Show Notes for The Aspiring Psychologist Podcast Episode: 21 with Dr Lucy Johnstone

Thank you for listening to the Aspiring Psychologist Podcast.

It was absolute pleasure to speak to Dr Lucy Johnstone within today’s episode of the podcast. She was ain inspiration and a great help to me as an aspiring psychologist. She does lots of work around formulation and helping psychologists understand the importance of it as a practice. Currently she is leading the charge to normalise formulation to be used in place of diagnoses which can be so harmful to many clients. I hope you will find the episode useful and thought provoking.

Links:

Links to Lucy’s books:

• Johnstone, L: Users and Abusers of Psychiatry: A Critical Look at Psychiatric Practice (Routledge Mental Health Classic Editions) Paperback – 23 Sept. 2021: https://amzn.to/3Ly6IJl
• Johnstone & Dallos: Formulation in Psychology and Psychotherapy: Making sense of people's problems: https://amzn.to/3y64Ovn
• Johnstone & Boyle: A Straight Talking Introduction To The Power Threat Meaning Framework: An Alternative To Psychiatric Diagnosis: https://www.pccs-books.co.uk/products/a-straight-talking-introduction-to-the-power-threat-meaning-framework-an-alternative-to-psychiatric-diagnosis and on amazon: https://amzn.to/3F66MgT
• A Straight-Talking Introduction To Psychiatric Diagnosis (Second Edition) https://www.pccs-books.co.uk/products/a-straight-talking-introduction-to-psychiatric-diagnosis-second-edition and on amazon: https://amzn.to/3s3qsws
• And link to the PTMF website:  https://www.bps.org.uk/power-threat-meaning-framework

Follow Lucy on Twitter: https://twitter.com/ClinpsychLucy

Connect socially with Marianne and check out ways to work with her including the upcoming aspiring psychologist collective book and membership via her LinkTree account:

https://linktr.ee/drmariannetrent

• To check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0

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If you enjoy the podcast, please do subscribe and rate and review episodes. If you'd like to learn how to record and submit your own audio testimonial to be included in future shows head to: https://www.goodthinkingpsychology.co.uk/podcast and click the blue request info button at the top of the page.

Hi, welcome along to the aspiring psychologist podcast. Thank you so much as ever for joining me. I am absolutely delighted that so many of you are finding this content useful. We very recently celebrated our 5,000 download, which means that 5,000 of the episodes have been listened to. And I am thrilled with that. Um, you know, we launched, um, Christmas Eve 21, and so it's been four months. So 5,000 downloads in four months for our really pretty niche market, um, is just wonderful. So thank you again, if you do like what we do with this podcast, then please do take a moment just to drop in to, um, at the podcast app on apple, uh, and, uh, rate it, uh, rate the podcast. Um, and you can do that by finding the podcast, the aspiring psychologist podcast in the podcast, apple app, um, scrolling to the bottom, um, and then right below the trailer, right to the bottom, um, you will find, um, just a where you can click on the stars to rate it.

That will take you like, you know, 10 seconds. If you've got a few more moments, I would be thrilled if you left us a review as well. Uh, because reviews and ratings help us demonstrate that other people might also find it useful. If you like to go one better. And you'd like to leave as an audio testimonial to be used within the podcast for either the podcast itself, the book, or the aspiring psychologist membership, I would be absolutely thrilled to, um, to have your voice, um, on the podcast and you can be anonymous or you can use your name to, with that in mind, we are still recruiting, um, people to write for the aspiring psychologist collective. Um, and if you would like to write with your actual name, that's okay. If you'd like us to give you a pseudonym that is also okay. You can find details of all of this stuff by heading it to, um, my link tree account, which is probably most easily found by clicking on the show notes.

But if you do follow me on any of my social media, um, then you can also click, uh, the link in my bio is also my link tree. Um, so yeah, find me that way, but do come and connect. I love to help you celebrate on social media when you have significant milestones in your career, um, like new jobs, you know, um, graduating, um, and just doing nice stuff in your life. So come and connect, come and follow me, um, interact with my content and let's get to know each other better, cuz that helps me know what you want me to create for you in this podcast too. Um, I am very excited to bring to you today. A, um, doctor, Lucy Johnston. She is someone that when I was an aspiring psychologist, I really looked up to and, um, was inspired by her work.

