Coping With Breast Cancer Author and Clinical Psychologist Dr Sarah Swan

Hello, and welcome to the Business of Psychology. Today I'm here with Dr Sarah Swan. Sarah was a senior level psychologist in the NHS specialising in severe and enduring mental health conditions, until in 2019 she struck out into the independent psychology realm and founded The Swan Consultancy. Since then, Sarah has also been on the board of the ACP, a body for clinical psychologists in the UK, and she's published a self-help book for people coping with breast cancer.

Full show notes and a transcript of this episode are available at The Business of Psychology

Links for Sarah:

Website: swanconsultancy.co.uk

LinkedIn: Dr Sarah Swan

Facebook: @swanconsultancy

Book:

Coping With Breast Cancer: How To Navigate The Emotional Impact Throughout Your Journey - Dr Sarah Swan www.sequoia-books.com/catalog/swan/

*Listener Discount: 20% discount code for listeners: put 'Rosie' in at the checkout*

Rosie on Instagram:

@rosiegilderthorp

@thepregnancypsychologist

The highlights

• I ask Sarah about her independent work; if she find it fulfilling and what it looks like 00:39
• Sarah talks about her decision to leave the NHS, and her breast cancer diagnosis shortly after  06:40
• I ask Sarah about the best bots of independent practice 12:42
• Sarah talks about the inspiration to write her book 15:05
• Sarah tells us about the challenges along the way 18:11
• Sarah tells us about the most joyful part of the book writing experience 23:54
• Sarah talks about the challenge of sharing something very personal in a book 26:27
• I ask Sarah about her hopes for the book 28:33
• Sarah gives us her advice for independent mental health professionals writing their first book 30:43

Thank you so much for listening to the Business of Psychology podcast. I'd really appreciate it if you could take the time to subscribe, rate and review the show. It helps more mental health professionals just like you to find us, and it also means a lot to me personally when I read the reviews. Thank you in advance and we'll see you next week for another episode of practical strategy and inspiration to move your independent practice forward.

Psychology Business School: Start & Grow and Coaching

Is this the year that you take your private practice seriously? Maybe you are just starting out or perhaps you want to grow your practice with a team or passive income. Whatever stage you are at, I would love to support you. For new practices, I have our group coaching programme, Start and Grow where you will find all the support, resources and knowledge you need to create an impactful and rewarding practice. 

https://psychologybusinessschool.com/psychology-business-school/

For more established practices come and take a look at my coaching for growth packages. I have a couple of spots left for individual coaching so let me help you get 2024 off to the best start possible.

https://psychologybusinessschool.com/1-to-1-coaching-for-mental-health-professionals/

Mentioned in this episode:

Psychology Business School

Is this the year that you take your private practice seriously? Maybe you are just starting out or perhaps you want to grow your practice with a team or passive income. Whatever stage you are at, I would love to support you. For new practices, I have our group coaching programme, Start and Grow where you will find all the support, resources and knowledge you need to create an impactful and rewarding practice. https://psychologybusinessschool.com/psychology-business-school/ For more established practices come and take a look at my coaching for growth packages. I have a couple of spots left for individual coaching so let me help you get 2024 off to the best start possible. https://psychologybusinessschool.com/1-to-1-coaching-for-mental-health-professionals/

Start and Grow

TRANSCRIPT

SPEAKERS

Rosie Gilderthorp, Sarah Swan

Hello and welcome to the Business of Psychology. Today I'm here with Dr Sarah Swan. Sarah was a senior level psychologist in the NHS specialising in severe and enduring mental health conditions, until in 2019 she struck out into the independent psychology realm and founded The Swan Consultancy. Since then, Sarah has also been on the board of the ACP, a body for clinical psychologists in the UK, and she's published a self-help book for people coping with breast cancer. Now there's a lot more that I could say, Sarah, but before I do, welcome to the podcast.

Thank you very much, Rosie. It's nice to see you again.

