Now ye're talking - to a psychologist

Deleted User wrote: »

Is there a thin line in your experience between objectivity and empathy?

I don't think I understand your question. Could you elaborate on what you mean and I'll do my best to answer?

wexie wrote: »

Presumably from the OP you've worked or at least been involved with in the prison system.

Has this been from an assessment or treatment angle?

Is there (in your opinion) much of an effort being made in the Irish prison system with regards rehabilitation? Would it be useful?

I haven't worked within the Irish prison system, I must confess. But in the forensic system I did work in (it was a secure hospital, not a prison, just to be clear), I have worked in both assessment and treatment. Emphasis was most definitely on treatment and rehabilitation, and the ultimate goal, where possible, was always to try and get someone back into the community.

Aiming for rehabilitation is always the best approach, in my view. It might not always be possible, but it's important to treat someone like a human being who has worth. Many people in the prison system have had truly impoverished lives - not always in a financial sense, but in terms of love and human connection and feeling wanted and valued. As odd as it sounds, secure services could and should be a place where time is devoted to instilling a sense of worth in people. Research tells us that punishment doesn't stop people doing bad things, it just makes them more careful about being caught. But care and compassion and helping people get their needs met in safe or legal ways will be much more powerful in reducing the odds of ongoing offending behaviour.

Sadly, I don't think the resources are there right now, but I hope in the future we'll continue to move towards more of a model of positive rehabilitation.

(Oh, one more, from what I understand pretty much anyone in Ireland, regardless of education or qualification can call themselves counselor or therapist, how do you feel about this?)

This drives me nuts! Technically, it's the same with "psychologist" - it's not a protected title and anyone with a psychology degree could call themselves a psychologist.

There are varying levels of qualifications, and it's so important for anyone considering going for therapy to check the qualifications of the person they go to. Any therapist worth their salt will be delighted to be asked. You could go on a weekend-long course in "Counselling Skills" and set up a practice if you wanted. The potential for damage is huge. At the other end of the spectrum, you have Clinical and Counselling Psychologists. Both will have completed an undergraduate degree and a doctorate degree, and may have further specialised training in certain therapy modalities, such as Cognitive Behavioural Therapy (CBT). So always check!

bobwilliams wrote: »

I appear to have almost no empathy.
Been to concentration camps etc...zero effect.
Seriously,would this be considered healthy in your opinion?
I suppose the reason for the question is the fact that I've read that a lot of violent criminals can exibit such traits or is that moreso a lack of self control and self conscience?
Thanks in advance.

There are so many reasons that a person might not feel a level of empathy that they would expect to, and I couldn't possibly even begin to scratch the surface of that here. I would say, if you're truly concerned, a quick chat with your GP would be the best first step.

The Black Oil wrote: »

Do you think we'll ever to get to a place where resources will actually meet the needs - e.g. CAMHS, autism services, etc?

I certainly hope so, but the government are completely reactive, rather than proactive. It doesn't take a genius to work out that serious investment in preventative intervention is key. Invest heavily in CAMHS, school supports and resources, and supporting parents and families and you'll have a much healthier population when they reach adulthood. Right now, we're waiting until the issues are present to react to them, rather than putting supports in place to prevent them becoming such a problem in the first place.

I don't understand why parents are just expected to magically know what to do, for example. Unless you learn something different, you'll likely just raise your kids as you have experienced yourself, which is often how cycles of abuse or unhelpful behaviours get propagated.

I saw something on Facebook recently where someone was lamenting that their child was wetting themselves frequently. They tried to deal with it by punishing and shaming them and couldn't understand why it wasn't having an effect. All the replies were along the lines of "That's a bad approach", but the OP came back and said "Well, I'm the parent, I'm going to do what I think is best and continue punishing my child until they learn". Basic behaviour management training would go so far for so many people, along with encouraging healthy expression of emotions in children and how to communicate needs in a way that gets them met positively.

alta stare wrote: »

Many years i done a course over the summer months in psychology in WIT and found it very interesting. I have to admit it opened my mind up to many things regarding peoples behaviour and how important it is to have an understanding of them before making a judgment on them or their situation. I only wish my circumstances at the time would of allowed me to take it up full time. Such and interesting field so thanks for doing an AMA.

Anyway after that needless story My question(s) is a simple one and perhaps maybe a silly one, Do you ever find yourself analysing people you meet, ie in social circles and how does it shape how you interact with people, assuming of course such a thing would even relate to you in the first place.

I'm really glad you enjoyed it! It sounds like you took away a really important message.

I wouldn't say I analyse people, but I do spot patterns of behaviour or thinking that may underlie the way they deal with certain situations, yeah. I used to get drawn into trying to solve everyone's problems, but over time, I had to learn to stop doing that. It's exhausting and draining and a lot of people just want to vent and don't want to change! My professional life was seeping into my private life too much and I wasn't able to switch off any more.