Um, and so I honestly couldn't believe it when I reached out to her to invite her along, um, to speak to us on the podcast asked and she was so happy to take part. So I hope you'll find this useful. Her work is incredibly valid, incredibly important, um, to you as aspiring psychologists and even qualified psychologists who, so I hope you'll find this a really inspiring, really thought provoking episode and as ever, um, would love any feedback or thoughts that you've got on it, um, enjoy, and I will catch you on the other side. So we are welcoming along Dr. Lucy Johnston to us, um, with the podcast today. Welcome along Lucy.

Thank you. Thank you for asking me.

Oh, thank you for saying yes. like your work, um, has been so important to me as an aspiring psychologist, a trainee psychologist and a qualified psychologist as well.

Good. I'm glad to hear that.

could you tell us a little bit about you and, and your work?

Um, well, I've been a psychologist, a clinical psychologist for a very long time. um, I've always worked in adult mental health settings and I've worked partly in clinical settings, but I've partly worked, um, uh, in training and in, uh, for a while I worked at, uh, one of the local universities in Bristol. So it's been quite a mixed career. Um, I actually gave up clinical work at the end of 2000 thousand and 16, and I'm currently describing myself as self-employed I do writing and training. So this is a new and unexpected part of my career, in fact, and the same themes have followed me throughout my work really, which is thinking about alternatives to the diagnostic model of distress and, um, everything I've written or done has been a, a variation of that theme.

Brilliant. Um, and yeah, you first crossed my path when I was, um, yeah, trying to get, um, interviews onto clinical training and uh, talking about formulation. Could you tell us a little bit about your, um, yours and Rudy's book on formulation, how that came to be?

Okay. So as we know, formulation is a core skill of clinical psychologists. Um, and I have always used it. I was trained to use formulation as all psychologists are. I hadn't think I probably hadn't thought a huge amount about the subject hill. I, um, took off a post on a clinical psychology doctorate myself, and then I was in a position of training, other people in using formulation. And it seemed to me that there was a big gap in the market. There's there were a few books out there and a few articles, but actually considering this is meant to be our core professional skill. That wasn't a, a lot of, of really in depth, thoughtful looking at what formula nation is, what it isn't, what its uses are, what its drawbacks are, what the conformities are, what the different perspectives of formulation might look like depending on which model you start with. So, uh, Rudy was working on the Plymouth course, which it, um, which, um, was close to the Bristol one. And we put on the workshop, lots of people came along. It seemed to be a subject. People are interested in and out of that arose the book, um, which is now in its second edition. The first edition came out in 2000. The second edition came out in 2014.

Well, I'm so thankful that you did. And for me you were really one of the, you know, the trailblazers for clinical psychologists, creating books as well. Certainly one of the first I was aware of. And so, you know, you showed me that, that we could, and, you know, we've got something useful to say that we should. So, um, an extra thank you to that, uh, to you on that one as well. But, um, you know, it's what I really like about the book and why our audience will, or find it particularly useful is that you, you introduce, um, you know, vignettes don't, you have, um, case studies and then you formulate them from a variety of different perspectives throughout the book. So you, you, it just it's just really well done.

Well, thank you. It was quite a lot of work and there are a number of contributors. And as you say, the common thread of the book is we take two case histories, which are based on real people. One is an adult man, and the other is a child and her family and the various chapters look at how we might formulate their difficulties from different perspectives, uh, the standard ones, C B T psychodynamic and so on. But, um, also perhaps less common approaches like narrative therapy and social and social equality approaches. And so on. Um, at the end, there's a chapter about controls and debates, which I hope kind of ties the whole book up and leaves us thinking, well, you know, we should have a critical perspective on anything. Everything that's always been what I believe. So of course I'm broadly in favor of formulation, done a lot of training it, um, as well as practicing, but I don't think we should doing anything without thinking very carefully about what we're doing, why we're doing it, how it could be helpful, but also ha perhaps sometimes it can be unhelpful because you know, there's no simple, perfect answer to anyone's difficulties.

Yeah, absolutely. And you know, when, when we share formulations with people and when we share, um, diagnoses with people, we, we are absolutely thinking about it as being a way of understanding their difficulties, but not necessarily defining them and to know them as a person.

