The Psychologist July 2018 by The Psychologist

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psychologist july 2018

Windows on our inner and outer worlds Christina Richards introduces psychologistsâ&#x20AC;&#x2122; musings on their own art, in a variety of media

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psychologist july 2018

contact The British Psychological Society 48 Princess Road East Leicester LE1 7DR 0116 254 9568 mail@bps.org.uk www.bps.org.uk the psychologist and research digest www.thepsychologist.org.uk www.bps.org.uk/digest www.jobsinpsychology.co.uk psychologist@bps.org.uk

Windows on our inner and outer worlds Christina Richards introduces psychologists’ musings on their own art, in a variety of media

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The Psychologist is the magazine of The British Psychological Society

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It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulﬁl the main object of the Royal Charter, ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied’

The Psychologist needs you! We rely on your submissions throughout the publication, and in return we help you to get your message across to a large and diverse audience. For details of all the available options, plus our policies and what to do if you feel these have not been followed, see www.thepsychologist.org.uk/contribute The main message, though, is simply to engage with us. Contact the editor Dr Jon Sutton on jon.sutton@bps.org.uk, tweet us on @psychmag or call /write to us at the Society’s Leicester ofﬁce.

Managing Editor Jon Sutton Assistant Editor Peter Dillon-Hooper Production Mike Thompson Journalist Ella Rhodes Editorial Assistant Debbie Gordon Research Digest Christian Jarrett (editor), Alex Fradera, Emma Young

Associate Editors Articles Michael Burnett, Paul Curran, Harriet Gross, Rebecca Knibb, Adrian Needs, Paul Redford, Sophie Scott, Mark Wetherell, Jill Wilkinson Conferences Alana James History of Psychology Alison Torn Interviews Gail Kinman Culture Kate Johnstone, Sally Marlow Books Emily Hutchinson, Rebecca Stack Voices in Psychology Madeleine Pownall International panel Vaughan Bell, Uta Frith, Alex Haslam, Elizabeth Loftus, Asifa Majid Psychologist and Digest Editorial Advisory Committee Catherine Loveday (Chair), Phil Banyard, Emma Beard, Harriet Gross, Kimberley Hill, Rowena Hill, Peter Olusoga, Richard Stephens, Miles Thomas

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Nick Oliver www.smilecreative.co.uk

july 2018

Letters Sonic attacks; adversity; and more

Obituary

News Research images; homeless services; and more

Conference Reports from the Annual…

Self-management versus face-to-face therapeutic interaction Karen Rodham with her ‘rated’

Windows on our inner and outer worlds Christina Richards introduces several musings on the writers’ own works, in a variety of artistic media. Find more contributions on our website.

‘They tried to paint me into a corner, where I didn’t belong’ Jon Sutton meets existential therapist Emmy van Deurzen to talk art, Brexit and more ‘The needs of the walking wounded are being ignored’ Priyanka Pradhan on mild traumatic brain injury

Careers We meet Hilary Cahalane, and Philippa East

Jobs in psychology Featured job, latest vacancies

Books With Thomas Calvard, Binna Kandola, Cecilia Heyes

Culture Poetry competition winners

Looking back Andrew Wickens marks a centenary for Brenda Milner

A to Z

A key characteristic of The Psychologist is its varied palate. Some broad strokes, then finer detail; realism and a more impressionistic approach side by side; splashes of personal colour, in amongst the more professional shades. Maybe that just makes a mish-mash. (‘Eclectic’ is so often a euphemism for ‘rubbish’.) But we can be a canvas for real creativity, with results you might not find elsewhere. Our feature on psychologists and their artistic endeavours (p.40), in various forms, is a fine example; as is our annual poetry competition (p.82). Also in the frame this month are Karen Rodham, ahead of her Psychologistnominated appearance at Latitude Festival; chats with Emmy van Deurzen (continuing the art theme), Priyanka Pradhan and others; a bumper selection of reports from the Annual Conference; and more. In May we won a ‘highly commended’ for ‘Best Launch/Relaunch’ at the Membership Excellence awards. We’ll soon be surveying your views on how we’re doing; you’re certainly our inspiration! Dr Jon Sutton Managing Editor @psychmag

Images of research

The prizes at this year’s Images of Research competition at the University of Bath were overwhelmingly scooped up by its Psychology Department. Ranging from a selfie of a group of young people with autism spectrum disorders to a representation of people’s perceptions of flooding risk the images truly capture the breadth of the field. Dr Jo Daniels, Senior Lecturer in Clinical Psychology at the University of Bath, contacted us with her entry, which won in the Best Image category. Titled ‘Cold hands, warm… Gloves?’, it depicts Raynaud’s phenomenon (RP), a painful long-term condition that affects up to 20 per cent of people, mostly women. Daniels told us: ‘RP reduces blood-flow to the fingers and toes, causing numbness, pain and disability in affected areas. We do not understand this condition well; however, we do know it has a significant impact on people’s lives. This photograph illustrates the role of helping hands – the RP-affected hands are offered for recognition of the impact of the condition, with the red-gloved hands symbolising therapeutic aid to “reperfuse” or regain blood back into the hands.’ The striking picture above of a lemon victorious in a race against a prune, by Yuqing Che and colleagues, illustrates crossmodal correspondence. This describes the arbitrary associations our brains make that can affect

all the senses – for example when people are asked who would win in a lemon vs. prune race scenario around 80 per cent of people say the lemon. Che wrote: ‘The brain can make use of this associated information in order to learn about the environment with the support from multiple senses. We are investigating crossmodal correspondences in order to better understand how sensory perception affects cognition. It further can inform us on how new assistive technologies for the sensory impaired should be designed in order to maximise treatment benefits.’ The winner of the best overall entry was a group selfie by Professor Mark Brosnan, which depicts 30 young autistic students who took part in the University of Bath’s Autism Summer School. The initiative brings together young people with autism spectrum disorders who want to come to university to teach them about university life, social and academic skills and take part in research on university transitions for autistic students. Niall McLoughlin was awarded the Edge Arts Prize for his beautiful photograph of a face overwhelmed with water – illustrating his research on people’s perceptions of flooding risk. Pain Researcher and Director of Engagement at the Department of Psychology, Dr Janet Bultitude, said she

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was delighted so many of the winning images were from researchers in the department: ‘Research psychologists study what makes people tick – from our most basic sensory processes to how our behaviour is shaped by the people around us. Psychology is well suited to events like the Images of Research competition because the topics that we study are very relatable to non-researchers. After all, who isn’t interested in better understanding themselves? By engaging with the public research psychologists can unlock people’s enthusiasm for thinking critically about how their minds work and what governs their choices, experiences and behaviour.’ We have been inspired by Bath’s competition and would be delighted to see photos from your research too. These can be actual photos from the depths of the lab or more symbolic takes on what you explore in your work. Tweet your photos @psychmag with the hashtag #PhotoPsych and a few words of explanation. To see the shortlist of entries from Bath’s 2018 competition go to tinyurl.com/ychv8dbn

Self-management

Karen Rodham argues that an empowering idea is yet to translate into practice

or some time now our healthcare system has been struggling ‘to cope with the demands of acute care, let alone the needs of those with long term health conditions,’ (Barlow et al., 2002). As this struggle has intensified, the phrase ‘self-management’ has proliferated, particularly in relation to people living with chronic conditions. Self-management can be defined as ‘a process in which individuals acquire skills strategies and knowledge to manage the physical, psychological, emotional and social effects of a chronic condition’ (Sadler et al., 2017, p.1). The idea underpinning selfmanagement is that people who are living with chronic (and sometimes multiple chronic) conditions can be helped to learn to manage their condition(s). If selfmanagement works, it is an empowering idea; it could have a positive impact on people’s quality of life. But it has not yet, in my opinion, been successfully translated from idea to practice. If we take the example of an area in which I used to practise as a health psychologist, people with chronic pain might be lucky enough to be referred to a pain management programme. High-quality pain management programmes are multidisciplinary in nature (in 2013, the British Pain Society published a booklet outlining guidelines for pain management programmes for adults). Typically, participants will have their medication reviewed, receive physiotherapy, occupational therapy and psychological input. They will be taught a variety of coping skills as well as exercises that they can undertake by themselves. Follow-up appointments are made, and then participants will be deemed to be on a self-managing pathway and are likely to be discharged from the service. This all sounds pretty marvellous. Indeed, work I have conducted with people who have completed pain management programmes shows that initially, they gain a lot of confidence and benefit from the programmes (e.g. Rodham et al., 2012, 2013). But actually implementing the skills outside of the pain management programme is much harder, and I know from my practice that patients can very quickly feel as though they have been abandoned, once discharged. So, while the idea of self-management is great, Redman (2011) suggests that there is ‘little or no prospect of achieving the intended outcome’ because many patients whose chronic diseases could be

managed by patient self-management are not prepared for, or supported to take on, this role. Our health system is not set up to provide ongoing care for people living with chronic conditions; for example, Palacios and colleagues (2017, p.2) report that ‘coronary heart disease patients may only have one scheduled appointment with their family physician or practice nurse each year’. In other words, professional support for self-management is limited. This, to my mind, is a false economy. Think back to when you were learning to ride a bike. I still remember my first proper solo cycle. For quite some time, I had been happily cycling with stabilisers attached to my bicycle’s back wheels. Then Dad decided that it was time to take off the stabilisers. That day, after school, I cycled (wobbling a lot) while Dad walked behind me holding on to the back of my bicycle seat. Gradually my confidence grew, helped by the knowledge he was close by. Then he let go without telling me. I was fine until I turned around and saw him standing some distance away. Realising he was no longer right behind me, I had a huge wobble and fell off. He helped me back on and walked behind me again. This time he told me when he was going to let go. I wobbled a bit and probably fell off, and I expect we went through this process a few more times. Then came the time I could cycle without him holding on (but I still needed him to watch over me). Eventually I felt confident enough to cycle without him. In my mind, the same principle applies when we want to help someone learn to manage their chronic condition. I found that drawing from the ‘Life Thread’ model in my practice offered patients an excellent visual representation of what happens when you are living with a life-changing condition (see Ellis-Hill et al., 2008, for further information about this model – developed for people with stroke, but easily applicable to any life-changing condition). When the condition ‘arrives’, the life thread (our narrative about our life) is cut. Some threads stay connected, but most are severed and fraying. Some of the remaining threads will need cauterising, whilst it may be possible to tie others back together. It takes time to work out what is possible, what is necessary and what may never happen. It is hard to accept that life as you used to know it has changed, and probably changed for ever. Indeed, reconnecting threads in order to be in a position to self-manage is not easy. The following quote from a physiotherapist highlights the importance of working with the patient:

the psychologist july 2018 rated Nick Oliver www.smilecreative.co.uk

In the beginning people are just really low in conﬁdence, they’re like shell shocked. They don’t know what to do, and when we set goals with patients, they often say ‘Oh well, you’re the professional, you tell me what to do’. So they are not ready to self-manage or to take responsibility themselves yet… They very much look at the healthcare professional to guide them. (Sadler et al., 2017, p.6)

