Trauma-informed forensic psychology

What Lies Buried: A forensic psychologist’s true stories of madness, the bad and the misunderstood (Endeavour) by Kerry Daynes is out now. Forensic psychologist Nisha Pushpararajah asks the questions.

 

You’ve authored and co-authored other books, what makes this one stand out from the rest?

I hit my story-telling stride with this book. It is the follow-up to The Dark Side of the Mind: Stories from my life as a forensic psychologist, and so remains an easy-read memoir about the warts-and-all world of forensic psychology, but I was more confident when writing this and I think it shows. The success of the first instalment gave me a huge boost and proved to myself that it was possible to describe cases in a way that engages lay readers, without sacrificing professional standards.

An interesting title. How would you relate it to aspects of forensic practice?

It never fails to amaze me how many people confuse me for a forensic pathologist, the title of the book might not help much in that regard! The title refers to what lies buried in someone’s history that, when revealed, becomes key to understanding how and why their problem behaviour developed. I’m a huge advocate for trauma/adversity-focused thinking and practice in forensic settings; each story essentially details the evolution of a trauma-informed psychological formulation and how that impacted (or not) on the treatment and management of the person involved. 

Your book offers an insight into the challenges of working within forensic settings and with diverse forensic clients. What has been the most challenging case you have worked with and why?

There is no single case that I can point to, as they all have their different challenges. I find the systems and organisations that I work in far more difficult and frustrating than any of my patients could be.

On a personal level, I have written about how I went through a phase of burnout and hopelessness, working day in and day out on what seemed like a never-ending tide of cases involving men who had sexually abused children. I went to the trial of Mark Bridger (who murdered five-year-old April Jones) in 2013 and found myself waking up in the small hours of the morning, overwhelmed by anger. My ability to remain professional and objective was under strain and I seriously considered whether I could continue in my job.

I like the concept behind your book. Each chapter seeks to provide an overview of the key issues many practitioners face in their day-to-day practice. Some are all too commonly known, such as the debate surrounding personality disorder diagnosis, the external control measures that are pivotal to the prevention of harm and reoffending, and the key limitations of offending behaviour programs like SOTP (Sex Offender Treatment Programme). What is the best strategy you’ve used to date that has helped you overcome or ethically navigate your way through these practice issues, ensuring the best possible outcome for your client?

I have left jobs where I have been required to uncritically adopt what I considered harmful or insensitive practice – a drastic but effective strategy (for me)! I try to stay up-to-date with research, new and best practice in forensic work and broader debates in psychology. But I don’t keep this all to myself, I discuss everything I plan to do and why with my multi-disciplinary teams (and patients where possible, of course). It’s not rocket science; providing people with good quality, accessible information and involving them in the process leads to better outcomes. Sadly, many settings don’t allow the time for these crucial discussions.

I get the sense that you aim to capture the nuances and individuality of different clinical presentations, and rightly so. You include an individual experiencing psychotic symptoms, and an individual affected by certain trauma memories, for instance. Why did you feel this was important to include in your book?

Most of the people I work with and therefore write about would be described as ‘mentally disordered’ in some form. I felt that I owed it to them to tell their stories in a way that brought them to life as unique individuals, not merely diagnostic labels or lists of ‘symptoms’. A book about forensic patients could so easily reinforce ‘dangerous lunatic’ or similar stereotypes and I wanted not simply to avoid those, but directly challenge them. I was at pains to show how our attitude to different manifestations of mental distress influences our treatment of those people in law and psychiatry. 

What advice would you give to anyone deciding to embark on a career in Forensic Psychology working within secure services, whether in a prison or hospital setting?

Read my books (obviously!). And if they don’t put you off, try to gain some paid or voluntary work at the ‘coal face’ of one of these settings. It will inform you very quickly if this is the field of psychology for you. Spend as much time as you can chatting informally to service users about their experience of prison/hospitals etc., as it will give you an insight that no amount of study can replicate.

BPS Members can discuss this article

Already a member? Or Create an account

Not a member? Find out about becoming a member or subscriber