‘I witnessed so many examples of people supporting each other’

In Penny Priest's debut novel Team of One, Psychologist Frances Fisher has been working in public mental health services for decades. Unlike the majority of her colleagues, she is deeply sceptical about psychological therapies. Yet the service where she works is keen to push more and more people through treatment programmes to meet the ever-growing demand.

In the novel, the most fashionable therapy of the moment is Zen Psyonics. As the story unfolds, the problems with Zen Psyonics (and most therapies) begin to become apparent. Does it actually work? Might it be dangerous? Can we really change our essential natures? Who benefits most, the patients or the therapists? And what do human beings really need in order to survive the harms and cruelties that the world inflicts upon them?

I caught up with Penny (pictured with me above, on the left) to ask her about writing the book, any overlap with her own career and ideas, and the significance of the title 'Team of One'…

My first thought when reading Team Of One was that trainee psychologists should read this. For any clinician working in mental health it raises so many issues which are relevant to clinical practice. And it gives the perspective not just of clinicians, but of managers and service users. You've managed to tell a very real and convincing story that gives us so many prompts to evaluate our own practice, and our ways of coping and defending ourselves from sometimes quite toxic environments. 

Thank you, Biza. I was hoping to do some of that at least. But don't you think we cover these things in clinical training?

Yes, but this book brings it to life and people can really identify with the characters. One of the things I noticed is that you don't have villains and heroes. Your people are quite rounded and I think that's quite clever because in real life, it's quite easy to demonise people that you don't agree with. 

What were your intentions when you first started writing the book, and how did you manage to incorporate such large and complex issues, and yet produce a 'page turner' of a story?

Well, a fair amount of how the book turned out wasn't intentional. It was an interesting process in that it sometimes seemed to write itself. Things emerged that I'd not planned at all. Like, I had no plan whatsoever for there to be a dog in the story, but then Buddha just appeared and he actually turned out to be quite important in one of the character's stories. 

I started planning the book in January 2021. In the Midlands Psychology Group, we were getting ready to publish our book Outsight, and I felt that the messages in our book might have a broader reach if they were in a novel rather than an academic book. In particular, that Psychology should stop looking inside people's heads for the causes of their distress and turn its gaze outwards, to the myriad of external factors that deeply influence our wellbeing. So I started planning the story, but couldn't get going… even though I had this quite elaborate plan, I had these characters, they had names and roles and lots that was quite clear to me, I just didn't know what was going to happen in the end! 

How did you keep it structured? Because that's what I admire about the book. You managed to cover all the things you wanted to say, beautifully woven together. 

I tend to kind of keep lots of notes and files. I've always done this with academic writing. I've tended to always have two documents running alongside each other. One is the plan where I'm constantly adding little notes to myself and the other is the document itself, the piece that I'm writing. So when ideas strike me, I'll put them in the plan so that I don't forget them and at a later point I can make the decision about whether to incorporate it or not. 

Another thing that's always been important in my writing life is that when I used to go running, that was my thinking and writing time. There'd be an overarching idea that would occur to me when I was out running and then I would start to furnish the idea later.

Going back to your characters, they're not archetypal villains or wonderful angels. You give just enough information to explain why they're thinking and acting as they do. I get from the book that psychologists are most useful when they can help people figure out why they're suffering and focus on 'outsight' rather than 'insight'. Do you think this is a transferable skill that you've used as a psychologist as well as a writer?

In writing fiction you need to be clear about the motivations of your characters, their wants and needs. It's psychological formulation basically, so I think many psychologists would potentially make really good fiction writers – we're probably drawn to formulating people's difficulties even before we go into a career in Psychology. We're interested in human beings and what makes them tick.

I suppose though, in Team Of One, the focus is much more on the characters of the workers than the people who are referred to services. That was a big part of my motivation for writing it, because of my experience working in the NHS and how difficult that could sometimes be. It's interesting what you've said about there being no pure villains because I could have made two of the male characters, Alexander and Jason, quite nasty, more extreme versions. 