It does still impact how I interact with people though. Simple things like active listening and reflection can strengthen a bond, and I've learned how to subtly help people think about things in a broader fashion than they might typically do.

fishy_fishy wrote: »

What's the difference between a counselling psychologist and a clinical psychologist?

In practice, there's not too much difference. Both are educated to doctoral level and have similar skills and abilities. I suppose counselling psychologists typically focus more on therapy and will use an integrative approach tailored to the individual. Clinical psychologists tend to be a bit more attached to CBT, in my experience. Clinical psychs will also do a lot of non-therapy work, like neuropsychological assessments and management/leadership-type roles that counselling psychs may not (but can).

The main difference may be in the pathway to training. Counselling psychology is a self-funded doctorate and, I believe, doesn't require across-the-lifespan experience. So you could do your 3 years of training part-time over 6+ years, or all in one area (e.g. adult mental health). The lack of funding means it's somewhat easier to get a place on a doctorate course as competition is less.

Clinical psychology, on the other hand, is fully funded, so you're paid a salary during training. This makes it extremely competitive, and means that many clin psychs will end up working for years in low paid work prior to training, in roles like research assistants, assistant psychologists, support workers, etc. The training includes mandatory 6 month placements in each of the following areas: Child and adolescent mental health, adult mental health, older adults (including dementia) and people with learning/intellectual disabilities.

Presumably you've had plenty of times where the people you were working with were offloading (for want of a better word) some horrible experiences and emotions at you. How do you protect yourself in those situations? I think most of us tend to feel exhausted, and even upset ourselves after say, spending time with a friend or family member who's very upset or distressed over something.

I find it's actually much easy to separate my emotions from work than personal situations! We have regular supervision with another psychologist, where we have a space to talk about things that bothered or stayed with us. I find it's important to plan your day carefully too - if I'm seeing someone who I know will affect me emotionally, I'll schedule them for the end of the day so I don't need to do much work afterwards. Having good colleagues is vital! Being able to offload to them helps so much. I think it's mostly about being on top of self-care, and making sure I make time to do things that relax me. I often pass my evenings playing rubbish games that require no thinking, and I'm careful about the books I read and the things I watch on TV. Also reflecting on my feelings and being aware of why I'm feeling certain things is really helpful - it's nice when I can say "Oh yeah, the reason I'm feeling really cranky is X".

WoolyJumper wrote: »

Hi, I recently graduated with a minor in psychology but I am thinking of going all the way and doing a H-DIP followed by a masters. But im not sure if I'm prepared for work and time it would take to be qualified? Any tips or advice for going down this road?
What area of psychology do you currently work in and what does your day to day look like in your job?
Any Aspects of your job you don't like?

Sorry I know they are big questions and might require sometime to answer

What area are you ultimately thinking of going into? You're right, it's a long road. My journey may have been a bit longer than typical, but it took me 14 years between doing my leaving cert and being fully qualified. If you're thinking of doing it, I'd say go in with your eyes open: Be prepared for a LOT of studying, failure, rejections and knock-backs. You'll likely spend several years earning a pittance, if that. It can feel like you're never going to get there! If you're aware of all that, and still want to do it, then I wish you the very best . It's a great job in the end!

I'm a clinical psychologist, and a typical day might, for example, consist of 4 hours direct clinical work and the rest of the time is preparing, writing notes and reports and going to meetings. It's hard to outline a 'typical' day because they all vary, but any day can consist of any mixture of individual therapy work, group therapy, neuropsychological assessment, consulting with other professionals, attending team meetings, supervising/supervision, researching, and writing.

Tell me how wrote: »

Do you find that many patients expect the experience of seeing a psychologist to be similar to the movie where they speak for a few minutes and then the psychologist says something insightful and their on the path to recovery, or do people generally recognize just how difficult the process can be (while still being helpful)?

I think people usually realise quite quickly that it's a long and hard journey! Some people will drop out because it gets too hard. I usually use a metaphor of it being like doing a really deep clean of your bedroom. First, you open the doors and cupboards and drawers, then you take everything out and pile it on your bed. Then you survey the mess and regret ever starting, and battle with the desire to just shove it all back in haphazardly. But if you stay with it, and put things away one at a time, you'll get there in the end and have a lovely tidy, organised room.

Deleted User wrote: »

We were just discussing in another area of the forum the concept of the "Just talk about it" message we send to the public in relation to Mental Health issues and well being? What is your position that debate/discussion? Is it a good message? A bad one? Is it - as some fear - a poor attempt to foist the responsibility from the government onto - essentially - the victims and those around them?

