‘I am constantly absorbing stories of trauma’

Tell me about your background, and what brought you into psychology.

There have probably been many threads that have come together to bring me into psychology, but I think my interest started way back in childhood. I grew up around complex relationships and an environment that didn't always feel emotionally safe or stable. I think my way of coping was to try and understand the behaviour of others.

A significant moment on this journey into psychology came when I was around 15 years of age. I had recently been watching a TV show called Little Angels, where the clinical psychologist Tanya Byron focused on positive reinforcement to improve family functioning. Having been sent out of lesson to the assistant head's office, I was moaning about how my French teacher would do much better at class control if she did x, y and z. He suggested I become an educational psychologist, and this stuck with me.

I then went on to do a BTEC in Care and learned about Freud and other developmental theories. This really captivated me and I went on to study psychology at undergraduate level. My first job after university was in a therapeutic home for people with eating disorders – it was here that I realised I wanted to become a psychologist. I didn't really know what a clinical psychologist was but knew I wanted to work with children, so left this job to get experience in schools.

After five years of building up lots of skills and experience I applied for educational psychology, only to receive a blanket set of rejections. This was around the time I was once again inspired by the work of Tanya Byron when I read her book The Skeleton Cupboard. Despite reading a book once in a blue moon, I couldn't put it down. I realised it was clinical psychology I wanted to do, not educational psychology. So I left my work in schools, got a job in NHS mental health services, did an MSc and the following year got onto the doctorate.

You recently completed that Doctorate… what was the experience like?

Mixed, for multiple reasons. At the time, I would have preferred a course that took on more community psychology and social justice approaches, but Bath was closest to me geographically. However, the course gave more space to these values than I had anticipated, and I was able to bring community psychology and social justice into my research and other areas of work on the course.

Teaching was really good on the Bath course. The pandemic meant most of this was delivered online which made it difficult to engage with, so sometimes I worry I've not retained lots. But there was some really amazing teaching that I feel very privileged to have had. The pandemic also meant placements were very isolated and my own mental health was probably not at its best, if I reflect back. I am also at my best when I get to innovate and be creative… there's not much room for that during training, when you have so many competencies to complete.

A key experience on training was probably some of the involvement in EDI stuff. I was part of a group of trainees and staff who really pushed for change. This work was rewarding but also tough at times; on one occasion after I had been taking a lead on something, I received some negative anonymous feedback about being combative in my approach. For my own emotional wellbeing I had to take a step back from it, but I don't regret speaking up. Sometimes change doesn't happen by asking quietly.

Overall training was okay though and I am so unbelievably grateful for the opportunity. I still cannot believe I am an actual psychologist!

Is there anything you would change?

I'm not someone who holds lots of regrets about what has been, but I guess if there was anything, it would be to submit my articles for publication earlier. They are still hanging over me and I feel like it is important to get them out there. This is especially true for my main research project. By not publishing from that I feel like I am not honouring the voices of the people I interviewed, which strongly goes against my values. I am now writing and illustrating a book, which feels like a second thesis, so don't have much spare time alongside my main job.

What spurred your interest in attachment and trauma?

I first learned about the theory in college, but it was my time working in schools that really brought theory into practice. I attended a training event based on the book Inside I'm Hurting by Louise Bomber. This book became my bible and attachment theory gave me a framework to help teachers understand what children needed. I think it gave me the words to explain my hunches on why behaviourist principles of punishment and reward do not always work when dysregulation and attachment issues come into play. I then got a job in the service I work in now, with children in foster care, and attachment and trauma is really embedded in our work.

And where did your interest in community psychology stem from?

I naturally see the bigger picture and the need for change in the wider context of people's lives alongside individualised interventions like therapy. During my time in schools, trying to settle some of the children I was working with into learning environments felt like fighting a losing battle when their family life was so difficult. I also knew this was not about cruel parents, but about families who faced multiple ongoing social injustice and uncompassionate responses to intergenerational trauma.

This was really brought to life when I ended up studying a masters in clinical and community psychology at UEL in 2017/18. This gave me frameworks and theories to bring my passion and way of seeing the world to life and I would sit every Friday totally engaged by the words of my two main lecturers, Angela Byrne and Deanne Bell.