I'm so pleased to have you here today because this series of the podcast is all about finding fulfilment in your work. And I think often when people are leaving the NHS, one of the worries is that independent work won't align as well with their values, or they won't be able to follow their interests. So, I'd really like to ask you some questions today about your journey into private practice and your experience of taking on the epic challenge of writing a book. So firstly, I suppose, would you describe your independent work as fulfilling?

Absolutely. And I say it so often now that yeah, I feel like I've been able to create a range of different activities that I do that absolutely does fulfil me. And yeah, I kind of wake up excited to work every day.

And that's such a lovely feeling isn't it? And I'm sure there'll be people listening to this who are dreaming of feeling like that. And so what does your work look like then, you mentioned you've got kind of diverse activities that you do?

Yeah, so I do a couple of days of therapy, and then I also have associates, so I've got other avenues for the too many referrals that I receive. And that's really nice as well to feel like I've got a team because that was something I thought I would miss in, in the NHS. And yeah, I think we've got a nice, a nice little group, we have like monthly CPD sessions, so we feel like we're coming together, sorry, peer supervision sessions, and then we do some CPD as well. So yeah, it feels like we've got a nice little team. And then I also do expert witness work for the family court, which was not something I envisaged doing and was kind of persuaded by a friend of mine who does this work a lot, but actually I've really enjoyed it, and it gives me greater flexibility because other than the time that you spend doing the face to face assessment, the rest of the work is obviously all the background reading and the report writing, so it gives me a lot more flexibility. And then we've spoken before about how I've done work with businesses and organisations around employee well-being, so I do bits of that. And then, although I'm no longer a director with the ACP, I still do work for them. So, I'm leading on setting up the independent practice network. Which has been really good so far and a great way of sort of networking and meeting other people that you wouldn't come across otherwise. And again, building up a sense of being part of something, having kind of a team and, yeah, just lots of opportunities to collaborate with people which is really exciting actually. Is that everything? And then the book, of course.

The small thing of the book!

The small thing of the book, yeah. And along with that has been, because it's a series of books, so I'm supporting the other authors in the series to, yeah, to put their books out as well, which again is just really enjoyable and satisfying and yeah, has brought you know, some new skills to light that I never knew I had around editing, and yeah, it's, it's really fulfilling.

There's such a theme of collaboration around that, and I think people often imagine that you go into independent practice and then you sit in a room on your own, and it can be that way, I think, but it sounds like you've been very proactive about reaching out, building those networks, particularly professional networks that give you the fulfilment that you found in the NHS before.

Yeah, absolutely. I think it was, you know, one of my biggest concerns on, on leaving the NHS and whilst I, I, you know, I, I do quite like working independently, you know, I really enjoy and get motivation, I guess, from, from working with other people as well. And yeah, the other thing I didn't mention that I do as well, it is supervision and coaching of, of other psychologists. And again, that was coming from the fact that my other biggest concern on leaving the NHS was losing that opportunity for supporting and mentoring others. So yeah, it was really about thinking when I was leaving, okay, what do I enjoy about my NHS role, what do I not want to lose, but how can I find that creatively in other areas in, in independent practice?

It's so helpful, isn't it, to come back to what do I value? And you can create that in such different and creative ways, but you have to be in touch with it first. And I think it's well worth anybody listening who's thinking about leaving the NHS, or, you know, even just setting up a small practice alongside your NHS work, thinking about what those values really are, so that you can build something that actually meets them, rather than just copying what somebody else did that might have worked for them, but might not sort of hit your values very well. So, I think that's a really helpful story to share.

I think for me, and I've had conversations with other people about this, you know, my value was about working for the NHS for such a long time, and I never envisaged working privately at all, and then when it came to actually the day to day work, and the way I had to work within the NHS, because that was conflicting with my values so much, it, it was then that I began to consider life outside of the NHS.

So, you mentioned that NHS work wasn't sort of hitting your values as much as it had done in the past. So, was it an easy decision to, to leave, or were there things that you worried about at the time?

