The ‘not so clinical psychologists’ offer fresh perspective on mental health difficulties

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TikTok/Instagram accounts offer a different way to look at emotions, therapy and mental health difficulties

We have long felt a certain discomfort with our titles as ‘clinical psychologists’. Our training felt quite embedded in medicalised ways of understanding mental well-being and distress, yet we did not ascribe to such a model as it felt limited and reductionist in attempting to understand the breadth and depth of human experience.

Cian: “Coming out of doctoral training, I took the better known traditional path of working as a Clinical Psychologist in CAMHS. This was a lovely service and team and I feel like I did good work there. At the same time, however, it did not feel fully true to the journey I was on with my values as a professional as my lens was firmly focused on looking at mental health from the dominant perspective of individual deficits and poor coping skills (which had been the emphasis of my training). Moving to a non-medicalised service and encountering the Power Threat Meaning Framework (PTMF) changed things for me and shifted my perspective almost entirely.” 

The PTMF is a framework of understanding that was developed in the British Psychology Society as an alternative to the dominant models of mental health used internationally (namedly the DSM and ICD). The PTMF changes formulative language to a more narrative and personalised perspective; for example, shifting from “what is wrong with you?” to “what has happened to you?” and changing the concept of “symptoms” to “threat responses”.

Emma: I was also introduced to the Power Threat Meaning Framework (PTMF) towards the very end of my training, and it has been an anchor and foundation for my therapeutic practice over the last four years as well as an ethos I stand by for team development and cohesion and community-based work.

“My initial drive to study psychology and to become a practicing psychologist was borne out of my studies in philosophy and interest in the links between our emotional well-being and intersectionality. I describe myself as a pragmatic idealist; I am strongly guided by both my moral and ethical beliefs and at the same time, realise these are influenced and diluted by the practical circumstances of any given situation. Clinical psychology training provided me with a wide breadth of experience and information on varied clinical and therapeutic orientations and ways of working with children, adolescents, adults and families. The common thread throughout these orientations was initially locating the problem, difficulty and struggle within the individual or specific individuals within a family. While this was not entirely unhelpful, it felt at odds with my tendency to try to fully understand a person’s/family’s relational, social, economic, educational etc. context and circumstance around the problem before intervening with specific therapeutic modalities,” Emma says.

A different way to look at emotions, therapy and mental health difficulties

We have both done lots of fulfilling work with the PTMF in therapy sessions with young people and in the community. 

At the same time, we recognise that “DSM-thinking” still abounds and is particularly dominant for young people who are trying to make sense of challenges with their emotions.

A major emphasis of our work in Jigsaw is to be young person focused. We involve young people in conference presentations, research, reflections on how our service operates and in lectures to mental health professionals. With this ethos in mind, we wondered what might be a powerful step to take in reaching a wider audience of young people and offering an alternative perspective to the one of disorder that seems so prevalent in young people’s vernacular.

TikTok, Youtube and Instagram are full of influencers and role models extolling the virtues of psychiatric diagnoses and disorders but there are very few (if any) popular influencers offering an alternative perspective or even letting people know that such a thing exists. Also, more and more, over the last few years, we have found ourselves having conversations with young people about their questions, curiosities, and interest in diagnoses to understand their struggles and distress. A common theme emerged from a lot of these conversations: A diagnosis can provide a formal method of validation for struggles, and it can help to be taken more seriously when there is a felt sense of being regularly dismissed, criticised and not heard by authority figures.

Hearing young people’s experiences of researching mental health online and finding one predominant model/method of understanding their difficulties sparked the idea for “TheNotSoClinicalPsychologists” social media pages. 

We took, what feels like, a brave step in setting up our own TikTok/Instagram accounts in an effort to offer a different way to look at emotions, therapy and mental health difficulties. The title acknowledges both our step away from the traditional clinical psychologist mould within existing healthcare systems and our wish and hope to be not so clinical in our therapeutic work with young people and families. The aim and mission of the page is to expand the narrative around mental health and to highlight that people deserve to have a choice in how their distress is understood.

We are trying to be a little edgy and provocative in an effort to grab young people’s (and professionals’) attention to hopefully kickstart some further discussions and reflections. We’re also trying to bring a bit of humour to very serious topics in an effort to engage people – we do not want our use of humour to be misinterpreted as minimising or invalidating very distressing and painful emotions and experiences. It is intended as a mechanism to try to stop people in their tracks as they scroll through vast amounts of posts and reels. We also are not aiming our posts as “attacks” on any given profession or discipline. In fact, we are also happy to poke fun at our own profession and acknowledge the flaws we have carried with being in positions of power. As we have said, this is about expanding the narrative, not pretending we hold access to the one real truth.

Valuing personal stories 

We are not naïve enough to think that we are going to change the world or to topple the dominant paradigm but we are naïve enough to think that we can make a bit of difference and hopefully contribute to the ripples that exist in the mental health landscape. The idealists in us want a mental health system that, at the very least, values personal narratives in the same way it values diagnoses. Ideally, we want a truly accessible and person-centred mental health system. There are people who experience distress, mild to severe, who may not want to be called disordered. The purpose of offering a different language and expanding the narrative is so people can be informed and draw their own conclusions in collaboration with their mental health professionals on their version of person-centred care. This is not a choice people get most of the time. The pragmatic side of us believes “The Not So Clinical Psychologists” is one small way we can work towards and contribute to this ideal.

It’s been wonderful to receive positive feedback from several mental health professionals already who seem to have a yearning for change and an openness to something different. We will continue to engage with young people to further our thoughts and processes in this area and are excited by the beginnings of our venture with these platforms.

Read more from Cian here.

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