‘Psychologists should stop selling themselves short’

Dr Hamira Riaz's experience in clinical neuropsychology and business psychology (within the NHS and Ministry of Defence, then at a global consultancy, and now in independent practice) helped form her opinions on psychology as a divided profession. She's authored articles on a dizzying variety of subjects and she identifies herself as an agent provocateur. 'The price you pay as a generalist rather than a super-specialist is that you're never truly part of a tribe. But you get the pleasure of sitting outside and throwing stones over the walls to remind people you are there.'

'We are there to serve people, not to treat them as data points'
'I was taught to believe that psychology's role is to guide people from dark places into light; to help them join up the dots of their lives in fresh, constructive ways. We make our core purpose harder by being a divided profession. Of course, there are distinctive elements in all psychology specialisms but there's common ground too; we are agents of change, striving for excellence, fixing what's broken and starting from the personal perspective. Being able to move between and across different areas offers nothing but opportunities: we have so much to learn from each other. The future is interdisciplinary… but having worked in both clinical and occupational psychology contexts, I would say that, wouldn't I!'

In expanding on this theme, Hamira uses clinical practice as an example. 'I qualified in 1996. I was part of the first-year intake for the Doctorate in Clinical Psychology at Leeds. It was very special to be part of that cohort: like being Kings and Queens of the therapy world! The course was multi-modal and eclectic, demanding big and broad thinking. The rise and dominance of formulaic approaches like CBT has meant clinical psychology practice has become increasingly reductionist. In the process, it has lost key aspects of its unique selling proposition, something clinical psychology must re-define if it isn't to become lost in an increasingly mono-therapy landscape.'  

Hamira argues that instead of challenging prevailing cultural paradigms, psychology has gone along for the ride, most notably in its longstanding obsession with being seen as hard science. 'I wonder what has fuelled this decades-long push toward treating people as confounding factors in carefully controlled experiments. Does it reveal a fundamental discomfort with the messy business of dealing with actual human beings? The current focus on publication bias, decline effects, voodoo correlations and the replication crisis, et cetera., is well overdue! I hope the profession can move away from a predilection for slicing and dicing human behaviour so that it is no longer relevant to peoples' real lives. I think psychological practice is at its richest, not to mention most honest, when characterised by theoretical diversity, clinical dexterity and a willingness to own up to everything we don't know about the human psyche.'

As an example, Hamira suggests the space opening up around wellbeing and the so-called 'worried well'. 'Providing timely help to distressed people, thus preventing problems from despoiling their lives, must be a golden opportunity for a united psychology; it's where clinical psychologists working in partnership with occupational, educational and coaching psychologists belong. Yet, this area has been colonised by homeopathy, life coaches and new age practitioners. I'd like to see psychologists shift from searching for silver bullets within their silos, and become more courageous and creative in how they think across mental health and work-related boundaries.'

Not that Hamira welcomes all cross-fertilisation uncritically. 'There's a new fad every year in business psychology. Most recent ones have been prompted by developments in cognitive neuroscience. One of the reasons I was drawn to clinical neuropsychology was the joy of working in multidisciplinary teams with neurology, neuroradiology, neurosurgery, et cetera. During those years, I began to understand the limits of our knowledge about the relationship between the structure and function of the brain. The most disturbing trend in the past decade has been leaps of inference about complex social behaviour based on pretty MRI brain scans. Clinical neuropsychologists working closely with occupational psychologists would be a dream team in this space, not only to explain what we can and cannot extrapolate from scanning technologies, but to stop the nonsense being fed to the public about brain–behaviour relationships.'

'I'm better at starting things'

I asked Hamira to describe her background and where these passionate views come from. 'I am a born and raised Northerner and a first-generation citizen. Mum and Dad were married by proxy and met for the first time at Heathrow Airport. One of my first memories – I was three – is a family car journey from Manchester to Karachi. The 1971 India/Pakistan war broke out while we were there, and I have flashbacks of bombs falling in the Karachi night sky whenever I smell aviation fuel.'

Hamira's father wanted her to become a doctor before she got married ('My mum thought I was too independent and was appalled at the prospect of leaving it so long'), and she had a place at Manchester Medical School. But human behaviour interested her more than medicine, mainly because 'people always seemed to feel comfortable confiding in me. I was thinking about psychiatry as an option, but when I didn't get the B grade in Physics that I needed, I took the offer of a place on the psychology course at Leeds University. It was a way of killing two birds with one stone; to move away from home and to get out of studying medicine.'

Hamira identifies another more major influence on her life. During her teenage years, two of her younger brothers were diagnosed with a very rare genetic condition, Friedreich's ataxia – 'think of it as a sort of long, drawn-out version of motor neurone disease. There was no test to determine whether I was a carrier. Though it wasn't done in an obvious way, slowly we all became pariahs in the community, and naturally my currency as a potential bride fell sharply. That drew us together. Our attitude was "To hell with you, we're fine as a family unit". I think I shut down emotionally over that period though and it cemented my sense of being "the other", the perpetual outsider.'

