‘I’m not the only one’

Ian Florance meets Jeremy Cripps, a Chartered Psychologist who is UK clinical lead at online CBT provider Ieso Digital Health.

Jeremy Cripps is clear that his involvement with mental health therapy ‘results directly from lived experience; two psychotic episodes in my late twenties. These led me to understand that everyone should be able to receive appropriate psychological treatment in a timely way.’

Before these events, ‘I was working and playing hard; hardly sleeping and at times drinking to control my mood. I’d done a Masters at SOAS University in London, was working as an intern at the ODI, a leading global affairs think tank. Then I experienced these profoundly scary episodes. I was sectioned, put in an NHS ward. I didn’t know what was happening and wasn’t told anything to contextualise or understand the experience. I was forcibly sedated; that was the low point.’

‘I was released after a month but after that I still suffered depression, panic attacks and acute social anxiety; I wouldn’t carry a glass across a room in case my hand shook. These were pre-IAPT days so I had to wait 18 months for CBT therapy. I’d been very confident before this but had to reboot… and that’s the positive side of the experience: my life changed direction.’

‘I did a journalism course before volunteering for MIND, then working as a mental health advocate in Brighton for Rethink. And that’s where I found self-disclosure can help: at the end of running mental health awareness sessions I would tell my story.’

‘These experiences led me to do an undergraduate psychology course and then I was interviewed for a post graduate course in Counselling Psychology at London Metropolitan University. I had the relevant work experience but as soon as I told them my story as a patient the response was astounding. They had a departmental meeting to decide whether I could join the training. My disclosure had risked my place on the course because there was still so much stigma attached to what I had been through.’

Working in areas such as student counselling and a drug and alcohol service gave Jeremy more experience but conflicting advice about self-disclosure. ‘I was told not to self-disclose when working in alcohol treatment. In other areas of the course there were two opposing views. People with a psychodynamic background tended to see self-disclosure as a real no-no: by contrast CBT trained therapists often saw partial disclosure as helpful, provided it was at a right level.’

Jeremy had been very open in talking to me about his story and agreeing that these details could be published. What is his attitude when working with clients? ‘I must stress I do less patient clinical work nowadays since a lot of what I do for Ieso is developing NHS partnerships. However, I believe in telling some of my story to clients if it can help to strengthen relationships and a sense of safety. Used carefully it can create necessary trust. I do not disclose being sectioned or my forced sedation to clients: I don’t want to frighten patients. But other experiences are OK.’

Can you give me examples? ‘The first time I self-disclosed was with a young man having panic attacks. He simply didn’t understand them, so I admitted I’d suffered them and had thought I was having a heart attack. His response was “so I’m not the only one”. As I mentioned, no-one helped me to this simple understanding when I was ill. On another occasion, a lady turned up very drunk and crying at a session. She said, “No-one understands me”. We discussed this and I admitted that I’d used alcohol as a crutch. The next session she was sober and we worked well together. That response “I’m not the only one” is critical. And it helps me walk in someone else’s shoes.’

Is there a downside? ‘It can backfire. Your lived experience can affect your judgment. Because you have had some similar issues you may assume the person in front of you is going through the same thing and that could muddy the waters. Relating or not you must rely on evidence-based interventions – which is why I’m so committed to CBT.’

Jeremy has recently had EMDR to address some historic trauma. ‘Interestingly I asked my therapist about himself and he was happy to disclose to a degree: his insights resonated with me and helped the process. We should never stop learning about ourselves through others.’

Jeremy delivered therapy in an IAPT service “Time to Talk” in mid-Sussex for a decade running a team there. He now works for Ieso (I learnt from Jeremy that Ieso is the Greek goddess of recuperation). ‘We have around 45 contracts with the NHS and around 650 CBT therapists with a team of supervisors and around 5000 patients. We experienced a big surge in May as NHS trusts tried to get their waiting lists down. We originally offered just a text-based service but we’ve recently added video CBT. The whole set up meets the goal I have: to deliver timely appropriate treatment. It’s flexible; we offer services at the weekend and in the evenings; it’s private and confidential  since patients can undertake sessions wherever they want.’

Jeremy is plainly proud of his journey from inpatient to clinical lead, and I would like to thank him for his honesty in answering my questions.

https://www.iesohealth.com/en-gb

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