Yes. Although, um, as I've suggested, in some cases I would hope we wouldn't be sharing diagnoses so, uh, and as I, another theme of the book is really that psychologists are something much better to offer than the vast majority of psychiatric diagnoses. I mean, obviously depending on which getting you work there, a valid diagnosis, if you're working, you know, in learning difficulties or in health settings, diagnoses may be may appropriate and helpful, they are virtually never. So in adult mental health settings. And so, um, I very much want to promote formulation as something we can do instead. And something that off was, uh, what diagnosis claims for fails to offers, which is an evidence based hypothesis and a way forward that can lead people outta services. We hope rather than as much to often happens, trap them within services possibly for many decades. Mm-hmm

my work is, um, in adult mental health as well. And so much of the work I do around developmental trauma is people, you know, really finding it very difficult and very uncomfortable and very painful to have gone through, you know, complex trauma and then find themselves with diagnosis, which feel like an added insult to, to their injuries. Um, you know, if they end up with a, a personality disorder, I, so, you know, they Google that and they feel like this doesn't describe me at all. And it, yeah, I think it's a useful conversation to have,

I think it's an essential conversation to have. And, you know, I absolutely think a psychologist, we should routinely be having these conversations with people who will often come up along to a sort of pre pre-labeled. If you like, they told they have a diagnosis of some sort, I, a common diagnosis, as you say, particularly for women who may very frequent down a history of trauma is a so-called personality disorder of some sort. Now I've always believed that people have the right to make up their own minds about best, describe their difficulties. But I very strongly believe that that should be a kind of informed choice and we should be letting people know these are controversial labels. They're not scientifically valid. They, you know, even the people who drop the diagnostic manuals are saying this, these systems of categorization are neither safe and nor scientifically sound, that's a quote from the chair of the DS for committee.

You know, it's, it's not professional acceptable for us not to inform people of that. And of course they may need their diagnosis for some purposes. They may actually feel it describes 'em quite well, but very frequently people don't feel that. And we can then obviously offer them a formulation based understanding instead, but also as you suggest a trauma informed understanding. So more recently, you know, I've become very interested in trauma informed approaches. And, uh, I think all formulations need to be trauma informed, which of course doesn't mean that every person we meet has experienced what we might classically describe as a trauma, but it means we need to be very, very aware of the fact that that may well be the case. And we need to incorporate that in our formulating,

Certainly, but I dunno what your experiences are, Lucy, but working in adult mental health people often tell me, I dunno, well, I feel like this, you know, I feel like I've had a good enough childhood and you know, I don't know, it's probably just me. And then you actually go through, you know, key, you know, the ACE scale, for example, or thinking about developmental experiences and you realize, and you help them appreciate that actually their needs and their difficulties can be understood with their diagnosis or a framework of, um, of complex trauma. And that can be incredibly, you know, validating and empowering for them, but also, you know, takes away a lot that guilt and that shame and that responsibility that they've been carrying for being the problem in it, being their fault.

Indeed. I mean the trouble with a diagnostic, it label, it sort of locates the problem within the person, doesn't it. And a lot of psychological explanations do as well, to be honest, I mean, I'm not just opposed to unscientific diagnostic categories, but also to narrowly individualizing psychological ways of categorizing people, essentially. So as you say, a lot of the people will say, and this may well be true. I had a comfortable home and I had loving parents, but things that can be experienced as traumatic can be a lot more subtle than that. Of course, there can be more subtle forms of invalidation and emotional neglect, neglect, which we don't always identify as such. And also we live in a difficult world don't we, you know, I thought there are many, many good reasons for, for really struggling, however fortunate we are in our families and our, and our lives and young people, I think particularly are facing horrendously difficult challenges nowadays. Um, very glad I'm no longer young because I think it's a difficult world, a very difficult world for young people to,

Yeah, I agree. Social media certainly adds new layers of, um, of difficulties. Um, and I found being a teenager, difficult enough

As it was, is bad enough anyway. Yes. Think how much worse it is. If you are also being bullied on social media, you know, and being told you want to look like this, have these kind of friendships live, this kind of lifestyle, all those kind of things. And, you know, mental health, social media is not always helpful either. There's a, I think a rather regrettable tendency for people nowadays to be self-diagnosing, not even waiting to see a professional to Google or look at a TikTok video that tells them they have something called ADHD or autism spectrum disorder or whatever, and to kind of find a sense of identity through that, which I can see the attraction of, but actually, I don't think that's necessarily in the long term helpful. And, you know, we seem to be rapidly reaching the point where we're all all going to be qualifying for a diagnosis of some sort.