A bit clichéd, almost like a detective story? With an evil person that needs to be sorted out at some point?

Yes, but I couldn't ignore the very real fact that we are all in this context. Even the rather obnoxious Alexander is in the same world as us. He's immersed in a growing therapy industry and a world where people are trying to work out how they're going to make lots of money, which is another idea that we're sold. The worth of your life is measured by the amount of money that you make. 

One of the things you share with Alexander is a passion for sport. In his case, it's surfing. And that also makes him a more rounded person. He truly believes that because he benefits from that surfing, he should pass on his experience and knowledge to help people feel better.

Yeah. But at the same time, there're potential problems with that, where people have found their medicine and they think that's what everyone needs. I've been into surfing and love it and I think it could be quite helpful for some people. I came across the surf therapy idea through a website of somebody who's made a business out of it. 

Physical exercise and its benefits for mental health is such an important theme in the book. I know you're a great sportswoman and that you have achieved some amazing feats in both running and cycling. Has this influenced your writing and clinical practice in any way?

My own relationship with exercise sort of fitted the story, as well as the cultural narrative about exercise and psychological well-being. And as you know, I did my doctoral thesis about the psychological benefits of being in a walking group. So I guess exercise was always going be in there somewhere.

In my clinical practice, it might be something I encouraged people to do, but probably only if I could see openings. In some ways, my own relationship with exercise might have had the opposite effect in that I was always mindful that just because it's important to me doesn't mean that it would be great for everybody. And a really important part of the book is about injury. If exercise is your medicine and you lose the ability to exercise, what on earth do you do?

One of the main characters, Frances, is a female psychologist close to retirement. During meetings she tries to remind her team of some of the pitfalls of the new therapy they all have to adopt. Jason sees her as burnt out and unable or unwilling to change with the times. Is this written from personal experience? How do you see these generational differences best approached? 

The generational factor wasn't something I necessarily experienced. It was more my fantasy about what somebody at work thought about me. I didn't have much evidence but the real Jason was into a particular therapy and my impression was that he was bemused by the fact that I wasn't practicing this particular amazing therapy. So that's the kind of backdrop to Francis and Jason's relationship. But I made more of the Frances character by thinking of her as the journalist Barbara Ehrenreich who died a couple of years ago. I used some of her work when I was teaching on the clinical psychology doctorate. I thought she was the perfect embodiment of Frances, who was a lot more commanding and much more likely to say something than I ever was!

I don't know! I've seen you in the workplace, reminding people of some truths that perhaps get glossed over. 

In terms of the generational gap, something I always felt confident about was working with young people coming into the profession. I loved having trainees on placement. Most of them were really amazing. I never had that sense I was too old or past it. The notion of wisdom is interesting. To me, Frances is this older wise woman. Wisdom can come with age and experience but it can also come with youth and curiosity, being able to see things in a fresh way. Jess, the young support worker has her own wisdom and it's not on the back of any clinical and academic training. It's just her life and the sort of person she is. 

The title Team Of One is brilliant because it crops up in almost every aspect of the book. For me what was particularly poignant was how the character Paula has to go through really gruelling treatment for cancer and feels very isolated. She finds it really hard because people don't really understand what she's going through. She's referred to a mental health service and put into one of Jason's groups. She's quite intelligent and astute so she can see the limitations of the therapy. At the same time, she's getting an enormous benefit from the other people in the group, particularly Mandy, who is a great influence on her, although Mandy is really struggling herself. I wondered whether that's something you've observed as a clinician? 

Over the years I was involved in running all sorts of different groups. Recently there was growing pressure to run skills groups based on particular therapies. I was very at odds with the reasons for running groups but I knew from experience that it didn't matter what you were doing, it was being part of something that mattered to people. Although it depends on whether the people referred actually want to be in a group. But I witnessed so many examples of people supporting each other, which meant I felt okay doing these skills groups, because I knew there would be something which people would find useful.

I found the way you described the clinical world meeting the legal world really fascinating, as it throws up a number of issues that we as clinicians tend to be a bit fuzzy on. I was very impressed with your legal knowledge. How did you research this?

