One on One with Psychotherapist James Barnes

Can you tell me a bit about your journey into psychology and psychotherapy, and what inspired you to pursue this as a career path?

Hi Fauzia. Well, that's a long story of course! The short version was that I was always involved in mental health in one way or another, and after being in my own long term-therapy for some time, I realised that becoming a therapist myself was the way I wanted to go. I consider myself to have 'lived experience,' and I wanted to use that and my experience of being in psychotherapy, making sense of myself and 'getting better' to help others. 

I was also, I have to say, very interested in the kinds of theory involved, which I found infinitely more interesting and important than many of those I found in psychology as an academic discipline. I am drawn to the philosophy of things and I never felt comfortable with the 'science of behaviour'; I was much more drawn to the subjective/intersubjective nature of mind as understood in psychotherapy.

What does psychotherapy training entail?

Everything that a psychology training doesn't do! I'm only half joking. Of course, you attend lectures, learn theory, write essays, do projects etc., but — at least if you go for a humanistic/integrative/psychodynamic kind of training (which I would recommend) — then it's also about being confused, uncomfortable and doubting most of what you thought about yourself and others. Again, I'm only half joking.

There is often a group process, you usually have to be in your own therapy and there is usually a strong emphasis on self-reflection. This means that such training ends up being as much about your own mind as it is about the minds of others. 

That was what is so brilliant about it for me, and also what can be so challenging. It is much more about breaking down your own preconceptions than it is about learning what you are supposed to think, unlearning as much as you are learning which can often be very disorienting. This is a vital difference to the other kinds of psy-disciplines that are mostly about becoming an 'expert' on a given body of knowledge.

You've also completed some of your training in California, what was that like?

It was very interesting. San Francisco is a kind of the Mecca for psychotherapy and it can be quite wild, in all senses of the word. I loved it and also was a bit disturbed by it. All in all, though, it was a fascinating and very rewarding time. 

What does your role involve and what does a typical day at work look like for you?

I work as a psychotherapist and at the moment do most of my work online. I only returned to the UK at the time of the pandemic, at which point there was no option. So, I have several clients within a working day, have a bit of space in between to think and reflect and sometimes get some time to do some reading and researching of my own. My other job is lecturing and tutoring. I deliver lectures on psychotherapeutic theory and practice, hold seminars, and run skills groups and group process.

What drew you to work in private practice and what are some of the challenges you've encountered?

There are positives and negatives about working privately, outside of the system. I am personally very uncomfortable with the kinds of models and practices that are generally used by the NHS. It is also hardly a secret that burn-out is very common in such settings. It is one thing for this to happen in general medicine, but in a situation in which psychological well-being is the name of the game, it is deeply problematic.

Having said that, working privately you of course only work with a specific range of clients and miss out on the comradeship of working on a team. Both of those are a loss. I do wish I could work in/for the NHS and have a broader impact, but it feels until such time as the system is changed working privately is best for me. The desire for change is one of the reasons that I am so active on social media and try to publish blogs and essays. 

Tell me about the book you're currently working on.

Absolutely. The premise of the book is that the model of mind used in most mainstream theories and practices, in psychology, psychiatry, and psychotherapy too, is outdated and ultimately flawed. I make the case that the mind must be understood in a relational and intersubjective manner, something which I think has been borne out by the evidence for the past 40 years or so, though we have 'known' for much longer.

I talk about how the history of mainstream thinking has been a history of decontextualized, individualistic understanding of psychological and emotional distress that has often illegitimately, in my view, located the problem inside the person and made them responsible for changing it. Assuming a relational-intersubjective model, by contrast, I suggest in the book, means coming to terms with the worldly, social origin of our distress and the (sorely lacking) need for social and relationally focused interventions.

Can you share a piece of work or research that has really changed or shaped your practice?
I would have to say the work of psychoanalyst Donald Winnicott. He was the one who first really elaborated on the relational nature of mind and what it means for psychology and psychotherapy. He has been a massive influence on me and on many of the relational persuasion. He is unrivaled in his wit, and his brilliance and sensitivity is something to behold, though, just to warn people, he can be hard to get on a first go.

What advice would you give to others that may be interested in pursuing psychotherapy training, or working in private practice?

With regards to training, do it and do it within an integrative model. Whatever your predilections, you should be exposed to various approaches, and, more importantly, to a lack of certainty and multi-dimensionality that befits the reality of mind and mental distress.

Fauzia Khan is an Assistant Psychologist currently working within the NHS, whilst completing her Doctorate in Counselling Psychology.

On Twitter: Fauzia = @itsFauziaKhan / James = @psychgeist52