In the same way that I needed reassurance and support when I was learning to ride solo, so too do patients, as they learn to cope with the demands of their chronic condition. It may not be obvious to them how to apply the skills they have been taught, or they may lack conﬁdence or knowledge to apply the skills appropriately. After all, successful self-management needs a range of skills, including knowledge of the condition and its treatment, maintenance of adequate

psychological functioning and the conﬁdence and ability to implement lifestyle changes required when living with a chronic condition (e.g. Clark et al., 1991; Redman, 2011). More often than not, this process takes longer than the set number of appointments that the system allows us to offer. A further part of the problem is that the term ‘selfmanagement’ focuses attention on the individual. It fails to recognise that how we behave, cope and react is intertwined with an array of contextual factors, not least our social network (including friends, family and trusted health professionals). The success (or otherwise) of this ‘intertwining’ is instrumental in our ability to self-manage. Indeed, Dwarswaard and colleagues (2015, p.202) argue (my emphasis) that ‘in order to self-manage, patients need support from different sources, each with its unique contribution. Health care professionals, relatives and fellow patients all fulﬁl their own distinctive role.’ The authors go

on to state even more starkly: ‘People with chronic conditions are not capable of self-management on their own. Signiﬁcant others are needed to live a good life with a chronic condition.’ Furthermore, Sadler and colleagues argue that for people living with

chronic conditions to practise self-management, the development of collaborative partnerships with health professionals is of paramount importance. And this last point leads me to what I see as underrated.

Face-to-face therapeutic interaction

he mobile revolution offers an unprecedented opportunity to provide medical support when and where people need it. A 2012 estimate suggested that the number of health-related apps had already reached 40,000 (Pelletier, 2012, quoted by Boulos et al., 2014). These range from basic text message reminders to more sophisticated apps that coordinate the management of a chronic condition. Indeed, as technology capability has grown, it is not surprising that ‘interest in Internetdelivered interventions for patients with long term conditions is increasing’ (Palacios et al., 2017, p.2). In an important paper reﬂecting on the future of psychological therapies for chronic pain, Eccleston and Crombez (2017, my emphasis) suggest that:

A frontier of therapy is to embrace the possibilities of technology, not only in augmenting, supporting or replacing the remote delivery of traditional faceto-face treatment, but for novel therapy content. Technology can do what therapists cannot, and can do many things better. [It] can accompany the patients, measure multiple aspects of experience, render data into accurate information instantaneously, give immediate access to knowledge, send and receive messages in near real time, and allow discourse anytime and almost anywhere.

Of course, technology is useful in the ways outlined in the quote above. For example, wristbands can monitor walking or number of hours slept, and this data can provide health professionals with useful information about how their patients’ function in their ‘real lives’. Indeed, to borrow a phrase from Rich and Miah (2017, p.86) technology allows us to ‘quantify and know thy post human self’; the underlying idea being that the more data we have about our bodies (or our patients’ bodies), the more likely we are to be in a position to make informed decisions about health and health behaviour(s). Ignoring for now the ‘intention–behaviour’ gap (which is well documented in the health psychology literature), there is no doubt that collecting extra information can provide greater insights. However, my concern is that we will be strongly encouraged to incorporate digital technology into our psychology practice, or worse, replace our practice with non-faceto-face digital therapy. Why this fear? Not least because of the ‘prevailing solution and instrumental approaches to the application of digital technologies to medicine and public health’ (Lupton, 2014, p.706), but also, because the rising appeal of digital technology is rationalised against increasing costs, worsening outcomes (e.g. Rich & Miah, 2017) and anticipated shortages of health professionals (Swan, 2012). And yes, I know that I could well be accused

the psychologist july 2018 rated

of worrying about something that hasn’t yet happened ‘Although it (catastrophising: psychologist, heal was not my thyself!) and of exhibiting Luddite intention tendencies. But I’m not seeking to when I started to, the nuances in face-to-face obstruct progress. I simply want to to write this communication is not easy: how ensure that we retain an important piece, the two would this work in a non-face-topart of the therapeutic relationship concepts that face technological scenario? This – the human ability to develop I have discussed are closely is especially important when you a relationship that facilitates linked – to each other, and consider that as humans we have collaborative working. If we were to principles I hold dear in an amazing capacity to say one to turn Eccleston and Crombez’s my work in psychology. Both thing whilst meaning another. quote around we can see that there refer to our need to ensure This alternative meaning can be is a dualistic paradox in that the we remember to include conveyed by tone of voice and opposite can be true at the same “humaneness” in our practice non-verbal behaviour. Bernard time: Technology cannot do what as we find the best way to Moss, in his 2017 book on therapists can. In short, technology prepare our patients to sally communication skills, highlights cannot hold a hand, empathise, forth confident in their ability this in the following exercise: ‘See offer humanity, react to the patient to face and cope with their how many different tones of voice humanely and work with them current and future problems.’ you can use in saying the words to foster a relationship that will “Can I help you?” You will quickly best help them to move forward. discover that some tones of voice It is the human connection, in Karen Rodham is Professor can contradict the very words you my opinion, that should not be of Health Psychology at are using, just as a very defensive underrated. Staffordshire University body posture can have the same Lambert and Barley (2001) Karen.Rodham@staffs.ac.uk effect.’ note that factors such as empathy, https://sites.google.com/site/ Moss calls warmth, and the therapeutic profkarenrodham/ non-verbal relationship correlate highly with Key sources behaviour the client outcome. Indeed, removal of ‘music behind the words’ and argues the opportunity for social interaction in therapy could Depper, A. & Howe, P.D. (2017). Are that it is the music that conveys be detrimental and increase isolation. This potential we fit yet? English adolescent girls’ the real meaning of what is being negative outcome was recognised by adolescent experiences of health and fitness apps. communicated. ‘If the listener takes girls taking part in a focus group study exploring Health Sociology Review, 26(1), 98–112. the words simply at face value, the health and fitness apps: ‘They simultaneously Ellis-Hill, C., Payne, S. & Ward, C. real meaning could be ignored.’ critiqued the individual nature of apps for isolating (2008). Using stroke to explore the Life Thread Model. Disability and Online technology removes the individuals and removing the holistic characteristics Rehabilitation, 30(2), 150–159. human connection, the ability to of healthy lifestyles they valued; being active in a fun Lupton, E. (2014). Beyond techno-utopia. ‘read’ the patient and potentially environment, socialising and competing with friends’ Societies, 4, 706–711. silences the music behind the (Depper & Howe, 2017, p.109). In other words, the Moss, B. (2017). Communication skills in words. participants felt that health and fitness apps could health and social care (4th edn). London: The dualist paradox I mentioned isolate adolescents and could be detrimental to their Sage. Redman, B.K. (2011). When is patient earlier is, I think, important. There long-term engagement in physical activity. self-management of chronic disease are things that technology can do, If this is the case for apps aimed at increasing futile? Chronic Illness, 7, 181–184. faster and better than humans, but physical activity, what might be the impact for Rich, E. & Miah, A. (2017). Mobile, there are also things humans can those using apps to help them cope with pain, or wearable and ingestible health do better than technology. I am not to reduce their social anxiety for example? Indeed, technologies. Health Sociology Review, arguing that we should instigate a my experience of working with people living with 26(1), 84–97. Rodham, K., Boxell, E., McCabe, C. blanket ban on technology: I think a chronic pain condition was that in addition to et al. (2012). Transitioning from a that a combination is appropriate. benefiting from meeting other people living with hospital rehabilitation programme to But I do want to suggest that we a similar condition (which they found profoundly home. Psychology and Health, 27(10), run the risk of undervaluing the helpful), they rarely came to the service with one neat 1150–1165. (sometimes intangible) benefits issue. My job was to help them unpick the barriers Swan, M. (2012). Health 2050: The that face-to-face therapy can bring. and identify facilitators, to help raise their awareness realization of personalized medicine through crowdsourcing, the quantified We also need to be mindful that of the connectedness of their thoughts, actions and self, and the participatory Biocitizen. as Susan Michie and colleagues behaviours; and in so doing, to help them develop the Journal of Personalized Medicine, 2(4), (2017, p.1) note: ‘we are still mainly skills to cope. 93–118. in the age of promise rather than In order to work collaboratively and in a patientdelivery’ where digital technology is centred manner, we need to communicate effectively Full list available in online/app version. concerned. with our patients. Picking up on, and responding

Windows on our inner and outer worlds How do psychologists’ own artistic creations reﬂect their internal lives and approach to the stuff of therapy? Christina Richards introduces several musings on the writers’ own works, in a variety of artistic media.

herapy is both art and science. We draw upon research as we practise naturally, but our craft is not so clear cut and limited as to be simply such-and-such an intervention to this degree and in that way. Humans are too messy. There are deeper waters in the human mind and being than the cold ones and zeros such brute rationalism tries to expose. Fecund, verdant, feculent in our messy complexity and humanity we dirty cold rationality. These things conspire to gesture to older truths; dances by fire at Beltane under stars that draw with them in their turn the fates of those fighting and fucking and laughing down below. We may appear civilised of course. We may sit on sofas, or on plastic chairs, and talk for a living. But nonetheless these deeply human currents move us. When we practise as therapists, we must therefore strive to reach to and through the ephemeral space between our self and the other person in the room. That reaching flows from the self, and out towards the other; And so, to be good therapists, we must be able to know ourselves by reaching in unbounded – sometimes paradoxically unknowable – ways. We must be able to express ourselves somewhat to the other person, and they to us. And express ourselves to us, as they do to them. All this calls for a different way of being in the world than Likert ratings and performance reviews. When we seek to know ourselves and our world, those are not the tools we reach for! Instead (dare I say it?) if we are wise, we look to art for expression and meaning. To find our evolving selves and to situate them within the world. Whether though photography, painting, crochet, comics, gardening, sculpture or other means; we seek something through art that can’t be measured, but that is central to what it means to be human. This collection is a part of that endeavour, the sometimes hidden worlds of therapists – those of us who can all too easily fall into only seeing the other, and then only by a certain specific degree; and so miss the hidden intertwining that interweaves us with the world. The work here is a reflection of therapists, our worlds, and the connection between the ‘two’.