Yeah, I wouldn't say it was an easy decision at all. And I think it took me several years really to, to come to that conclusion that that was the right thing to do. Yeah, I think it was, you know, a culmination of different things within the NHS that was just making it feel like it wasn't, I wasn't able to work in the way that I wanted to work that it wasn't good for my well-being, that I was compromising too much in terms of my work life balance and spending time with my family. So yeah, I started out doing a bit of private work, because initially my request to compress my hours to give more time off was denied, so I decided to cut my hours, but that meant I had to make it make up the money elsewhere. So that's why I started doing a little bit of private work. And yeah, having got to a senior position in the NHS I wasn't doing very much clinical work so actually got back in touch with why I went into the profession initially was around the client work actually and found that, you know, whereas I've maybe got quite burnt out in the NHS of working with people with really very complex difficulties, you know, the private work was actually more rewarding in that way. So yeah, that started to give me a bit more confidence that actually I could create something more fulfilling outside of the NHS.

So, did you start off with the kind of usual model of seeing a few people for therapy work to start with? How did that evolve into the kind of diverse practice you have now?

Good question. Trying to recall now. I think alongside that I started doing the stuff with businesses. And so that, although it was really scary, it was really good to show me that actually my skills were transferable and that there were other ways of using my, my skills outside of an NHS context. And so then I started to kind of build a kind of business model of what I needed in order to be able to afford financially to leave the NHS. And yeah, then started to build up my client work. It was sort of started to build through word of mouth, through doing sort of some promotion locally, joining the directories, that kind of thing. And so, when I resigned in 2019, it, you know, I was anxious of course, about how it was gonna pan out, and whether it was gonna bring me in enough money, and whether the work would be stable enough. But I, I had got to a point where I felt confident enough to take the risk and confident that I had exhausted the options in the NHS.

Were there any major struggles in building the practice to the point where it does sustain you financially and feel fulfilling?

Well, my breast cancer diagnosis was the, the major obstacle there, which happened just two weeks after I resigned. So, in my three month’s notice period, I was planning to explore all the critical illness cover and all of that sort of stuff, but I hadn't had that in place. So that was an issue financially. So, for people setting out, I would say, get that in place straight away. But aside from that I think, you know, there's obviously then the pandemic hit as well, and that was a concern, but as most of us have found, actually, that's increased our referral rate even more. It's difficult building the stuff with businesses, you kind of, I've, I've found any way that I've needed to have a foot in the door by having some kind of connection, even if that's been quite sort of a loose connection. And I've struggled to kind of keep up the promotion of that side of things. in order to keep work flowing in. Yeah, does that answer your question?

Yeah, I mean, I, it's, it's difficult to imagine how much pressure you must have been under getting such a big diagnosis at such a critical moment. But I wonder if going through that experience at the beginning of your journey of being a full time independent practitioner, I wonder if that's given you anything that is useful to you now. Does that make sense?

Yeah, I mean, I think definitely it highlighted I needed to have work could be done more flexibly and wasn't necessarily face to face or, you know, online work. So that I could, or so that I can flex up when I want to, and I can ease back if I feel I need to rest more. Yeah. So that's been really important. And yeah, giving me the confidence actually, because I, I worked throughout my treatment. And yeah, it gave me the confidence that I can do that. And also that if your work is in line with your values, but actually, that's something you want to do, rather than it feeling like an absolute chore. So, you know, although it was incredibly hard to keep working throughout my treatment, I also think it really helped me to maintain my sense of who I am. And yeah, gave me the confidence that I can, I can do that even, even at times that are really difficult.

And what would you say have been, you know, the best bits of independent practice up to now? Are there any like standout highlight moments for you?

Oh gosh, that's a difficult one. I don't think there's any particular moments as such, but it's just the day to day, being able to arrange things on the whole around how I want to do them, to be able to fit in going to the gym, catching up with a friend for coffee, going for a walk, you know, being there when the children need me. Sorry that, that bit came later because they're teenagers now they don't need me so often but yeah, it's just, it's more the small things actually that, that make the difference.

I think it's really important to reflect on that because often, you know, and I'm sure that I've been guilty of doing this as well. We can get really hung up on these, like, big goals, like, oh, I want this amount of income, or I want to get this, you know, program or course out there. And we can stop, we can fail to stop to notice that our lifestyle day to day is what we always wanted it to be. You know, I very often with my coaching clients, we’ll kind of, you know, try and ground in the present moment a bit and be like, hey, like, look at your job that you have created for yourself. Does this match the life that you want or not? And very often it does. Independent work really does have that ability to allow us to day to day live that lifestyle that we wanted to.

