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There’s a problem in clinical psychology. Maybe it’s in all professional roles, or at least those where - at some point along your journey to qualification - you’re made to feel special.
Bear with me.
One of the lightbulbs I’ve had since discovering I’m Autistic is finally having an explanation for why I just don’t really get hierarchies and competitiveness. Don’t get me wrong, sometimes we’d all like to feel centre of the universe (even just to one person). And, just as my mother taught me, I respect my elders and wisers. When I’m on a certain trajectory, I want to finish it and I want to finish it well. But, I’ve learned, I don’t seem to mind stepping off that trajectory and starting a whole new one. And I don’t mind where I am on that trajectory as long as it feels ok for me. And, if I do manage to finish one trajectory, I quickly find another one which has often been a bit unexpected and occasionally (frequently) a little on the unconventional side.
Caveatting here - this is my flavour of autism, and of course won’t apply for all autistic people or even most of them, and maybe it just applies to me, who knows.
Clinical psychology training, as with many other professions, is notoriously competitive. Many people apply over years to gain a place on training, and psychologists are also given that hallowed status of ‘Doctor’ (a ‘mind doctor’ I like to remind people when I’m asked for the twenty zillionth time whether I had medical training and what is the difference between a psychologist and a psychiatrist). And of course many Clinical Psychologists remain grounded, slightly cynical and down to earth. And many (again, as in many other professional roles) take that title and forget that, no matter HOW much training you do, no matter HOW many patients/clients/service users you meet, no matter HOW many books you read - you will always know extremely little about the complexity of humans. Maybe this is more likely when we are made to feel distinguished? If we feel special, if we are made to feel special for achieving a spot on a training course, and then achieving a title - then how does that translate to how we understand, relate to and support other humans? Is it possible, I wonder, to be truly collaborative if there is even a glimmer of self-satisfaction in the psychologist role?
So much of psychology is trying to understand humans. To simplify our myriad thoughts and beliefs and behaviours and ideas and relationships and histories and values and contexts and goals etc etc etc. And I’ve written before about why that has been so incredibly helpful to me in making life (and people) feel more predictable, in building a career that I genuinely love and feeding my mind the new and (to me) fascinating information that it craves, and providing models that make the world and the people in it feel more neat and contained and understandable.
But psychology, of course, has its limitations. New evidence emerges all the time. And sometimes the lofty status of the ‘expert’ position of psychology (as well as other mental health related fields) means that we don’t always listen unless we feel the evidence is comprehensive enough. And comprehensive often means a Randomised Controlled Trial (RCT) - which are very expensive and need lots of backing. Sometimes this leads to a split between anecdotal - or lived experience - information, and scientific evidence. This is what has happened with autistic research, of course, where the understanding and raising of awareness of autistic experience from the vast and diverse autistic community has had a direct impact on research and clinical understanding. And it makes me wonder how we - psychologists - respond to critique and challenge. What happens when we are proved wrong - individually, or as a collective?
I’m interested in a more general sense too about the other side of this, how often we humans like to have an expert around. How often we hold people aloft in the position of a guru. The function of celebrity, even. In psychology, there are often Big Names that we look up to as teachers, nowadays not always because we feel they educate us - sometimes because we just like the cut of their jib. We learn about these individuals - akin to religious leaders - as the mothers and fathers of psychology, the parents of our psychological understanding.
It is important, to me essential, to have teachers. Whether these are people who live next door who teach you about neighbourliness and don’t mind if you pop over for a cup of sugar, or whether these are educators who teach you theory, concept, vocation. But at what point do teachers become gurus? And where, then, does ego come into it? If we are teaching understanding about connection and humanity, is there any place for ego and hierarchy at all? And what position does that put us in - does that make us disciples?
I have had many teachers in my life, people who have been inspirational, challenging and expanded my mind exponentially. In clinical psychology, and often in mental wellness in general, what so often happens though is that these teachers become guru-like. They invent a new model or therapeutic approach which is lauded as the next big thing. And then, nowadays, a whole machine kicks into gear around them and they go on the circuit, and end up speaking to thousands of people in stadiums. As mental health has become such a prevalent part of our mainstream discussions, therapists have become celebrities. Was it like that for Freud, I wonder? But we - the disciples - end up in a position where we are learning about being in relationship, without any relationship at all. Glorifying the knowledge that someone can provide us, without any personal connection. Head lead, but are the hearts left empty?
And of course, in psychology as in other professions there is little genuinely new information. Sometimes something comes along that is revolutionary. Often, there are old ideas repackaged with new labels and a step-by-step model.
Quietly, in the background, what I also see happening are people creating community hubs where there is an exchange of care. No ego, no new theories, no stadiums, just connection. Pods, constellations, communities, these wonderful words that bring people together. No gurus, no disciples, just connection. No bells and whistles, but unobtrusive support and relatedness. One of my teachers - a brilliant psychologist who happens to be my father - taught me that the best teachers in therapy are always going to be your clients.
When it comes to your own mental health, wellness, your understanding of humans and relationships - who have you learned from the most?