Waiting, watching, and wondering… Martin Milton on wildlife photography

What an interesting question: how does my art relate to, reﬂect or impact on my work as a therapist? I know that for some the answer would be ‘it doesn’t’ or ‘it can’t’. Other than suggesting a predilection for pastimes beginning with P, the practices of psychotherapy and photography are different. One is a profession and the other a hobby; one about people and the other, not necessarily. One is led by a responsibility to the ‘Other’, the other… not necessarily. My work is a constant, whereas photography, again… it’s not necessarily. But that doesn’t capture the relationship for me at all. It is true that there are differences in kind between the two, but it seems to me that both rely on the personhood of the practitioner. It is true that I have seldom walked away from a photography project and

the psychologist july 2018 psychologists’ art

thought ‘Oh that’s what Freud (or Heidegger, Beck, the HCPC, etc.) meant’, but both challenge me and have led to me seeing things anew, having a different perspective, an altered composition if you like. Both are creative processes that constantly challenge and enhance my grasp of the world, of others, and of the ways in which relationships are played out. These, I would suggest, are ways in which both of these practices enrich each other, profoundly. Wildlife photography, it seems to me, is a process very much like the psychotherapeutic project. In both I have to be patient, waiting for the other to arrive. Then there is a period, sometimes short and sometimes long, of orienting oneself to the other, watching, listening, wondering whether the ﬁrst thing you see is the main phenomenon or whether other urges and behaviours will emerge as you observe them, or as you observe one another. To me photography and psychotherapy both require attention – not so much technical, but free-ﬂoating and attuned. They require readiness and patience, a willingness to wait and to act.

Sometimes one has to do something, at other times one is called to simply observe, put the urge ‘to do’ aside, and to take your cue from the ‘subject’. One’s own presence and attributes are also part of the experience. As with my talents and shortcomings as a therapist, as a photographer I can be too keen to act, scaring off the subject, or limiting them to a more distant relationship; at other times clients and wildlife alike can sense quiet confidence and gradually make their way towards me. Our willingness to wait and watch and be accepted is part of the discipline of those that excel in both fields and that I aspire to. I find that an awareness of nature and ecology, that is richly fed by spending time with my camera in the wilds, powerfully enhances my understanding of the human condition, something beneficial to my work as a therapist. When caught up in a human-centric worldview it is easy to assume that our distress and its manifestations are ‘illogical’, problems in thinking and so forth. And being a human means that I can get caught up in this all too easily. Spending time with

Martin Milton is Professor of Counselling Psychology at Regent’s University London miltonm@ regents.ac.uk

our mammal cousins reminds me of the meaning of our distress and its embeddedness in the world, the challenges of the environmental niche that each species has. The body shaking so characteristic of panic makes sense once you’ve seen an impala survive a chase by a predator; prey species tremble after that run, they need to process the physiological results of what we call the ‘fight or flight reaction’ to threat. And so it is with us… panic is seldom a stand-alone experience. We may not always be clear on what scary eventuality we are responding to, but it can only be understood in context, and the body is a meaningful part of that experience. Similarly with depression: remove an animal from its natural habitat, limit its contact with others of its own species, stop it from being able to hunt or to protect itself, and you will see the low mood, lethargy, refusal to join in pointless activities; and this is the same with us. When life is against us, when we are bereft and isolated, thwarted in our ambitions and reduced to going through the motions, life can feel pointless. Nature and wildlife have always been important to me, both as aspects of the world in their own right but also as some of the most magical experiences I have ever had. I have lost myself while sharing a sunset with cheetahs atop a Botswanan koppie, experienced ecstasy as I drifted on the waves with wild swimming dolphins off the coast of Kenya, felt privilege beyond belief on my birthday when surrounded by chimpanzees in the rainforest, and felt every fibre in my body shake while walking near lions as they fed. I feel alive in natural spaces whether that be snow-topped mountains, the heat of the desert, or traipsing through Richmond Park, one of the wild spots close to where I live. These experiences have connected me to the world and to myself. I feel more present, more alive and more… me. Moments that I often hope my clients will come to experience (once again) somewhere in their lives. Moments that nourish me during those hard, sometimes lengthy, periods of despair that we navigate; in that way the landscape of my art contains and strengthens me as I attempt to do something similar for the clients I work with. Photography is an interesting field, in some ways like applied psychology, sometimes seen as an art, sometimes as a science… or both. Some of it is definitely art, clearly the product of a creative mind with images begging for interpretation. On the other end of the spectrum, photography can be highly technical – requiring skill but the results intended to be a factual transmission of information, more report than story. Increasingly we are asked to practise in this manner too. For me, wildlife photography falls in the middle. Of course, technical skill is important… but even more so is an ability to tune into the animal and its world, to discern what its life is about and to find ways to tell a story, often of life and death, love and hate, hunting and gathering. As it often is with clients, questions explored of how to survive and how to thrive.

When photographing wildlife, I tend to do a bit of both types of photography. A furious few moments where I want to gather images of the animal that is blessing me with its presence, my camera offers me proof that this meeting did indeed happen; and this creates anchors for those precious memories of a special encounter, a bit like notes written after a session. These initial images also allow me to test my camera settings. After that initial burst, I can be calmer, sit and watch, marvel at the animal and its preoccupations, and start to imagine its life and the story I am witnessing. Choosing whether to take more photographs, from what angle, of what behaviours… I have chosen a photograph I took of a bloody jawed polar bear mother leading her cubs across the pack ice, bellies ﬁlled and energy restored. It was taken in the high Arctic in the summer of 2012. The notes in my journal read: It is about 2am and the sun has still not gone down, it won’t set tonight, the most it will do is dip towards the horizon giving this eerie feel to the experience; the cold is also a part of this, casting a heavy stillness across the world. The sparkling white ice and cream coloured bears contrast with, yet also complement, the murky blue that masquerades as ‘darkness’.

We had to travel for 8 hours further North than is normal at this time of year. It seems the pack ice really is melting a lot more than it used to, making it harder for these bears to survive and more difﬁcult for us intrepid amateur naturalists to see such a wonderful sight. Harder for our privilege, harder for their survival. The image tells several stories. One is a universal story of family: I see care, maternal pride and childhood delight. The cubs linger a little, having tasted freedom and being tempted by the vast spaces around them. Mom has to look back, check that they are indeed following and not, as they tend to do, playing in the ponds and puddles that mark this landscape. Mom is the focused one, her back to the camera she is on a mission, one meal down, but it’s time to hunt again, with three of them to feed, she cannot be too relaxed about that. She has multiple jobs here, not only does she need to nourish her cubs, but she needs to provide them with the skills necessary to survive alone in this vast wilderness in the not too distant future. Alternatively, this is an image of authenticity and the sublime ﬁt between animal and surrounding, this is being-in-the-world. These bears are perfectly adapted to this environment. They do what they do, and their world provides for them – not too much, but just enough. Or it has done, who knows how well they will fare now that the ecosystem is so affected. I veer between awe and anxiety when thinking about these meanings. There is a tension between the heartwarming experience of respect and a more guilt-ridden sense of responsibility for an everincreasing struggle.

the psychologist july 2018 psychologists’ art

This interpretation sets my mind wandering, as I not only know about the additional eight hours we had to travel; but also, I have felt hardship every time I set foot on the deck. The freezing winds, the vast spaces and the calls of the whales were all part of the process of getting this photograph. As we got to the pack ice, the squeaking and screams of the ice against the hull have awakened my sense of hearing, unlike

anything else. So whether it is the photograph or the memory, I also see fragility in this image. Overall, this is a bittersweet image, full of opposites – cruel beauty, beautiful fragility, solid water, liquid ice, neither light nor dark, but something in the middle. It captures a painful dilemma, the tension between destruction and conservation, something else that I think is at the very heart of psychotherapy.

Under the therapy tree Emmy van Deurzen on painting I have painted in oils for nearly 50 years. I was never a great artist, but have always practised my art in a devoted and dedicated, quasireligious fashion. My art and my therapeutic work are interwoven, because to me they are about the same vocation and involve a similarly deep and meaningful engagement. My ﬁrst wooden box of oil paints arrived by surface mail on the morning of my 16th birthday, on that dark and cold 13 December in the year 1967. I can still feel the sharp jolt of joy that burst forth from my chest, as I unwrapped this very special parcel, this unexpected and most beautiful present. My mother said guardedly: ‘That is an expensive gift, use it wisely.’ She was shocked to see that the postage had been equally dear and she thought none of this was very sensible. And she was right, for it wasn’t sensible. It was madness. I spiralled into new aspirations and new ways of seeing the world and myself immediately after. This was my most special gift, sent from France to the Netherlands, by my 21-year-old French boyfriend Bernard, whom I had only just met that summer in Portugal, where we both were on camping holidays. He had seen me doing some sketches during those heady days of sunshine in the Algarve, when I fell head over heels in love. He thought I would make a great artist. He wanted me to practise. He too was deeply in love and sent me his own poems and daily letters, in French, which I translated carefully, thus improving my French dramatically.

I knew I had started a new life and that I would never be that frightened, lonely girl again. Now I was loved and I had found my art. I was determined to drink in all the beauty and pleasure that was promised. I asked my art teacher in school to reveal the secrets of oil painting to me and soon painted my first tree: a melancholy sunset. Perhaps I already sensed what was to happen. Bernard and I met regularly during the next two years, in holidays, but by the time I was doing my final exams he had deserted me, leaving me without my poems and letters, but with all my capacity for feeling deeply, my guitar, my songs and my oil paintings. It was a life-and-death struggle for a while, as I tried to find the courage to live my life alone with the help of the arts I was left with. I painted desperately and invented all my own methods, never having any

Emmy van Deurzen is Principal at the Existential Academy, London emmyvan deurzen@gmail. com See also our interview on p.52

further lessons. My art became a steady force for the better. It was a form of meditation, an exploration of the places I had learnt to recognise as special and sacred. I moved to France after my exams and studied philosophy, continuing to write songs, sing and paint, with ever-greater dedication. There were many periods where my arts lay fallow. They always coincided with busyness and alienation. When I came to the UK in 1977 to work and live in an Arbours therapeutic community, I started to sing and paint more seriously again. I recognised that ‘Arbours’ was a signiﬁcant term for me, as it referred to the way in which a migrant people had lived when they were without a safe place to be: they had lived under the arbours of the trees. Similarly I had come to see trees, woods and forests as safe places to hide in and renew myself, whenever things were hard and trying. Sitting under trees became a metaphor for me for doing psychotherapy. I started picturing myself not just as sitting under a safe tree with my clients, I began to experience myself slowly but surely as the tree itself. I felt that the more peaceful I became and the more steadfast my breathing and my sense of trust in the wider landscape of life, the better I became as a therapist. Over the years my own life tested me many times, and I always found my balance and equanimity by walking in nature… by taking my sorrows and troubles to the shores of seas and rivers, or my heaviness of heart to the branches and canopies of the wild woods and forests. I tried to paint many themes and have dabbled in painting people and faces, enjoying grappling with the complex emotional expressions, and badly failing. I learnt that I need to paint landscapes to fully allow myself to become absorbed by the painting and lose myself in it. When I sit down at my easel and I lay out my colours on my palette and smell the familiar fragrances of my oil paints, something shifts in my inner landscape. I know instinctively where I want to go, and I ﬁnd a picture that I have taken on one of my walks to remind me of the place I want to retain and take myself into. I seek the perspective of that landscape and penetrate into it as deeply as it will take me. I easily lose myself on the path that I follow and I hide in the hollow of the trees, hills and meadows that I am painting. It is transformative and I lose all sense of time in the process.

