A reflection from the Royal College of Psychiatrists Congress in Newport, Wales.

She told me to grasp the nettle. Not gently. Not with caution. ‘If you hesitate’, she said, ‘you’ll get stung. But if you meet it with intention, the sting won’t rise’.

Instead of networking, or queuing for lunch, I had joined a group of psychiatrists in the woodland, beyond the Congress centre. We were gathering nettles. Not metaphorical ones, but real, stinging nettles, thick against the hedgerow. We pulled on gloves, not to protect ourselves but to begin the work. We stripped the leaves, snapped the stems and teased out fibres from their cores. What we made wasn’t delicate, but it was strong. We twisted one set of stripped fibres over the other, to make the cordage. I wove mine into a bracelet and wore it as an emblem of something enduring, twisted from what we’re usually taught to avoid.

The instructor said that you could tow a broken-down car with those fibres. I believed her.

It made me think of how much weight the system asks us to carry. ‘The NHS is not broken’, a speaker said to the delegates later, ‘it is traumatised’. Another added, quietly, that ‘many clinicians are morally injured. We are left frayed by knowing what care could be and being unable to deliver it’. Those words stayed with me. I felt them coil in my palm, tight as the nettle strand around my wrist.

We cannot treat moral injury with resilience workshops. We do not audit staff trauma. These injuries don’t appear on performance dashboards. They surface in sleeplessness, in doubt, in distance. Perhaps what they need is not more efficiency, but attention.

At this year’s Congress I had not come to report, but to notice. I was one of four roving artists, participants invited to witness rather than summarise. My tools were not slides or statistics, but ink, paper and, as it turns out, nettles. I listened not just to keynotes, but to what moved beneath them. My mind stayed with the pause before a question, the sigh after an answer and the stories passed quietly between sessions.

Many conversations circled around moral injury: its cost, its accumulation, its slow erosion of care. Colleagues spoke of burnout, workforce gaps, waiting lists and systemic harm. The emotional weight was often softened into policy language, or edited out of abstracts and posters.

Psychiatry trains us to observe, to diagnose, to intervene. It prizes clarity, structure and a necessary degree of detachment. Stinging nettles demand something different. To weave a nettle, you need courage. You have to be bold to grasp the stalk, to anticipate that it may hurt and to do it anyway. It feels countercultural to put your hand into discomfort, not around it.

When I closed my hand around the stem, I expected pain. Instead, I felt resistance. Strength. A kind of tensile dignity. I pulled. The fibres held.

In a side-room that day, someone said that care cannot live only in documents. That presence, the real kind, the kind that doesn’t look away, isn’t part of the audit cycle.

In my clinical work, I find myself returning to this. The nettle is not just an irritant. It is a threshold. The moment of discomfort we’ve learned to flinch from. It may also be the very material we need. There is strength in what stings, if we’re willing to reach for it.

What does it mean to practise psychiatry without flinching?

To sit with a patient who undoes us.

To grasp what hurts, and weave it into something strong.

That evening, at a poetry reading, a psychiatrist said ‘care is not always an act’. Sometimes it is a way of staying. Sometimes, it is the refusal to look away.

‘Grasp the nettle’, she had said. And we did.

Surprisingly, it didn’t sting.