The Psychologist April 2022

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psychologist april 2022

‘Change must engage a person’s senses of identity, meaning, and belonging’

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psychologist april 2022

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‘Change must engage a person’s senses of identity, meaning, and belonging’

www.thepsychologist.org.uk

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’

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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, or tweet us on @psychmag.

Managing Editor Jon Sutton Deputy Editor Annie Brookman-Byrne, Shaoni Bhattacharya (job share) Production Mike Thompson Journalist Ella Rhodes Editorial Assistant Debbie Gordon Research Digest Matthew Warren (Editor), Emily Reynolds, Emma Young

Associate Editors Articles Paul Curran, Michelle Hunter, Rebecca Knibb, Adrian Needs, Peter Olusoga, Blanca Poveda, Paul Redford, Sophie Scott, Mark Wetherell, Jill Wilkinson History of Psychology Vacant Culture Kate Johnstone, Chrissie Fitch Books Emily Hutchinson Voices in Psychology Madeleine Pownall Psychologist and Digest Editorial Advisory Committee Richard Stephens (Chair), Dawn Branley-Bell, Kimberley Hill, Sue Holttum, Deborah Husbands, Miles Thomas, Layne Whittaker

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psychologist april 2022

‘EDI’: Endless Distraction and Inaction Sanah Ahsan confronts the reality of Equality, Diversity and Inclusion

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‘Change must engage a person’s senses of identity, meaning, control and belonging’ Adrian Needs in conversation with Sarah Lewis for Growth Uncut

Juliet Young

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Letters David Dunning responds; and more

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Obituaries

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News Ukraine; Covid; and more

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Digest How do we see our own physical selves, and more; plus the latest research

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Beyond a baptism of fire Amanda Mwale introduces pieces on being an Assistant Psychologist ‘What may seem like chaos from the outside is in fact a deep well of knowledge and wisdom from the inside’ Adriana Lisowski on how working in a crisis team changed her When misplaced glances turn into the sharing of smiles Laura Waring works in perinatal mental health Spinal injury – finding strength for an unplanned future Melissa Potter ‘The continuity of my role has given me the chance to grow’ Lucy Freemantle with the reflections of a Senior Assistant Psychologist, a decade on

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Jobs in psychology Featured job, latest vacancies

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From assessing individuals to transforming organisations We meet Nigel Evans

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Books Sarah Riley, Adrienne Evans and Martine Robson on their BPS award winning book, Postfeminism and Health; making sense of microaggressions; and more

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Culture Latest from the Bethlem Museum of the Mind

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One on one Iyabo Fatimilehin

This doesn’t feel like an easy time to be writing an editorial. Yesterday, Putin sent more troops into Ukraine, and threatened the world (to my ears at least) with nuclear war.

Earlier in the week, many of our readers were reeling from the latest blow in the academic pension dispute. Restrictions may have largely lifted, but the pandemic is far from over.

In the face of such events, Psychology – and The Psychologist – can feel powerless. I can source and tweet articles all day long, but does any of it make a difference?

Well, yes, I have to argue that it does. Pretty much everything around us, it’s all psychological.

Psychologists are at work helping to heal and grow. To give just one example from this issue, Adrian Needs talks of how change must engage a person’s senses of identity, meaning, control and belonging.

Belonging, community, the language of shared identity and common humanity, will surely be everything in the months to come. There must be brighter days ahead.

Dr Jon Sutton Managing Editor @psychmag

Tim Sanders

The Dunning-Kruger effect and its discontents

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The Dunning-Kruger effect suggests that unknowledgeable people lack the very expertise they need to recognise their lack of expertise. They thus overrate their knowledge and performance. Put more technically, deficient cognition (i.e., expertise) leads to faulty metacognition (i.e., self-evaluation of expertise).

In contrast, highly expert people underrate their skills socially because they overestimate the knowledge level of their peers (Kruger & Dunning, 1999).

The effect has been uncovered in many settings involving medical residents, gun owners, tournament chess players, debate teams, beginning aviators, and hospital lab techs (Dunning, 2011). In a 2021 study, people who were the least able to separate fake from real news demonstrated little awareness of their failures but the most willingness to trust false news and spread it to others (Lyons et al., 2021).

In a recent Psychologist article (March issue), Robert D. McIntosh and Sergio Della Sala reviewed research arguing that the Dunning-Kruger effect has no real existence but is a mere statistical artefact. They argued that the typical study ‘double-dips’ in its measure of expertise, in that the same task performance measure is used a) to classify people into expert groups and b) to benchmark the accuracy of self-appraisals of expertise.

This opens the effect to the statistical artefact of regression to the mean.

However, their discussion of the effect focuses on a slim sliver of work amid 20 years and more of active and varied research on the topic (for an ageing review discussing possible statistical artefacts, see Dunning, 2011). They also oddly ignore scholarship that directly

contradicts their assertions. For example, they cite the original statistical complaint about Dunning-Kruger (Krueger & Mueller, 2002) but not the response that immediately follows it in the same journal (Kruger & Dunning, 2002).

In this limited space, let me present that contrary research. First, regarding double-dipping, the authors fail to mention research that avoids it (Feld et al., 2017).

Researchers asked economics students to estimate their performance on a course exam. However, they sorted students on their objective expertise separately, based on grade-point average in previous courses. Although somewhat reduced, the Dunning-Kruger effect survived quite well. We have adopted Feld et al.’s smart technique whenever we can in our ongoing research.

Second, the authors fail to mention that we have examined regression to the mean effects directly across several studies (Ehrlinger et al., 2008; Kruger & Dunning, 2002). The key test is to see whether the effect survives when noise (or measurement unreliability) is reduced or eliminated. The effect remains quite robust even after we do so.

Third, the authors fail to mention research that reveals that something more than statistical artefact is going on and affirms the original metacognitive account for the effect. Jensen et al. (2021) asked respondents, in two separate studies that each involved over 3500 respondents, to gauge their performance on logic or grammar quizzes. They then carefully asked which computational model, based on item-response theory, best anticipated the pattern of misjudgment seen among poor and top performers. The model that worked best

the psychologist april 2022 letters

included the assumption that poor performers were more prone to judge the accuracy of their answers poorly, as anticipated by our theoretical 1999 framework.

Similarly, Engeler and Häubl (2021) found that people who were worse than average but thought themselves as better than average tended to commit the error of overestimating their performance. Their error was about the self. In contrast, those who performed better than average but thought themselves as worse tended to overestimate others – that is, their predominant error was one in social perception. These findings are consistent with our original theoretical framework and subsequent statistical investigations (Ehrlinger et al., 2008).

Fourth, the authors conflate the idea behind the DunningKruger effect with its concrete measurement, as though research on the effect stopped after Study 2 of our original 1999 paper.

There are many other ways to assess whether low performers lack insight into their deficits that avoid regression artefacts. In a class of 95 medical students learning cardio-pulmonary resuscitation (CPR), 36 failed. But only three recognized that failure before seeing a video of their performance (and only 17 after) (Vnuk et al., 2006).

In a national survey asking 1300 Americans their opinions about vaccines, roughly a third implausibly claimed to be as knowledgeable about the causes of autism as doctors and scientists. In reality, this overconfident group, who affirmed many myths about autism, demonstrated the least amount of knowledge (Motta et al., 2018).

I apologise for the selectivity in this review. Science communication should humbly nod to when the situation is complicated, and there are some fascinating twists and turns in the story of the Dunning-Kruger effect outlined by over two decades of research that I hope would be a good read. I have also avoided a long-winded critique of the research featured in the original Psychologist article.

For example, Nuhfer et al. (2017) may have asked people for nuanced and granular self-assessments, but then

they lumped participants into crude categories (e.g., people more or less than 20 points overconfident) that obscured much of the information contained in those finegrained measures and which limited what they could find.

And, again, there is other on-point research that tells a different story. We have used similar fine-grained self-assessments and replicated the original DunningKruger effect. But more than that, we found psychological conditions that exacerbate or lessen the effect. In one such study, we asked participants financial questions like, ‘If you invested £100 in a bond with a 5% annual interest rate, compounded every year, how much money would you have after 20 years?’

We asked participants to guess the chance the that each of their psychologist march 2022 answers was right.

In the example above, the correct answer is £265, which surprises some people, usually because they are not aware of the power of compound interest. Instead, they have a different Confidence, wisdom, theory in mind in which money grows and the crowd along a rigid straight The Dunning-Kruger Effect and Groupthink examined line, and so think the answer is £200. They are quite confident in their answers because they apply a systematic misbelief to their reasoning. also Others without such We need to talk a strong theory are about Long-Covid… more aware that they do not know. Thus, the Dunning-Kruger effect is most pronounced when people harbour systematic misconceptions about a task (Williams et al., 2013).

And, of course, such a psychological circumstance would not matter if the Dunning-Kruger effect were a mere a statistical artefact.

But one last thought. Often, scholars cite statistical artefacts to argue that the Dunning-Kruger effect is not real. But they fail to notice that the pattern of self-misjudgements remains regardless of what may be producing it. Thus, the effect is still real; the quarrel is merely over what produces it. Are selfmisjudgements due to psychological circumstances (such as metacognitive deficits among the unknowledgeable) or are they due to statistical principles, revealing selfjudgement to be a noisy, unreliable, and messy business? www.thepsychologist.org.uk

Either way, there are potential consequences. Among over 1100 medical students in an obstetrics/gynaecology rotation, those receiving a grade of D+ or lower on their final exam thought on average they would get a muchhigher B-. Those getting an A only slightly underestimated their grade as a B+ (Edwards et al., 2003). No matter how these patterns of mistaken self-perception arise, I’d be interested in how they play out as students move on to their medical practice.

David Dunning University of Michigan Key Sources Dunning, D. (2011). The Dunning-Kruger effect: On being ignorant of one’s own ignorance. In J. Olson & M. P. Zanna (Eds.), Advances in Experimental Social Psychology (vol. 44, pp. 247-296). Elsevier.

Edwards, R.K., Kellner, K.R., Sistrom, C.L. & Magyari, E.J. (2003).

Medical student self-assessment of performance on an obstetrics and gynecology clerkship. American Journal of Obstetrics and Gynecology, 188(4), 1078-1082.

Ehrlinger, J., Johnson, K., Banner, M. et al. (2008). Why the unskilled are unaware: Further explorations of (lack of) self-insight among the incompetent. Organizational Behavior and Human Decision Processes, 105(1), 98-121.

Engeler, I. & Häubl, G. (2021). Miscalibration in predicting one’s performance: Disentangling misplacement and misestimation.

Journal of Personality and Social Psychology, 120(4), 940–955.

Feld, J., Sauermann, J. & de Grip, A. (2017). Estimating the relationship between skill and overconfidence. Journal of Behavioral and Experimental Economics, 68, 18-24.

Jansen, R.A., Rafferty, A.N. & Griffiths, T.L. (2021). A rational model of the Dunning-Kruger effect supports insensitivity to evidence in low performers. Nature Human Behavior, 5(6), 756-763.

Kruger, J.M. & Dunning, D. (1999). Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology, 77(12), 1121-1134.

Kruger, J., & Dunning, D. (2002). Unskilled and unaware—But why?

A reply to Krueger and Mueller. Journal of Personality and Social Psychology, 82(2), 189-192.

Lyons, B.A., Montgomery, J.M., Guess, A.M. et al. (2021).

Overconfidence in news judgments is associated with false news susceptibility. Proceedings of the National Academic of Science, 118(23), e2019527118.

Motta, M., Callaghan, T. & Sylvester, S. (2018). Knowing less but presuming more: Dunning-Kruger effects and the endorsement of anti-vaccine policy attitudes. Social Science & Medicine, 211(C), 274281.

Nuhfer, E., Fleisher, S., Cogan, C. et al. (2017). How random noise and a graphical convention subverted behavioral scientists’ explanations of self-assessment data: Numeracy underlies better alternatives.

Numeracy: Advancing Education in Quantitative Literacy, 10(1).

Vnuk, A., Owen, H. & Plummer, J. (2006). Assessing proficiency in adult basic life support: Student and expert assessment and the impact of video recording. Medical Teacher, 28, 429–434.

Williams, E.F., Dunning, D. & Kruger, J. (2013). The hobgoblin of consistency: Algorithmic judgment strategies underlie inflated self-assessments of performance. Journal of Personality and Social Psychology, 104(6), 976–994.

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Time for applied psychology to catch up?

A line caught my eye in the March 2022 letter on Neurodiversity: ‘… applied psychology needs to catch up with medicine in including and valuing neurodiversity within teams’.

The authors’ lived experience as neurodiverse psychologists in the workplace did seem particularly disappointing given the nature of the profession, but not only against a benchmark in medical employment.

Throughout current leadership

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and management theory, the idea of a preferred set of characteristics for an imagined ideal colleague has been firmly set aside in favour of an understanding of the value of diversity of cognition in the workplace. Indeed, the entire approach to building high-performing

Letters online: Find more letters at www.thepsychologist.org.uk/debates, including several from psychologists in Ukraine.

Deadline for letters for the May print edition is Friday 25 February.

Letters received after this date will be considered for the following month and/or for publication online.

Email letters to psychologist@bps.org.uk with the subject line ‘Letter to the editor’.

teams is actively to seek out people with divergent behaviours, ways of looking at the world, neurology, and of course different personal needs. This contrasts sharply with the assumptions behind the term ‘neurotypical’. Neither it nor its nearsynonym ‘normal’ would be used in any of the workplaces I am involved with.

Perhaps applied psychology is indeed starting to fall behind the times?

Christopher Gallop London

the psychologist april 2022 letters

what to seek out on the

psychologist website this month

Letters on Ukraine We reach out to those impacted by Russia’s invasion of Ukraine, and share their accounts and calls for support. thepsychologist.bps.org.uk/letters-ukraine

‘Making the jigsaw pieces as you go along’ Chartered Psychologist Dr Will McConn-Palfreyman navigates the Winter Paralympics, with advice for practitioners thepsychologist.bps.org.uk/ making-jigsaw-pieces-you-goalong Find all this and so much more via

thepsychologist.bps.org.uk

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‘The international psychological community must now stand together with our Ukrainian colleagues’ A

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t the time of writing, Ukraine’s future hangs in the balance following Russia’s full-scale invasion in late February. Ukrainian people mounted a fierce resistance, with citizens being given arms to help defend their country while many thousands fled across European borders.