It is almost as if I stretch my consciousness beyond my boundaries, as if I round myself up to fit with the ground and skies, the branches, leaves and clouds. I am no longer just myself, not the person I am when I am living my daily life. I am in a state of special arrest. Time stands still and I am at rest, easing myself into the earth that extends itself in front of me, expanding me to go beyond me. It is a sense of personal transcendence, of spirituality. I am inspired to breathe restfully, though I catch myself suspending my breathing all together at other moments. Most importantly it is about phenomenology: I make myself one with the phenomenon in front of me. As I trace the lines of the tree, I also trace the lines of a person’s life. As I make myself small and easy under the tree, I make myself humble and at ease while listening to the other. Silently soaking up the soft air, the sun and the sky above, I melt into the universe. It is a kind of dying of my own personality, which swoons in front of the overwhelming reality of the landscape. The discipline of my art in mastering the medium, learning about proportion, movement, perspective and depth, is not unlike the discipline of learning about life and understanding how to observe another person’s position, situation and direction in the world. The one helps with the other and each complements the other. This particular painting, of a tree I photographed in the New Forest some years ago, is highly symbolic of the feeling of painting and the feeling of therapy that are so very similar and so much about placing myself in harmony with my surroundings. I can feel the way I made myself melt into the whole landscape, creating a bit of the sky behind the painting, an awareness of infinity and the universe. There is a reminder of human society in the background with the lightly drawn fence which speaks of frontiers and boundaries of safety and passageways towards other areas. The tree itself is softly expansive, not obstructed by anything, able to extend its branches as far as it fancies. Its roots are quietly steady underneath, and the shadows it casts are contained at its feet. The tree looks both strong and vulnerable, just as I feel when I am doing art or therapy. It fills the space, while interacting organically with its environment: a powerful metaphor for courageous being and affirmative living, with a sense of glorying in the pleasure of just being. Then in front there is the grass and the flowers, powerfully growing in their spring impulse of revival. The yellow light in the field is what overwhelmingly appealed to my search for sunshine and light: that striving to find the positive power of that which creates us without us having to do anything about it. I need to remind myself of the way in which my activities are always cushioned and upheld and lit up by that light. I find it restful to know that I will never have to sow the field, or cut it down, that it just grows there for all to enjoy.

the psychologist july 2018 psychologists’ art

Untitled sculpture Martin Adams on stone work All meaningful work, and that means all creative work, for they are one and the same, starts from a position of full attention. Phenomenological practice of any sort, whether it is therapy or not, begins with and is sustained by attention. I begin by attending to, looking at, thinking about, imagining the object, in this case a piece of limestone. While I may have some vague ideas of the form I want to make, this is just an idea; and before I start I have no idea how the piece of stone will respond to the ideas. It may be that the ideas just cannot be done with this medium. This will be discovered as I go along, and stone is an unforgiving material. It has to be respected. It may be that imperfections in the stone, shells, fossils, hidden fault lines, for it is a natural imperfect material, will not allow the idea to be carried out. Therefore as in therapy I may have some rough ideas about the final ‘shape’, and I have to bear these in mind but suspend them because I am guided principally by the nature of the stone. I know that the finished piece will not be like my idea at the beginning. I do not believe in the idea of finding the shape that has already been decided on somehow inside the stone. If this happens, then it is an example of a technical approach to production and nothing to do with art, creativity or anything valuable. It is a repetitive activity that does not need full attention. It is the equivalent to a manualised approach to therapy. It is present-athand, rather than ready-to-hand. Everything we do is done at a particular time and a particular place for a particular purpose. This includes both therapy and the making of art works. The piece is therefore site-specific. If anything, this was the primary influence on my initial thoughts about what I wanted to make. Not so much what I wanted it to be but where I wanted it to be. This is analogous to Heidegger’s being-in-the-world. It is not a piece of work on its own, it is a piece in a context for a purpose. This includes its scale. It has to enhance, respect and echo its surroundings. It has to create enough tension by its placing and its nature that it does not merge in or dominate. The piece does not stand or fall on its own merits, for it has none, as such. For it be in-the-world and of-the-world, while it is obviously three-dimensional it is also important

Martin Adams is an existential psychotherapist and writer, and also a sculptor martincadams@ icloud.com

to me that it has no front or back, no left or right. These are post-hoc cultural constraints, based on two-dimensional literal thinking and a need to reduce ambiguity. All it has is a bottom. It is grounded, it is bounded by gravity and its material nature. Its connection to the ground is analogous with our connection with the givens of existence and our material nature. This is all we have. It is our thrownness. It is also important that it has no title. Even ‘Untitled’ is a title. To give it a title is to separate it from its context and to make it in to an object that has a meaning. Art works should be able to stand on their own without an explanation of what it ‘really means’ or how to look at it. It is what it is, and what it is changes. Like people.

Picturing different understandings Meg-John Barker on comics, zines and therapy My love for comics and zines (short for magazine or fanzine) has always been entwined with my mental health. Growing up, comics were a safe place to escape when times were hard. However, they also provided me

as an adolescent with damaging messages about how to be, and how to relate to others. In the 1970s and 80s girls’ comics – like the teen magazines that have superseded them – contained

strong messages about gender and relationships that reflected and reinforced those circulating in wider culture. There were common stories of self-sacrificing, nurturing femininity being rewarded. Another frequent theme was the vital importance of finding one true ‘best friend’, as a kind of preparation for later finding ‘Mr Right’. The repetition of such messages left a strong mark on me as somebody who was being bullied at school, and struggling to belong anywhere. I internalised the idea that I should be what other people wanted me to be, and that finding ‘The One’ person who would love and accept me would be the way out of my suffering. These linked assumptions resulted in the creation of the ‘painful triangle’, as one of my clients describes it: a psyche dominated by a three-way relationship between a powerful inner critic, a desperate pleaser, and a descent into depression when attempts to please

seem to fail, or are revealed as impossible. As with so many people who develop along these lines, mental health difficulties were exacerbated by the suffering and loss caused by this triangle. The unsustainable attempt to be constantly approved of, and the pressure on one person to meet all my needs, inevitably led to relationship breakdowns. However, reading comics and zines has also been extremely helpful in relation to my mental health. In college, queer-themed comics like Strangers in Paradise, Dykes to Watch Out For, and Leonard and Larry offered different models of relationships and gender to gently challenge my assumptions. In later years, it has been deeply powerful for me to see an experience of distress or suffering similar to my own illustrated in graphic memoirs like Fun Home, Marbles, and Lighter Than My Shadow, in webcomics like Hyperbole and a Half, I’m Crazy, and better, drawn, and in long-term perzines like Telegram or Clark 8. Something about the combination of pictures, spoken/thought words and narrative seems to enable a connection that’s more powerful than written memoirs or other media. Mental health comics and zines have also helped me to explain emotional struggles to other people in my life who don’t share the experience. Collaborative mental health zines like Do What You Want, Collide and Pathologize this! are particularly helpful in emphasising the diversity of experiences, rather than supporting the popular assumption that a difficulty like depression or addiction will always look and feel the same. After many conversations with my friends Joseph de Lappe and Caroline Walters about how helpful such mental health comics and zines had been in our own lives, in 2014 we edited a series of special issues of Asylum mental health magazine on this theme, which brings comic creators and readers together to reflect. Many people wrote about the value that making comics and zines had on their own mental health, and this is where my picture comes in. For the past decade or so, as well as reading them I’ve also been creating comics and zines about my own mental health and about therapy more widely. I’ve been fortunate enough to work with professional illustrators on some of these projects, culminating in the book Queer: A Graphic History, with Julia Scheele, which addresses the impact of cultural messages about gender, relationships, sex and self that were so profound in my own struggles. However, comic and zine creation is something that anybody can do, whatever their artistic ability. My own created zines have much less professional drawing accompanying the text, and the online comics XKCD and Hyperbole and a Half are great examples of how very simple images can powerfully capture the experience of mental health struggles. I first started drawing my experiences in comic form simply as a way of expressing emotion. Something that I explore in my zine on Staying with Feelings is the way that the expression – or even experience – of certain emotions is discouraged in our

the psychologist july 2018 psychologists’ art

culture. This was certainly the case for me as a child, and therefore drawing became an important way of putting the pain, anger or sadness I was feeling down on paper. My picture about depression, here, was a way of recording, for myself, the experience when I was in it. Given that the ability to sit with difficult emotions seems to be highly valued across therapeutic approaches, I think that comic/zine depictions can be a useful practice to add to our toolkit, especially when alternatives like meditation or journaling aren’t working for us. Something I’ve found particularly helpful for selfunderstanding is to draw big comic maps or timelines of my life, sketching particular moments from childhood that resulted in the triangle that I described before developing, for example. Another important comic for self-compassion was one where I drew – in parallel rows of panels – an experience from childhood and a similar one from adulthood that brought up the memory: going to a party and not fitting in. I ended the comic with the adult me breaking out of their panel and into the child’s panel in order to comfort them. One problem I’ve had with the mental health memoir comics that I’ve read is that they tend to take a fairly individualistic approach to mental health, similar to that taken in wider culture. Often they locate mental health difficulties in a person’s physiological make-up and/or in their psychological development. There is generally less of a sense of the ways in which the social and cultural forces – which seem central to my experience – might be involved. Mental health zines tend to be more critical and take a more social perspectives, perhaps due to the radical roots of zining

(they were associated with punk in the 1970s and 80s, and then became part of the ‘riot grrrl’ movement as a means of sharing feminist content). My own comics and zines were driven by a commitment to communicate different understandings of mental health to mainstream audiences. Early comics included in my (anti) self-help book Rewriting the Rules tried to capture the way in which neoliberal capitalism operates by engaging people in self-monitoring and comparison with (imagined) others to reveal our ﬂaws. This leads us on to comics and zines as a way of disseminating helpful ideas and practices to other people. In my book Mindful Therapy I used comics that I drew on a Buddhist retreat to illustrate various mindfulness practices, and how challenging they are: something that often gets missed in the current emphasis on mindfulness as the answer to everything! This led on to my Social Mindfulness zine where I tried to bring together mindfulness practice and social justice understandings of privilege and oppression. In the area of relationships I’m now creating a range of ‘make your own’ workbook zines with my collaborator Justin Hancock, which help people to think through the ways in which they do relationships, so perhaps they – like me – can explore their patterns and take a more conscious or intentional approach, relieving some of their suffering in this area.

