Dialogue as therapy: the role of the expert in the ICRP Dialogues

Abstract

Science communication is commonly framed as a battle with ignorance and the field of radiological protection is not exempt from this tendency. By correcting deficits in the public’s understanding of science, the expert is often imagined to be able to convince the public of its objective safety (‘anzen’), thereby inspiring a sense of calm (‘anshin’). In the wake of the 2011 Fukushima Daiichi disaster, however, the International Commission on Radiological Protection has sought to break with this tradition by organising a series of participatory seminars in which experts engage those affected by the disaster as equals. Drawing on ethnographic fieldwork, this article suggests that the Dialogue seminars can be best understood using the metaphor of therapy; using it to describe the premise, form, and objectives of the Dialogues with a view to identifying good practice for future radiological protection scenarios.

1. INTRODUCTION

What is the role of the expert in responding to a nuclear disaster? Two roles are often offered in answer: the expert might act as an advisor to the state, thereby informing policy; or she/he might act as a science communicator, educating the public on the science of radiological protection. Both roles are premised on a linear transmission of knowledge from the expert to the audience. Implicitly, the expert has much to teach but little to learn. What then to make of the seminars staged by the International Commission on Radiological Protection (ICRP) in Fukushima? For in the ICRP Dialogues (2011–2016) and Fukushima Dialogues (2016–2018), ICRP members said relatively little, allotting more time to listening to local stakeholders. This article examines how these Dialogues sought to reconfigure the role of the expert. Drawing on participant observation, interviews, and textual analysis, I argue that, in these seminars, ICRP members adopted a role akin to a therapist: one who listens to their client’s concerns and provides factual context, but refrains from offering judgement on what the client should or should not do. ¹

2. FROM SCIENCE COMMUNICATION TO DIALOGUE

Science communication has traditionally been premised on a one-way flow of information from rational experts to an emotional public. This model of science communication remains influential in the response to the Fukushima Daiichi disaster. By correcting deficits in the public’s understanding of science, experts have been imagined as able to convince the public of its objective safety (‘anzen’), thereby inspiring a sense of calm (‘anshin’). In so doing, the expert is able to both promote public (mental) health and restore the fortunes of the affected territory, encouraging both the return of its citizens and the consumption of its produce. These assumptions are particularly plain in efforts to frame science communication as a battle against ‘radiophobia’: excessive and irrational fear of radiation.

Both the notion of radiophobia and the deficit model of public understanding are objects of extensive critique (see, for example, Wynne, 1992; Girard and Dubreuil, 1996). ² Though it is beyond the remit of this article to retrace the contours of this debate, it is worth noting that parallel critiques of radiophobia have been made in both critical and technical literatures and that the Dialogues – as well as antecedent projects in Belarus ³ (Dubreuil et al., 1999; Ando, 2016; Lochard, 2017a) – have consciously built upon the latter (Takahashi 2020). Core organisers of the Dialogues (including Jacques Lochard) also contributed to the International Chernobyl Project: an IAEA assessment ‘of the guidance given by Soviet authorities to persons living in radiologically contaminated areas’, which explicitly condemned the discourse of radiophobia:

If the stressor is a real threat, it is dishonest to pretend otherwise or to imply that an anxious response is in some way abnormal… While it may have suffered in translation, the use of the term ‘radiophobia’ by scientific experts in the USSR illustrates this problem. In a spirited exchange at the IAEA Scientific Meeting in 1988… it was argued that the use of this diagnostic term, at any rate in western Europe and the USA, implies a fear reaction to a stimulus that is normally regarded as wholly benign. Few would place Chernobyl in this category (IAEA, 1991).

Both this report of the International Chernobyl Project and its 1996 successor – published to coincide with the 10th anniversary of Chernobyl (IAEA, 1996) – estimate the biological effects of exposure to be relatively modest, while emphasising that ‘dismay has been universal and anxiety widespread’ and poses a risk to public health (IAEA, 1991). However, the authors remain at pains to emphasise that anxiety is ‘understandable’ in such circumstances and should not be interpreted as abnormal or irrational (IAEA, 1996). Rather than reducing anxiety to a symptom of ignorance, to be fixed through science communication, the reports call for a ‘campaign of therapeutic advice on stress management’ – thereby establishing the ‘management of emotions’ as a vital aspect of radiological protection. It is within this ‘therapeutic’ tradition that the Dialogues fall.