I'm really pleased that I was able to pull the wool over your eyes so effectively! Because my legal knowledge is very rudimentary. But it was whilst working in your department that we did the two-day expert witness training. I was so impressed with it. The thing that struck me most was the massive difference between the legal and psychological professions about what constitutes evidence. I think the bar is way higher in the legal profession.

I also relied heavily on the legal documents that are available online about a real trademark infringement case. I'm not sure where I stand with naming these things. You never know whether there's going to be a lawsuit down the line!

Going back to the title, Team Of One, I know you became very interested in watching a reality TV programme called Alone. It's all about surviving in the wilderness completely on your own. Some people cope really well and other people who seem incredibly skilled and together can fall apart. 

I'd already written a few chapters when I started watching Alone. I could immediately see the links. I really wanted to incorporate it but had to give it a different name because of copyright… Team Of One just beautifully captured a lot of the themes.

• Team of One is published by Egalitarian Publishing.

A dose of realism

I became interested in technologies of the self (after Foucault) whilst studying for a degree in Anthropology and Religion. I was therefore naturally drawn to a book which tells the story of how this gets played out in our mental health services.

Team of One is partly about the latest technology of the self, Zen Psyonics. But it also emphasises the importance of community for our wellbeing and tragically reveals what can happen if that community is stripped away.

In an increasingly individualistic world, it seems we are expected to find our own ways to be resilient against life's hardships. Many of these strategies for resilience come in the form of technical sounded therapies and marketable buzzwords that do little more than line the pockets of the wellness gurus who promote them. The inclusion of various therapy descriptions at the end of each chapter reinforces the notion of an industry saturated with attempts to mould individuals into an ideal rather than acknowledging the impact of external forces on their well-being.

The novel does a great job of grounding its characters in lived experience. The character of Frances stands out in particular. Her rants – brilliantly crafted and deeply engaging – serve as both a critique of and a call to reconsider the dominant ideology in mental healthcare. A particularly striking moment is her introduction of the concept of 'outsight', which challenges the traditional emphasis on self-awareness (insight) in therapy. Rather than internalising one's problems, Frances suggests, individuals may find greater clarity and agency by recognising the external structures that contribute to their distress. This theme resonates throughout the novel, positioning Team of One as a powerful commentary on the limitations of mainstream psychological practice.

Team Of One also offers moments of profound beauty in its descriptions of nature and the solace it provides. The autumnal imagery surrounding Paula's reflections on change, decay, and renewal is particularly moving, as is the passage describing her connection with a tree – a moment that encapsulates the novel's reverence for the natural world as a counterpoint to human-made pressures. This recurring motif of nature subtly reinforces the book's philosophical stance: healing and meaning are not solely found within the confines of therapy rooms but are also present in the rhythms of the world around us.

The final sections, including the epilogue, contrast the perceived fortune of Alexander with the more tragic trajectory of Mandy, highlighting the unpredictable and often unjust nature of outcomes in both life and the mental health system. The inclusion of the Chinese Lost Horse allegory is a clever narrative device, reminding readers that luck and success are often fluid and dependent on context. Most conversations I hear about self-improvement invariably (and perhaps deliberately) fail to account for luck. Instead, they favour a narrative suggesting that it is up to us to manifest the right state of mind, regardless of how crippling our circumstances may be. This book offers a dose of realism, reminding us that, for some people, the world is actively working against them. In doing so, it raises questions about whom the wellness industry is really serving and makes us grateful for mental health practitioners who have the wisdom to see it for what it is.

The book affords readers a glimpse into the frustration and despair of characters who have the misfortune of finding themselves in a 'team of one'. For some, this might amount to minor professional or financial setbacks; for others, the consequences can be dire.

Team of One allows us to see through much of the bullshit that goes on in the psychotherapy industry while reminding us of the power of more fundamental remedies – such as forming friendships and talking with people who care. 

• Reviewed by George Callaghan, BSc Hons Anthropology and Religion