Graduating in 1988, during a recession, Hamira says that in common with many psychology graduates she didn't know what to do next. 'I applied to the likes of Mars, Accenture and the Civil Service, but I was drawn to the idea of a clinical career. The problem was – and still is for many students – that it's a long, hard road. I was going to find it very difficult to sell the idea to my parents because by this time, my mum was desperate to get me off her hands. Luckily, I was presented with a get out of jail card. I applied for an ESRC scholarship to do a PhD at the Institute of Psychiatry. I built my application around Peter Stratton's Leeds Attribution Coding System – it had a lot to do with me getting the grant and for that I'll always be grateful. I moved to London for three years. The problem was, at the end of it, I still didn't know whether I'd take a clinical or occupational route. Then my father died and I became the main provider for the family. Clinical was the safer career choice.'

Hamira claims luck and opportunity shape her experiences, though it's clear that a huge variety of interests also defines her choices. This 'protean' approach to career progression might underlie her suspicion of silos. 'Neuropsychology was still seen as a little exotic back then. Yorkshire didn't have a regional neurosciences setup, so I looked at doing my final-year placement at the Walton Centre in Liverpool. Gus Baker and Eric Ghadiali, who ran the Neuropsychology Department there, were the most glamorous psychologists I had met – it was then that I knew I had found "my people". Much later, working in neurosciences proved invaluable in getting access to the expertise and support networks we needed as a family when my brothers' condition worsened.'

Hamira's first job post-qualification was at Hope Hospital in Manchester, which had just been designated the neuroscience hub for the region, a 'once in a generation opportunity'. She commissioned and set up regional neuropsychology services, specifically for neurological conditions. She recalls working flat out for three years whilst also completing a PGDip Clinical Neuropsychology. 'I got close to burnout. I had set my heart on getting to consultant grade and I was very proud of the work we'd done, but I started feeling that it wasn't enough. Then, a job appeared at the Psychological Corporation, the publishers of the Wechsler IQ tests. By the time I moved back to a consultant grade job in Manchester 15 months later, the NHS just didn't fit me any more. I'm at my best when starting with a blank page and building something ambitious from nothing.'

That's why the next job as Head of Neuropsychology at the Ministry of Defence ticked all the boxes, on paper at least. 'I had the honorary equivalent rank of Lieutenant Colonel: I won't pretend I didn't enjoy being saluted and being called ma'am! I also know that as a woman of colour, I got the diversity vote. But the MoD quickly taught me anything I hadn't already learnt about the power of patriarchy, the perils of in-house politics, the cost of personality clashes and systemic resistance to change.'

Leaving without a job to go to, Hamira trekked around India for three months. 'I spent my savings and shrugged off my clinician identity so that when I came back I started a journey with YSC, a business consultancy, which was just then expanding its global footprint and recruiting clinical psychologists. I moved to Australia and spent most of the next year working across Asia-Pacific. Despite feedback that it would take time for me to understand the commercial context of the work it really didn't, but I did learn some important lessons: building my personal brand; selling psychology to clients and that you're only as good as the project you've just finished.' Here Hamira emphasised a point strongly. 'The work done by occupational psychologists is worth no more than that done by clinical psychologists employed by the NHS, but the fee structures are vastly different. That can't be right and I'm all for the idea of a Royal College for Clinical Psychology if it can redress the balance.'

'Psychologists are special!'

Hamira was one of several directors who left YSC in 2013 to set up her own practice. 'Since then I've combined clinical work with corporate consultancy and executive coaching. I follow my interests in areas as diverse as unconscious bias, women in the workplace, the crisis of masculinity and the role of mid-life crises. I'm finally at liberty to use an arsenal of techniques that transcends the Society's Division structure. And I've also faced up to my fear of public speaking. For years, I've watched people talking and writing about psychology and thought, "I could do that". As you can tell, I have strong opinions about just about everything. But I used to keep a lot to myself, expressing opinions brings the risk of being judged. However, such reticence born of fear is the ultimate betrayal of one's ability to affect change. Besides, I'll be 50 this year, and maybe I just don't care what people think as much as I did.'

A couple of years ago, Hamira joined the British Psychological Society's media panel, started writing a regular column for a compassionate business magazine, and she's the resident psychologist for a TV show about generational differences which aired in May. She's also a mentor on the Clinical Psychology Future Leaders Programme (CPFL): 'It's a great initiative supporting clinical psychologists in a way I wish had been around when I was in the NHS.'

I asked Hamira what she'd say to someone considering psychology as a career. 'Dig deep to understand why psychology excites you, then decide which area you want to start with… and how you can best express your core purpose through that. Don't let anyone tell you that you can't change your mind later. You can! Have the courage to stand out. Learn to say "no" if the system you're part of no longer serves you. Your perspective as a psychologist, whether that be clinical or occupational, is unique and eminently transferable to other areas of psychology. Psychologists are special! If you don't believe that, don't do it!'

And one thought for practising psychologists? 'I'd ask them to stop selling themselves short. Human beings have always been fascinated with themselves and with each other. The public will never get enough of psychology. There's magic in human behaviour and there's an artistry to understanding it. The practice of psychology is as much alchemy as it is a science. It's inherently mysterious, and because as a profession we aren't comfortable with that, we leave people at the mercy of stage hogs and charlatans.'