Thursday, July 7, 2016

Activities 4th July to 12th August

I’m posting a relatively long list of activities because I’m planning ahead, because quite a lot is planned, and because I’ve a lot to do, further posting might be difficult.

After a day catching up on both university and British Psychological Society business on 4th July, I attended and presented at a conference on psychological therapies on 5th July – an event enlivened by the presence of protestors, arguing that links between the Department of Work and Pensions / Job Centre Plus and the Improving Access to Psychological Therapies programme pave the way to permitting compulsion to enter therapy (something they, and I, repudiate) and run the risk of implying that unemployment is a kind of, or symptom of, some form of psychological disorder (again, a point of view I repudiate). As I said at the time, I think that meaningful and purposeful activity and high quality, well-paid, work are important for our wellbeing. I have long argued that employment advisors play a valuable role in psychological care and should be part of multi-disciplinary teams. However I believe that a return to work should be a goal of therapy only if the client wants it to be a goal. Compulsion should never be part of therapy. I’d go much further. I believe that ‘conditionality’ – making, for instance, the receipt of benefits conditional upon other factors, for instance attending therapy – is misguided. In any event… I share the values of the protestors, even if I accepted an invitation to speak at an event they picketed.

On the 6th July, I met colleagues from MentalHealth Europe – Sante Mentale Europe to discuss how we might work together on joint projects, and then attended the launch of “A Healthier Life for All: The Case for Cross-Government Action”; an essay series (for which I’m an author) on health and social care [] prepared for the All Party Parliamentary Group on Health and the Health Foundation. As well as attending an awards ceremony at the RoyalStatistical Society, I also posted a comment about the Chilcot Enquiry for the British Psychological Society’s Presidential blog.

On Thursday 7th July, I followed up previous actions with further discussions with colleagues about both Mental Health Europe and possible briefing papers on complex strategic decision-making.

On Friday 8th July (at the time of writing), I will be involved in a teleconference about the future shape of clinical psychology training, before visiting the Department for Work and Pensions for discussions on a wide range of issues.

On Monday 11th July, I shall hold a regular teleconference with colleagues before continuing to help edit a forthcoming BPS report on depression.

Tuesday 12th July will see me continuing in the same vein – further editorial work and a meeting with clinical psychology colleagues.

My Vice-Chancellor will be delighted to know that I will be spending Wednesday 13th, Thursday 14th and Friday 15th on university business (with some NHS work).

I am involved in personal issues on Monday 18th, Tuesday 19th and Wednesday 20th July, and then I travel first to Google Headquarters in San Francisco for their SciFoo conference, before travelling on to the International Congress of Psychology in Yokohama, Japan (I will, bizarrely, add a day to my life, I think… by flying eastwards to America and then Japan and the further east to come home, I think I’ll be ahead of the sun… which will be interesting, although somewhat stressful, as my subscription-paying colleagues will be delighted to know I’ll be spending around 48 hours flying in economy class).

Bad for my health, after a short break, I’ll be flying back to the USA for the American Psychological Association’s Annual Congress, returning on 10th August.

Finally (for this post), I shall be meeting colleagues from the Irish Psychology Association … thankfully, in London (which means merely a 5am alarm call and a train journey rather than a transatlantic flight).

Thursday, May 19, 2016

Making Sense of the World - Nature, Nurture and Beyond

This was first published on the Huffington Post on Thursday 19th May 2016.