3. THE DIALOGUE FORMAT

The metaphor of therapy is also useful in describing the format of the Dialogues. ⁴ ICRP Vice-Chair Jacques Lochard has stressed that the Dialogues were not organised around a model per se, but an ethos, directly inspired by the ETHOS project in Belarus and distilled into three guiding maxims: (1) the role of the expert is to ‘work with the people, not for them’; (2) the seminars should be ‘a suitcase without a handle, belonging only to those who participate’; and (3) ‘the path is built as you walk, by walking’. Where these aphorisms aim to distil the guiding spirit of seminars, the metaphor of therapy seeks to accomplish a more prosaic task – that of describing ICRP’s practices. Any observer would notice that the Dialogues were predominantly organised around two types of session. Each seminar has featured presentations delivered by both lay and expert participants. These have been described as a ‘warm-up’ for a second type of session, namely structured dialogues in which stakeholders sit in a semi-circle and take it in turns to share. This format is redolent of group therapy. The microphone makes its way around the semi-circle twice, giving each participant an opportunity to reflect on what their peers have said before the discussion is opened to the floor. No interruptions are permitted, and criticism of other participants is strongly discouraged. Engaging with notable reserve, ICRP members act only as facilitators. They do not join the circle and fastidiously avoid offering any explicit judgements, even when they are solicited. ‘We really try not to tell people what to do even when we’re asked, “is it safe for me to do this and that?”’, Clement stated. ‘We don’t answer “yes” or “no”... because it’s not our role to tell people what to do’. ⁵ Implicit in this code of conduct is an assumption that Fukushima residents are experts on their own lives. In a similar vein to non-directive therapists who insist that ‘it is the client who knows what hurts, what directions to go, what problems are crucial’ (Rogers, 1961), members of ICRP have aspired to let their interlocutors steer their interactions on the basis that when experts ‘make up the questions we think people want us to answer… it doesn’t really work because we usually don’t get it right’. Though this was not a self-conscious emulation of therapeutic practice, Lochard notes that the comparison is apt:

What is important is to put words to what they [the participants] are feeling, what they are living. I think this is a process. I like your term, therapy. Somehow, it’s like psychoanalysis. You don’t give advice to people. You organise a mechanism where, in fact, people just speak, and the psychoanalyst is just listening. Don’t speak anything, just listening. You have a mechanism. You lay out the bed and ok… I think, in a way, there is something a bit like this in the Dialogue. The purpose is not to say, “you should do this. You should do that”. “This is what ICRP is thinking” “These are the recommendations”. We are listening. ⁶

4. WHAT DOES DIALOGUE DO?

Listening to those affected by the nuclear disaster has an obvious value for ICRP. ⁷ By the ICRP’s own account, the perspectives offered by local residents have powerfully informed both Task Group 94’s work on Publication 138 (ICRP, 2018) and Task Group 93’s efforts to update the ICRP’s earlier recommendations on responses to large nuclear disasters (Lochard, 2017b; ICRP, 2020). The organisers were keen to stress, however, that the Dialogues were not primarily convened for the benefit of ICRP. ‘First, we’re human beings and wanted to help in some way’, Clement noted. ‘We knew we had some expertise or knowledge or experience that might help. That was key, on a personal or human level’. ⁸ The dialogue process, Lochard agreed, was driven ‘first’ (and implicitly, foremost) by a quotidian desire to ‘empower’ local participants, helping them to ‘regain control of their daily lives’ (see also: Lochard et al 2019). ⁹

How was this empowerment achieved? The seminars certainly offered an opportunity for local participants to learn about radiological protection from both ICRP and one another. Yet accounts of the Dialogues consistently tie empowerment to the act of being heard. Many emphasised the value of being able to express fear, anxiety, and pain – instinctively reaching for the language of therapy. Having observed a seminar for the first time on 7 and 8 July 2017, Board Director of Institut de Radioprotection et de Sûreté Nucleaire Dominique le Guludec remarked that the seminar reminded her of her own time as a medical practitioner:

I used to be a doctor. I used to work in a hospital. I know that half the cure is the communication between patient and doctor. Why is it so important? Because, for the patient, expressing his pain – his difficulties – is very helpful… (le Guludec, 2017).