You currently work in two services.

Both posts are wonderful and challenging and very trauma-filled all at once, but I feel so lucky to have landed in areas I am really interested in straight out of training. The service for children in foster care where I was an assistant psychologist is where I am two days a week. This role includes a mix of 1:1 therapy, network liaison and support, supervision of assistant psychologists, cognitive assessments, thinking about complexity, formulating and offering containment. Often children's responses to abuse and trauma really challenge and worry the systems around them, so the systems-based work is primarily about containment and modelling compassion.

My other three days is in the service for young people seeking asylum or with refugee status. We are specifically a trauma service and based on a three-phase model of stablisation, therapy and integration into the community. It grew from the other service but was newly commissioned and I am the only psychologist, so much of my time is spent planning with the clinical lead and bringing in systems and processes and evaluation skills in. My week is so varied but tends to include a mix of initial assessments, psychoeducation groups, 1:1 trauma therapy, linking in with the networks, supporting families housed in hotels, collaborating with the crisis team, offering supervision and service planning and development.

I feel very lucky to be able to shape the service and have the opportunity to innovate in this area. I am developing and evaluating an intervention that combines aspects of tree of life narrative therapy and narrative exposure therapy, and I hope to contribute to the evidence base eventually. I am learning so much about cultural differences in conceptualisation and responses to traumatic experiences and spend a lot of time reflecting with the team about this.

What do you find most challenging about your role?

Across both roles there is a lot of trauma and I think this has the potential to be challenging later on… but it feels ok at the moment. I am constantly absorbing stories of trauma and that must be doing something to me because it pops up in my dreams and I struggle to watch violence on television these days. But I think there are also different challenges across the two roles.

Working with children in foster care is challenging because the systems around us can often replicate previous abuse experiences. It makes me very angry, but I have learned that systems change comes in many ways including overtime in small shifts.

In my work with young people seeking asylum, the challenge is personal and professional. Professionally I find it so frustrating that the systems are so inequitable and hampering to young people. There is also a huge challenge because of the lack of research into the validity of measures and interventions with the communities we are working with so I don't always feel I am offering the best service to people. I would also like to bring in more community psychology values on a larger scale, but I know I tend to have big ideas and I need to remind myself I have only been in this post five months!

The personal challenge, which I thrive on, comes from working with so many barriers. I am constantly reminded to question the assumptions I am making and am learning a lot about cultural differences in conceptualisation of distress and how people respond to power. The majority of my 1:1 work is also through interpreters which brings its own challenges because dialogue is one of my main tools. This work definitely requires lots of critical thinking, creativity and curiosity!

Prior to pursuing clinical training, you worked with children and young people for a number of years. What made you passionate about that?

Apart from wanting to swim with dolphins and be a mum, my first aspiration was to be a youth worker. I would have really benefited from a compassionate adult in my life so in a way decided to become one. I also think that there is a lot of opportunity to positively impact people's lives in childhood, and I just really love working with children and teenagers. There is something magical about adolescence where you have this person who can carry a child-like innocence and curiosity, and project out a terrifying bravado all at the same time!

Can you share a piece of research or work that has really changed or shaped your practice?

A piece of research that immediately pops into my mind is my main doctoral research project. For this, I was looking at the personal impact and usefulness of community led organisations. I was led by Arnstien's ladder of participation and the top rung of 'citizen led structures' being the top. I went into my interviews with the assumption that participants would talk about the benefits of collapsed hierarchies but to my surprise there was a strong theme around the importance of leadership. This has really challenged my thinking with participation but also reminded me to remain open about assumptions.

You're known as 'The Creative Clinical Psychologist' by many, and your illustrations have become really popular, used widely by professionals from a number of different disciplines. How did this all start?

I have been doodling and drawing for a very long time, but was really able to apply this to work when I was based in schools. I would make resources for my direct work with children and illustrate training I delivered to make it more visually interesting. I have a dyslexia and an ADHD diagnosis, and whatever the controversies around diagnosis, I really struggle to read and digest information without visual scaffolding. So, I guess I feel other people may need this scaffold too. During training, I bought a tablet and just thought I would share some of this online. To my surprise, it became very popular. I now have regular commission requests and hope to dedicate more time to it in the future.