And do you find - as I have - that one issue with people being expected to "Just talk about it" - is that they often do not have the language to do that? That concepts you and I might known well from things like CBT or Transactional Analysis - and that mode of thinking and talking - they almost have to reinvent themselves before they can usefully articulate their issues? And perhaps there is some way we as a society can be giving the public those tools even long before they need them? If you could press a button and install certain ideas or language in the neck top computers of the masses in other words - what would it be.

Finally when it comes to the criminal element what is your position on "free will" as people traditionally understand it. So you think we have it? How do you distinguish between a Charles Whitman who was found to have a tumor pressing down on his brain that he never chose to have - and people who did not choose their genetics their parents their eduction and their circumstances. Can it be "Tumors all the way down" in some sense as people like Sam Harris suggest? And that not only can we abandon traditional notions of free will - but we can do so without any negative impact on our justice system or sense of justice and goals therein?

Those are some big questions! To your first question, I'm not sure I know enough to have a position. I'm a big supporter of trying to reduce the stigma of mental health through open dialogue and conversation. I think it's really hard for someone to understand the true experience of different aspects of mental health difficulties without experiencing it for themselves, so being open and talking about that can help everyone. For instance, I think it's only recently that people are starting to understand that "depression" is less "sadness and crying" and more "numbness and lack of feelings", and that's come about through people being open.

I think language is definitely an issue. When you think about a young infant, parents and caregivers use language constantly to help the baby understand what it's feeling. "Oh, you're crying, I wonder if you're hungry? Let's get you a bottle. No, not hungry? Maybe you need your nappy changed. Let's check" and so on. I think it goes back to my ideas in the post above yours about preventative intervention - give people the tools early. Mental health should be taught about from junior infants onwards, IMO.

Your last question - gosh, that would take a book to answer! I don't think it's binary though. I'd never heard of Charles Whitman, but a skim of his Wikipedia page suggests that the brain tumour was just a very small part of the story. And if I'm honest, I'm struggling to even follow the last part of your question, never mind answer it!

Rex Calm Barbell wrote: »

Whats your opinion on social media & how it effects peoples mental health?

thanks for doing this AMA, quite interesting.

I have mixed feelings. I think it allows for people to connect with others who may be struggling with similar things, and that sense of connectedness and shared understanding is important and helpful. But I also think it allows people to really dwell on their problems with a platform and a receptive audience, and that's unhelpful - even dangerous, at times, as it can be an avoidance strategy that helps them avoid getting proper help.

I do also despair at how we all present our "ideal" selves online, which is rarely a true reflection. Even I feel under pressure to be prettier, thinner, wealthier, more fun, travelling more, whatever - and I'm a relatively well-adjusted adult. I think it's probably really damaging to teenagers with fragile senses of selves. I particularly hate the elevation of total nobodies into something like deities that we see so much of on social media these days.

Tell me how wrote: »

Some of the other questions touched on this one, namely the influence of the "just talk" ideal and also social awareness.

Do you think we have created a grouping of people who identify as having mental health problems but really are just coping with normal life challenges?

Do you think, as a consequence, some people abdicate responsibility for dealing with these challenges by saying their mental health is being severely affected?

(I'm try not to be judgemental of any individual but I do find myself somewhat sceptical at times such as, for example, hearing the leaving cert is bad for students mental health, and should be changed)

That's one where my professional and personal responses would probably differ! But at the end of the day, it's not my place to invalidate another person's experience. It is part of the problem with "labelling" or "diagnosing" - even if you follow the diagnostic guidelines, depression can present totally differently in two different people - one could be sleeping all day and losing weight, the other could be awake all night and gaining weight, for instance. Neither is "wrong".

I think there have always been varying levels of resilience and coping abilities. In the past, society was in a place where you either had to manage regardless or probably die. Thankfully that has changed. People have also always been inclined towards hyperbole! Have you ever said "I have the flu" when you just have a cold? Does the label really matter at the end of the day? You feel sh*t whether it's a cold or the flu - just different degrees of sh*t. Either way, you're not healthy.

mitresize5 wrote: »

Im really interested in your opinions about psychotherapy.

My perhaps naive view is that anyone can call themselves a psychotherapist after doing a short course over a couple of months or through distance learning and in effect set themselves up as a professional dealing with the most intimate details of a persons life.

Im not convinced that these people are adequately qualified to deal with issues that will have serious consequences on peoples lives.

Whereas a psychologist to me has years more education and a clinical background.