Meg-John Barker is at the Open University meg.john. barker@gmail. com

Further reading, You can ﬁnd my comics and zines on rewriting-the-rules.com/zines, megjohnandjustin.com/ publications See also http://zinewiki.com

Gardening with Heidegger Rupert King on creating a haven for healing I trained as an existential psychotherapist, and the writings of the German philosopher Martin Heidegger (1889–1976) play a formative role in my professional life. After several years of practising I experienced a period of burnout and depression, and Heidegger’s later works provided the solace I needed. These is a series of essays and lectures replete with poetic imagery of wooded paths (Holzwege), clearings (die Lichtung) and shadows (concealment). One essay in particular struck a chord – ‘Building Dwelling Thinking’, in which Heidegger talks about the importance of learning to dwell: ‘Dwelling, however, is the basic character of Being’ (Heidegger, 1993, p.362). What does Heidegger mean by dwelling? In my busy life I had certainly lost all sense of dwelling. Why are the simplest things so easily overlooked? As I pondered how to dwell, the answer came in an unexpected form. It was around this time I moved house, the garden I acquired with my new home was in a sorry state, a threadbare lawn dominated by a Leylandii hedge under

which nothing grew. The garden was surrounded by a beautiful red brick wall most of which was covered by a suffocating mass of ivy. Mindful of Confucius’ saying ‘Life begins when you plant a garden’, and the renowned psychoanalyst Nina Coltart writing ‘in an ideal world, all psychotherapists would have a garden’, my plan was to create a water garden – a haven where I could heal. I wanted to evoke the same kind of sanctuary as my great-grandmother’s garden, where I recalled stepping through the gate, from the ordinary into a magical world, a mature, well-cared-for English garden with no shortage of hiding places, old trees, beautifully kept lawns, and garden ‘rooms’ in which I could create fantasy worlds. With no formal design training I followed my imagination combining it with a love of Japanese gardens and an interest in exotic, sculptural plants. In doing so, I built a space where I could reconnect with the world and myself – a space for dwelling.

Rupert King is a psychotherapist kingrupert@ hotmail.com www.ﬁeldhouse garden.co.uk

In another of Heidegger’s later essays, ‘The Origin of the Work of Art’, there is a line that I have always found apt: ‘In the midst of beings as a whole an open place occurs. There is a clearing’ (Heidegger, 1993, p.178). Heidegger’s clearing communicates the essence of his later philosophy, namely that the nature of Being is openness. This is our need to create space and dwell in openness whether it’s physical or psychological: ‘Such standing in the clearing of Being I call the ek-sistence of man’ (Heidegger, 1993, p.228). The image of the clearing certainly resonates with my work as a therapist. Sitting with clients echoes the dappled sunlight of the clearing; where patterns emerge, things come to light and insights are uncovered – Heidegger’s aletheia. At the same time the clearing is an inherently ambiguous space with blurred edges. In the clearing certain things remain for ever in shadow. The clearing teaches us to accept these every present mysteries, it inspires both therapist and client to ‘let things be’, to tolerate uncertainty and become present to the unfolding of life. Gardening is more than merely an escape or distraction. Feeling the earth in my hands and the dirt under my fingernails is a grounding experience. Planting bulbs, pruning climbers and sweeping autumnal leaves remind me of the passing seasons – very existential. Gardening is a form of dwelling, it is about creating and nurturing. I see myself as an artist, sculpting space and creating forms through planting, building layers of texture with my choice of plants. When I garden, I become ‘one with the process’, time stops and I am in flow. These are the moments that any artist cherishes, that sense of getting Key sources lost in the creative process. My garden is a space where my psyche Coltart, N. (1993). How to survive as a finds expression and responds to psychotherapist. London: Sheldon Press. the world – it is my ‘soulwork’ Heidegger, M. (1993). Basic writings (Romanyshyn, 2007). (D. Farrell Krell, Ed.). San Francisco: HarperCollins. When Heidegger talks about Heidegger, M. (1962). Being and time. the dwelling he refers to it as (trans. Macquarrie & Robinson). Oxford: ‘gathering’: the fourfold elements Blackwell. (Original work published coming together – Sky, Earth, Gods 1927) and Mortals, each representing a Kurtz, S. (1989). The art of unknowing. different aspect of Being-in-theNorthvale, NJ: Jason Aronson. Naydler, J. (2011). Gardening as a sacred world. My garden, in Heidegger’s art. Edinburgh: Floris Books. phrase, ‘holds open a world’ – where Romanyshyn, R. (2007). The wounded the wildlife, visitors and I, the researcher. New Orleans: Spring gardener, become present (Mortals); Journal. all this that happens under heaven – ‘the vaulting path of the sun’ Find many more contributions in the online version of this piece: Birgit (Heidegger, 1993, p.351), which is Innerhofer and Rauter Kathrin on captured and reflected in the pond connecting with the inner child (Sky); the garden arises out of the through painting; Jessica Parmar London clay soil (Earth). And what on her artistic depictions of the fairy of the gods? A visitor to my garden tales and battlegrounds of becoming furnished me with the best answer a counselling psychologist; and Marta Sant on a process of unwinding in her to this question. While discussing journey into crochet. the ceramic sculpture at the centre of the pond she referred to it as ‘very

Jungian’. The gods then are the numinous aspects of life. They are the spiritual made present yet not fully understood. I like Heidegger’s idea of the gods because they remind me of the importance of not-knowing, a quality similar to Keats’s Negative Capability, which is an uncomfortable, yet familiar, place in therapy. Where we sit awaiting the gods as ‘the beckoning messengers’ (Heidegger, 1993 p.351) and for the psyche to manifest itself. In short, my garden represents all aspects of the fourfold – it also a symbol of Being and nothingness: ‘The clearing is the open region for everything that becomes present and absent’ (Heidegger, 1993, p.442). I once worked with a young client who suffered from terrible social anxiety. As a result his world was all about constriction and limitation – his physical presence, the way he curled up in the chair, the shallowness of his breathing and his reduced group of friends. He feared the world and so literally shrunk it to the point where there was no more space until he felt totally trapped. Much of our work was about exploring his worldview, but in equal measure it was about increasing his awareness of the physicality of space and the need for openness. We did this through relaxation, breathing and just sitting (which at times he found excruciating). Gradually he began to tolerate difﬁcult feelings and learnt to dwell, in doing so the constricting tentacles of anxiety loosened their grip. Indeed, Heidegger wrote: ‘dwelling itself is always a staying with things’ (Heidegger, 1993, p.353). The years spent gardening have taught me vital lessons: the need to create space, to let things be, to surrender to not-knowing and to dwell in openness. I started my journey in the belief that gardening was a creative outlet and an essential antidote to therapy; over time I discovered that gardening and therapy have much in common.

the psychologist july 2018 psychologists’ art

Creative discipline Christina Richards on the restorative power of the natural world When I consider my therapeutic practice I am in tension. There is tension in my shoulders and back from stress certainly – stress from folding the human into the inhuman. From meeting people as people in the machine of the NHS. From being positioned as a person with power, but understanding that if it is not I who wields that power the machine will simply replace me with a more willing part to turn on, to not stick and cause a moment’s pause in the relentless grind. Hard surfaces surround me, purchased for their ease of cleaning (to keep costs down of course) tacky, reflective, cold. Drops of humanity sprinkled like rainwater on oil – a picture there, a favoured mug here. I try to reach for the other, but the machine, what Pirsig called the Giant, grabs me and holds me. The other tells me I must choose while berating me for doing so. They are in the machine also, grinding in its gears. At the end of the working week I am spat out. To wander the hills. My shoulders relax as the clear air flows through me, into me and out again. In and out. In and out. I become one with the place around me. There is a smell of green and earth and living things. The skies open and the crows circle and call. I open out. The rough rock I press my face against has a covering of damp lichen which is familiar to my fingers; spiderwebs hold dew and then give it up to the morning sun as beech leaves slowly deliquesce into a mulch for new life to draw on, to burrow into, to grow. Clouds blow across the open moor shadowing brown to green to purple as the seasons turn. A nesting grouse explodes upwards at my approach, out across the heather towards the sweep of bracken spiked with

Christina Richards is a counselling psychologist contact@ christina richards.co.uk

foxglove with rock islands across the valley. It flaps and chatters as the curlew had called under a limpid watercolour sky time before, and after, and before, and after. Home again, I rest my hand on a glass before the fire. The flames curl and coruscate holding me gently; calling something ancient, some fragment of attention and peace planted by a Palaeolithic ancestor. I am rested. My head lolls, my dog sighs in her sleep and starts to run, dreaming of bouncing like an otter through damp heather no doubt. Of stretching muscles across an endless moor under an endless sky. Some days we walk in the cultivated land. Mules and Texels on close cropped grass. Over stiles and down footpaths once ancient highways. Past ruins of the reformation, and by farms changing, always changing to draw the most out of the land while locked into it – more than had been thought it seems now. We need the butterflies and birds, the wildflowers and the beetles our grandparents saw without end. Up the hill though the wooden gate and then through the narrow sheepstones to a field of green barley. The wind blowing, and swirling, a susurration more complex and more perfect. Just there. Just there. The copse on the horizon swaying, shadowed. The barley all around me, growing under the sun. The wind across my skin. Standing, I am part of the world. I can feel the world turn. Then I am back among the wipe-clean plastic. In the system. This now, because – well because it’s policy. It may be ineffectual, it may be harmful. But it is Policy. I cannot see anything green. I must make decisions with Policy and money in mind. I must sit on the painful chair with the fake covering. I must try to reach another person here. I try to remember, try to reach the open spaces I keep in my heart. But the system tries to grab me and crush me to its synthetic will. It is not easy to stay human here, not easy at all. But I must because I, and the people I see, are. And we come, ultimately, not from the plastic but from the earth and the sky.

Emmy van Deurzen ‘They tried to paint me into a corner, where I didn’t belong’ Our editor Jon Sutton meets existential therapist Emmy van Deurzen

Do you think we’ve lost academic debate? Certainly in the media. When I think back to 30 or 40 years ago, there were programmes on television where intellectuals, professionals, had discussions and debates and dialogues with each other, on really interesting topical issues. Where do you see that these days? What we’ve got is Question Time, which is completely not a real debate. It’s gone. Why has it gone? People are controlling the discussion in this country, there isn’t that openness to actually exploring with another person, and for people to be able to participate in it. People are scared. Whenever we’ve tried to set up debates in The Psychologist, I’ve had that sense… they fairly quickly ﬁzzle out, with people seemingly unwilling to take a ﬁrm stance. People seem to think that to properly debate is to be aggressive and confrontational, but it doesn’t have to be like that. Not at all. It can be very respectful. It’s only in dialogue that you can learn something new. You don’t see that at all. The only way we learn something new is by doing research and arguing about it in a very factual way, but what we don’t see is in-depth philosophical debate about things we have discovered. About ideas… And what it means to society, and what we can do with it, and how we can interpret it in different ways. We’re hiding at the surface of things, all the time. You think that’s changed in the last 20, 30 years? I think in the last 10 years it has become really bad.