The International Criminal Court planned to launch an investigation into possible war crimes and crimes against humanity during the conflict. And the international community, including professional Psychology, largely came together in solidarity and support.

The Executive Council of the National Psychological Association of Ukraine urged the European Federation of Psychologists’ Associations (EFPA) to exclude Russia from the organisation. ‘… Russian psychologists have undeniable responsibility for what is happening today on our land, in Europe, near the borders of your countries.

The work of many of our colleagues from Russia aims to support the propaganda of the terrorist regime in Russia,

and they work with their military, which today came to our homes to kill us, destroy our lives, fake the past and steal the future.’

The BPS initially expressed its concern over the conflict, saying the society stood shoulder to shoulder with its Ukrainian colleagues and would draw on the BPS’s membership to provide any psychological aid and human rights support during the crisis. ‘We believe in the values of freedom and democracy, and the role of psychology and psychologists in uniting and finding shared beliefs, over those that try to divide us.’

Then on 3 March, The British Psychological Society voted to support the expulsion of Russia from the European Federation of Psychologists’ Associations (EFPA), as a demonstration of solidarity with Ukraine.

The vote to expel Russia was held at a special meeting of EFPA’s Presidents’ Council, which was attended by the BPS. Following support from over 85 per cent of member

the psychologist april 2022 news

progress a recommendation that it withdraws from the memorandum.

Further solidarity Along with widespread protests in Russia, hundreds of Russian scientists also signed an open letter condemning the war in Ukraine saying there was no rational justification for it. ‘Our fathers, grandfathers, and great-grandfathers fought together against Nazism, and unleashing a war for the sake of the geopolitical ambitions of the leadership of the Russian Federation, driven by dubious historiosophical fantasies, is a cynical betrayal of their memory.’

Across the Atlantic the American Psychological Association sent a message of solidarity to Ukraine.

‘We are gravely concerned about the immediate and long-term trauma and psychological impacts on people of all ages, families, communities, and the environment.

We deplore the human cost of such aggression, including violations of human rights, adverse humanitarian consequences, deep psychological distress, and the loss of dignity and freedom. We stand in solidarity with all who are raising their voices and working tirelessly to protect and safeguard human life.’

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organisations, EFPA will now move forward with the formal process of expulsion, according to the processes set out in their statutes (see tinyurl.com/efpastatement).

President of the BPS, Katherine Carpenter, said: ‘The decision to support the expulsion of Russia from EFPA was not been taken lightly, as we know many of our Russian colleagues will also strongly oppose the war. However, in the face of the escalating conflict and growing Russian aggression, of paramount importance to us right now is supporting our colleagues in Ukraine.

One of the greatest strengths of our profession is how we unite together in order to protect our core values of democracy, freedom and human rights. The international psychological community must now stand together with our Ukrainian colleagues in their time of urgent need.’

In 2015, the BPS signed a Memorandum of Understanding with the Russian Psychological Society.

The BPS’s board of trustees is meeting shortly to

Sharing resources Meanwhile Professor Vivian Hill (UCL), a committee member of the BPS Division of Educational and Child Psychology, shared ideas on how to speak to children about war, conflict and crises (see tinyurl.com/yyuytruh).

She suggested listening to children’s questions and giving honest answers, ensuring they felt safe and supported, planning how to cope with the situation and emphasising ways to help, for example through fundraising, avoiding constant news, and for parents and caregivers to seek support if they were worried about their child.

Social Psychologist and founder of Rethinking Refugees Sindhuaja Sankaran took to Twitter to appeal for the support of volunteer psychologists to give psychological support to displaced Ukrainians.

A Twitter account Science for Ukraine shared information on practical support and research placements being offered by the international community for researchers and students in Ukraine including jobs, internships and research opportunities. Psychologist Pete Etchells was thankful for a massive response when he shared a request from colleagues in Kyiv for health care professionals with expertise in crisis counselling victims of war.

On The Psychologist’s Twitter feed we shared numerous articles related to the conflict, including stories of psychologists working with children who have witnessed war, an interview with Professor Mari Fitzduff on global peacebuilding, and articles and interviews around Psychology in Ukraine. We also reached out to psychologists impacted by the conflict, and have started to share their experiences and calls for support via thepsychologist.bps.org.uk/letters-ukraine.

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Get a grip on your self Emma Young digests the research on perceptions of our own physical appearance and more

Find our Research Digest at www.bps. org.uk/ digest

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n 2020, we looked at the mistakes we make in seeing ourselves psychologically. But how well do you know what you physically look like? Given that you probably see yourself in a mirror every day, you might imagine that your judgements about your face and body should be pretty accurate. But it turns out that we make some often surprising mistakes about our physical appearance, too.

tended to overestimate the length of various body parts (such as their hands and legs) but underestimate the volume of those parts. These findings add to growing evidence that, contrary to previous assumptions, healthy adults don’t in fact have a highly accurate understanding of their own body size, the team writes.

Strange body changes Editor: Dr Matthew Warren Writers: Emily Reynolds, and Emma Young Reports, links and more on the Digest website

Facial errors Most of us are incredibly familiar with the sight of our own faces. But that doesn’t stop us from making errors. If you become close friends with someone, you might well find it harder to tell apart their face from your own [tinyurl.com/ digest080818]. The researchers behind this study suspect that this is because close friends become partially absorbed into our self-concept. A clever study led by Lara Maister at Bangor University and published earlier this year also found that our perceptions of our own personalities affect how we see our face in our mind’s eye. For a self-reported extravert, say, their mental image of their own face had exaggerated facial features known to relate to extraversion. It seems, then, that there are clear links between how we see ourselves psychologically and physically. And this holds not just for the face but the body, too…

Distorted bodies

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The team behind the face and personality research also asked 39 young female students to produce a body shape self-portrait. They were terrible at it. In fact, there was a ‘negligible’ relationship between the two main measures that the team analysed: perceived and actual hip width.

In this study, levels of self-esteem were linked with these misperceptions – the lower a person’s self-esteem, the more likely they were to exaggerate their own hip size, and the slimmer they considered a ‘typical’ woman to be.

We make all kinds of other body-related mistakes, too. For example, according to research from Jack Goncalo and Michelle Duguid, when people feel powerful, they’re more likely to think they are taller than they actually are. Also, typical healthy people have a distorted sense of their body volume and length, according to a paper in Cortex in 2019 led by Renata Sadibolova at Goldsmiths. The 40 young adults involved in this study

You might not have a great grasp of your physical body, but you probably think of it as being pretty stable. Yet it’s surprisingly easy to make people feel as though they are drastically changing. The ‘magic shoes’ experiments led

by Ana Tajadura-Jiménez are a great example. Study participants wore sandals fitted with microphones that transmitted, via headphones, only the higher-pitched portion of their walking sounds. This had the effect of making the wearer feel physically lighter. Why? The team thinks it’s because higher-pitched walking sounds are generally made by small animals – so in an attempt to resolve the mismatch, participants’ brains reduced their perceived size.

Tajadura-Jiménez has also recently explored the ‘auditory Pinocchio illusion’: if adults pull up on their index finger while listening to brief sounds of rising pitch, they have the feeling that their finger is getting longer.

Young children don’t succumb to this, however, so it’s likely to be something that we learn. Other research has found that we associate a ‘high’ pitch with a high position in physical space. And so, Tajadura-Jiménez suspects, as we learn this link, it starts to influence perceptions more generally.

Third arm, anyone?

Feeling that we’re suddenly a bit lighter, or that one of our fingers is growing, is one thing. But we are vulnerable to even more extreme bodily illusions (see our March 2014 interview with Henrik Ehrsson). While the ‘rubber hand illusion’ is a classic, and the ‘three-arm illusion’ is pretty cool, my own personal favourite is the Barbie illusion, in which people are made to feel that they are the size of a small doll. The participants in this study wore headsets that displayed a video feed of what the doll would see if it were able to look down at its body. Then the researchers repeatedly touched both the doll and the participant on

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the leg, in the same place, at the same time. The illusion worked because (as also shown in the Magic Shoes studies) our brains use input from our senses to build and update a mental representation of our ‘self’ – and if the input changes, that representation does, too.

Body-hopping Very similar techniques can also lead people to flip into feeling that another person’s face, hand, or even entire body has become their own. And when we take on someone else’s body, we change in other ways, too.

Psychologists have made people feel that they were inhabiting the body of Einstein (increasing cognitive performance for some) and also Freud (improving the quality of advice that they were able to offer themselves).

As work published in 2021 (tinyurl.com/digest121121) revealed (again using similar techniques), it’s also possible to make people feel as though they have been duplicated, and that another version of themselves is in the same room.

Body-swapping experiments with pairs of friends have produced some fascinating results, too. Relating back to the findings on facial mental images and personality, Pawel Tacikowski at the Karolinksa Institute, Sweden and colleagues used the Barbie illusion procedure to lead one friend to ‘inhabit’ the body of the other, and found that they took on some of their friend’s psychological attributes, too. So if they rated their friend as being really talkative and confident, for example, their self-reported scores on those traits became higher after the body swap.

This is further evidence that our bodily and psychological self-representations are linked in our sense of who we ‘are’.

Voice There’s another aspect of our physical selves that we often have trouble with: our voices. Many of us will have had the experience of hearing our voice in a recording for the first time – and hating the sound of it. This phenomenon of ‘voice confrontation’ was documented by psychologists back in 1966. It’s thought to happen because when we talk, inner transmission of the sound through bone provides us with more low-frequency sounds than we get when hearing a voice only through air.

So in a recording, our voice sounds higher-pitched than we’re used to, and that’s unsettling because it makes us question our self-concept.

However, there are also times when your voice is likely to actually be higher-pitched. A study in PLOSOne led by Juan David Leongómez found that we tend to talk to high status people (bosses, high-achievers, and so on) with a higher pitch. Higher-pitched voices are perceived to be less dominant, so this could be a signal of subservience, which, depending on the circumstances, might be practically useful to you, or not – but either way, it’s worth knowing about.

Body dysmorphic disorder Some physical misconceptions are more extreme than others. Though healthy people do make mistakes, someone who becomes obsessed with a perceived flaw in their physical appearance – a flaw that either doesn’t exist, or that is over-exaggerated in their minds – suffers from body dysmorphic disorder. This is thought to affect up to about 1 in 50 people, and there are fears that selfie filters designed to ‘fix’ imperfections actively encourage it. For some patients, their physical misperceptions relate to their body shape – they believe that it is either thinner and less muscular, or that they carry more weight, than they do in reality. This can have serious implications, as poor body image judgements are thought to play a part in various eating disorders, including anorexia.

What all this work shows is though we might imagine that we have a clear picture of our physical selves, the reality is very different. Not only are we vulnerable to misperceptions in just about every aspect of what we look like, our mental grip on our bodily self is pretty tenuous, too.

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When we’re in a good mood, we’re more likely to engage in healthy behaviours Getty Images

Researchers have identified a variety of ways to encourage healthy behaviours, from avoiding indulgent friends to paying to remove temptation. Now a new study in Motivation and Emotion finds that simply being in a positive mood can also help – at least in the short term.

Over the course of ten days, participants responded to questionnaires administered by email five times a day. For each questionnaire, they rated their own moods and reported whether they had engaged in four healthy behaviours: exercising, spending time with someone supportive, taking part in a hobby, and relaxation or meditation.

Participants who generally felt more positive mood were more likely to engage in healthy behaviours – but momentary changes in mood contributed to such behaviours within participants as well. When

participants reported more positive mood at one questionnaire, they tended to report engaging in more healthy behaviours at the next one.

However, the impact of positive affect on health behaviour weakened over time – in fact, good mood only seemed to have an impact within a day, not across days.

Sleep may play a part here: the team suggests that our moods may

be ‘reset’ with sleep. Indeed, many of us will have experienced going to bed in a bad mood and feeling a lot better in the morning, while even the best mood can be knocked by a terrible night’s sleep. Exploring the impact of sleep on the longevity of moods and their relationship with healthy behaviours could provide further insight.

EMILY REYNOLDS

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People underestimate the likelihood of contracting Covid from their friends.

That’s according to a series of five studies which found that people rate friends as less of a risk than strangers. This belief may have an impact on behaviour, with the team finding some evidence that people are less likely to physically distance from friends.

(Humanities & Social Sciences Communications) 18

the psychologist april 2022 digest

The dark side of Aha! moments Word puzzles are all the rage right now. But if you’ve already done today’s Wordle, here are some anagrams to keep you going until tomorrow: Reality is only a matter of… tvesrecipep Free will is a powerful… oinliusl If you managed to solve the anagrams at the end of these statements, you may have experienced a ‘Eureka’ or ‘Aha!’ moment, in which the solution suddenly seemed to appear, perhaps accompanied by a sense of happiness or relief. And if you did, according to a new study in Scientific Reports, you’d be more likely to believe that the statement itself is true.

We’ve all experienced Aha! moments in our daily lives. They often seem to come out of nowhere after we’ve been stumped by a problem for a while, perhaps while we’re doing something else like having a shower. And generally, an Aha! moment is more likely to occur if we’ve arrived at the correct solution to a problem than if we’ve reached an incorrect one.

In fact, because they are normally associated with finding the right solution, when we experience Aha! moments we get a gut feeling that what we’ve come up with is correct or true. But a 2019 study by Ruben Laukkonen at Vrije Universiteit Amsterdam and colleagues found that this intuitive response has a dark side: experiencing Aha! moments while reading false statements can make these statements seem true.

In their new paper, the same group explored whether Aha! moments can also influence how much people endorse particular worldviews. They asked participants

Digest digested Americans and members of a remote community in Nicaragua both interpret a downwards head tilt as indicating dominance. A tilted head gives the illusion that the brow has been lowered, which is a sign of threat. The researchers say their findings show that this illusion might be a ‘universal feature’ of human psychology. (Scientific Reports) When a perpetrator apologises to a victim but doesn’t receive forgiveness, they see this as a violation of norms, and end up feeling like a victim themselves.

