‘That was all I needed. Someone believed in me’
We heard about Fiona’s self-help book integrating CBT and third-wave therapies – Get Your Life Back: The Most Effective Therapies for a Better You, co-authored with David Pearson (2017, Little, Brown). We started there, but her job title covers a multitude of activities and interests.
Some people are rather dismissive of self-help books. Others find it difficult to move from academic writing. What was your experience like?
‘In 2013 I co-edited an academic book for Routledge – Cognitive Behavioural Approaches to the Understanding and Treatment of Dissociation. It was a real honour to edit 23 other authors, but I quickly learnt that academics often use 16 words where one would do. A lot of my work was in shortening contributions, sometimes drastically. I really wanted to write a self-help book integrating CBT and ‘Third Wave’ therapies. The key to writing was reading a book called Calling Mrs Christmas by Carole Matthews. She’s a Times bestselling author, writing in a very clear, simple way, and people want to read her books. That motivated me. Every time I wrote a long sentence I cut it in half, then half again. In the end David complained it read like Morse code, so that needed some more work.’
We discussed some tips for academic psychologists wanting to write in a more accessible style, not least reading the advice of people who are masters at it. Fiona added ‘You need to get a plan sorted out early on, not just chapter order but what sort of material you’re going to include. In a therapy session you connect reading, learning and doing. I wanted to do the same in the book – it asks people to fill in forms, to do things, think about their experiences and write their reactions down. The idea is to generalise from one context – a book or a therapy room – to the outside world.’
Fiona identifies several motives for writing the book. One is to provide a self-help approach integrating different therapies. ‘Various therapeutic approaches often get treated as anthologies – you chose one technique from here, another from there. But these approaches are coming together. I use cognitive behaviour therapy (CBT), acceptance and commitment therapy (ACT), dialectical behaviour therapy (DBT) and compassion-focused therapy (CFT) in my practice. A second idea was that a book written simply, conversationally and non-technically can assist the therapist or psychologist. Often, in a busy schedule there’s no time to think about how psychologists and therapists choose what techniques to use in what circumstances.
I wanted to show how behaviour analysis, mindfulness, schema work, metaphors, exposure work and storytelling are themes in common. Nor is there time to reflect on the underlying theories. For instance, DBT and ACT identify with contextualism, whereas CBT is more mechanistic. Thirdly, the therapist can ask a client to read chapters between sessions or use some of the proformas in the book to guide exercises. These are also downloadable free from www.getyourlifeback.global. The book can even be used with waiting lists. Feedback suggests that the book is being used exactly in this way, as well as being read by individuals. People also say that as the book covers challenging areas like addictions and voice-hearing, it goes further than many self-help books.’
‘The island is a unique and fascinating place’
I asked Fiona to give me some idea of her background: how did she get interested in psychology, and train in it?
‘I grew up in Blackburn, Lancashire in a family of teachers. My father would have been much happier being a footballer. Although I am deeply grateful for having been cared for, fed, kept warm and educated, my parents’ marriage was sadly unhappy. While my sister had a special knack for getting everything right, I would in the end get things wrong, and my father’s temper would boil over into violence against me.’
Do you think this experience ultimately led you to study psychology? ‘I’m sure it was a factor and gave me a personal interest when I studied family therapy. This background was also a factor in my becoming the object of domestic violence in my first marriage.’
You said you got things wrong. What did you get right? ‘School work. I was an academic child and consistently did well at school, giving me one area where my actions were valued. I finally rebelled at 15 getting involved with drugs, self-harming and going out with “the wrong sort of boyfriend”. It finally came to a head and I was going to be admitted to Macclesfield Child and Adolescent Unit. Instead, I ended up seeing a psychiatrist in Manchester one day a week.’ Fiona describes how the psychiatrist hardly said anything – ‘I think he was a trainee’ – but, when she challenged him, he said that he was writing down everything she said. One of her comments ‘I don’t think I’m a strong person’ finally elicited a reply ‘I think you’re a very strong person.’ Fiona says ‘That was all I needed. Someone believed in me. I didn’t go back.’
Turned down by Cambridge to study English Literature, Fiona told the careers adviser she wanted to be a psychiatrist. ‘I thought I could do better than the one I saw! I was told I was doing the wrong subjects but that I could do psychology, so I ended up doing a psychology degree at Bangor. My headmaster put me up for a Rotary Club scholarship which got me a fabulous year studying clinical psychology at Duke University in North Carolina, with the offer of five years more.’
Despite this, Fiona came back to the UK but couldn’t get on a clinical course: ‘So I studied systems analysis. This was not a complete diversion – systems analysis is all about thinking through how things fit together. It’s very helpful in understanding contexts of every kind, from partnerships to families to organisations and societies.’