Yeah, in fact, not so long ago I was clearing out my office of piles of paper, and I came across a kind of vision board that I can't even remember ever doing. I think maybe I did it when I don't know, I was either reading some sort of self-help stuff or I had some coaching for a while. So maybe I did it then I can't remember. But I had achieved everything on that list, down to having a garden office in which I see my clients. So, yeah, it was amazing to see that actually.

Yeah, it's so important to reflect, not just on the massive, big things, but also on those little things that really make the difference. So, you know, what inspired you to write the book? Because I know you did it as part of the ACP's initiative. What made you think, yes, I want to share this personal experience that I've had and help others through it?

Well, I, when, when I was first diagnosed, I was lying awake one night with all of this going through my mind and having never really been a writer at all, I just felt I needed to write it just to, you know, get it out there. And so I sat at my desk here in the middle of the night, just writing about the sort of initial process of diagnosis. And I got to the end of it and I actually wrote, maybe this could be a book. So the idea came to me very early on, but I never thought it would actually come to fruition.

But the ACP partnered with Sequoia Books and were looking for ideas of books to publish. And initially, I thought, oh no, I can't, I can't say about my idea. No one else will think it's a good idea. I can't write a book. All of those thoughts showing up. And yeah, eventually I, I put my idea forward, they loved it. And then I suddenly thought, well, hang on a sec, I'm not the only clinical psychologist going through difficult stuff. And this could be a series of books in which clinical psychologists talk about their own lived experience and bring in obviously the professional training that we've got.

So again, I put that forward and, and both ACP and the publisher really liked it and so I was then faced with writing the book and also being the series editor.

Wow. But I'm just wondering, you know, do you think it's because you were at such a senior level in the NHS that your mind always goes to, how can I bring others with me on this journey? Because a lot of people might have thought, yeah, I'll just focus on writing my book, but your first thought was, oh, there'll be other people that should be writing books.

Maybe I'd never thought about it like that. Yeah, I mean, it just, I think it was because when it dawned on me actually what a unique position that is to have both the personal and the professional. But I just thought, yeah, you know, we will have so much to share with other people going, going through difficult things. So, I think maybe as I'm answering this question, maybe it was just about, you know, connecting with those values of you know, caring and wanting to help. And that because those are the values that I've held on to when the, when the writing has been difficult.

I was going to ask about that actually, because I've never managed to complete a whole book. Started a few, gotten to the middle point with a couple, but I've never gotten to that completion aspect. What were the challenges along the way? Because I'm sure it's, it wasn't easy.

Yeah, it was challenging and, and certainly when I'd sort of been given the go ahead, I remember having a conversation with my husband and sort of saying, oh, do I want to do this now, because it means reconnecting with this really difficult time? I felt I was sort of just through the other side and could focus on life outside of cancer now.

So yeah, it was a difficult decision to start writing it and then yeah, the process of writing was at times really, really emotional. Actually, I think it was quite cathartic and therapeutic for me as well, but it was difficult at times. I mainly sort of would sit down on a Sunday to write and yeah, it was, you know, faced with that choice of sitting and writing about some really difficult stuff or just having a nice Sunday afternoon doing something with the children, you know, it was difficult to make myself sit down. But yeah, having made the commitment and knowing there was a series coming along did help with that as well. But yeah, it was holding onto the fact of, you know, I feel like hopefully I've got something to say that other people going through this will find helpful. And so I just kept reconnecting with that value and making myself sit down and write and taking it in smaller chunks when I needed to. And I'm quite an organised person, so I kind of set my own sort of goals of how much I wanted to get done. I was aiming for doing writing a chapter per month, so that sort kept me on, kept that momentum going, I suppose. So, I didn't have to too many long breaks where I wasn't, wasn't in, in the habit of writing.