This in turn can lead to a smaller likelihood of reconciliation. The findings could be useful in restorative or transformative justice. (Personality and Social Psychology Bulletin) Does VR give you motion sickness? A new study suggests there may be an easy remedy: chewing gum. Participants who chewed flavoured gum reported less severe symptoms during a VR helicopter flight compared to those who had no gum. The physical act of chewing may interfere with signals from the vestibular system which can lead to nausea. (Experimental Brain Research) Frequent apologisers take heart: you come across as warm and sincere. There can be a downside, though, with people who regularly apologise also being seen as less in control – but luckily this was only the case for those whose apologies were typically poor. (Personality and Social Psychology Bulletin)

to read 15 statements, like those above. For half of the participants, the final word of each statement was scrambled and they had to try and solve it within 15 seconds. The other half just read the statement in full, with no anagram (e.g. ‘Free will is a powerful illusion’, if you are still scratching your head about that one).

All participants then rated how true they thought the statement was on a 12-point scale. Those in the anagram condition also indicated whether or not they had experienced an Aha! moment while unscrambling the word.

Overall, participants in the anagram condition rated the statements as more true than those who saw the statements with no anagram. Furthermore, in trials where they successfully solved an anagram, they rated the statement as more true than on trials where they weren’t successful.

But here’s the crucial finding: participants in the anagram condition also rated the statement as more true if they had experienced an Aha! moment than if they had not, and this effect held even when the researchers looked only at trials where the participants had successfully solved the anagram. In other words, Aha! moments seemed to give a ‘ring of truth’ to these worldview statements, above and beyond any effect that might have been caused by successfully solving the anagram. A replication study found exactly the same result.

In a second study, the team showed that the timing of the Aha! moment mattered. When participants completed an anagram in isolation (e.g. ‘oinliusl’), and then saw the full statement 10 seconds later, their truth ratings were not affected by whether or not they had experienced an Aha! moment. That is, Aha! moments only made worldview statements seem more true when they occurred at the same time as reading the statement.

The research suggests that Aha! moments can influence fairly fundamental beliefs about the way the world works. ‘Because aha experiences tend to be a marker of good ideas, it makes sense that humans learn to draw on this feeling as a source of information about our beliefs,’ the authors conclude. Unfortunately, this mental short-cut doesn’t always work as intended.

Of course, completing an anagram at the end of a statement is a fairly artificial scenario. But the authors do hint at how a similar process might play out in the real world, pointing to the example of conspiracy theories and specifically QAnon. Followers who have been told that there is a cabal of satanic paedophiles in the upper echelons of government might experience an Aha! moment upon discovering a ‘secret code’ in leaked emails that supposedly supports this theory, making those outlandish claims seem more true. More work is clearly needed to understand how the ‘dark side’ of Aha! moments can influence our real-life beliefs and behaviour – and what can be done to prevent any harmful effects.

MATTHEW WARREN

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Juliet Young

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‘EDI’: Endless Distraction and Inaction

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Dr Sanah Ahsan confronts the reality of Equality, Diversity and Inclusion in clinical psychology training.

he summer of 2020 ignited a season of white panic. In the face of a deadly pandemic, George Floyd’s murder and a powerful iteration of BLM uprisings, the UK was forced to reckon with whiteness. The lie of whiteness has existed for centuries: this systemic process upholds false hierarchies through rules, ‘norms’ and discourses, to maintain the so-called superiority of people socially racialised as white, which systematically disadvantages People of a Global Majority (PoGM)– wreaking most violence on those racialised as black. Systemic Whiteness thrives through its apparent invisibility to white people. That summer created conditions of stark, undeniable visibility which contested the dominance of whiteness. A move to escape the discomfort of this led to elaborate performances of ‘anti-racist’ credentials.

Black squares and BLM hashtags were thrown up over newsfeeds, even Ben & Jerry’s introduced a sprinkling of anti-racism statements. The red-velvet curtains of UK academia opened to a performance of ‘commitment to diversity’ statements and schemes.

In 2021, Higher Education England (HEE) clinical psychology training courses across England were given an opportunity to bid for, and win a payment (typically £74K) by HEE, specifically for ‘improving equity and inclusion for Black, Asian and Minority Ethnic trainees’ (though a more specific framing would be, dismantling whiteness)under a broader framework of ‘equality, diversity and inclusion’ (EDI) initiatives. Given that clinical psychology is an 88 per cent white profession, this fund seemingly offered promise for the beginnings of change.

For the first time in history, a large portion of money (£30K) was ringfenced to establish a mentoring programme to support aspiring PoGM trainee psychologists in entering the historically inaccessible profession. Money was also allocated to an EDI leadership role within each university to lead on tasks including anti-racist education for course staff and supervisors, curriculum reviews, anti-racist recruitment processes, support for PoGM trainees and more. An increase in funded training places dangled the promise of more PoGM trainees entering white institutions.

Universities had to react rapidly to secure that money, churning out EDI action plans within weeks to meet the deadline, each outlining how they would reach nine key performance indicators for addressing racial inequality. There was little time to think, breathe and have space to respond thoughtfully or systemically.

Before we knew it, EDI consultants, many of whom were black and brown people, were transplanted into institutionally racist academic spaces for one day a week, for one year, with the goal of promoting ‘racial equity’ within an ‘equality, diversity and inclusion’ framework. But could we trust the money would be honoured to dismantle whiteness in clinical psychology? And if so, could one person be recruited in to fix an enduring, deep-rooted, systemic problem – for one day a week, in just one year?

What does ‘EDI’ actually mean?

The term EDI (equality, diversity and inclusion), is a vast net with gaping holes that catches very little at all. Although the HEE funding specifically targeted

racial inequalities in clinical psychology, the broadness of the term has allowed room for confusion across training courses, with some universities diluting and redistributing funds towards other intersections of oppression that fall under this umbrella term. For example, some universities allocated funds towards projects that centre white-identified folks with different lived experiences of oppression. Of course, whiteness interlocks with other systems of domination including patriarchy, capitalism, ableism and heteronormativity, but people racialised as black are at the most violent crossroads of how these systems intersect and oppress.

The work of undoing whiteness requires a focus so rarely given – defensive manoeuvres and distractions often operate to move away from this focus. The acronym EDI would be better placed as ‘Endless Distraction and Inaction’.

If language is a vehicle through which power is gained and maintained, the vague language of diversity and inclusion upholds whiteness by default. As Resma Menakem states, we are ‘diversifying’ from white people being the standard of humanity. The HEE EDI scheme is structured by ‘task and finish’ groups, often chaired by a white person, with EDI job descriptions and action plans dictated by white programme directors, embedded in majority-white teams. Such processes are emblematic of what Tema Okun defines as ‘white dominant culture’, specifically a ‘sense of urgency for funder-driven deliverables’, ‘transactional goals’ or ‘rushing to achieve numbers’. The alternative visions that Okun offers is a movement away from cultures that prioritise neat, ‘finishable’ tick-box tasks and toward the ongoing, gradual transformation and commitment to the liberation of all people.

Nevertheless, with the HEE EDI scheme being structured by a ‘task and finish’ approach, the potential of the EDI worker in this context is already constricted by the systems they are being hired to challenge. But what happens when the EDI worker leaves? Where is the collective responsibility in doing this work?

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The trap of the EDI role On the tin, the EDI role is one where a lone individual (usually an outsider) is allocated the task of somehow transforming racism and other oppressions within an institution. In other words, the EDI worker is one person who is mandated to do the work of a whole institution. They are set up to fail, due to the inherent structure of the institution.

Sara Ahmed, who has extensively critiqued the EDI model within universities, uses the image of a brick wall as a job description for this role. In reality, it is to do work that is unsupported and met with institutional resistance. EDI workers pose a problem by exposing the problem of whiteness, quickly becoming the institutional “killjoy”, as Ahmed defines. The shame and failures of the institution are expelled into the EDI worker, and the presence of this person becomes a cue for discomfort. The resistance to meet this discomfort

manifests in a range of violences from individuals in the institution, from the subtle sense of ‘here she is, talking about race again’, to bureaucratic brick walls, to the worker being positioned as ‘incompetent’.

Ahmed says that, through the effort of trying to transform academic systems of domination, individuals tasked with an EDI mandate gain knowledge about the institution itself. The HEE funding enabled EDI to get up close and personal with how whiteness leaks through veins of clinical psychology training, through obstructive HR processes, all white staff teams (often under-resourced and exhausted), power-hoarding programme directors, inexcusably low budgets for visiting lecturers, and so on. With job security limited to merely one year, their temporary, siloed and disposable position granted little leverage for influence, squashing the space to envision any longterm transformation, let alone undo decades worth of racial inequality. Finally, there were no systems of care in place for those being invited into these often loveless and hostile conditions, to do great emotional and spiritual labour, that is fundamentally unwanted.

The appointment of an EDI lead, or EDI workers, does not guarantee an institution is willing to be transformed. Universities may tokenistically employ a PoGM, who is complicit and upholds systems of domination within training: Tony Sewell’s claims that institutional racism doesn’t exist are a reminder that whiteness is not synonymous with white people.

Additionally, universities may employ somebody to do the work they are unwilling to do themselves. In many cases, those in power draw up rigid superficial action plans, which EDI leads are instructed to deliver in silo, without creative freedom. This ‘stay in your lane’ device is a further manifestation of Okun’s ‘white dominant culture’ in clinical psychology training programmes. Like the black square or BLM hashtag, universities are invested in the performance of diversity, ticking the box of representation whilst upholding the hierarchies that maintain domination.

They choose this rather than the uncomfortable, painful, life-long work of transformation, liberation and love.

One example of this rigid, misdirected work is the mentoring scheme mandated by the HEE funding.

Mentorship may build community among marginalised trainees, offering a place for connection and pastoral care. Perhaps it even offers a sense of tangible action for those who want to do something. But it does not address structural barriers and can serve as a distraction from addressing the deeply rooted systems of domination. Mentoring may be understood as the contorting of people’s bodies into a rectangular shaped door so they just about get in, rather than knocking down the tiny frame and building a new place anyone can enter. Therefore, even with an increase in funding for PoGM training places, we see the contorted bodies of PoGM trainees walking into harmful conditions that haven’t been changed, so ‘diversity targets’ are reached.

Over the course of the training, it is the bodies

Juliet Young

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of PoGM trainees that weather racism, described

by Ta-Nehisi Coates as ‘a visceral experience that dislodges brains and blocks airways’.

Disembodiment, Discomfort and Deconstructing Whiteness Academic institutions invite us to engage at an intellectual level, often disconnecting us from the abundance of wisdom and data in our bodies. For the HEE EDI worker, the administrative demands and procedures, which must be crammed into eight contracted hours per week, leave little room for anyone to feel fully and acutely, to connect with their embodied creative and spiritual power, what Audre Lorde termed ‘the erotic’. EDI workers, who tend to be black and brown people, are already living in a physical place of threat detection. The heightened states of adrenaline, having to fight fires and navigate constant threat and resistance weathers the body, especially if untended and unsupported. Showing up fully as oneself, being honest and speaking the truth of what you witness, defining oneself rather than being swallowed into other’s fantasies in the thick EDI fog, is a difficult, but brave and radical thing.

The black feminist author bell hooks reminds us that there is some degree of necessary pain in giving up old ways of thinking and knowing, and learning new approaches. When institutional racism is scrutinised (i.e. when EDI workers actually do what they are purportedly there to do), programme directors and teams are forced to confront the limitations of their practice, with harms and problems being exposed, and a possible loss of ‘authority’ and power. White directors or staff who initially attempt to deconstruct whiteness may be terrified to make mistakes, offend or fail. What they do to escape their embodied shame or pain, is perhaps what we all might do, in our shared cultures

of chronic shame: fearfully retreat back to the familiar.

In this instance, it means maintaining harmful practices that uphold white domination. It is a skill for the EDI worker to meet their new colleagues with fierce compassion in these places whilst honouring one’s own boundaries, and ensuring there are structures supporting staff accountability for change.

As Lama Rod Owens teaches us, we cannot force anyone to do the work of liberation, nor can we take on their work. A huge requirement of the EDI work is therefore to give the work back to those who need to do it, whilst occupying the grey space: where harm, failure and hope are possible all at once.

To do this, we also need to recognise the generativity in open conflict, that relationships can deepen and flourish with radical honesty, alongside a willingness to be accountable to ourselves and each other. In undoing the lies of whiteness, all people must thoughtfully and heartfully act, not merely engage in intellectual debate. Standing up against entrenched systemic processes and authoritative figures who hoard power is imperative. But this is not just the role of the EDI lead, in fact there is less risk for white staff embedded in the team whose roles aren’t as precarious, to do this. As Cornel West states: white people who stand up against whiteness are constructed as white traitors, which is ultimately a traitor to our shared humanity. There lies the motivator: a return to a fuller humanity. Telling the truth of whiteness requires noticing and responding (rather than reacting) to the body’s signals to help navigate such action, and meeting our individual and collective discomfort.

Refusal to meet that discomfort is where so many forms of violence are enacted, maintaining conditions of comfort for white people (socio-economically, physically and emotionally) at a great cost to PoGM. As Paolo Frieire teaches us: without both embodied reflection and action, clinical psychologists risk becoming complicit with upholding whiteness in the profession – which my earlier research highlighted.

What can we re-imagine instead?

As Bayo Akomolafe states, good questions transcend the answers that we give them. It is my own living of the problem of whiteness and its lies, that roots me in imagining other possibilities. That includes my own experiences of contributing to ‘EDI’ work in clinical psychology training over the past year as a visiting lecturer. These are the questions I leave my readers with: • Can we re-imagine nurturing and compassionate systems of accountability across each clinical psychology training course, to focus the work of liberation? This would support people to maintain an ongoing commitment to anti-racist praxis, leaving less room to retreat, or act out as soon as things feel uncomfortable. White programme directors and core staff team especially require this support in being accountable. Regular affinity

spaces for white-identified people, may scaffold the work of meeting the bodily discomfort that arises in undoing the lies of whiteness; returning to the narrowing to and centre this work, with throat and tightening chest, as a whatever resources are available. place of opening for change.

