New voices: Reflections on writing my first textbook

An e-mail started it; just as many things do in my life as a practitioner psychologist. A commissioning editor, whom I did not know, got in touch from a publishing house: Would I write a textbook on psychopathology? I said ‘No’, but she continued contacting me with the request. Each time I said that I was not the person for the writing job ‘because I do not psychopathologise’.

She did not give up, and said that she wanted me to write it, because others recommended me to her, for the work. So, I asked to meet this persistent woman face-to-face. We met: she, an enthusiastic, bright young lady who seemed very interested in listening to what I had to say about psychopathology. I warmed to her immediately and explained the reasons why it is important for potential practising psychologists to learn about psychopathology on their training courses. Yet I was critical about the whole concept of labelling individuals. Therefore, I doubted whether the publisher would be interested in a book that I might write about psychopathology, which would explain the existing state of affairs, then be critical.

How I was hooked in
I explained to her that ‘psychopathology’ is understood to mean how purported mental disorders originate, their development and signs or symptoms. However, the word stems from the Greek words psyche, defined as ‘soul’ (perhaps currently thought of as the inner person, the subconscious or the subjective experience of the individual, and the feelings or lack of feelings of connection with other people and the cosmos), and pathos, defined as ‘suffering’. Yet where do the treatment guidelines for the mental disorders specified by the National Institute for Health and Clinical Excellence mention ‘soul’? Nowhere. However, these guidelines, which suggest ‘best practice’, have their uses: for example, with psychology trainees at clinical placements where evidence-based practice is expected. Further, adopting a categorisation system that is widely used within the field of mental health (in the Western part of the world) offers a shorthand way of communicating inter-professionally.

Her interest seemed to increase the more I spoke, and eventually she said that the best way forward may be for me to put my ideas in a book proposal to see what the publishing house thought. I did. The proposal was accepted, and I spent the next year enjoying almost every minute of writing the volume, reading widely within the subject to investigate relevant practice, theories, research findings and how these might interlink, and reading wildly around the subject for good-enough research findings and investigations from other disciplines that could shed light on any aspect of psychopathology and that were worth including in the book.

What my searches revealed intrigued me, eventually leading to evidence-based recommendations for government with a view to eradicating undue mental distress in the UK. When I was a student at university I had wished for a book that described psychopathology in a jargon-free, step-by-step way, while explaining the historical and philosophical foundations. I also wanted case vignettes, self-tests, ways of identifying problems and guidance relating to what therapeutic approach to use, bearing in mind aspects such as cross-cultural issues, gender and age, as well as ideas on what the future might hold within the field of mental health. The more I created what I had wished for, the more my passion for supporting current and future trainees in gaining knowledge, understanding and insight into the topic, fired-up. As I wrote in the book’s preface, this is how this exciting process crystallised for me:

My intention with this book is to help students, researchers and those in clinical practice easily understand the categorising of mental distress into specified sets of disorders. I include opportunities for critical debate, as well as information about what to do for mentally distressed clients, based on theory and evidence.

I decided to offer insights into assessments and referrals regarding individuals suffering from psychological problems and to pepper the book with ethically disguised case vignettes. These are composites created to illustrate teaching and learning points. The final part of the book is an overview of research from other disciplines, looking at how it can have a professional impact within the therapeutic field and how  it might illuminate various highways of realistic hope for future directions.

I included clear pointers to where further relevant information can be found, in the hope of supporting trainees on their therapy courses.

Vision into action

So I knew what I wanted to achieve but I needed to get from an idea to a publishable text. Before I started writing, the notion of creating a textbook was daunting. Consequently, I made the following four-step writing-plan, as a way of putting my vision into action.

I    Step 1: I set myself mini-steps towards finishing the work with a self-reward each time a little step was achieved in a timely way. 

I    Step 2: Working ‘backwards’, I put in my diary the deadline date for the book and the number of words that were required by that day.

I    Step 3: Holiday dates were then marked, so that work-related material did not impinge on these.

I    Step 4: Clients still needed to be seen – my best writing time is very early in the morning, therefore I set myself the task of writing a certain number of words, whatever their quality, on most early-mornings; saying to myself, ‘I can edit them when the first draft is finished’. (Many potential authors I have spoken to fail to complete their work because they keep polishing the first chapter and never write chapters two, three, and so on.)

Since the main audience for the book is students, I thought that the best way to structure it was by having 12 chapters. In this fashion, a student can look at a different chapter for every month of the year, or divide the 12 chapters between three academic semesters. As for the chapter headings, most of them have a specific categorical title such as ‘Psychotic disorders’ and ‘Personality disorders’. In addition, I structured in, what in my view is very important not only for trainees but also for practising psychologists: information on assessments and referrals (with examples of these), why being reflective can be of great value, how to keep records and what to put in them, and possible future avenues for overall good (mental) health. Structuring the book provided a useful book-plan for me.

