our meetings were clandestine
DB ensured that I didn’t speak about our relationship; he told me he was putting his career on the line for me. Our meetings were always clandestine and he said he knew the professionals outside of the clinic I was likely to talk to. He told me that he knew these professionals personally, and also that there were staff at the clinic who were jealous of his position and were out to get him ousted.

I knew he had been suspended in 2001 but he told me this was a conspiracy to get rid of him and I had no reason to doubt him. He had always been revered as being ‘married to his work’ and he encouraged me to join other patients and staff who were lobbying to get him reinstated.

Then in June 2004 everything I thought I had believed in was shattered. I found out quite by chance about the real reasons for DB’s suspension and dismissal, that our ‘relationship’ had been anything but, and that I had been caught in his elaborate con plan affecting any number of women in similar and sometimes almost identical circumstances to my own, probably since the early 1980’s. Most painful of all was the realisation that I wasn’t the ‘only one’ and that what I had experienced was indeed abuse.

We patients were effectively silenced
I chose to attend the subsequent Nursing and Midwifery Council Hearing, the outcome of which was that DB was struck off the nursing register. I heard the shocking testimonies of the women who were brave enough to expose his fraudulent and often malicious deception. Of how he had manipulated them in quite the same way as I had been and that his disclosures about his cancer were most probably untrue.

The hearing revealed a catalogue of clinical and management failures and loopholes that easily enabled DB to create his own locked empire where he could boldly exploit and abuse vulnerable young women without questions being asked. Such was the strength of his reign that even when concerns and complaints were raised about his conduct by both staff and patients and that there had been an internal investigation in 1998, he was allowed to continue to abuse us without checks being made, in a culture where staff felt unable to challenge him and we patients were effectively silenced.

I was appalled to hear about his behaviour; his refusal to be supervised was explained by his managing consultant psychiatrist as attributable to his ‘unusual way of working’. His supervisor felt terrorised by him, wasn’t able to manage him and didn’t feel supported enough to take her concerns further. It quickly transpired that many staff actively colluded with him and those that didn’t were quickly pushed out or bullied into complying with his regime.

Staff members who gave evidence at the hearing, including his supervisor, were commended by trust’s chif executive for their bravery in coming forward. They may have felt harassed and intimidated by DB and we were meant to be grateful that they were finally speaking out, but the fact remains that they were the professionals in this situation and owed us a duty of care. They let us down by not whistleblowing or challenging his behaviour a lot sooner and I can’t bring myself to be grateful for their failure to protect us.

The staff who colluded with him quickly left the clinic’s employ. We were told by the Trust that had they not left, they would have faced disciplinary action. Those professionals are still working within the NHS and I am amazed that they have been allowed to continue to work with vulnerable people without any blemish on their records.

I was met with huge hostility
Initially I was impressed by the support given to us from the chief executive, we were all extremely traumatised and he seemed to have a real commitment to our well being. He made many promises to us that our long term needs for support and treatment would be met after the hearing. This was not to be however and my experience was that after the hearing we were left fighting for therapy and support. Indeed it was six months after the hearing that were even invited for a debriefing, at the clinic where the abuse began. It was a further year before therapeutic support was arranged. As I began to ask questions about why we were not being supported and indeed started to need answers as to how and why such abuse had been allowed to occur I was met with huge hostility. My impression was such that the Trust wanted to move on from a sordid affair and wanted us to do the same. If only it could be as easy for us as it was for them.

This prompted me to seek legal advice, as I was not happy to leave matters there without any acknowledgement of our suffering or any demonstration by the trust that they wanted to learn from what had happened to us.

Then began the legal roller coaster, a most painful, dramatic but ultimately empowering process of extremes of highs and lows. This was the beginning of my quest to turn from victim to survivor. I sought to ensure not only that our suffering was recognised but also to get an explanation of why we were so horribly failed by the system. I wanted to ensure the safety of future patients treated by the trust. I was joined by six of the other women and together with a skilled and sensitive legal team we set about suing the Trust for negligence. This was no easy task given that it seemed our case was quite unique and that we had a number of legal barriers to overcome. One of the most distressing of these was that in preparation for our case we were required to be assessed by two leading psychiatrists to ascertain the psychiatric damage caused by the abuse. The Trust’s expert, a seemingly kindly man and a leading expert in Eating Disorder’s after questioning each of us for a gruelling four hours deduced that DB was merely a philanderer and that we were unfortunate to have fallen prey to his charms, but that his behaviour could not constitute abuse. This was devastating to hear and had a very detrimental affect on us all. We could not believe that an eminent psychiatrist could draw such outrageous conclusions and undermine the magnitude of what we had been through; with these attitudes no wonder such abuses occurred within mental health services.

Eventually after many ups and downs we agreed with the trust to try and resolve our case at Mediation, however even there although we received financial compensation and were relieved not to have to go through the additional trauma of a High court hearing, we still did not receive an unreserved apology, as this would have only been made conditionally.

It is unlikely that DB will never be fully punished for robbing me of so many years of my life. He managed to manipulate every area of my mind and it will take time and skilled treatment to help me unravel the knots he so tightly tied. My life was quite literally on hold and in his grip for over ten years, preventing me from enjoying any semblance of normality and where I have slipped in and out of severe depression. I do feel as if I want to survive now. I am no longer sinking and gasping for air but feel as if my head can finally be allowed to stay above the water.

It doesn’t end there
It doesn’t end here however and we are anxiously awaiting an independent inquiry commissioned by the Department of Health. We hope that it will hold those that failed us to account and provide us with some cohesive answers. I remain concerned that unless lessons are learned and preventative measures enforced, that a climate continues to exist where future patients are at risk from professionals who could so easily slip through the net. I hope that the enquiry’s recommendations will seek to close some of these gaps, that their report will lift the shroud of secrecy about professional abuse and ensure mandatory training to staff working in the mental health sector. Above all I hope that through this process patient protection and safety will be made paramount. Then, perhaps, some sense can be made of our suffering.

© WITNESS 2006