A radical position might say, • Can we bravely and Dr Sanah Ahsan is a Liberation a meaningful dismantling of compassionately enter and Community Psychologist & whiteness isn’t possible within generative conflict, and return Poet. www.sanahahsan.com academic institutions that, in their again and again to the inevitable ‘With deep gratitude to Julie essence, are hierarchical and act discomfort that arises when Baah for her generous guidance, as gatekeepers to knowledge as a deconstructing whiteness? support and care – not only means of power. As the American Transformation cannot happen towards this piece of writing, writer and civil rights activist Audre in isolation. PoGM and whitebut throughout this work.

Lorde states, the master’s tools identified people all need Thank you to Juliet Young will never dismantle the master’s connection, community, care (Twitter: @Juliet_Young1) for her house. But we know that academic and boundaries to resource artistic interpretations.’ institutions that provide clinical ourselves and each other, in psychology training aren’t going undoing the false hierarchies anywhere anytime soon. We are constantly negotiating and lies of whiteness. our longing for revolution, for true liberation, whilst • Can we re-imagine significantly greater funding, navigating the reality that reform is a perhaps more as an ongoing, sustainable support every year? achievable short-term goal. Our imagination begins This will offer further resources and space required with transformation within the institution, but does for envisioning and implementing meaningful not die here. transformation. This feels especially important, The conditions as they stand, are unsurvivable for as we approach a moment where decisions and EDI workers. If the HEE funding is to be reviewed applications for further funding are being made. and renewed, I hope that a more thoughtful, holistic, We do of course want there to be work and liberatory, collective and country-wide approach is roles focused on dismantling whiteness, but this invested in for the future. cannot happen in isolation.A whole team needs I end this piece in deep gratitude and honour of all to be built around this work, to offer the care and of those who have given their heart, spirit and body support it deserves, whilst cultivating a sense of to this work of liberation, often in hostile conditions. collective responsibility across the institution.

Audre’s poem A Litany For Survival gives me some rest PoGM involved in this work are understandably in this work of unrest, as we occupy the shoreline and longing for the nurture and care needed to support constant edges of decision. this work: affinity PoGM spaces that help deepen the practice of boundaries, interdependence, embodiment, care and rest, may offer a lifeline to ‘For those of us who live at the shoreline this exhausting work. standing upon the constant edges of decision • Can we use language more consciously? Can we crucial and alone call this work what it really is? It is the practice for those of us who cannot indulge of dismantling whiteness, of anti-racism and a the passing dreams of choice commitment to the liberation of all people. who love in doorways coming and going

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Life at the shoreline Some readers may come to this thinking, but efforts have been made, HEE are finally putting money where their mouth is – is nothing good enough? It is important to discern a reactive, knee-jerk performance of ‘EDI’ rooted in the intolerance of discomfort, from the sincere work of meaningful liberation: a praxis of commitment and action, coming from an embodied place where we are connected with wisdom, and make the choice to cultivate learning conditions which are truly loving for all people. Regardless of whether this work is funded, clinical psychology training institutions have a collective responsibility to commit

in the hours between dawns looking inward and outward at once before and after seeking a now that can breed futures like bread in our children’s mouths so their dreams will not reflect the death of ours; … when we speak we are afraid our words will not be heard nor welcomed but when we are silent we are still afraid so it is better to speak remembering we were never meant to survive.’

the psychologist april 2022 equality, diversity and inclusion

Early Career and Postgraduate Study Visit Schemes 2022 The Early Career Study Visit grant scheme provides funding for UK based psychology early career researchers and lecturers to undertake research study visits in the UK, Europe and internationally. These are offered alongside the Society’s Postgraduate Study Visit Scheme which provides grants to support research students who are registered for a doctoral degree in psychology at a UK university to acquire skills directly relevant to their research training above and beyond that required for the completion of the doctoral degree. All applicants must be a member of the British Psychological Society.

Six grants will be available under each Scheme, two in each of the following categories: • Up to £500 for a visit to an institution in the UK • Up to £800 for a visit to an institution in Europe • Up to £1200 for a visit to an institution elsewhere in the world The closing date for applications is 5pm Thursday 30 June 2022.

Please contact awardsandgrants@bps. org.uk for full application details Note: The schemes do not provide funding for conference attendance or to present conference papers.

‘Change must engage a person’s senses of identity, meaning, control and belonging’ Dr Adrian Needs is the winner of Lifetime Achievement Awards from the British Psychological Society’s Practice Board and Division of Forensic Psychology.

Here, he talks prison and reform in a conversation recorded by Sarah Lewis for her Growth Uncut podcast.

You work at the University of Portsmouth, where you run the MSc in Forensic Psychology; indeed, you were my supervisor. Before academia, you worked for 14 years in the prison service as a psychologist, mainly in high security but towards

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the end, in training. Through involvement with the British Psychological Society, you helped get training and qualification for forensic psychologists off the ground. In terms of that breadth of experience, and looking at it through the context of growth, what does personal growth mean to you?

One of the most useful approaches is from Blake Ashforth. It was originally developed to understand role transitions into, within and out of organisations, but it actually provides a useful starting point for understanding other sorts of change in people’s lives.

It’s centred on the idea that personal change must engage a person’s senses of identity, meaning, control and belonging. Interventions, for example in the criminal justice system, haven’t always recognised the importance of these areas. You go through a programme, but then because other influences and pressures on the person are still the same, they actually go back to where they were. In dynamic systems terms, which are very relevant to change, that would show that there’s a very strong attractor state, maybe reflecting the person’s previous reconciliations of identity, meaning and control are still in operation.

So through a systems lens, people are trying to get over those obstacles and there’s almost this edge of chaos at which people either get through that transition and make that identity change, or resort back to that old sense of self.

That’s absolutely true. In the desistance literature in recent years the importance of change in the area of identity is being recognised more and more, and research coming out that supports that… not just small sample qualitative research. In institutions such as prisons, if people feel that others still regard them as they were, or if they feel society regards them as excluded or looks down on them, then it’s quite

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had never really developed a coherent and consistent sense of self in the first place. To me that was one of the most striking findings. Everybody talks about the big problem with young women prisoners or prisoners in general being lack of self-esteem, but it wasn’t so much lack of self-esteem as just lack of a sense of self.

These people were often overly responsive to situational cues… what people were saying and that sort of thing. There was a very high correlation between having an unstable sense of self and paranoid ideas. That set off a number of thoughts: to what extent should an institution be focusing its efforts on trying to give people a foundational sense of who they are, and can there ever be much positive development until that’s achieved?

There were other ramifications. This was also in the early days of Big Brother on the TV. I was very reminded how in male, long-term prisoners there is often a dog-eat-dog, survival of the fittest, look after number one ethos. That’s exactly the sort of ethos that some people have identified as being the core of, for want of a better word, psychopathy. The person feels disconnected from others and it all comes down to survival… ‘why should I bother with others, nobody’s ever bothered with me’. Get enough individuals like So if we can nurture an individual to think of that in an environment, they create themselves in a different way, then the environment in their own ultimately that adaptation could be one contributing factor if the “…it wasn’t so much lack image.

At Holloway, there was context was congruent to change of self-esteem as just lack something about the environment – and positive in nature, with you probably remember the noise, support networks around them… of a sense of self” the volatility, the way people were lots of aspects have to line up for constantly moving from being best that pull factor be strong enough friends forever to worst enemies to get people over those obstacles – that reflected some of the characteristics associated of identity in order to transform. It’s a hard job, a with the sort of people in it. Through that environment painful process.

Yes. Systems develop in interaction with other systems; being constituted, it was helping perpetuate those problems. Unstable relationships, and leading on from of course, with people, other systems are other people. that, the unstable sense of self, was often very evident.

That’s why human development is not just influenced It was a lesson in how environments can both by social factors, it’s constituted by them. Think of the work on the growth of intersubjectivity in early years – reflect and perpetuate individual characteristics. If we want to do anything therapeutic we need to interrupt the capacity to make sense not just of people but with that cycle, perhaps try and create the conditions in people. That ties in with work on attachment. which people can develop a more stable sense of who The view is being put forward more and more in they are. fields like Acceptance and Commitment Therapy that all forms of psychological problems – certainly all In enabling environments or therapeutic things that are usually described as mental disorders communities, there are ways in which that context – represent a fundamental stagnation. The person has is considered, so people feel less on survival mode. stopped changing, stopped transitioning.

They’re creating those safe spaces. Yet we continue to have the majority of our prisons, not taking on that.

When I did my masters, and working with you on Why don’t we learn the lessons from more effective the HMP Holloway project, we looked at some stuff around attachment. There’s that idea of a secure or an prison environments?

It’s got a lot to do with lack of imagination, probably insecure attachment that creates a blueprint of life. lack of resources, as well as the tendency for all But I’ve read recently about experiences of neglect, organisations to become self-perpetuating rather than longitudinal studies in orphanages, where children transforming themselves. In some places there is some didn’t get any kind of form of attachment. Is that a movement, there has been some useful development lost sense of self, or is that something different? in areas such as five-minute interventions, and Every ‘Lost sense of self’ suggests there was one to start with.

Contact Matters. I remember doing some work on that What we saw with Holloway was that quite often they difficult for them to really get hold of the possibility of a new identity.

In other areas of psychology, it’s very important how people feel about themselves. One of my favourite studies in psychology was an old one Liam Hudson did, where he looked at whether school kids thought of themselves as arts people or science people. He gave them tests of divergent and convergent reasoning and lo and behold the arts people were better at divergent and the science people at convergent. But it gets interesting when he asked them to think of themselves as a person who was characterised by the opposite set of aptitudes, so the arts people now thought of themselves as science people and vice versa.

He found that, typically, people were able to up their scores on these ‘reliable’ ability tests. These tests are constructed so as to be insensitive to change, and yet sometimes people were knocking their scores up by as much as 15 points, which you’re not really meant to do. These roles, the perspective associated with a role that a person incorporates into their identity, can have very real and tangible effects. It gives them a different vantage point from which to make sense of things.

in the early 90s, really trying to encourage staff to use even routine interactions that occur at several points in the day, as opportunities for helping a person’s development in areas such as problem solving, seeing other people’s points of view, that sort of thing. But a lot of these things are done rather inconsistently and staff aren’t allocated sufficient time. They need good leadership as well, otherwise we get people saying, this is not part of the job of a prison officer’, whereas you get other people saying it most emphatically is part of the professionalism of being a member of prison staff.

I feel sad when I meet some new officers who say ‘I came into the service to make a difference in a person’s life, but now all I do is turn keys’. When we look at how many prison officers leave the service it’s heartbreaking. If an environment is hostile, you might see some fantastic officers with a real heart for the work and yet their hope erodes. They don’t have that level of investment or care from the top.

That’s why some get cynical, burned out, have early heart attacks…

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Who has inspired you along the way?

One person who comes to mind was Don Bannister, who I got to know in the last three years of his life.

He tragically died in 1986 at the age of 58. I had come across his name when I’d read about personal construct theory. The approach was all about how individuals make sense of things, and behave, experience and feel accordingly. At the time, most psychology was not like that at all: it was very behaviourist, and to do with observable events. ‘How people make sense of things, why would that possibly matter, it’s how psychologists make sense of things that counts!’ I was doing a doctorate, and it really was quite difficult to get access to participants because not just the psychiatrists but the clinical psychologists too were saying ‘You want to know how people make sense of things, what’s that got to do with anything?’.

Anyway, Don was a leading light in this approach, he was very encouraging, and I kept in touch with him. (A nice clinical psychologist had introduced me!)

I joined the prison service in 1983 and a couple of years later was applying this approach with prisoners.

He was a larger than life character: great sense of humour, successful novelist in his spare time, quite a renaissance man but very human, very warm. His approach put the focus squarely on how individuals make sense of their lives.

Why did you become a psychologist, working in prisons? What did you value?

It’s a cliche but I wanted to do something useful in my life. I was never particularly drawn to just making money. Which is just as well, because I haven’t! I was never interested in being a cog in the machine, making money for somebody else. I studied psychology and Which is so important, in the context of desistance wanted to continue with that. and identity… it’s not necessarily about the things Nobody talked of forensic psychology in those that we do, it’s about how we can reflect and learn days, it was usually prison psychology if you were on those things. The process of making sense and in the prison service, or the relevant Division of the making meaning, that’s got to be good in terms of British Psychological Society was the Criminological resilience, coping, all these things. and Legal psychology. It seemed that area offered Fundamental, yes. Another person, I’ve always been variety, as well as being very worthwhile. I had some intrigued by is Henry Fielding, best known as author sort of inkling of traumatic backgrounds, for at least of Tom Jones, one of the first novels in the English some of the prison population… language, published in 1749. He there seemed a cruel irony that was a bit of a lad in his younger “… different people will even though they might have days… gambling, drunkenness, done some pretty awful things, assault. But it seems that he give different accounts they should go on living in this completely turned his life around, of things and each will distorted environment, excluded and became a humane magistrate believe that they’re right” in an era when you could get from society. Most people deserve a second chance. But how do you hung for over 200 offences. He actually do that, in a government wasn’t soft or anybody’s fool, it institution such as the prison was about being compassionate. service, which hardly seem to be organised around He was also a friend of the artist William Hogarth, a things like compassion? social reformer involved in the Foundling Hospital There seemed lots of things that needed doing in London. He wasn’t all touchy feely though, he also – to contribute to positive development, both of an founded the Bow Street Runners, are usually taken as organisation, but also the application of psychology the forerunner of police service. He often behaved with to that environment itself. It was trying to develop great courage, going and ‘lifting’ people who have done new ways of understanding and facilitating change in pretty nasty things from quite hostile environments. individuals who had long-standing problems, but it He was exposed to a lot of danger, but he stuck to his was also about understanding and developing more principles. effective interviewing techniques with people who had, So he could be regarded as a forerunner of forensic for example, killed somebody. Plenty of challenges to psychology, not least because in Tom Jones there are a think through. lot of things that are pure personal construct. He talks

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about how different people will give different accounts of things and each will believe that they’re right, but also how some people can be misled by other people who are seeking to influence their perceptions. It’s quite modern in a way.