How does it affect your practice? That’s an interesting question… a lot of people come to me because they want to have that kind of discussion about their own life, and they don’t feel they can do that with the people they know. If they try out an idea about what they think has happened to them, what they think they might want to do, other people will immediately judge them or make them ‘ﬁt in’ with the

norm… settle into something predictable, when they might want to experiment with something different. And your approach is to explore… …to go down any avenue, see where we get, and if that isn’t where we want to go we backtrack and we go down a different one. But not in a passive, ‘what do you think you should do?’ kind of way? Oh no, I will challenge. ‘So if you do that, you think that this will happen? But what about that, what about what happens to your family, your future?’ I make them think about issues they may not have thought of. Then they go down that path and they discover something completely new again. Cognitive behavioural therapy is the prevailing framework, do you think that involves challenge in the same way? It depends who does it and how it is done. A therapy is as good as the practitioner is, and as good as the client is. They make something of it together. A lot of CBT is done at a very superﬁcial level, but I also know people who are more experienced and who use that instrument to do something much more interesting. Certainly some of the ‘third wave’ therapies seem to be more willing to give an opinion on what’s going on… I’ve always thought that if I was in therapy, that’s what would drive me mad, you go and see a professional and they pretty much say, ‘What do you think you should do?’… ‘I don’t know, that’s why I’m here!’ You have expertise, and that doesn’t mean imposing your views, it means helping people see the horizon that you’re capable of seeing and that they might not, and then for them to do the exploration and make the decisions. How quickly are you capable of seeing that horizon after you meet a client? I’ve done this for 45 years. By now I get a very good overview quite quickly. I know what questions to ask

the psychologist july 2018 interview Jon Sutton

and I make observations about how a person is in the room, how they are in relation to me, how they hold themselves, how they are dressed, their facial expressions… there are so many things I’m used to picking up on. But I slow myself down, I don’t jump to conclusions, so it will take me several weeks to really begin to feel that I know how that person is in the world, and what things matter to them. What are the contradictions, the conflicts, their purpose, values, beliefs, fears, hopes… all these sorts of things, that takes a bit of sorting out. It’s like the painting I do. Layers. Exactly that. I get an immediate impression, and sketch something out, and then I start checking it out, and gradually the picture fills in. And do you think you’re about as good at that as you have ever been and ever will be? Much better. At my absolute best. No doubt about that. But I have lost certain things. When I started when I was 19… I’ve actually done it for 47 years, I’m 66 now… I was naive, and I was open, and I was willing to share myself straight away. I was willing to plunge in really deep and be passionate and enthusiastic. I couldn’t do that now. I’m still passionate about the work, but I wouldn’t engage with somebody in that fresh, deliberately open way. I’m far more cautious. You see that as a loss, even though you say it was born out of naivety? There are clients who I think just need that, they need to find somebody who makes them revitalised, believe that life is possible. I don’t think I can do that quite in that way. I think I can help them understand life, and see the complexities and the possibilities and the fascination with it, all of that, but that takes more time. In two sessions, engage somebody out of suicide and make them inspired, to think ‘Ah! That’s how I want to be. I want to be like her!’ You talk about time, and I guess the drift towards the ‘manualised’ version of therapy, to ‘austerity’ measures, your approach is obviously more intensive over a longer period. Is it a therapeutic approach based on luxury, and only a certain kind of client can benefit from it? Not at all. We run a low-cost clinic at the Existential Academy in London, with people coming from all kinds of social backgrounds. They can work with us for maybe just 10 sessions, or 20 sessions, but they can also do longer-term work. Of course I’ve also seen many people who write to me who live in Japan, or India, South America, and they say ‘I’m coming on holiday, can I have one session with you?’

Just to revitalise, recharge? Just to get a different view on things, to re-experience themselves. I don’t want to boast, but… I think you should! I like the fact that you boast.

…they very often say, ‘Wow, that’s really changed everything’, and then maybe they come back four years later and say they want to do that just one more time. I think, ‘How did that happen, I didn’t do that!’ It’s something that happens between us, in the room, in a very short period of time. They put so much energy into it, they have high expectations. They have been stuck, troubled, and they think, ‘Maybe she could help.’ When they come into the room it’s already highly charged. Somehow, I know how to bring that out, put order into it and put light through it. Again, like painting! With the right organisation, perspective, the sense of solidity and lightness, purpose and direction, suddenly the fire takes again. You say it involves a lot of energy on their part; do you get people that you hear about further down the line who didn’t benefit from that approach, or where you immediately think ‘This isn’t going to work with you, you haven’t got the spark’? I never think that, but there are people where it takes many years. I have had clients in Sheffield I have seen for 12 or 15 years, and there is still a darkness and a struggle. They’re getting the hang of it, but some people work with great troubles. That is also part of the essential core of anybody though… I think the ‘light versus dark’ struggle is a vital part of everybody. We all need to retain some of that darkness inside, don’t we? Totally. I completely agree. Some people are too light! But there are also people who have been trapped into the morass of life, they’re not just in the darkness but they are stricken by fear, terror, paralysis. That can take a very long time. What’s the basis of that, do you go naturally to childhood, or fear of mortality, or just the state of the world as it is at the moment? Everything. Existential work has got to do the whole range. It’s about the long distant past, the immediate past, the present, the near future, the faraway future, temporality in general, eternity, you name it. All of it matters. To figure out where that person has a problem, you need to broach all of it. You can’t select something, you have to see where that person is stranded, unhinged, unwoven, stuck. Do you think you’ll be doing this into the faraway future? It’s a way of life. That’s how I live for myself, how I try to be with my employees at work, and how we are in our couple together. Working like that with people is just part of what nurtures me and keeps that alive, so I think I’ll always do a bit of it. We’re sitting next to the study you share with your husband, Digby Tantam, who is both a Professor of Psychiatry at Sheffield and a Visiting Professor of Psychology at Middlesex. You collaborate with him?

the psychologist july 2018 interview

We work together, have meetings together, write together, travel to conferences… we haven’t spent a night apart for 24 years. But we’re completely different characters, totally different. This constant dialogue, of unravelling the issues and straightening them out, ﬁnding something that works, is just the learning process every day.

I think we don’t know the half of it. There’s a lot more going on behind the scenes, and it’s very dangerous. It’s by no means all about remaining or leaving, it’s much bigger than that.

More existential than that? More political than that, more ideological than that. There are ideologies driving politics that we should be very worried about. They remind me very much In what core ways are you totally different? of the things I could never understand as a child in So many ways… for example, Digby is very good the Netherlands. I was born in 1951 and my parents at managing structural things and seeing to it that things operate well. I’m much more interested in being had very difficult war experiences, people in the family shot and in concentration camps, my grandparents inspirational or having new ideas, pushing things becoming refugees when their house in Arnhem was in a new direction. That steadiness along with that bombed. My father hidden away from the Germans volatility or exploration, sometimes rub each other up the wrong way, but overall that is a wonderful strength for an entire winter, losing everything. I grew up in the shadow of that war, with all those stories and all you can work together. Each of us is better for it. the fear of it. They took us around Europe and made But also character-wise, we want different things, us play with children in all the we have different ways of doing different countries and learn the things all the time. Digby is much “Somehow, I know how languages, because they were very more British, I’m much more keen for us to understand that you Dutch. So Digby will work with to bring that out, put to work together and you have negatives very well, he’s fantastic order into it and put light have to accept difference. You have to in conflict. He’s a group analyst, through it. Again, like learn to be flexible about that. so he will push people to express The one thing I never their negatives, their conflicts. I’m painting! With the right understood – I remember asking much more of a peacemaker, I’m organisation, perspective, my parents about it over and over more interested in seeing how to the sense of solidity and again – ‘How could this happen in harmonise things. But I’ve learned Germany, how did people allow it?’ from that, as you say – the more lightness, purpose and mother used to ask people that you can face the dark, the better direction, suddenly the fire My question, in front of me, when we it is. So I help him harmonise, takes again” went to Germany. I remember very be more appeasing sometimes, well what they would say, always and he helps me to be more the same thing. ‘We didn’t know.’ confrontational in a way I didn’t How was that possible? My mother tried to explain it, dare be 20 or 30 years ago. Or stand up to people who might bully me, which he is absolutely amazing at. He’s saying, ‘Well, it was slow, people thought the situation is difficult, maybe this guy will make it better, you confident and strong, and I’m careful and gentle. But have to take a bit of rough with the smooth, it can’t I’ve learned to be strong and solid, robust, and I think be quite that bad, maybe it’s a good thing to separate he’s learned some things from me too. That takes a people out…’ Very gradually, the standards slipped long time, and to dare to admit what you might bring. and changed and people accepted it. I thought, ‘I don’t know, I don’t think that could happen now’, and I felt You’re not in any great rush. superior about it. Now I understand. I know how it You’ve got to trust that if you pay attention to what works. I know how it happens. Yet it is so difficult to goes where, and how you can settle it in, it works out. get people to take notice of what is going on. Like in the garden, we’ve put loads of plants in, but when you look out there you can’t see that any more… Because it’s slow. they’ve kind of worked it out with each other. Some Yes. They think, ‘Maybe it wasn’t that great, we’ll be OK plants have died, some have thrived, and they’ve all anyway’… it’s frightening, because I recognise it. Same settled in without having to do much to it. You can’t in the United States, one of our sons lives out there, really see why you planted them like you did, because and we’re very aware of what’s going on there too. they’ve rearranged themselves somehow. Utterly terrifying. In terms of our society at the moment, I know you’re Can psychology do anything about this? a keen Remainer… It bloody well should. Because we know how that I am an activist I’m afraid. works, we know how people are manipulated. All of this has been done with psychology. I realise with Do you think there’s too much meddling, for want hindsight that I was being manipulated. I became of a better phrase? That people should be left to activated just six months before the referendum, rearrange themselves?