Our mental health reflects a complex and turbulent dance between nature and nurture. But we are not merely passive slaves to these forces, we actively learn about, make sense of and respond to the world. The essential added element in the 'nature-nurture' debate, too often overlooked, is human psychology itself.
We are biological creatures. It is an undeniable fact that neural activity and chemical processes in the brain lie behind all human experiences. It is therefore very common to assume that our distressing emotions or inexplicable behaviour must stem from illnesses or disorders of the brain. And, from that perspective, individual differences in mental health outcomes (why some of us experience psychological problems while others are more fortunate) are best explained in terms of individual differences in biology or genetics.
It's undoubtedly helpful to understand more about how the human brain works. But the human brain is not only a complex biological structure, it is also a fantastically elegant learning engine. We learn as a result of the events that happen to us, and there is increasing evidence that our mental health problems are not merely the result simply of faulty genes or brain chemicals. They are also a result of learning: a natural and normal response to the terrible things that can happen to us and that shape our view of the world.
There is very powerful evidence that even serious problems as hallucinations and delusional beliefs are associated with traumatic childhood experiences (poverty, abuse, etc.). And it is important to remember that the recent economic recession has had a direct impact on suicide rates - a rather dramatic (and sad) example of how social factors impact on our mental health.
Fundamentally, our mental health depends on how we understand our world, our thoughts about ourselves, other people, and the future. Biological factors, social factors, circumstantial factors - our learning as human beings - affect us as those external factors impact on the key psychological processes that help us build up our sense of who we are and the way the world works.
This means we should think differently about the 'nature - nurture' argument, and add a third factor; human psychology. It's absolutely true that biological factors are important in mental health, and that biological differences can partially explain individual differences in mental health. But that happens if those biological factors affect the way in which we think - how we make sense of ourselves and the world. And that is equally true for environmental factors. The events we experience in our lives also affect our psychological make up and how we make sense of the world around us. In rather more technical language, the effects of nature and nurture are mediated by psychological factors.
This approach to psychological wellbeing is diametrically opposed to the traditional 'disease-model' of mental illness, and should change how we help people in distress. We should replace diagnoses with straightforward descriptions of people's problems, radically reduce use of medication, and use it pragmatically rather than presenting it as a 'cure'. Instead, we need to understand how each person has learned to make sense of the world, and tailor help to their unique and complex needs. We need to offer care rather than coercion, to fight for social justice, and to establish the social prerequisites for genuine mental health and wellbeing.
These ideas form the basis for the free, online course I'm leading on - Psychology and Mental Health: Beyond Nature and Nurture, which is available on FutureLearn, starting on the 13th June.

Wednesday, May 18, 2016

Presidential blog #4 - Marching for mental health services

This was first published as a 'Presidential blog' on the British Psychological Society website on Wednesday 18th May, 2016

I had the great pleasure to be in York on Saturday, marching in support of colleagues calling for proper investment in mental health services in the city. It is ridiculous, in one of the wealthiest nations on earth, to be fighting for the most basic of social services. But the march and rally were great, and I am heartened by several elements of the day. 

The local people, and media, were welcoming and positive and there was strong support from local and national politicians. I was delighted to be shoulder-to-shoulder with colleagues fromPsychologists Against Austerity and sharing the speakers’ platform with the local MP Rachel Maskell and Len McClusky from Unite.
Having been a clinical psychologist for 25 years, I was delighted to hear the message that psychological health is a matter for everyone -  one-in-one, not ‘one-in-four’ - and that our psychological health (and therefore mental health services) is intimately linked to social circumstances and the economic, political and material health of civic society. That message needs to be repeated and clarified - hence my visit to Channel 4 on Tuesday, to attend a meeting discussing media portrayals of mental health problems – but I think it’s getting across. I was delighted, for example, that Alistair Campbell has started talking about mental health as an issue that touches ‘one in one’, not just ‘one in four’ of us. For me, this is a welcome recognition of our shared humanity and common psychology.
Otherwise, issues around work and psychology have dominated my email inbox and Twitter account this week. We’ve seen reports of psychologists themselves issuing ‘zero-hours contracts’, and unpaid intern posts for people wanting to enter professional psychology careers. Is this a growing trend that BPS Members and other readers of the blog would like to share their views on?
We’ve also seen increasing discussion of the impact of Work Capability Assessments, the DWP’s in-work progression trial and sanctions in our benefits system. We’ve seen sexism in the workplace and we’ve seen further discussion of the importance of maintaining the psychological health of workers in the NHS.
So… two questions (for the comments section below, perhaps):
  1. What are readers’ views on psychologists issuing zero-hours contracts or contracts for unpaid interns?
  2. Is the time right for a British Psychological Society Presidential Taskforce on ‘Work and Psychology’?