Yes, all the stuff around suggestibility and eyewitness testimony…

Yes it’s interesting, somebody saying all this stuff but in 18th century language. You asked me about values, and I guess the ones I would sign up to would be regarded as rather old fashioned… integrity, honesty, empathy, courage, compassion, duty. Sometimes you don’t always find them where you might expect them… in academia, for example.

The list wouldn’t be complete without saying humour: I think that’s important in life. Henry Fielding also wrote political satire, exposing bribery and corruption, under the name of Captain Hercules Vinegar. Sounds almost like something out of Blackadder. He said that his purpose in writing Tom Jones was to ‘laugh mankind, out of their favourite follies and vices’.

Love that! We’ve talked about your values experiences along the way. But what has been the biggest obstacle you’ve faced, and what have you learned from it?

Eight years ago, I received a diagnosis of posttraumatic stress disorder. I experienced an accumulation of situations where I felt metaphorically seriously stabbed in the back. These circumstances seem to take the lid off something that had actually been laid down 20 years earlier, when I had been involved in some quite seriously violent situations in the prison service. I wasn’t fazed by the violence,

I think I can honestly say that. But what really got to me was bad decisions that really undermined things… everybody makes mistakes but it’s when they start doing things like covering up, being dishonest.

I didn’t have too long to think about it at the time, it was on to the next one. But in 2012, after some not very decent goings on at work, I started to experience the sound of somebody burning alive in my head.

Oh my word.

It seemed to be linked to a hostage incident in the prison service where one prisoner trussed up another, and absolutely drenched him with a full large canister of lighter fuel, and was going to ignite it. The powers that be made some pretty awful decisions along the way, including trying to hurry the bloke into giving himself up… it was a Saturday night, I think they were bored and wanted to go home. I had to take over at the siege and it was the most intense 10 minutes of my life. The whole thing lasted about four hours, but after there was one thing they did which nearly pushed things over the edge, I had to work quite intensively to rein the situation back. If the guy had flicked his lighter we’d have all gone up, you could smell the vapour.

I just can’t think of anything worse than someone burning alive in front of me, and the fact that it would have been unnecessary just adds a twist.

I did manage to get things back on track, the perpetrator gave himself up, and nobody was hurt… at least physically.

What did you take from that, in terms of making sense of it?

That there can be a resonance between current circumstances, and earlier ones. It was interesting that there was the sound of someone burning alive when actually that didn’t happen in real life. So it gave me a renewed interest in trauma. It even connected me to the prisoners… they’re not a separate species.

And if we continue to create these distant relationships where there is a lack of understanding – prisoners towards staff and staff towards prisoners – then there will be a gap in understanding behaviours.

If people work with those behaviours knowing that there’s reasons behind them – not excuses, but reasons – that’s creating a compassionate environment.

Yes, that can move towards co-creation of more positive behaviour. Let’s not just punish bad behaviour but let’s make it a better environment, a community. In a community, everybody has responsibilities. OK, the backgrounds and past experience that people have had don’t just go away overnight and everybody lives happily ever after. But you’ve got to make a start because otherwise, things will just drift towards the other extreme.

In society as a whole we need to develop the vocabulary that reflects some of the things we were talking about. People need to be much more aware of

the importance of connectedness – put that in systems terms if you like, the fact that we’re systems who’ve developed with other systems. And there are a range of things that can stop us from developing. There’s a range of things that can make us instead of develop and be connected, actually turn inwards. I mentioned earlier about how I see some individuals who grow up with a dog-eat-dog mentality which can set the tone of prison establishment unless you bring other influences.

Very often these are people who’ve never really learned that there is such a thing as connectedness. To them the world is a hostile place, it’s them against the world.

I think Alex Gillespie called it a semantic barrier. You can’t mobilise your other psychological functions towards openness and development if you’ve got this big distrust. In prison, that lack of trust can just be perpetuated: people remain rigid, closed, and any sort of rehabilitation or therapy is a non-starter.

Do you think you could trust people, the system that’s there, if you became a prisoner tomorrow?

I think I could probably trust some individuals within it. But as a system, it shares a lot of the problems of large organisations, including impersonal bureaucracy.

When I was in the prison service, the governors I was friendly with were the ones regarded as delinquents or oddballs! They were often the ones passed over when it came to promotion… there was an image that we

imagined the service wanted to see, held by those who were top of the pile. Most of the thoughtful ones didn’t get lucky, even though their own staff often thought they were great because of things like their sense of humour and thoughtful solutions to problems.

With one governor we had this system called ‘cunning plan management’. If there was a problem on the wing, we’d think about it and one of us would say ‘I have a cunning plan’, which would start off as something pretty off the wall. But often it became surprisingly effective, because it was going beyond the obvious.

I probably laugh the most within prisons, and that’s not to say it’s happy place, certainly, but it’s a buffer, a protective factor to unite people a little bit.

It’s important that whatever the governor does, it doesn’t cause that team spirit to be lost. Until staff morale is improved, then it’s unlikely that prisoners are seeing any benefits. It’s a basic aspect of morale that people feel acknowledged or recognised or valued.

There was research, I think it was Lyons, 1992, that indicated that low morale, and then being assaulted, had a very close relationship. Not because people were assaulted and then morale was low, it was the other way around. When morale was low, interactions with prisoners became much more negative, and limited, and then they were much more likely to get assaulted.

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the psychologist april 2022 interview

I speak as somebody who spent most of 1995 doing team building training with prison officers. Within a couple of years the Leadership and Team Building Centre was shut. It seemed such a retrograde step, you know, it’s an accountants’ world. And same as when they build new prisons, they get architects to do it. Use architects, but don’t forget people who actually know about prisons. Sometimes the architecture creates the problems, if you’ve got lots of blind spots, that sort of thing.

and jangle with early experiences, and probably elicit the kinds of behaviours that we associate with those thoughts, whether that’s the pervasive sensitivity to things like rejection of the anxious style, or the ‘couldn’t care, I’m self-reliant, sod everybody else’ perspective of avoidant attached people.

The things that we develop from our attachment relationships, in terms of intersubjectivity and making sense with people, are empathy and thinking ahead, problem solving, being able to self soothe, that kind of thing and not “In prison, that lack get carried away. These are the It’s about connecting people and things we try to teach prisoners adding value, building resilience of trust can just be in cognitive skills programmes. before people go on a landing. Just perpetuated: people But there seems such a paradox. to excite people about the impact remain rigid, closed, and A prisoner comes from a classroom of the work that they’re doing, the virtues and rewards of it. Get any sort of rehabilitation or straight back to a prison where undermines or even people that have been in prison therapy is a non-starter” somebody contradicts what they’ve just been to come and talk to them about hearing about; where they’re not the importance of being a prison given any opportunities to take officer – whatever they do, good or responsibility and make choices. So the way the prison bad, that impact lasts. environment is constructed needs a lot more thought, That’s absolutely right. Another thing I did was live as a prisoner for a few days, testing security and that kind and staff need to see their place within that as part of their professionalism. of thing. The insight that gives you into things like A lot of these concepts are actually very simple, what it’s like to be in a cell, blocked in, and somebody I only wish they were part of the school curriculum! on the outside has got the key. A very valuable There’s some catching up to do. experience.

Did you change? Did you find yourself shifting and shaping?

It made me more aware of some of these pressures on prisoners that we probably take for granted. Some of the areas that certainly psychologists would never normally see them in. It also made me aware of some of the security implications, for example, how much voices travel. If you’re a prisoner listening behind the door you know what a couple of staff are saying 30 yards away around the corner. Things occurred to me, possibilities presented themselves from that perspective that wouldn’t have normally from my perspective as a psychologist. That goes back to what we were saying about how things appear differently from different perspectives, and that influences identity, meaning and so forth.

If prison officers did have experiences such as this, and things like teamwork were not neglected… if they felt recognised and valued, and the senior officers were no longer snowed under with paperwork and bureaucracy… maybe that does promote the beginnings of being able to talk about things like connectedness. ‘You value connectedness as part of the staff team, how would you feel if you didn’t have that?’

You can then maybe even introduce attachment concepts. A lot of prisoners do come from backgrounds typified by anxious attachment, which is to do with erratic responsiveness, and avoidant attachment, which is to do with lack of responsiveness. So put them in an environment where their caregivers are often either erratic or unresponsive, that can only resonate

But if we are going to transition into a ‘new normal’, if we looked at it identity meaning control and belonging in terms of that transition, that could be really powerful. Co-producing a new community… how does that new community behave towards each other, and what happens when things go wrong?

It’s not necessarily about HMP Utopia, it’s about small steps or a roadmap to something that’s really ambitious.

It’s almost like people don’t expect a lot from prison, or from prison officers and prisoners. But that is completely the opposite to what I see. I see so much in terms of what all those individuals can offer and what it could be rather than rather than what it is.

Yes, and it’s not just about things within the individual, it’s about viewpoints can come together and maybe the interaction can create another viewpoint, one that people can agree on, because they have co-created it. For many years, our big logical mistake has been overlooking or ignoring the effects of context, even when it’s such a powerful influence, self-evidently so, somewhere like a prison environment. We stick people on programmes which are focused mostly on effecting change within the individual, whereas really all we’re beginning to know about change is about creating context, it’s allowing interactions, it’s fostering openness to change by those interactions. Otherwise things just stagnate.

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Spinal injury – finding strength for an unplanned future Melissa Potter on working as an Assistant Psychologist at a Spinal Cord Injuries unit

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hree months ago, my patient tripped, fell down the stairs and woke up unable to move their own body from the neck down. They cannot get themselves out of bed, feed themselves, or dress. Their only agency now is through using a wheelchair. My patient tells me they feel down, hopeless, that they have no reason to live, that they are not the parent they were before and that it’s all too difficult. How do you formulate a therapeutic plan for someone who has undergone such lifechanging events?

This is the kind of scenario I often see as an Assistant Psychologist at the Yorkshire Regional Spinal Injuries Centre at Pinderfields Hospital in Wakefield (Mid Yorkshire Hospitals NHS Trust). Working in health psychology has allowed me to grow not only as a practitioner and a psychologist, but also as a person.

My career started in inpatient mental health hospitals. Working with adolescents and women from the forensic system, I worked in a high risk environment with patients in crisis. I learnt core therapeutic skills, as well as resilience and teamworking. From there, I worked in NHS community Child and Adolescent Mental Health Services. My appreciation grew for systemic ways of working and I broadened my understanding of therapeutic models and formulations. The opportunity to work in physical healthcare arrived. The prospect excited me – it was so different from my previous experiences.

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Car accidents and rugby At the service, I work with adults of different economic classes, heritages, occupations, social backgrounds, faiths and more. Spinal Cord Injuries (or SCIs) can occur through trauma such as a car accident, rugby gone wrong, or a fall from a ladder; or they can occur physiologically, either suddenly (such as a spinal stroke or abscess) or gradually (such as spinal stenosis, where the gaps between the vertebrae narrow). Some patients on the SCI ward have a psychiatric history and diagnoses of mental health disorders prior to their injuries, and may have engaged with community

mental health services in the past. Others may not consider themselves to have ever had mental health issues.

Within our psychology team in Spinal Cord Injuries, we meet every patient admitted to the centre, whether they have a history of mental health difficulties or not. We offer a screening session, which the majority of patients are keen to accept. This involves a clinical interview to learn more about the individual’s background, the nature of their injury, and their goals and expectations for rehabilitation. We often complete psychometric measures, which can be helpful to understand the patient’s current mental state and management of their injury. We then encourage patients to make a plan with us around what support would be helpful.

Therapeutic work with patients usually focuses around acceptance and adjustment. We therefore draw from Acceptance and Commitment Therapy and Compassion Focused Therapy models most frequently.

We work with patients to develop strategies to make room for their emotions and to validate their feelings in the context of their recent life change. We often use the Kubler-Ross grief cycle to demonstrate how loss of bodily function and the loss of a loved one can elicit similar feelings of denial and bargaining before reaching acceptance. Relatedly, we work with the multi-disciplinary team (MDT) to share our understanding of where the patient is at mentally and psychologically with rehabilitation, alongside their understanding of their physical progress and our psychological plan for care. This can be particularly helpful for patients with psychiatric histories to help the MDT better understand their needs.

Prolonged fight or flight I recently worked with a client who has a long and complex history with mental health services and has experienced a lot of life trauma. As a priority, I worked with the patient to firstly, manage the re-traumatisation that was occurring as a result of their spinal injury and hospital admission. We achieved this through gentle and gradual anxiety management and grounding.

Secondly, with the patient’s consent, I shared the necessary parts of their story with the MDT – so that

the psychologist apriil 2022 working lives

the patient understands how they could understand how, why sessions are a safe space and the and when rehabilitation was so purpose of our role. We bring lots challenging for this patient. of normalising into our sessions – As part of their coming to not just that what they are feeling terms with their spinal cord is normal following such a physical injury, some patients can have change, but also, in most people’s unrealistic goals (which may be to lives at some point. walk again), whereas others can I have noticed that the group struggle to find the motivation to Melissa Potter is an Assistant which needs the most time and achieve anything (when they are Psychologist at the Yorkshire reassurance is working age or older capable of doing so). We work with Regional Spinal Injuries Centre adults, who identify as male. My patients in aligning their goals and at Pinderfields Hospital, time in the spinal injuries centre expectations with the professional Wakefield (part of the Mid has highlighted how so many men advice of physiotherapists, Yorkshire Hospitals NHS Trust) go through life feeling as though occupational therapists and medical they should not share their feelings, consultants. express their emotions, cry, struggle… because of the As well as low mood and motivation, another expectations set and reinforced for their gender. common emotional response to a spinal cord injury is anxiety. Our patients can experience a prolonged fight or flight mode, due to the stress of surgery, the Impact of Covid-19 medical environment and ongoing challenges as they Coronavirus has been another challenge for the learn basic skills all over again. Some patients also feel unit’s patients. Over the last 18 months, almost all fragile and concerned that further injury may occur. patients went through their rehabilitation unable This can extend to the degree of post-traumatic stress to see their loved-ones. Our Trust had to make the symptoms, particularly when the spinal injury has occurred through a traumatic incident, or if they found difficult decision to cease visiting to keep patients and staff safe from Covid-19. So patients went through the surgical procedure incredibly stressful. significant life changes, large surgical procedures and Some people with a spinal cord injury experience length periods of recovery without the level of support neuropathic or musculoskeletal pain. The pain can we would have hoped. Some more technologically heighten emotions and increase stress, and in turn, accustomed patients were able to regularly access elevated emotional distress can increase pain. Pain their support networks via telephone or video calls. can then become a barrier to their engagement in However, many others did not have the skills or their physical rehab (physiotherapy and occupational means for this contact. The Psychology service took therapy). We work alongside the medics to provide on a family liaison-like role; this involved facilitating a psychological perspective on pain management, video calls to spouses and children, as well as regular helping patients to understand how they can take control of their pain and what parts of their daily living supportive and informative phone calls to family members. The vulnerability of spinal cord injured can impact pain. people to severe Coronavirus symptoms, the impact of Covid on our wonderful staff, the barriers to accessing further services and the removal of peer support Relationships and sex workers should also be acknowledged in this context.