because I applied for British citizenship. I wanted to work and I was confused by the Home Office. I didn’t have the right residence card, I had ‘indefinite leave to remain’, instead of ‘permanent residency’, which was the newfangled thing they had brought in. I thought, ‘This is crazy, I got that certificate from the Home Office in 1984, they can’t refuse me.’ So I tried again, and I was refused again. I got my MP Nick Clegg to help me. Then I discovered the AIRE Centre in London, and they helped me put a letter together, which Nick sent to the Home Office. They phoned me up on a Friday night, saying, ‘We have refused you twice, but would you consider applying again because maybe it will be different this time?’ I got it in the end, but this was post-referendum, it took a year. So by that time I was very cross. I was on social media a lot. I realised that when I was trying to explain to people what was happening, I was getting trolled all the time. I didn’t know it. There were people who would say to me that they were psychologists, or counsellors, or psychotherapists, and they were scandalised that I should talk about these things: ‘What would your clients think?’ These weren’t psychologists, they were people putting pressure on me. They’re wasting their time there aren’t they? No, it had a huge impact on me. I was silenced. And then I decided that was nonsense, that I didn’t care any more what people thought of me, that it was more important to speak up and not let it happen. So when people started on me, I accumulated lots of factual things, or I would just block or mute them. But these were things I had to learn.

you’d just go back to being a psychology magazine.’ The way I explain that is that there are actually a fair few people doing what you’re saying, pushing back… but it seems to me that is leading to a splitting of the discipline, between people who are saying ‘This is the very stuff of humanity, we should have plenty to say and the conﬁdence to say it’, and others who think that psychologists don’t even have the right to address these types of issues. Absolutely. And these people pursued me for it. They used words like ‘neo-liberalist’, and ‘privileged’, and said philosophy is irrelevant… to which I could say I work in Yorkshire with ex-miners. They couldn’t quite locate me. They tried to paint me into a corner, where I didn’t belong. I’ll admit, I didn’t know much about you before I came today, and I had formed the impression that existential therapy would be a luxury of the privileged. How does a Yorkshire miner decide that what he needs is an existential approach? Because he doesn’t want to be psychopathologised. He says, ‘I don’t want some psychologist or counsellor who’s going to tell me what’s wrong with me, I just want to talk about my life… I want you to help me understand it.’ People aren’t daft… they just need somebody who can help them do these things and come to some conclusion about themselves. It isn’t about where you were born, how much money you have, how intelligent you are… all human beings can do that.

That links in with the anti-diagnosis movement, and perhaps the recent Power, Threat and Meaning I ﬁnd it interesting that you were silenced… I’ve only framework… that’s talking in those terms of people met you today, but I would imagine you’re relatively not necessarily beneﬁting from saying ‘I have got hard to silence! depression’. It’s more about what’s happening to me I was so worried about my ideas in my life, the sources of power not being welcome in the country. and threat… Before I got British nationality I Yes, and also the limitations that “People aren’t daft… was actually beginning to get really have encountered in their they just need somebody people scared that after 40 years in the life. An existential approach is who can help them do country I would have to leave. always political, and it is always these things and come to socially and culturally informed. Did it add an element to your fears If you haven’t had certain some conclusion about that you thought they were your opportunities, you just don’t know themselves” peers? That takes us back to the about certain things, that it is start of the interview, the idea that possible to get out of a place and people in psychology are perhaps discover difference. scared to seem outspoken? This is why I came to this country. I was invited It was exactly the same thing. That peer pressure stops by Laing and Berke to come to London and work in us, it mutes us, it makes us bland. We’re so cautious the therapeutic community. We didn’t use medication, that we don’t explore things any more. We have to take or categories, people would explore their madness. that risk, we have to venture out with our ideas, then It was a very disillusioning experience to live in a maybe other people show us a different side and we therapeutic community and discover that people change. What we shouldn’t do is just block ourselves. just end up self-medicating when they don’t take anti-psychotics… drinking, smoking dope, stuff like We’re increasingly getting emails, online comments that. But nevertheless, that tough exploration, sitting and so on, saying, ‘What is all this post-modernist, with people for hours, living with them, that really left-wing, liberal agenda-pushing nonsense, I wish changed the way I work. It made me aware that it’s

the psychologist july 2018 interview

about enabling people to ﬁnd the strength and courage to face their problems and live in a different way. It doesn’t matter where they come from and it doesn’t help to say, ‘Oh, you have schizophrenia’, but it helps to have that background and to recognise that they may be suffering from biological things too. So they may well ‘have schizophrenia’, it just doesn’t necessarily help them to see it in that framework? Yes, and they may well be autistic, it’s important to recognise that may well be the case and it’s not all in the mind, but you can still have a dialogue with them and help them explore in a different way. And do you think you’re going to carry on getting better at this exploration? I hope so. I have no doubt that I’ll also get worse in some ways. At this age things start changing… I’ll get more tired more quickly… That’s started for me already. The Japanese see 61 as heralding an entire new phase of life… Well, Carl Jung used to say you can’t be a therapist before you’re 60. You have to have been through all those phases to get to that stage where you can reappraise and re-evaluate. If you haven’t done that for yourself, you can’t really properly do it for other people. There is some truth in that, I think… that mature way of being with people is important.

A relaxed way that is based on knowing yourself ﬁrst. It’s about wisdom. We need to dare to use that word. It’s about moving from knowledge to wisdom, and from doing things to people to being with them. One of the most interesting aspects, to me, of what you’re saying, is that you’re brave enough to say that you’re wise and you’re at the top of your game. I’ve worked at it long enough. I’ve got two master’s degrees and a doctorate, I’m a philosopher and a psychologist, I practise psychotherapy, I’m a business manager, a Principal, a political activist, an artist… it’s taken me a lot of time to do all those things and pull them together, to understand how it all connects. I need to get better at that. Well, you just took my photo, and you say you’re not a photographer, but I see what you were doing. There’s a search in that, you were looking for a new angle, you brought something out. That’s like doing therapy. We haven’t been having a therapy session, but I feel much better about myself already. You are good. That’s the general idea. You start looking at the different aspects, you begin to see that each of them is a facet of life. Bring it to life and it all starts sparking again, and then you actually want to do things differently. You feel more passionate, more vital.

CULTIVATING COMPASSION | POSITIVE EMOTION | WELL-BEING

The Compassionate Mind Foundation’s 7th International Conference 3-5 OCTOBER 2018 | LONDON Professor Phil Zimbardo (via a live video link)

Transforming Compassionate People into Everyday Heroes Professor Ernst Bohlmeijer | Dr Allison Kelly | Dr June Gruber | Drupon Khen Rinpoche plus many more special guests There will be a variety of workshops, keynotes and symposiums covering ... Compassionate Mind Training for All | Therapeutic Relationships | Eating Disorders | Positive Parenting | Growing Areas Developing CFT and Complex Cases | Recovering from Complex PTSD | Motivational Interviewing | Positive Relationships Positive Psychology | Sustainable Mental Health Care | Positive Emotion and Psychopathology

For full conference details and to book your place visit:

WWW.COMPASSIONATEMIND.CO.UK and go to: conferences (Note: Early Bird rate ends on 31 August 2018)

Living a dual life Ian Florance meets Dr Philippa East

Dr Philippa East’s website details the range of clinical services she offers, but two headings are particularly arresting: ‘Mental Health in Fiction’ and ‘Consultation Services for Writers’. Further research revealed details of her prize-winning short stories on the Fiction Desk website. Where does the combination of clinical psychology and writing come from?

Since starting her own private practice, Dr Philippa East has chosen to work part-time, keeping her clinical work to two days a week. She spends the rest of her time writing. It sounds like this rebalancing was always inevitable. ‘Books are in my DNA,’ she tells me. ‘I grew up without a TV until I was about 11, and read voraciously from a very young age. Strangely enough, although I often wrote stories as a kid, I never considered writing seriously until I was about 30. At this time, I was moving jobs to the Maudsley Eating Disorder Service and I had a true week off with no clinical issues to think about. I suddenly realised I had an idea for a novel. I then spent two years writing it and found myself gazing at the manuscript of – you’ve guessed it – an atrocious novel. But I enjoyed writing. I joined an online writing group and started writing short stories – a good form to take up around a full-time job, and a good way to experiment with the craft. When I started getting these published in literary magazines and even winning a few prizes, I realised writing was really something I could do. I had tried lots of creative pursuits before – drawing, pottery, photography, music – but I never felt at home with any of them. Writing felt like the perfect fit. Then, when I left the NHS to become self-employed I started writing another novel. For about six months I had a mentor, which was brilliant, and I’m still a member of various writers’ groups who support me in the writing journey.’ Philippa says that she writes short stories in any genre. ‘I’ve written ghost stories, speculative fiction, dystopian tales, love stories. At the heart though, I write about relationships, the human condition, how we tick. I’m a slow writer: I write the first draft quickly but then rewrite and rewrite: my novel is on draft 13. It’s a process of finding out what you

the psychologist july 2018 careers

want to say – you start writing for yourself and end up working out what you want to say to others.’ Psychology is rich fodder for fiction, film and other writing. Since novels like The Silence of the Lambs, serial killers and forensic psychologists have been hugely popular figures in crime and thriller entertainment… it’s easy to forget that, once upon a time, crime fiction tended to focus on amateur detectives solving murders within families. Publishers even refer to a genre they call ‘misery lit’, which comprises stories examining the psychological traumas and behavioural implications of abusive upbringing. Philippa offers consultancy to writers seeking to use psychology in their work. ‘This is done as informal advice, not as a paid service, but I see it as an interesting bridge between being a writer and psychologist. Let’s face it, the stigmas of mental health problems have been strengthened by serious misportrayal in fiction and films, such as the inevitable psychotic killer. Some writers perhaps choose drama over accuracy, or some writers simply don’t know enough to realise the mistakes. But many want to get it right and that’s where I hope to help. Someone I advised started with a simple technical question “Do they have locks on the bedroom doors of a psychiatric unit?” and it went on from there as he realised how much more there was to know.’ Are there any books that really do seem to get it right? ‘A Little Life by Hanya Yanagihara is amazingly accurate in its depiction of complex trauma.’ I wondered where Philippa’s journey started. ‘There was no psychology at my school. I enjoyed learning and my A-levels – or rather their Scottish equivalent since I spent a lot of my childhood living about 30 miles east of Edinburgh – were in classics and arts subjects. I was originally going to study ancient history and philosophy at university, but the obvious question was “What job can I get with that degree?”. I ended up doing a combined degree in psychology and philosophy at Oxford.’ Where did the psychology come from? ‘I’ve always been interested in people. In retrospect I’m a human archaeologist. The phrase next to my photograph is my school yearbook was that I was most likely to “have a heart to heart”. My Aunt was an educational psychologist, so it’s a thread in my family, but the link between writing and psychology shows that trying to make sense of the human condition is always an art as much as it is a science.’ ‘I saw great links between philosophy and psychology too – the obvious area is the overlap in their concern for philosophy of mind. Writing and philosophy also go very well together. Both disciplines refuse to take things for granted and seek to imagine what things would be like if they were different – the classic “what if…?” question.’ Again, the issue of what job she was going to do came up: ‘…so I googled psychology jobs and got interested in clinical work. It was fairly competitive to get onto training back then; not as bad as now but still hard. What attracted me was that they offered