That sounds really helpful. I've heard a lot of writers talk about having a consistent writing cadence and having that accountability. So, somebody's expecting that chapter to be there at a certain time. So, was it mainly a Sunday afternoon activity for you or? How did you fit it into your week? Because you're pretty busy.

Yeah. So, I think I, you know, I was working a bit less then because obviously I'd recently finished treatment. So, I think I sometimes had Fridays that I could spend writing and then, yeah, Sundays. So yeah, I've actually had more time to get it done than a lot of other authors in the series. So that's been something that we've talked about a lot is, yeah, how to try and create and protect some space for the writing.

Hmm. And do you have any tips around that? Because that, I think that's been my problem, if I'm honest, it's that I've never been realistic about the amount of time it takes to finish a chapter. I always think, oh yeah, a couple of evenings, I'll get that done. And it, you know, of course you're just setting yourself up to fail. So how did you find, you know, goals that you could actually stick to?

Yeah. I mean, I think as you said, that kind of, having, having someone to whom you're accountable really helps if you know if it's difficult for you to hold yourself accountable, I suppose. Yeah, making, making the time and trying to be realistic about that. Thinking about where you write as well I think is, is useful. On the whole I've, I've tended to write at home and that's been fine, but I know other, other authors in the series have maybe taken themselves off to a cafe, so they're out of the distractions of home, and that's worked for them. Yeah, some of the authors use, use me to be accountable. So, for just for setting smaller deadlines, they've got, they've got a deadline with the, with the publisher, but they use me to, to, you know, set goals, smaller goals that will keep them more on track. Yeah, and, and keep coming back to why you want to write it. And I think envisaging the end points as well as something that we've, we've all done. And once we got, get into looking at cover designs and that kind of thing, that's always really exciting and it starts to feel like it could be a real book. And so I think, yeah, probably, you've got to the most difficult bit maybe of the middle bit, and then, you know, once you're three quarters through, the end is in sight and it's easier to keep going.

Yeah, I mean, I think something else that it's so interesting, actually, because I've just come off a coaching session talking with one of my coachees about their book, and something that I feel I had in common with them is sort of losing a bit of enthusiasm for the idea, and having to tease apart whether that is imposter syndrome, or you know, whatever you want to call it, your mind monkey or whatever, trying to protect you by making you kind of go off the idea, or whether it is because it's, it's not quite right anymore for your values or your interests. And I think that can be really tricky sometimes. But perhaps that happens more often when you've let it drag on too long anyway.

Yeah.

So yeah, I think I'm gonna, I'm gonna take your advice. And set myself some really clear goals with accountability partners to get my book done. Because I think I do still care about it. So, what was the most joyful part of the experience for you?

I mean, I think I found I actually liked the writing process. And, you know, although it was difficult, it was, it was, it feels good to have got it down there as a sort of, you know, as a timeline and a, as a document of what I went through. Completing it was obviously a joyful moment. Seeing, seeing the cover. So the cover, the artwork on the cover was done by a friend of mine who died of cancer. So yeah, so that had real meaning as well to, to see the, see the cover. And then probably the best bit was receiving it in, in actual physical form. That was a very exciting moment.

Oh, I bet. But I have heard a lot of authors say that when the book is complete, you feel really elated and you feel like all the hard work's done and then they kind of hit you with the promotion that you have to do. So how has that been? Like, how are you promoting the book?

Yeah, I think you're absolutely right there, I think it did feel like the end point with the book, but then you realise actually that's just the starting point because no one knows your book is there unless you're promoting it. So, yeah, it's a challenge actually, and, you know, especially around all the other things that I, I do in my work life. So yeah, I've been doing some, some podcasts trying to connect with people in like relevant charities, so there's several cancer charities, so that's been useful. I've done some things locally, like going to my local bookshop and library. But yeah, it is difficult and it's difficult because it's, you know, about self-promotion in a lot of ways, which feels so difficult for a lot of us. And it's also about exposing something very personal about myself, which has been a challenge for, for me and all the authors. It's the thing that we've talked about most through the process so far is about that dilemma of needing to share personal things and, you know, that's the essence of the book, but equally feeling comfortable with that when really we're trying not to share anything personal about ourselves.