Patients often also think about how their bodies have My role at the SCIs unit has contributed to my changed (often including the use of a wheelchair development on a personal level. I work with people or aid) and this can involve relationships and sex from all walks of life who, in the face of fear, change or sexual dysfunction. We work on self-esteem and and uncertainty, are able to find the most amazing body image, sometimes with the involvement of strength to achieve varied levels of independence their partners. We work with patients to help them again and adapt to a future they had not planned. My understand what the body may, in time, be capable of patients have experienced loss, anger, injustice, panic and direct them to strategies and equipment available and embarrassment. They have fantastic senses of to support sexual intercourse. humour and are kind, caring and generous towards An observational reflection of mine has been how much of my therapeutic work at the ward is to provide each other. I am inspired every day within my work and the patients motivate me to be the best practitioner a safe space where patients can express their thoughts I can be. One thing I find patients saying most often and feelings. Being a physical healthcare service, many of my clients have never encountered the psychologist- is ‘I didn’t think something like this would happen to me’. It has emphasised to me just how much we take client dynamic and this can bring anxiety and/or for granted in our daily lives. It’s also reinforced within uncertainty. Psychology in a health world can come me the power that the mind has to drive us through with stigma; patients have queried if I have been sent the most difficult times – if we have the right tools to to see them because they have been perceived as not do so. coping, or ‘losing the plot’. I dedicate time to ensuring

‘The continuity of my role has given me the chance to grow’

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Lucy Freemantle with the reflections of a Senior Assistant Psychologist, a decade on…

s we ‘collect’ our final person of the day from the virtual waiting room to triage for our autism assessment service, I barely need to ask our initial questions before we are swept along by their story.

Their reasons for believing this diagnosis is right for them are interspersed with talk of ‘special interests’ that appear characteristic of autism. I’m intrigued as we’re taken on a range of meandering paths, and instantly reminded of why I love this clinic and working with those we see.

This person is totally different to the other three we’ve seen that day, though all displayed some traits akin to autism. Despite the wide variety in presentations, there are undoubtedly some uniting positive themes – passion, honesty, and attention to detail.

Seeing people by video due to the pandemic presented a whole host of new challenges for our small service but, after a period of adapting, these changes became just the latest of many made to our service over the years. Having now reached the milestone of a decade working as an Assistant and Senior Assistant Psychologist within this specialist team, I’ve come to realise that the longevity of my experience is somewhat unique. When our service was recently integrated into the NHS, I was both surprised and pleased to learn I’d been allocated Agenda for Change band 6 in the banding process. I felt incredibly proud that my many years of experience working in the service, along with the skills I’ve gained along the way, had been formally recognised and rewarded. This did make me wonder, though, why this isn’t more widely available to others.

Are we missing out on part of a more diverse career pathway for those working in psychology?

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A significant role I have been on a considerable journey in my role over the last 10 years, from the starting point of being in a very small team where there hadn’t previously been an Assistant Psychologist. Having developed my knowledge and skills, I moved on from predominantly clinical administration and scoring of psychological questionnaires, to taking a significant role within

the team’s clinical work, under the supervision of qualified Clinical Psychologists. I’m trained to take comprehensive developmental histories, work with families, and conduct in-depth interviews, in addition to conducting assessments of intellectual functioning and social cognition, under supervision. I’m proficient at writing complex psychological reports (though still encounter some challenges!). I am also able to develop psychological formulations, a skill helped by a previous role I had in the Improving Access to Psychological Therapies (IAPT) service, which provided a solid foundation in mental health, for constructing formulations and considering differential diagnoses. In addition, I undertake service reporting, help inform wider service developments, and help with the induction and supervision of other Assistant Psychologists in the team.

I have grown along with our service. I now have a clear understanding and experience of every aspect from administrative processes to the clinical work, which gives a unique insight. I know my team really value that. They are quick to comment on my ability to keep track of different aspects and processes, as well as helping to provide assessments and forming a secure foundation for the service to operate from overall. I believe the continuity of my role has given me the chance to grow and develop both personally and professionally, in tandem with the various changes that have been implemented over the years. There are always fresh challenges to face.

Whilst I have been fortunate enough to move up the bands in recognition of my length of service and the specialist knowledge and skills I bring to the team, doing so appears to be somewhat of a rarity without wider comprehensive training. We see so many shortterm Assistant Psychologist or Honorary Assistant Psychologist posts advertised. Both clearly have great value and are needed, but it is disappointing to see that short-term roles seem to be the norm. This inevitably creates a lack of security for those working in this field.

Moving beyond a band 5 as an Assistant Psychologist is not suitable for everyone, but when an individual is able to demonstrate sufficient competency, along with significant experience and expertise within their particular discipline, it would help to retain staff who

the psychologist april 2022 working lives

have that depth of service-specific knowledge. It would provide a level of progression that means Assistant Psychologists don’t have to always be thinking about ‘what next’ for them in a short-term post. Talking of which…

What next?

I believe that Senior Assistant Psychologist roles in some services could offer a welcome alternative to the much aspired for Clinical Psychology Doctorate.

I personally haven’t taken this route yet – I have a young family, and live a considerable distance from the nearest university. I’ve accepted this is not something I’m able to do in the immediate future… that wasn’t easy, but since being awarded this higher-level banding, I feel some of the pressure to move on has been taken away.

I feel that the progression to include band 6 Senior Assistant Psychologist posts as a career route would be rather timely, sitting alongside a shift that has started to take place in Clinical Psychology over recent years [https://thepsychologist.bps.org.uk/wideningpsychological-workforce] towards a wider and more inclusive workforce. Roles such as Clinical Associate Psychologists (CAPs), first piloted here in Cornwall, provide much needed stepping-stones for those who, like me, cannot or do not wish to progress to full Clinical Psychology training. In many ways, I see my role as the equivalent of a CAP, though based on significant clinical experience and proven skills rather than an emphasis on academia.

Traditionally, lots of Assistant Psychologists have felt pressure to gain as much experience from several different clinical settings to support applications for further training, and have shown incredible drive in doing so. My experience has involved developing a depth of knowledge and skills within a particular core clinical speciality. I don’t see this as limiting.

I hope that if I do decide to apply for the Clinical Doctorate, it may even stand me in good stead, as it will be different to most experience that others bring to their applications. At this time, though, I don’t feel the Doctorate is an essential pathway for me. That is what I find so exciting about the ‘wider workforce’ changes. It’s great to have specified pathways such as the Doctorate, but alongside a shift towards less rigidly defined routes too. Accessible options for a long and fulfilling psychology career for more people will in turn allow for a more empowered and diverse psychology workforce.

There are clearly drawbacks of not having further official training. For example, if I were to switch roles, I don’t know whether I would be able to do so at the same band and this may obviously depend on the role itself. Additionally, despite my increased independence, I can only practice under the supervision of a Clinical Psychologist and whilst registered with the British Psychological Society as a graduate member, I cannot for instance register with the Health and

Lucy Freemantle is a Senior Assistant Psychologist working in Cornwall Partnership NHS Foundation Trust Email: Lucy.

Freemantle@ nhs.net

Care Professions Council. The great benefit to this, though, is that I continue to receive regular valuable supervision as part of a close-knit team.

Shape and develop your role So what’s my take-home message for aspiring psychologists? I really see the value of long-term roles and would encourage others not to rush between positions. If you are able to secure an Assistant Psychologist role – a considerable challenge itself! – push yourself to see how you can shape and develop it, and yourself as an individual. This is an exciting time for those working in this area. Our service users will reap the benefits, if these changes lead to greater diversity, longer term posts being available and higher staff retention in specialist roles for individuals to progress.

And what about my message to services?

Consider the skill set of those who may be working at a higher level, having shown commitment and significantly contributed to their service. They deserve to be recognised and valued. Obviously, Clinical Psychologists are still in high demand but let us not underestimate or undervalue the workforce that we already have. Assistant Psychologists are often motivated, driven and passionate. Giving them the chance to accomplish and demonstrate skills in the workplace is just as valid as requiring them to prove worth within further educational training.

Revealing cracks in the logic When Sarah Riley pitched to the Routledge Critical Health Series, she knew she wanted to write with Adrienne Evans and Martine Robson. Here, they explain how they addressed psychological questions on women’s health, from a transdisciplinary perspective underpinned by philosophy, in a book which won the British Psychology Society academic monograph book award in 2021.

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ecognition for Postfeminism and Health from the BPS and scholars whose work we admire has truly moved us. But perhaps what delights us most is that, without losing academic rigour, our book speaks to a diverse group of people outside of the academy. A relative asked for another copy because her 20-something art-school daughter had taken her copy into her bedroom and ‘it’s not coming out’. In New Zealand, a senior member of the Ministry of Health perused a shelf carrying the books in this Series and walked away with ours in hand. In Poland, a clinical psychologist reviewing the book for Feminism and Psychology described reading it as a form of ‘selfhelp’. Her description resonated with our own experiences – through writing this book we have come to different understandings about our bodies, health, and psychology,

including the relationships between our health, identities, behaviours and the wider commercial and mediated world.

What’s the secret to this impact? We discussed this in a recent Zoom meeting connecting us across time zones – Coventry and Aberystwyth in the UK, and Wellington in New Zealand.

Being a good person We reflected on how we have long recognised the importance of connecting media, culture and psychology – a sense of dis-identification with the disciplinary boundaries given in undergraduate psychology lectures, an ‘un-disciplined’ approach which connects with feminist

the psychologist april 2022 books theory and research more generally. Actively using philosophy to think through these issues is important.

The complexity of the relationships between psychology, our wider social, mediated and digital cultures and health require a logical and ethical framework for exploring psychological thinking and experience.

In particular, we reflected on how Michel Foucault helps us think about the dynamics between power, psychology and subjectivity through the concept of discourses. Discourses – ways of thinking about the world that circulate in our social milieu, including ideas about what it means to be a good person – come to structure our understanding and our innermost thoughts.

Once these ideas are part of our innermost thoughts they feel like they originate from us, which makes them particularly hard to challenge, especially as we are exposed to the idea that good people make independent, autonomous choices. This makes it hard to recognise when ideas that feel like they come from us started outside of us – i.e. that we are influenced. Or it makes us feel bad if we recognise we are.

Coupled with the idea that good people also make healthy choices, it becomes very difficult to challenge the commercial interests that are invested in us having particular desires, desires that might be harmful to our health. And this is especially so when media supported by these commercial interests recognise the damage. For example, in our chapter entitled ‘intimate responsibilities’, we analysed how a baby milk formula advertisement recognised the divisions and difficulties mothers are exposed to when making decisions around baby-feeding, appearing to offer an affirmative and supportive address to mothers in an otherwise judgemental world. However, at the same time it is commercially motivated to direct parents towards bottle feeding at a time when public health experts highlight the importance of breastfeeding.

A philosophical toolbox How do people make sense of themselves? What can people say, think or do when they understand themselves this way? And what social, political, economic or material conditions enable such understandings? These questions allow us to understand the person in context, value their sense making, and explore capacities for action with a view to identifying more affirmative directions when needed.

To answer these questions we drew on Foucauldian ideas of genealogy, power, norms, confession and technologies of self (the work we do on ourselves in order to produce ourselves into particular culturally valued self or body); Deleuzian thinking on desire and flow; and when called for, psychoanalytic or sociological concepts such as melancholia, mis/recognition, symbolic violence and cultural habitus and capital. Laurent Berlant’s (2011) concept of cruel optimism, when desires are directed towards things that ultimately are toxic for us or unachievable, was also important. In doing so, our work aligns with Guattari’s (2007) affirmation of the practical uses of philosophy in his statement that he is an ideas

thief and a shuffler of second-hand concepts, and with Foucault’s statement: ‘I would like my books to be a kind of tool-box which others can rummage through to find a tool which they can use however they wish in their own area’ (1974, p.523-524).

We brought this philosophical toolbox into dialogue with Rosalind Gill’s concept of postfeminist sensibility, and the more sociological work on postfeminism of Angela McRobbie. The term postfeminist sensibility describes a set of ideas about ideal femininity in which regulatory work on the self and body to meet cultural ideals is framed as a form of empowered, individual choice underpinned by biology.

Thus, at a time of unprecedented economic and public participation women’s desires are directed back to traditional feminine pursuits of appearance concerns, heterosexual attractiveness, consumption, and domestic responsibilities, but framed within a language of empowerment, pleasure and choice. A postfeminist sensibility captures the multiplicity and complexity of often contradictory ideas that coexist or actively enable each other, but which make it almost impossible for women to be good people, citizens or health citizens – to be one, you’re not the other.

We discussed this, for example in the expectation of ‘normal perfection’, an apparently affirmative idea that perfection is attainable that creates a range of anxieties.

A ‘postfeminist perfection’ presents health as both a normal, anticipated outcome of engaging in particular practices, behaviours and thoughts, which anyone with a bit of effort could achieve, but also as a perfect, idealised way of being. Women are encouraged to measure themselves against this, find themselves failing, and work on their selves and their bodies. Thus, postfeminist perfection actually creates the contexts for anxiety and fear (Evans, Riley & Robson, 2020), where feeling good about oneself can also create forms of sickness.