What is your opinion on psychologist V psychotherapist

Kind of answered above, but you've hit the nail on the head: It totally depends on the qualifications. A psychotherapist who has a doctorate will have extensive training and I'd trust them completely. For instance, the DCU Psychotherapy doctorate has these requirements:

https://www.dcu.ie/courses/Postgraduate/snhs/Doctorate-Psychotherapy.shtml#tab5 wrote:

Applicants must:

hold a primary degree or equivalent in a relevant area, such as humanities, health or education;
hold a Masters in Psychotherapy or equivalent (which incorporates a minimum of 300 hours clinical practice, 50 hours clinical supervision and 80 hours personal therapy);
have a minimum of 2 years post-training practice experience working with a broad range of psychological problems;
be personally suitable to undertake advanced training within the context of a taught programme (e.g. motivated, reflective)
demonstrate evidence that they can undertake a research project at doctoral level
successfully undertake a selection interview

SimonTemplar wrote: »

I unfortunately had a bout of mental illness (depression) this year. I was referred to a mental health department in the HSE. Over the course of a few months, I saw three doctors - two junior and one senior. The medications weren't working due to various reasons. At the end, the senior doctor said that the HSE is a public health system with limited resources and that I needed to "make an effort" to get better.

What is your opinion of this? Was this reasonable for the senior doctor to say this?

Thanks.

I'm sorry to hear about your difficulties, and pretty horrified to hear that you were told that. It was absolutely not reasonable, but I think it was reflective of the pressures of the system. Some services are really stripped to the bone, and if someone is perceived as "not motivated", they can be dropped by the service to make way for someone else. It's horrible, but the only way it's ever going to change is if resources and funding increase dramatically.

frankhon wrote: »

What are some non-obvious signs that somebody is seriously not ok? We often hear tragic stories of people dying by suicide and the people closest to them genuinely had no idea that they were in such a bad way.

Also: is there an easy way to distinguish somebody experiencing a rough patch in their life to somebody who is having a mental health emergency? Is A&E the best entry point to definitive care for somebody who is acutely unwell, mentally speaking?

The first question is out of curiosity. The second one is related to a situation that I have found myself in as an EMT with a voluntary ambulance service. The treatment of mental health emergencies does not get the time and attention that they deserve in training!

Someone attempting to give their possessions away can be a sign that they're planning suicide. It could be overt, like "Here, have this expensive item, you'll get more use out of it than me" or something like "If something happened to me, would you take my dog in?". Of course, that alone isn't a sign of them having suicidal thoughts, but it can be if they have other signs of low mood.

For your second question, it's hard to answer generally. An emergency is generally that - an emergency. Our advice would generally be to speak to your GP first, if possible, but if it's an acute emergency or out-of-hours, then A&E is the place to go. As always, resources may vary but they should be best equipped to manage the immediate risks.

mariaalice wrote: »

Why is insight so difficult for individuals, is there any healing in mental health without insight.

Why is motivation so difficult for individuals.

How come some psychologist are so vague saying it maybe be an X issue and so on why are they so good at giving a description and are wary of giving a diagnosis.

Do psychologists provided a treatment plan or what is their functions, in other words, do people have an incorrect perception of what a psychologist can do.

Haha, more questions that books have been written on! I'll do my best to respond.

Insight can be really painful. It requires us to confront the darker parts of ourselves and that's deeply uncomfortable. I think it's important for recovery, yes. But it's frightening and people need patience and support.

Motivation... If I knew that, I'd be a millionaire! The reason is unique to every individual, I would say. Maslow's Hierarchy of Needs would suggest that several needs must be met before a person can attend to other needs. So if a person is really stressed with work, they might not have the ability to motivate themselves to work out, because all of their resources are used up coping with work.

Psychologists are always vague because you can't be definitive about human behaviour. I feel that being definitive is reductionistic - it tries to boil things down to bare bones, rather that look at all the details. What would be gained by being definitive, do you think?

Psychologists absolute provide treatment plans when working within teams and services. I'm not sure what peoples' perception might be, or what might be incorrect about it. I've lifted the following to save me typing it out again:

https://www.prospects.ac.uk/job-profiles/clinical-psychologist wrote:

As a clinical psychologist, you'll need to:

assess your clients' needs, abilities or behaviour using a variety of methods, including psychometric tests, interviews and direct observation of their behaviour
devise and monitor appropriate treatment programmes, including therapy, counselling or advice, in collaboration with colleagues
work as part of a multidisciplinary team alongside doctors, nurses, social workers, education professionals, health visitors, psychiatrists and occupational therapists
offer therapy and treatments for issues relating to a range of mental health conditions
develop and evaluate service provision for clients
provide consultation to other professions, encouraging a psychological approach in their work
counsel and support carers
carry out applied research, adding to the evidence base of practice in a variety of healthcare settings.
More experienced clinical psychologists may be called on to write legal reports and act as expert witnesses.