A physician by training, le Guludec’s point of comparison is to the hospital bed, not the psychiatrist’s couch. Nonetheless, a focus on the catharsis of self-expression has long been a feature of therapeutic practice and is a common motif in accounts of the Dialogues. The KOTOBA web documentary, for example, speaks of how actors ‘release’ their ‘restrained fear and frustration’ through vocalisation (KOTOBA, 2016) – suggesting that by expressing negative emotions in a ‘neutral territory’, ¹⁰ one is able to purge or purify them. In discussing the therapeutic function of the Dialogues, Clement emphasised that he was not qualified in psychology or psychiatry: ‘I’m not a therapist. I’m not a medical doctor. I don’t know these things’. ¹¹ Nonetheless, he affirmed that ‘letting people say their piece is really important… That is [a] huge for many people, and that is therapy’. ¹² One frequent participant went further in asserting the value of cathartic expression, suggesting that ‘at times, th[e] process [of dialogue]… uncovered people’s emotions that had been buried intentionally and rationally to move forwards’ (Ban, 2016). In celebrating the exposure of ‘intentionally’ repressed emotions as a boon – rather than portraying this as a potentially traumatic experience – Ban tacitly ascribes to the Dialogue process the function of exorcising negative emotions through open expression.

5. CONCLUSION

The metaphor of therapy helps to distinguish the Dialogues from science communication efforts aimed at combatting radiophobia. It is clear that ICRP did not organise its seminars in the hope of persuading residents to return to Fukushima. Indeed, the organisers remain explicitly agnostic on the question of safety. Instead, the Dialogues aim to help participants feel able to make choices. ‘We’re not trying to convince people that it’s ok to live with radiation’, Clement stated, ‘We’re trying to help people share their experiences… so they can decide’. Lochard was no less emphatic. Whether participants made decisions that were ‘in line, or not’ with his own appraisal of the situation was ‘not the issue’, he insisted:

What is important is that they regain some confidence and that they start to move and to say – to think – ‘this is not something that is out of my understanding. I can understand’. ¹³

This call for action over inaction, decision over indecision, and active choices over passive ones is coupled with an ambivalence toward the content of these decisions. It is the paralysis of confusion, not a reticence to live in Fukushima, that is constructed as the problem to be overcome. To become ‘empowered’ in this context is to pass from one state of experience to another. As one frequent participant noted, the societal norm when facing a technical problem is to have ‘productive discussions’ based on ‘what can be seen and what can be heard’ (Ban, 2016). However ‘ICRP focused on what is unseen and unheard’ on ‘people’s feelings and determination’ – understanding that ‘[i]t is the ‘unseen’ that inspires people to action’ (ibid.). Such work does not diminish the challenges of evacuating or living with radiation. Participants are still forced to make ‘wrenching decisions’ in conditions that are not of their choosing. As in therapy, the Dialogues aim to ‘empower’ participants principally in the sense of making them feel able to face these decisions.

The organisation of the Dialogues has garnered considerable attention, and some suggest that it could mark the beginning of a ‘participatory turn’ in responses to nuclear disasters. If this is true, the challenge for future programmes will be to build on the experience of ICRP to go beyond therapy. Where the Dialogues offered catharsis, participatory forums can also offer mechanisms for collective decision-making or political advocacy. In short, they can offer different modes of ‘empowerment’ to participants, including ones more directly concerned with the exercise of (political) power. ¹⁴ In fostering formats which take the lay expertise of affected residents seriously, one should also examine the wealth of participatory practices that have been championed outside the nuclear domain. For this reason, dialogue between different expert communities remains crucial. Continued engagement between experts in radiological protection and science and technology studies, in particular, promises to bear fruit at a time when ICRP is continuing to develop notions of scientists and local residents acting as ‘co-experts’ in developing ‘practical radiological protection cultures’ (ICRP, 2020).