Healthism So we thought a postfeminist sensibility was an important lens to explore women’s health through, but so far these two areas have not been connected. To do this, we brought postfeminist sensibility into dialogue with the sociological concept of healthism. Healthism refers to an understanding of health as a personal responsibility, risk to be managed through lifestyle choices, and site of identity, in relation to being a ‘good’ health citizen and consumer (Cheek, 2008; Crawford, 1980, 2006; Robson et al., 2022).

Using these analytical tools, we started with a chapter on self-help, with its promise that we can be agents of change for a happier life. We considered how very old ideas about gender and health are repackaged as new: for

example, historical notions of women as psychologically flawed continue to circulate in a variety of ways but, in a postfeminist twist, contemporary self-help locates not just the problem but the solution in women working on themselves. We continued to explore the gendered nature of self-help as part of a special issue for Feminism and Psychology – one of their most cited articles of the last three years, a metric that points to the importance of taking a postfeminist lens to psychological issues of our time.

We couldn’t write about contemporary issues of health without having a chapter on weight. Body mass index is a population level measure now being used to regulate individuals, a ubiquitous proxy measure for health, despite its poor efficacy and rhetoric of blame and judgement. Many of us will have put our own weight and height into the NHS ‘your choices your health’ website, and perhaps felt a rush of relief if the result comes out in the green. We can make sense of that feeling through Foucauldian ideas of norms and confession – we learn what is normal and expected and review ourselves against these norms, Key sources confessing if we fail to meet them, and then working on ourselves to rectify our failures.

Riley, S., Evans, A. & Robson, M. These norms are powerful – (2018b). Postfeminism and health: Critical we use norms to think, we make psychology and media perspectives.

Routledge. ourselves through norms, they are Berlant, L. (2011). Cruel optimism. Duke part of us. This is why they have such University Press. an affective pull on us, why they are Cheek, J. (2008). Healthism: A New so hard to resist. Our chapter ended Conservatism? Qualitative Health suggesting that the question ‘what is Research, 18(7), 974-982. a normal weight?’ cannot and should Crawford, R. (1980). Healthism and the medicalization of everyday life. not be answered in our contemporary International Journal of Health Services, context: as Wann argues, ‘Just as Kurt 10(3), 365-388.

Cobain of Nirvana sang, “everyone is Deleuze, G. & Guattari, F. (1987). A gay”, in a fat-hating society everyone thousand plateaus: Capitalism and is fat’ (2009, p.xv). schizophrenia. (B. Massumi, Trans.)

Continuum.

Gill, R. (2017). The affective, cultural and psychic life of postfeminism: A postfeminist sensibility 10 years on.

European Journal of Cultural Studies, 20(6), 606–626.

Guattari, F. (2007). Soft Subversions.

Semiotext(e).

McRobbie, A. (2009). The aftermath of feminism: Gender, culture and social change. Sage.

Riley, S., Evans, A., Anderson, E. & Robson, M. (2018a). The gendered nature of self-help. Feminism & Psychology, 29 (1), 3-18.

Robson, M., Riley, S., Gagen, E. & McKeogh, D. (2022). Love and lifestyle: How ‘relational healthism’ structures couples’ talk of engagement with lifestyle advice associated with new diagnosis of coronary heart disease.

Psychology and Health.

Full list available in online/app version.

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Technologies and the life course It was from that point that we started to discuss technologies people can use to work on their bodies, including weight loss surgery and female genital cosmetic surgery. For example, one woman who underwent surgery said her ‘before’ fat body looked how you would imagine without clothes. In contrast, her slim post-surgery body appeared normal in clothes, but naked was as wrinkled as one might expect on a woman 50 years older. For her, the offer of normalcy through surgery was an illusion.

The next chapters implicitly follow a normative life course approach – around sex, pregnancy and childcare responsibilities. Weaving through these were ideas about how normative notions of these elements of a life course were performative. Every era has its own discourse about sex, shaped by the major ideas of that particular moment.

More recently, framed through a postfeminist sensibility, this has included the notion of the sexually agentic, active and choice-ful heterosexual woman. However, there are risks with this concept, where heterosexual women still have to navigate sexuality in relation to, among other things, class and race. The resulting performance of sexuality appears to many feminist researchers to reproduce a look very similar to what is valued by heterosexual men. Sex as highly stylised, penetrative and orgasm-oriented limits what the body can do and how it can experience pleasure.

In looking at pregnancy, its performative elements were in representing perfection, a wholesome and enjoyable bodily transformation that needed constant care and attention (and consumption). We located this as a tightening of power around the pregnant body, since in it represents a challenge to neoliberal, individualistic and stable embodiments. We showed how this challenge is managed, from imagining the foetus as separate from the mother in photography and medical imaging to ideas of post-partum bodies ‘snapping back’ into shape.

The final topic was pro-ana communities, flipping our analysis by looking at what is considered unhealthy to better understand and develop a critical understanding of what is healthy. We also highlighted tensions in feminist theory, where eating disorders can be lethal and yet also celebrated as resistance to patriarchal body ideals, tracking the contradictions and tensions that a flow between these different digital spaces of value and devalued bodies.

Lines of flight Throughout our book we took an affirmative poststructuralist approach – not just ‘doing critique’ but finding directions, or ‘lines of flight’, that increase capacities for action. Within Deleuze’s philosophy, the fullest capacity for connecting and acting in the world is the definition of health. We can change the fundamental questions about what something is, to how it works and for whom? What does it allow? Then we can explore the complexity of lived experience, and how we can meet needs and offer a challenge when discourses reduce these capabilities.

Being committed to an affirmative poststructuralist approach wasn’t always easy, it required us to do extra work, but it was always worthwhile. We saw where the pleasures were in what might otherwise be considered disciplinary practices. We noticed cracks in the logic that limited women’s ability to experience health, we highlighted the role of psychology as a medium through which ideas about health are circulated. Ultimately, we hope we’ve got readers thinking differently.

the psychologist april 2022 books

Microaggressions ‘A constant and unwelcome companion’ ‘Making sense of microaggressions’ is a graphic and written book with words

by Susan Cousins and design by Barry Diamond. It is published by Open Voices. Deputy Editor Annie Brookman-Byrne hears from Susan, Barry, and Peter from Open Voices.

Your book highlights 25 common microaggressions that people of colour experience. Seeing them all brought together emphasises that although they may each be ‘micro’, experiencing many of them regularly must have a huge psychological impact.

Susan: The psychological impact is significant because microaggressions are so firmly fixed in our culture. They show up, day in and day out, like a constant and unwelcome companion. How we experience the psychological impact is unique and depends on the individual’s development of vulnerability due to past and present levels of exposure, and protective factors such as existing strengths, particularly in access to relevant, meaningful and informed emotional support.

The dominant culture exerts a physical and psychological pressure on the mind and body that reveals itself in symptoms of anxiety, depression, agoraphobia and obsessive-compulsive disorders.

This amounts to an almost invisible force, often experienced over a lifetime where we are left to try and fit into uncomfortable and invalidating spaces.

I’m certain my school life was dominated by trying to grapple with overt and covert forms of racism which without doubt diverted my energy and resources away from learning and living up to anything near the potential within me. I think that being unable to trust what we know and experience does the most psychological harm. This book is all about validating that experience.

You start with an introduction to the term microaggression, which was coined in the 1970s by Chester Middlebrook Pierce, a Professor at Harvard.

He described microaggressions as ‘subtle, stunning and often automatic non-verbal exchanges which are put-downs’. Has much changed since then?

Susan: I think the idea of where we position change and how we measure it is interesting. My observation is that things feel somehow worse when in fact they

are the same. Overt and hostile racism has existed throughout my lifetime, but it appears that many white people are recently discovering what black, brown and people of colour have known and lived over hundreds of years.

Legislation against racial discrimination and harassment has had a direct impact on many people’s lives. For me, it represents the single most important factor in creating an anti-racist society, and it empowers the lives of people who were previously unprotected by the law. Microaggressions are difficult to challenge. They are the passive aggressive side of racism. They are sly and underhand, and this is why they cause so much harm. I don’t think the types of microaggression have changed, I think they are mutated forms of overt racism. You may not be able to directly harass me in work without losing your job, but you will be able to talk over me, hold me to higher standards, micro-manage me and exclude me without consequence.

The topic is heavy but you’ve created an accessible and fun book, helped by the vibrant graphic design. Why did you decide to take this approach? And what was the collaboration like?

Barry: From the moment we first talked about the idea, we made a conscious decision to try to make the book appeal to as wide an audience as possible.

I know from my own experience that many readers would love to read and benefit from information on microaggressions (and many other subjects) but

would be put off by page after page of grey text. We wanted the book to be a visual and accessible journey through a very serious and difficult subject.

Using type and colour to illustrate each microaggression allowed the words to shout, whisper, sneer, cry for help, try to sneak off the page – we wanted to express emotion through the typography.

The cover was the first piece of artwork to test the thought process. Microaggressions come in all shapes and sizes – sometimes bold and obvious, sometimes hidden with a smile or an attempt at humour. Creating a unique ‘character’ for each letter of the word, and expanding or shrinking the size of each letter, attempts to visualise the tones of the aggressions and the different personalities expressing them.

I am aware that it might take a moment for the viewer to work out what is being spelled out. This was a deliberate part of the design. It mimics that ‘pennydrop’ moment of realisation – with the ‘Oh, that’s what it says’ thought imitating ‘Did they really just say that!?’. The cover sets the tone for the inside pages.

We also wanted to try to visualise the moment that a microaggression is dealt – conveying the surprise/shock/anger/hurt. We decided to work on one microaggression at a time. Susan would send me the copy for one microaggression. We’d have a chat about its character and impact, and I would immediately work on it to ensure the energy and impact Susan had described was fresh. The process really helped me not shy away from being bold and free with the designs.

I should mention too that collaborating with Susan has been so refreshing. She said right from our first conversations that she knew what I was capable of and that I should let myself go with the design process. Working with such a talented writer and generous soul, I feel privileged.

Peter: Open Voices has been a longstanding idea, but we were waiting for the right book to come along before we brought it to life. Our aim as a hybridpublisher is to cultivate a group of authors whose work stands out from the crowd for its originality and its ability to challenge the status quo. When we heard of Susan and Barry’s book we were so determined to have it as our first publication.

Collaborating has been such a joyous experience.

To collaborate with an author requires a strong and trusting relationship built over time. Because we truly believed in this book and its mission, we were confident that it would be a success.

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It has been a privilege to witness Susan and Barry collaborate! We have admired their innovation and tenacity in delivering something truly original, which is no easy task in this day and age.

You provide solutions – some practical (‘Never leave the shop without a receipt’, ‘Make a complaint’), and some psychological, focusing on self-care (‘Break the circle of stress and tension, and make a conscious decision not to complain this time’). What other solutions would you like to see, that don’t focus on the individual on the receiving end?

Susan: This is an important question, although most of my work comes from my concern for the individual experience of racism and how to empower the reader.

Unless we stand up to racism when we witness it, to interrupt the flow of harassment and discrimination, however uncomfortable and challenging that may be, it will continue to find spaces and places where it will go unchecked and unchallenged. When people stop saying they didn’t notice, they didn’t hear, they were doing something else when ‘that happened’, we will see more change. This amounts to institutional and societal denial that acts as an enabler.

My observation is that unconscious bias training, for example, is not a solution. It is a non-event that barely touches the surface in terms of its impact.

I do, however, realise that for some people it was an important part of their journey towards a better understanding.

Anti-racism requires sustained challenge. It will take years of hard work to undo the legacy of colonialism and slavery that is the cause of what is so deeply entrenched in our psyches. And it cannot be undone with a few ‘key takeaways and tools’. Our education, from school to lifelong learning and all that is in between, needs to reflect the whole truth and not the partial truth that runs so very deep within every aspect our culture – including psychology.

Some psychologists have published research and opinion pieces questioning the very concept of microaggressions, in terms of definition, scope, utility etc. How do you respond to them?

Susan: There are challenges to the term microaggression which I have defined as ‘subtle, stunning and often automatic non-verbal exchanges which are put-downs’, originally defined by Pierce, Carew, Pierce-Gonzalez, and Willis in 1978 (p.66).

I think that it’s possible to question the concept of microaggressions but not the existence of covert and aversive forms of racism that exist alongside the more overt forms of racism. The term is useful, the term is empowering and the term names and defines what has previously gone unnamed. Naming an oppressive form of communication disempowers the innuendo and allows the target to process and move on from the resulting impact.

the psychologist april 2022 books

How we think How to Think is an approachable and engaging book about cognitive psychology for the curious lay reader. It doesn’t require much prior knowledge about cognition, but an ability to follow arguments and quite complex discussions. John Paul Minda writes: ‘…if you want to understand why people – and you – behave in a certain way, it helps to understand how they think…’ and to enable that ‘…it helps to understand the basic principles of cognitive psychology, cognitive science and cognitive neuroscience’ (p.8). This is what How to Think is about.

Minda, a psychology professor at the University of Western Ontario in Canada, has a research background in concepts and categories.

Unsurprisingly, he is fond of using conceptual metaphor and analogy to explain complicated ideas. Minda relates complex ideas to familiar real-world experiences, bringing the topics to life. He uses anecdotes and examples from his youth, his home life (occasionally involving his cat,

Peppermint), his teaching and his experience of COVID-19 lockdown.

The book starts with the history of cognitive psychology and an overview of the brain and how its study is relevant to cognition, before tackling the classic areas of perception, attention, memory, concepts and categories, language and thought, reasoning, and decision making. Later chapters on inductive and deductive reasoning and that on decision making were rather more complex and more philosophical than the earlier chapters, and their details may tax some readers. The important topic of cognitive bias is given its own chapter, accompanied by a discussion of political bias, gun ownership, and fake news.

There are plenty of crossreferences between chapters, reflecting the heavily integrative nature of cognitive psychology.

Language and thought have strong links (think Sapir-Whorf), as do memory and attention, and Minda makes these connections explicit.

Without the constraints of a textbook, How to Think goes into detail about specific studies and people, and Minda puts flesh onto the bones of certain key psychologists, such as Skinner and Chomsky. Even as a seasoned cognitive psychologist, I learned about research and details of cognitive concepts of which I was not previously aware.

