Case No. LV20C00210

: Trauma Symptom Inventory version 2. A psychometric examining reported trauma symptoms.”30.As I understood Dr Hansen’s evidence, she deferred to Dr Weir as to the making of any formal diagnosis. Though M had blocked or disengaged with Dr Weir’s assessment, he considered that analysis of the evidence made available to him enabled him confidently to conclude that M has a Paranoid Personality Disorder. He did not exclude features of the other personality disorders set out above but considered that the paranoia predominated. Mr Browne submitted that reliance on the filed evidence rather than information solicited from direct interview fell outside the relevant professional guidelines for establishing secure diagnosis and that, accordingly, Dr Weir’s opinion could not stand, in what he contended was, the effective breakdown of his assessment of M. 31.I am not persuaded by this submission, given the strength of the broader evidence supporting the relevant diagnostic behaviours, in particular Dr Hansen’s own identification of them. The respective professional skills from these two disciplines establish, to my mind, a confluence of information for Dr Weir’s conclusion, and I consider he was, logically and in the circumstances, entitled to take such an approach. In her report, Dr Hansen specifically suggested that Dr Weir had sight of the extensive ‘self-reported’ information that she set out in order for him to consider any formal diagnosis. However, I doubt whether the distinction between the facets of behaviour pointing to a disorder of personality (as identified by Dr Hansen) and a formal diagnosis of Paranoid Personality Disorder (determined by Dr Weir) has any real forensic significance, at least in illuminating the outcome in this case. To some degree, the actual label strikes me as largely irrelevant. What is pertinent is the prognosis for significant change and the likely timescales for it. 32.The evidence is replete with examples supporting Dr Hansen’s observations. Most strikingly, is M’s persistent and pervasive feelings of tension and her excessive preoccupation with being criticised. This has been observed not only in each of the residential placements she has occupied, but also by the social workers in the earlier proceedings concerning Q. M expresses emotions on a dramatic scale and her oral evidence, on my own assessment, reflected a strikingly egocentric perspective of the world. 33.One of the tensions in the breakdown of her relationship with both Q and A centred upon M’s fastidious preoccupation with housework and tidiness (itself, I note, foreshadowed in Dr Hansen’s identification of anankastic or compulsive behaviours). M told me that she was much more relaxed about it now but recent observations in the latest 247 assessment reveal it still to be troubling for her. This is certainly associated with times of stress for M. I also note that M had recognised within the Independent Social Work assessment, conducted by Ms Amanda Walsh, that she ‘could be paranoid’. She disavowed that, however, in her oral evidence. Certainly, she has a deep mistrust of the social workers and in particular, Ms C, the present social worker. Ms C told me that M is controlling of their relationship, obstructs day-to-day communications and behaves in a loud and intimidating manner. Though Ms C was at pains to emphasise that M had never been violent or threatened violence to her or indeed to any of the other professionals in the case, the height and level of verbal aggression seemed consistently to carry with it, a physical threat. There have been 5 social workers involved in M’s case. Three, including Ms C, have experienced strikingly similar behaviours. I also note that social workers investigating Q’s case record similar experiences of M. 34.In her meeting with Dr Weir, M described how social services were treating her disrespectfully, she spoke of a ‘personal vendetta’, engaging in what she considered to be ‘dirty tricks’ and ‘making the rules up as they went along’. Dr Hansen, reviewing Dr Weir’s report noted that he considered M’s belief ‘that she was lied to and treated disrespectfully’ was both ‘intense and enduring’. Dr Hansen enquired of M whether she considered that she had learned from the social work assessment. M said she had learned that ‘she must not trust social services again’. She went on to say ‘this is her second run in with social services and … she is paranoid about things’ and ‘she has never had good experience of authority, government, or social services’. When asked what she considered the impact of the care proceedings on her children had been, she told Dr Hansen that ‘it has been toxic when A has been at home’ and that although she would like A home, she feels A needs help first. This resonates very strikingly with her earlier views of Q. It is clear (see paragraph 19 above) that Q accepted M’s narrative that all fault lay with him. The evidence before me is that A has been more resilient and was fortunate to find a placement with her brother that enabled her to move forward. I also note that in one of her interviews with Dr Hansen, M had spoken enthusiastically about applying for the foster carer’s notes which she believed would reveal that A had acknowledged that she had been the attacker and that accordingly, M would be absolved of responsibility. 35.Dr Hansen’s 19 hours of interview produced a very great deal of information. Overwhelmingly, however, it is ‘report’, rather than analysis. Her analysis is inserted into her report by subtle inference and her conclusions are oblique: “There are a number of potential presenting difficulties for [M]. She could have a non-bizarre persecutory delusion of feeling judged, targeted and fearful of life. This could manifest itself in relation to ex-partners, her family, professionals and her children. A delusion is said to be a strongly held belief. This could have resulted in a life of living in fear. Alternatively, she has experienced trauma being raised in a community filled with criminal activity and drugs, she has connected with men who have been high profile criminals and are dangerous, and this is a reality. Her own brother who she was close to, attacked his girlfriend with a machete. It could be added that such experiences have predisposed her to being paranoid as a safety survival strategy. She has used avoidance as a key mechanism to avoid criticism, conflict and to provide a better life for her children; somehow she has been unable to escape it.6.11. Being involved in such a highly criminal community would exacerbate any underlying feelings of paranoia so she stays alive. Aged 16, she described hiding out in hotels, being involved by association in gang and drug dealing. She was pregnant and experiencing challenging and traumatic experiences from this age.It may be understandable therefore that she can misinterpret innocuous events in a negative and paranoid manner. What was once a crucial survival strategy, might now be a sensitive response. For example, she reported consistently that the social worker smirked at her. Whilst I cannot comment if this was true or not, it would give an example of where she perceives was not able to tolerate alternative explanations such as she might have been nervous. Instead, her perception is always that intent is malevolent. A further example is when she saw other mothers at the school laughing and she interpreted this to be connected to her. Such a cognitive bias and thinking error when predisposed to paranoid thinking would then lead to confrontational responses.”36.These insights into M’s predisposition to interpret innocuous events in ‘a negative and paranoid manner’ provoke interesting alternative analyses of her behaviour. It may be that they can be harnessed in the therapeutic process. Some of Dr Hansen’s observations are elliptical. This has led occasionally to confusion amongst the professionals e.g., “As a way of coping, [M] has developed an attitude where she can appear over-confident, boasting and cold and detached from others. Her confidence, passion and demeanour is also connected with her cultural identity