the chance to take on a therapeutic role while still continuing my interest in academic work. So, I signed up for various voluntary placements at university, roles like being a welfare officer, to build up required experience. After graduating, I got an assistant psychologist role in an outpatient eating disorder service in Southampton and then applied for the doctoral training programme.’ Philippa got turned down by three of the four courses she applied for – including at her own university – but got taken on by the Institute of Psychology. ‘I had a first class degree from Oxford; maybe they liked my academic record, even though I had very little clinical experience.’ The course was CBT heavy ‘so I took opportunities to learn about other approaches and had placements in health psychology and eating disorders, where I leant about IPT and CAT. And my interest in writing cropped up again when I wrote my dissertation on the use of therapeutic writing in the treatment of anorexia.’ Philippa says she has a ‘two to two-and-a-halfyear job cycle – a typical amount of time it takes to complete a novel, funnily enough. My first job was in a community mental health team. That’s a good role for anyone newly qualified as it widens your experience of different clients, disorders and approaches. Then I spent time at the Maudsley Eating Disorder Service, where I’d previously had a placement before moving to Lincolnshire – my husband is a psychiatrist and moved here for his work with the RAF.’ After working in a specialist complex case service in Lincolnshire, during which she learnt further therapeutic approaches such as EMDR, Philippa felt confident enough to ‘jump the NHS ship’: ‘I didn’t really get on with the NHS in the end, and I’ve also come to accept that I’m not necessarily a great team player. In addition, after our move to Lincolnshire, I’d gone back to working five days a week… I was keen to work part-time again.’ What’s it like working in a private practice after working in the NHS? ‘I can help people better, and I can see people much quicker when they are keen to get going. The delays in the NHS were at times souldestroying. I can also see a wider range of people rather than specialising, and I can choose more what sort of caseload I want. A downside, though, is that people can struggle to pay for private psychology services.’ Did you find it difficult to set up your own practice? ‘At the beginning I panicked because I had no referrals. But I pounded the pavements and built up a caseload. You can feel isolated and somewhat exposed. Support and supervision can be a problem, but there are several of my NHS colleagues who are now also in private practice, and we support each other.’ I ask Philippa to sum up her dual life. ‘I see my clinical and writing work as complementary, they have a common root. But I don’t draw material directly from my case work to use in my writing.’ And your plans? ‘Well, I hope to secure a publishing deal for my novel in the not-too-distant future. However, even successful writers don’t earn much, so I’ll be keeping the day job!’

…winning entries in our annual poetry competition, from Rebecca Poinot, Hanna Akalu and Angharad Morgan

Three

One afternoon of April, 1963, you opened your eyes, For the very ﬁrst time Two parents by your sides, sisters 1-2-3, opening their arms, Hypnotised by your smile Three kilos three hundred, on April the third, you entered the world Aries, hear the chimes Baby boy, blessed with talent One two three, your voice is instrument Follow the movement One heart, musically ticking, beating in rhythm, like a metronome Steady melody Two eyes, blinking and clicking, observing the world, capturing the wisdom Sublime photography Three swallows, landing one by one, in your new built house that you now call home Complete Family Little boy; poet you became One two three, play with words with fame Can you feel the ﬂame? One man, once said these few words, it’s only with your heart, that you can see right Little prince, you see To… eyes, what is essential, is not visible, not intelligible

Concealed beauty Three petals, beautiful rose, listen to the prose that your heart compose, Feel the harmony Little prince became grand homme One two three, artist, you blossom Embrace the freedom Rebecca Poinot is a member of the British Psychological Society ‘This is a poem about my dad, whose favourite number is three. This is a poem about a man who loves singing, capturing the beauty of the world with his camera and putting it into words. His favourite story was always Le Petit Prince, with its strong message: ‘On ne voit bien qu’avec le coeur’ (‘It is only with the heart that one can see rightly; what is essential is invisible to the eye’). This is the story of an artist, a poet, a photograph, a writer, a dad of three girls. A man whose dream was always to be free.’

the psychologist july 2018 culture

Touched by your light In my mind was a vision, a longing, of you. Mesmerised, as I ﬁrst cradled you. Discovering you were special, your hidden inner being touched by a spectrum of light. From gentle murmurs, to words lost in utterance. You found your voice through writing. To convey, to us, what was manifest, the many depths of you. Some days you cling to me tightly seeking solace in my embrace. On others, you yearn for seclusion. Savouring solitude, From the sublime chaos Of our social world. As we stumble together on this journey, Moments tinged with angst and joy. Touched by your light, fear slowly ebbs away. As I humbly watch you soar, my arms wide open, should you ever fall. Hanna Akalu is a ﬁrst-year PhD student at GCU London

‘I’ve never written a poem before. This was inspired by my sweet daughter, Ayshah. It’s about my experience of being a first-time parent to a child who is on the autism spectrum. It’s about the bittersweet journey that ensues as you begin to see the world through their unique eyes, transforming your own understanding of the world in the process. It attempts to capture the many layers of my daughter, who is by no means defined by autism. I’ve watched her blossom at her own pace, and in a way that is at times blissful and, at others, heartbreaking. It’s about being present, as her mother, in a way that neither over pressures nor limits her being. It explores an equally challenging and rewarding journey, transcended by love, filled with shifting expectations, and a subtle realisation that even though she sees the world a bit differently, it doesn’t make it any less meaningful to her. Being “touched by your light”, is being able to see the world, novel, through her eyes.’

Cerebellum & Sons We offer to you, at no price at all, This instrument of uncanny power. You can use it in a multitude of ways – Look, we’ll show you – For good or for bad, for pain or for pleasure, For leisure or genius or playing out dreams; As a weapon against others or against yourself. Handle it carefully, it is made up of many parts. Do not, whatever you do, take it out of the case that protects it – Doing so will cause a fatal malfunction. We have warned you. The product does not come in fancy colours – Just grey – but we wager you won’t be disappointed. There is no manual included, however, you wouldn’t understand it if there was. Why not give it a try? If it’s not to your satisfaction, we promise you your oblivion back. Oh and one last thing, before you go: Sorry about the constant interior monologue. We’re working on that. Angharad Morgan

‘I saw your competition on Twitter. I started writing poetry around seven months ago. I have a layman’s interest in psychology, I’m quite drawn to the surreal and I liked the idea of these slightly shady characters selling brains even though the human mind hasn’t been fully perfected yet. There’s a lot of humour in the idea, but also a reminder that actually human brains are not only fragile, but can cause a huge amount of destruction in the wrong circumstances. ‘I do ﬁnd myself writing about the brain, body and anatomical references a fair bit, which is odd because I don’t have a scientiﬁc background – but I do think it is important for writers to challenge how we look at ourselves. And Cerebellum & Sons does make for a great shop name.’

the

psychologist

AZ S

Karla Novak

...is for stress

Suggested by Karen Shepherd PhD student at the University of Nottingham @Kaz_Shepherd ‘I chose stress because I’m interested in why mothers of children with type 1 diabetes – reported in the literature as experiencing higher levels of stress – use online support groups, and their motivations for doing so.’

Can stress ever be beneﬁcial? In a fascinating talk we reported in November 2016, Ian Robertson considered how we can push ourselves into the ‘sweet spot’. His focus was noradrenaline – ‘a potential candidate for the most remarkable brainenhancing substance’. The idea that stress can be good for you was also reinforced in our popular ‘Guide to Healthy Living’ last year.

Are women the ‘stressed sex’? In a February 2014 article, with an audio interview you can listen to on our website, Daniel and Jason Freeman delved into reasons behind

coming soon… how selﬁsh is your pursuit of happiness?; awakening experiences; plus all our usual news, views, reviews, interviews, and much more...

their ﬁnding that women experience around 20–40 per cent more mental ill health than men. Letters followed… Caregivers experience a particular burden of chronic stress, and our 2012 ‘Viewpoints’ piece looked at a carer, the researchers, and the health professionals hoping to put the ﬁndings into practice.

A to Z Tweet your suggestions for any letter to @psychmag using the hashtag #PsychAtoZ or email the editor on jon.sutton@ bps.org.uk Entries so far are collated at https:// thepsychologist. bps.org.uk/ psychology-z

contribute… reach 50,000 colleagues, with something to suit all. See www.thepsychologist.org.uk/ contribute or talk to the editor, Dr Jon Sutton, jon.sutton@bps.org.uk, +44 116 252 9573 comment… email the editor, the Leicester ofﬁce, or tweet @psychmag to advertise… reach a large and professional audience at bargain rates: see details on inside front cover

Taking a mere ﬁve-day break from Facebook will lower your physiological stress levels, according to a study covered recently on our Research Digest blog. Introverts may miss leadership chances because they overestimate how stressful it will be. That’s according to a 2017 study led by Andrew Spark and reported on our Digest.

Search for more on this topic and any other via www.bps.org.uk/thepsychologist and www.bps.org.uk/digest

Find out more online at www.bps.org.uk

President Nicola Gale President Elect Professor Kate Bullen Honorary General Secretary Dr Carole Allan Honorary Treasurer Professor Ray Miller Chair, Membership and Standards Board Dr Mark Forshaw Chair, Education and Public Engagement Board Professor Carol McGuinness Chair, Research Board Professor Daryl O’Connor Chair, Professional Practice Board Alison Clarke Chief Executive Sarb Bajwa Director of Policy and Communications Kathryn Scott Director of Corporate Services Mike Laffan Director of Standards and Qualiﬁcations Andrea Finkel-Gates Director of Member Services Annjanette Wells (Acting)

society notices Psychotherapy Section ‘Food: Disorder or Wellbeing’ London, 26 October 2018 See p.8 BPS conferences and events See p.32 Award for Equality of Opportunity – call for nominations See p.32 Developmental Psychology Section Annual Conference Liverpool, 12–14 September 2018 See p.38 Division of Sport and Exercise Psychology Annual Conference Belfast, 3–4 December 2018 See p.38 Division of Occupational Psychology Annual Conference Chester, 9–11 January 2019 See p.50 Wessex Branch 6th Military Psychology Conference Basingstoke, 8 November 2018 See p.51 Early Career Conference Bursary Scheme See p.61 Psychology in the Pub Huddersﬁeld, 24 July 2018 See p.74 Professional Development Centre e-learning courses See outside back cover

Director of Finance Russell Hobbs The Society has offices in Belfast, Cardiff, Glasgow and London, as well as the main office in Leicester. All enquiries should be addressed to the Leicester office (see inside front cover for address).

The British Psychological Society was founded in 1901, and incorporated by Royal Charter in 1965. Its object is ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied and especially to promote the efﬁciency and usefulness of Members of the Society by setting up a high standard of professional education and knowledge’. Extract from The Charter