There were a few missed opportunities. I would have liked brief notes for each chapter with more detail and references, as many claims are made without references.

More diagrams and figures would have helped illustrate and explain certain concepts.

Overall, I recommend this book to anyone with an interest in cognitive psychology or simply understanding human behaviour. Just ask Peppermint the cat – I’m sure she’ll agree.

How to Think: Understanding the Way We Decide, Remember and Make Sense of the World John Paul Minda Robinson

Reviewed by Dr Philip Fine, School of Psychology, University of Buckingham, Twitter: @philip_fine

A beautiful portrayal of the journey of grief If Only He’d Told Her Katherine Markland 2QT Limited Publishing

If Only He’d Told Her is the story of Emma, who at age 32 loses her boyfriend, Mark, to cancer. In order to come to terms with his death, she must first understand the relationship between them and their love for each other.

The story begins at Mark’s funeral, then moves both forwards in time over five years as Emma works through her grief, and backwards in time over the three years before then as she untangles a relationship overshadowed by terminal illness.

At the start of the story, the immediate aftermath of upset, loss and disbelief is also compounded by Emma’s doubt that Mark really loved her. Emma is unwilling to accept events, and feels only loss and abandonment.

Upset and emptiness, however, are soon replaced by anger and hatred. Emma further doubts Mark for the pain and anguish he caused in her life. Their last holiday together, dominated by the burden of impending death, is remembered now through the eyes of guilt and recrimination.

As time marches on, the pain reduces, the hate reduces, replaced with feelings of incompleteness and a wish for Mark to return. Emma settles into a happy state of living with Mark still by her side. The story moves back to the happy times they had as their relationship grew, while treatment for the cancer still offered hope, and earlier still as their relationship began. Gradually Emma

lets go of Mark, and can focus on her life and her future.

The book presents an almost textbook account of the grieving process that can only have been written from real experience. Through the book’s website (www. ifonlyhedtoldher.com), I learnt that the author Katherine Markland based the story on her own journey through grief, following the death of her boyfriend. Markland covers many difficult topics, including guilt, depression, fear, recrimination and, above all, poor communication.

It is a difficult read in places, with an ending both beautifully sad and uplifting. I think it has the potential to support those who are grieving, but it may also be informative to students and trainees of bereavement, psychology and counselling who are currently trying to understand these issues.

If Only He’d Told Her is a very honest and beautiful depiction of how difficult it can be to love someone. As in all relationships, there are soul-stirring moments of intimacy coupled with moments of pure hostility and cruelty. Ultimately the two people involved are simply too young, and the relationship between them is not well enough established to deal with the pressure that terminal illness can impose.

Reviewed by Jo Wood, Bereavement Counsellor, Outlook Bereavement Support

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PsychCrunch Podcast sponsored by Routledge Psychology episode 29 Why do people share false information?

Research Digest www.bps.org.uk/digest ‘Easy to access and free, and a mine of useful information for my work: what more could I want? I only wish I’d found this years ago!’

Dr Jennifer Wild, Consultant Clinical Psychologist & Senior Lecturer, Institute of Psychiatry ‘The selection of papers suits my eclectic mind perfectly, and the quality and clarity of the synopses is uniformly excellent.’

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An unlikely pairing of music and fabric This month, we have a special focus on the Bethlem Museum of the Mind and the Bethlem Gallery, with two reviews from Sally Marlow and a preview…

exhibition In this Moment Bethlem Gallery

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T

he Bethlem Gallery shares a building with the Bethlem Museum of the Mind on the Bethlem Hospital site, but its mandate is very different. The Gallery is not a formal museum with fixed art and artifacts – it is a dynamic gallery and studio space in which artists with a connection to South London and Maudsley NHS Foundation Trust both create and display their work. The Gallery’s latest display, In this Moment brings together the work of musician Gawain Hewitt and musicians from the City of London Sinfonia, with that of artist researcher India Harvey. The connection between the two is that they both worked with children and young people at the Bethlem and Maudsley Hospital School to create sound and fabric sculptures.

The Bethlem and Maudsley Hospital School has two sites, one at the Bethlem Hospital, and one on the wards in the Maudsley. Its pupils are patients at these psychiatric hospitals, being treated for what are often severe mental illnesses requiring inpatient stays or structured Monday–Friday programmes on site. The

school is a vital adjunct to treatment, continuing the education of those who can’t attend their usual schools because they are unwell, and the team there under the direction of Headteacher John Ivens are innovative, flexible and creative. Hewitt and Harvey have worked with the staff, and with separate groups of children and young people for some time (in Hewitt’s case, more than three years), enabling safe workshop spaces for the creation of work with the school students. They then take the outputs of those workshops (sound for Hewitt, fabrics for Harvey), and create sculptures.

Hewitt’s wooden sculptures cleverly disguise the technology which allows them to be interactive and immersive sound pieces. Gallery visitors are encouraged to move wooden birds from branch to branch of a beautifully carved tree, or to change the yellow tops of a hexagonal box and apply pressure to various points. The reward is sounds which were previously generated in the school workshops, and which form the backbone of the

Sam Curtis

the psychologist april 2022 culture

Sam Curtis

musical collaboration with City of London Sinfonia called Sound Young Minds. Students from the school worked with Hewitt and musicians on harp, clarinet, violin, viola, double bass, cello, oboe, French horn, bassoon and other instruments, drawing on themes of bird song, the seasons and astronomy from CLS’ repertoire, as well as classical pieces by Vivaldi and JS Bach.

Sam Curtis

These workshops were of course closed to the public and could not be observed, but Hewitt and Katherine Spencer, Principal Clarinet at City of London Sinfonia, ran a workshop for a research team from King’s College London who were seeking to understand the workshops and the process, and the therapeutic benefits of these.

I attended that workshop, and was struck by how the process designed and managed by Hewitt flattened hierarchies and facilitated the involvement of everyone attending, regardless of any prior musical experience.

Just as in the workshops with the school students, the musicians responded directly to sounds made by the workshop members on bespoke instruments, resulting in collective music making.

When Covid hit, Hewitt moved the workshops online, using digital platforms and adapting the workshop methodology, so that music could still be produced.

Hewitt then turned the hybrid compositions produced in both real life and online workshops into sculptures.

The sculptures are clever, inviting interaction; and the sounds they produce are poignant and mesmerising. The brilliance of the project both culturally and therapeutically was recognised when Sound Young Minds won the 2020 Royal Philharmonic Society (RPS) Impact Award.

Alongside these sound sculptures are Harvey’s soft, sculptural pieces. Harvey worked with students in what are described as ‘intuitive, gently exploratory and safe ways in multi-sensory environments’, using innovate ways to create fabrics, which were then used in the

sculptures. These included the students wearing drawing and painting tools attached to their bodies, using sunlight to make cyanotype prints with found natural objects, and casting shadows with aluminium sculptures on folded fabric to create fractal patterns.

This relatively small exhibition is ambitious in scope.

It brings together two very different artists, using different media, and different inspirations – classical music, sunlight and shadow. Both artists have created bespoke technologies to work in psychiatric settings, and both have created processes to encourage young people to refocus

their attention away from illness and move towards immediacy, spontaneity and improvisation – hence ‘In the Moment’. For young people whose illnesses often make it difficult to express their experiences verbally, the workshops and this subsequent exhibition are an insightful example of how the non-verbal captures what can’t be said, and how collaboration can result in unexpected outcomes.

Find out more via bethlemgallery.com/event/ in-this-moment

The cats’ whiskers exhibition Louis Wain Bethlem Museum of the Mind (until 13 April)

It’s been claimed that Freud said ‘Time spent with cats is never wasted’. In fact there is no record anywhere of him actually ever saying that, although he did write to his friend Arnold Zweig: ‘I, as is well known, do not like cats’.

As someone who is more a dog person myself, I wasn’t sure what I would find to like at Animal Therapy: The Cats of Louis Wain, at The Bethlem Museum of the Mind.

This exhibition has been timed to coincide with the release of The Electrical Life of Louis Wain, a biopic starring Benedict Cumberbatch as the man himself. For those of you unfamiliar with Wain’s work, he painted and drew cats of all shapes and sizes, not just as cats, but also in anthropomorphic scenes such as classrooms and at pianos, and embedded in kaleidoscopic images. He

painted on board, canvas, paper and glass, and his work was widely published in newspapers and magazines, earning him enough of a living through the late 19th century until his death in 1939 to support his mother and his five sisters. He was also a long-term psychiatric inpatient at Springfield, the Bethlem and Napsbury, and there has been much debate over what his illness actually was, and whether diagnostic clues are visible in his artwork over the years.

Animal Therapy (in my view wisely) does not speculate on Wain’s mental illness: rather it shows Wain’s art in its own right. There are cats on toboggans, playing cricket, and dressed up for Christmas. It is said that Wain often sketched in public places, secretly depicting people as cats. His cats are all wide eyed, which perhaps explains some of their appeal – Lorenz named this feature as one of the key Kindchenschema, i.e. characteristics of babies which serve to create the parental bond necessary for their survival. Wain’s work has an extraordinary level of detail, especially the other-worldly cats depicted in kaleidoscope format. Even for those of us who do not consider themselves cat people, and/or who tend to run to the hills when presented with the cute, there is much to like here. The exhibition also shows some of his nonfeline work – a rare dog’s head for the Illustrated Sporting and Dramatic News, architectural illustrations, and the rather beautiful ‘Sparrows, Ivy and Fires’.

Inspired by the exhibition, I watched the movie, available on various streaming platforms. Having been primed by the exhibition, I found it riveting, filling in autobiographical details which enhanced my understanding of Wain and his life. The Bethlem Museum of the Mind is a rare resource, doing something unique, and this Wain exhibition draws from its impressive permanent collection. If the cats entice you to visit, leave time for the rest of the museum too.

Reviewed by Sally Marlow, Engagement and Impact Fellow at the Institute of Psychiatry, Psychology and Neuroscience

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See also https://museumofthemind.org.uk/whats-on/ exhibitions/animal-therapy-the-cats-of-louis-wain and https://thepsychologist.bps.org.uk/volume-29/july/smallmuseum-making-big-impact

the psychologist april 2022 culture

More events as part of Bethlem Gallery’s 25th anniversary programme exploring music, mental health, climate change, care, racism…

Black Men’s Minds, 27 April – 7 May This audio-visual installation by artist and psychotherapist Stephen Rudder is a stream-of-conscious exploration of masculinity, power and culture, social pressures and lived experience. Interweaving spoken word with a musical score developed from the frequencies of psychotropic medications, the work bears testimony to the psychological tensions present in Black men’s minds, voices that are often missing in the conversations around mental health.

Black Men’s Minds was developed in response to statistics illustrating the disproportionate numbers of Black men sectioned under the Mental Health Act. These show that Black people are four times more likely to be detained under the Act, and 17 times more likely to be diagnosed with a serious mental health condition than their white counterparts.

An Ecology of Mind, 18 May – 27 August Re-imagining the grounds of the Bethlem Royal Hospital in Beckenham and The Maudsley Hospital in Camberwell as a ‘commons’, making cultural and natural resources accessible to all members of society. A series of exhibitions, outdoor commissions spanning 270 acres of green space, a one-day festival, and a symposium, linking to recent research suggesting that developing our sense of agency around climate change can be beneficial to mental health.

Artists, mental health service-users and Climate Science academics will work together on and off-site exploring the relationship between our inner and outer worlds to present creative responses mapping change, building on the local knowledge of hospital staff and residents.

We dip into the Society member database and pick out…

Dr Iyabo Fatimilehin, Consultant Clinical Psychologist and Director of Just Psychology CIC

One thing psychologists could do better I’m a huge fan of community-based systemic approaches to prevention and intervention.

From my work and research, I believe it does not make sense to individualise psychological distress. When I worked in Liverpool, we ran a narrative-based community project aimed at strengthening relationships between fathers and sons in the Somali, Yemeni and Black British communities. During one of the mealbased events for Yemeni fathers and sons, Amira Hassan (my esteemed colleague) and I walked past a father who was speaking loudly in Arabic on his phone. Amira started to laugh and explained that he was saying ‘I’m at a party!’. A highlight of my career! The least we can do is intervene systemically; the best we can do is community-based prevention.

One film The Princes’ Quest by Michel Ocelot is a beautiful family film that resonates with my childhood experiences of living in multicultural, multiracial, multilingual, multifaith family contexts. I was born in London and lived in both the UK and Nigeria during my childhood and adolescence. This film challenges attempts to restrict people to specific categories or communities of identity.

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One moment that changed my career I worked as a nursing assistant at Fairmile Hospital while I was an undergraduate at the University of Reading. I conducted a single case project with one of the men on the semi-secure unit under the supervision of the Clinical Psychologist. Later that year, after my graduation, I received a letter from the hospital’s matron explaining the difference that my work had made. This man had been

one on one

in hospital for many years and considered too aggressive and violent to be rehabilitated to the community. As a result of the work we did, this decision had been reviewed and he was in the process of moving into the community.

I committed myself to a career in Clinical Psychology and have never looked back!

One nugget of advice for aspiring psychologists from BAME backgrounds Choose your battles and keep your eyes on the prize! Be clear about what you want to do with your life and don’t waste your energy competing with others. Your path is unique.

Seek advice and support from people who share your values and are further along their career journeys.

One book My work with children and families has been heavily influenced by research and writing on anthropology. I strongly recommend LeVine and New’s Anthropology and Child Development: A Cross-Cultural Reader. I also love the work of Heidi Keller – start with Keller and Bard’s The Cultural Nature of Attachment: Contextualising Relationships and Development.

One hope That within my lifetime, psychological knowledge and research will be decolonised and no longer based on research based on WEIRD (White, Educated, Industrialised, Rich, Democratic) societies. It is time we recognised the harm that this does to people who have grown up in very different cultural and social contexts – it is important to consider this both for people who have migrated to the UK as well as for those in other sub-cultures such as White working-class communities.

One inspiration My Christian faith has been a source of inspiration and motivation throughout my career. It forms the basis and bedrock for my commitment to social justice (hence, the ‘just’ in Just Psychology CIC) and the empowerment of marginalised and oppressed peoples.

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