With the plan in one hand, I could write with the other; while trying to keep a rein on my stress levels. Endeavouring to stick to my daily word limit, I woke up early (at 5am) and wrote the number of words, on average, that I planned to write per day, within the time I had allocated for the job (two hours). Sometimes though, particularly on cold, dark winter mornings, I preferred to snuggle into my duvet for an extra hour or more. Also, sipping a hot mug of sweet tea in my warm bed seemed preferable to writing a textbook; but whether I felt like it or not, the writing had to be done at some time because I had given my word (and signed a contract) that I would send in one chapter a month to the publishing house. The thinking behind this was that the ‘blind’ reviewers could read it before sending their feedback to the publisher who would then give me the comments in case I wanted to ‘tweak’ any chapter, bearing in mind the feedback.

As a reviewer myself for an international publishing house and for certain articles submitted for publication in a professional peer-reviewed journal, I like reading cutting-edge information. My comments for the writers are intended to improve the quality of the finished product, not to criticise the author. Knowing that each of my chapters focused on a different aspect of psychopathology, I felt honoured to have the safety net of three reviewers per chapter and was ready to give serious consideration to all the comments received; yet I was concerned that the reviewers might not like what they read.

On more than one occasion while I was a trainee (right up to PhD) I recall being asked to throw away a piece of work and start again. My feeling was sheer disappointment, but I had respect for the ‘reviewer’s’ opinion, and considered the feedback in the light of what I aimed for. Remembering these experiences, I waited for feedback from the reviewers of the chapters in my book with trepidation. There was no need for such concern. Overall, feedback was enthusiastic and positive, adding sweetness to my first experience as an author of a textbook. It also helped me to stay focused. Yet, there were setbacks.

Things did not always go as planned. For instance, my computer broke, with all my work in it. Although much of it was saved, I cried. Occasionally, I did not stick to my plan because grandchildren were born, illnesses emerged and, apart from procrastinating, other life-events grabbed my attention. When these happened, I fell behind with the number of words that needed to be written to meet deadlines. Due to this, I sometimes had to write late at night, into the early hours of the mornings (not my most mentally alert time!) to catch up. I planned to not work at weekends, but I felt that I had to finish before the deadlines, so this part of the plan was not always kept, which was a frustrating setback because it meant spending less time with loved ones.

I wrote approximately six drafts and at least double the number of words required per chapter before cutting and rewriting; I struggled distilling my writing for each chapter until I felt it was good enough to let my editor read it.

A lesson I learned from having to catch up was to get ahead of myself by writing a little more than I had planned (on most days). To my editor’s pleasure, this resulted in finishing the book earlier than expected. Sending in my final chapter to the publishing house, I felt a tremendous sense of elation – yelling with delight after I sent it as an attachment with my last-chapter-finished e-mail. Meeting the deadlines early, I felt amazingly free. Now that the book is published, I have the excitement of seeing it ‘in the flesh’.

What happened next?
Agreement about book’s design, indexing and proof-reading were needed. Financial arrangements were checked and ideas for promotion were batted back and forth. So, much activity happened after sending the final manuscript.

The publisher asked for book-cover ideas. I wanted the cover to marry with the text, and primary colours wrapped around the jacket. When I was sent book-cover possibilities, none of these were mine and I felt uncomfortable with the illustrations. Eventually, the publishing house decided to use the current cover, created by the design-team. I looked at the design saying, ‘Eye-catching’. They said, ‘That’s why we chose it.’

Sage sorted the index and sent it for approval. I went through it repeatedly, ensuring that the pages referred to corresponded with the appropriate text. This part of the process was tedious. Once I gave the OK about the index, proof-reading was necessary.

The proof was sent electronically and I spotted a few typos. There was a proof-reader at the publishing house. Between us, it took less than a fortnight to sort the proofing. Then, the money agreement was checked. How much advance and the percentage of royalties I would receive were pre-agreed with a contract. The publisher sent me the agreed advance before the book’s launch. My promised royalty will be sent every six months. Now, it is book-promotion that the publisher wants.

Thought for discussion
What now? Currently, psychopathology is discussed due to the recent release of DSM-5. Perhaps it is time for a new lens with which to view mental distress. In my view, it is important to read widely within the field of psychology, and wildly. To read research findings from other disciplines, because we might learn something that we may not dream of in our wildest dreams, which can be transposed into  the future of mental healthcare.

Betty Rudd is a Chartered Psychologist at Freedom Healthcare. [email protected]