Yeah, I mean, can you say a little bit more about how you've reconciled that? Is there a way that you think about it that helps?

Yeah. How I wrote and I think how some of the others are writing was, first of all, I just put it all down there on paper. And then I went back through and thought about, does that still feel comfortable for me to share? Am I happy for, you know, someone I know to read this? Am I happy for potential clients to read this? I mean, we, we did agree that my husband and children wouldn't read the book because we agreed that it would be too painful for them. But outside of that, you know, was I happy with family, other family members reading it. So that's, yeah, that's always been my, my guide really. And so, yeah, as I went through editing the book, several times, each time I was reading it with that mindset of, am I happy to share this? So yeah, there were maybe times when I took things out that might have been helpful for other people to read, but I wanted to make sure I, it was going out there in a, in a state that I was, I was happy for that to be shared.

I think that's so important. And thank you for talking a little bit about that process because I think people worry about this a lot in advance before there's any words on the page, but actually doing it the way that you did it, getting the words out first, knowing you're going to have several edits to go through, where you've always got permission to say, no, I don't want that anymore. I think that sounds much more helpful than editing it before it's even been written.

Yeah. Because that's just going to keep you paralysed really. The other way that sometimes we've done it is, is, you know, we've maybe written it in our first person to begin with, but then we've maybe adapted it and changed it into a third person story.

So, then the information, the helpful information is still getting out there without necessarily it being so personal.

Yes, yeah, there are lots of different ways I imagine that you can, you know, take what you want to share and find maybe multiple voices to contribute to it. So that it doesn't feel so much like it's just coming from your experience. No, that sounds really helpful. So, what is your biggest hope for the book and what it's going to achieve out there in the world?

Well, I suppose my reason for writing it was that I felt my emotional needs through my cancer journey were not frequently asked about, recognised, validated. You know, I had amazing treatment through the NHS. I absolutely cannot fault the medical treatment I received. But you know, I found it such a difficult process to go through. And so I really wanted, you know, anyone else going through that to be able to read somewhere that the emotions they might be experiencing are understandable, that, you know, it's, it's good to sit with them and not push them away, that you can still re-evaluate your values going through this process and you can still take some control in your life to be able to live in ways that align with those values, even while you've got this awful diagnosis and this awful treatment going on.

It sounds like that message will be so much more powerful because it is coming from somebody that's been through it. So, I think it sounds like that book's going to make an amazing contribution but I appreciate that it's probably stressful going and talking to lots of people like me to get the word out about it. So, you know, before we wrap up, is there any advice that you would give to another independent mental health professional about writing their first book?

I think it's really important to think about who your audience is going to be and why they're going to pick up your book. If you're really clear on that, who your audience is and what the value of the book is going to be, I think that will really help with, with writing. And then also just to, you know, notice those thoughts that show up that, that tell you I can't do this, I can't write, I can't, you know I mean, without fail, all of the authors in the series have had those thoughts show up. And there's some brilliant books in the pipeline. Absolutely brilliant books. So, yeah, keep, keep going get stuff down on paper. Edit it later. Worry about that later. Just start, keep going, and you will get there.

That's really helpful advice. I mean, thank you so much for being so honest. I think it really helps me and hopefully other people listening to hear impressive people like you talking about those kind of mind monkeys that make it difficult sometimes to keep going. I think if you're ever feeling like you shouldn't be doing something because you're struggling so much with anxiety around it, just remember that people like Sarah struggle too. Even though I'm sure when you look at her credentials, you're pretty impressed, as I am. So yes, thank you, Sarah. Where can we find out more about you and find your wonderful book, Coping with Breast Cancer?

Well, I'm assuming we can put some, some links to the Sequoia website with the link to the book. And yeah, I can put my socials on there as well. But yeah, you can Google The Swan Consultancy and find out most about me there.

Brilliant. And I'll put all of the links in the show notes so that you can do that nice and easily. Thank you so much for your time today, Sarah. I really appreciate it.

Thanks, Rosie. Really nice to chat.