After studying clinical psychology at Liverpool University and then working with Dorothy Rowe on personal construct theory, Fiona completed her doctorate at Leicester University. Then came a job on the Isle of Wight – where she still lives. ‘Six years after I qualified I was Head of Department – though, it has to be said, there was only one post! We quickly built up staffing to cover the main areas of need and had a thriving and happy department. Having strong links with Southampton University helped – we accommodated students on the Island and provided all their clinical placements. The island is a unique and fascinating place, so that, on qualifying, the students often wanted to stay.’
In 2000, however, the Department did not survive the latest re-organisation. Fiona left in 2006, starting to work for herself. ‘I offered CBT therapy via e-mail, then on Skype. I set up a company, GreenWood Mentors Ltd, and started to work with companies like Vestas and Lloyds Bank on areas such as leadership development and downsizing.’
Was it difficult to start working in the business area? ‘I think many clinical psychologists believe it’s hard to make that transition. It’s often my job to convince them they can. The problem can be knowing how to set up the project – understanding the needs of the system, training, mentoring or data collection. When interacting with companies, it’s important to use the right language and terms for the audience. In that sense it’s very much like writing a self-help book! Many business leaders really want to know how to work with difficult and talented people, and about the effect of emotional states on behaviour, areas clinical psychologists know about. One of my supervisors, Professor Frank Bond, who is Director of the Institute of Management Studies at Goldsmiths, has done great work applying ACT approaches in the workplace, for example. He is currently working on the best ways to help elite performers.
Fiona had many interests and wanted to reduce her work to two days a week. She split her time between clinical and business work (you can find more about her work at www.greenwoodmentors.com), delivering training and supervision.
Working in India
Another strand of Fiona’s work is with severely disadvantaged children in India. I asked her how this came about. ‘When I was 50 I went to India for a yoga holiday as a birthday present. There were problems with an internal flight and we had to wait at Mumbai. On a bus to the hotel I got talking to Ekta, one of the managers of Dream a Dream. This is an NGO in Bangalore that works with children and young people from severely disadvantaged backgrounds. It works with NGOs who have placed children in safer environments, providing enrichment activities with them. At first it provided sports training and art work, later adding areas like English language, computer skills, and so on. It also runs a mentoring programme, recruiting volunteers from middle class backgrounds – mostly software engineers from IBM, Oracle, et cetera – who give up their Sunday mornings to work with the children. But the mentoring programme wasn’t working, partly I think because of the culture of respect. In India it is considered unacceptable to disagree with or refuse to obey one’s elders. The mentors would say “We need to improve this, learn that”, and have a big change agenda. The children would feel overwhelmed but unable to disagree, and so not return.’
With David Pearson, Fiona trained volunteers in how normal development is affected by neglect and abuse, and the impact of malnutrition: 48 per cent of all Indian children, not just those living on the street, are stunted in growth. They also trained volunteers in how to use psychological skills to respond to the young people and stay in the relationship with them. ‘David and I authored a manual to train the volunteers and another to train the trainers. The first is now used in three universities in Bangalore.’
Fiona identifies a particular problem – and a benefit – of this work. ‘Perhaps because of the caste system, university courses don’t cover these sorts of children and their issues. Equally the newspapers don’t cover initiatives like Dream a Dream. Middle-class readers are interested in middle-class children. Yet Dream a Dream by its nature mixes castes together.’
Charitable donors want evidence of outcomes – that their money is having some effect – so outcome research was another project. ‘Most NGOs in India have a problem measuring outcomes. We couldn’t find measures validated for disadvantaged children from the developing world, nor could we find measures about skills for living for this group. We looked at the World Health Organization life skills list and operationalised some of them. We developed a five-item observational scale, the Life Skills Assessment Scale, which we standardised and normed with around 1400 children and young people, and published in the Journal of Social Behaviour and Personality in 2013. We need to raise awareness amongst the NGO’s staff about why assessment is important and have developed metaphors to do this. We start by asking, “Would be OK if a tailor used a stick from the ground to measure cloth instead of a ruler?” Then we discuss what are the properties of a ruler and how to make a ruler. We emphasise that first you must make the ruler and then use it to measure things. Because Dream a Dream is now able to measure outcomes it has gained large amounts of funding and picked up awards. We think that this model, giving a subset of skills to volunteers, has great potential for addressing global needs for life skills, health and wellbeing.’
Fiona sounds a warning note about this sort of work in developing societies. ‘If you work directly with the children you set up expectations which can’t, often, be met. Very well-intentioned people will work with kids pro bono, as part of a gap year or a holiday and lavish care and attention on them. Then they disappear, leaving the children wondering, “What was that all about?” You have to be very careful in managing expectations.’
Fiona has further writing plans for a series of therapist and coaching manuals integrating CBT and Third Wave therapies. What I took from our conversation – and it could have lasted a lot longer – is the fact that core psychological skills are applicable in so many different areas – from elite performers and the worried well to severely disadvantaged children in Bangalore. But those applications need thought, an ability to adapt communication and expectation and the sort of energy that Fiona obviously has.
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