So that's one of the themes of, um, the second edition of my book, a straight talking introduction to psychiatric diagnosis, which came out just last week. Uh, first edition was 2014. And one of the trends that's, um, increased very significantly since 2014 is the whole social media stuff, both I think in terms of making all of us feel somehow less adequate and less so care about ourselves and in the form of offering kind of ways out in the terms of labeling ourselves, which I think, you know, is a trend that we need to think about very carefully because I think it may well have more disadvantages than advantages.

Yeah, absolutely. Congratulations on your newest book baby, um, for, for this year, very recent this week. Um, and I think, yeah, absolutely. We need to be careful about the diagnosing ourselves and, and looking at labels. But I think for the general public, it's also really important to think about who is labeling themselves as something they may not be. Um, so I often see people who might have done a psychology degree, um, or, you know, counseling to calling self a psychologist, um, publicly. And that can be really damaging and D and part of my most recent media work is to try to encourage people to know what, what you might look for in a qualified therapist, a qualified psychologist.

Well, there are plenty of bad psychologists and bad therapists out there. I'm afraid

Yeah. Yeah. I hear you. Um, I have been asked a couple of, from our aspiring psychologist audience for our formulation expert, is there, um, a go to formulation, stance or approach that you'd recommend for people to kind of keep in their back pocket to pull out, um, a interview or, you know, any moment of pressure where they're asked for formulation,

Oh, it's interview season at the moment, doesn't it. So there's gonna be lots of people anxiously spotting up. What is a formulation? I mean, you know, if you wanna be a bit strategic about it, most courses are going to be looking for some kind of awareness or competence in C, B T, and I think C has strengths. And I think it has has some limitations, but I guess it probably be important in that situation to show know awareness of the various versions of C B T formulation, but as people get trained and as they develop their own personal style, I think it's really important that we move beyond any particular model held onto to closely if you like. So the, um, book that we've just talked about, formulation in psychology and psychotherapy has a whole chapter on integr integrative approaches. And I personally think with almost inevitably going to be missing something, unless our approach is to some extent integrative.

So what, what the particular or ingredients of your own integrative approach will be up to you. But as I've already said, I think a trauma informed perspective should be one of them. And I, I mean, I see myself as coming fundamentally from a psychodynamic perspective, I guess, but other people might, you know, have their own preferences. And in fact, in 2011, um, was, uh, the leader author and the small group of people who dropped the division of clinical psychology, good practice guidelines on the use of psychological formulation. So a while ago now I think they're still very relevant. And one of the things we said in those guidelines was that psychologists really need to be starting from was broader basis. They can, in terms of their formulations, even if any particular situation, they choose a narrower, almost more specific formulation or model. And, and, and I still think that's very true. Let's think as widely as possible, then we'll be in a better position to think about, you know, which of our tools or approaches or perspective is going to be more helpful for the, this particular person.

Thank you. That's so interesting. And I really, really are speaking to the expert in this. I'm really honored to have you here. I tend to start any assessment or formulation that I do with a family tree and trying to get an understanding of people's relationships. Who's alive. Who's not alive, you know, the context of relationships. It can be really, really powerful and really enlightening. And it's something I first learned in, in a cam service, but I still do it now, you know, years and years and years later, it can be really enlightening.

I think that's a very good place to start. You know, there are a number of good places to start. And the way, the reason that sounds useful to me is cuz it's immediately starting from the context, isn't it. It's going to be, you're going be less likely to come up with something that's perhaps more individualizing in an unhelpful way.

Yeah. And the question why now is also quite

Why now indeed, what started it? The, the trigger in the jargon terms triggers and it always significant because they nearly always stand for something much broader or much more complex about a person and their struggles. So why now, what understandings do you have? What diagnostic understandings may have come across? Shall we talk about that? what are your goals? But I mean, centrally formulation is about meaning it's about co-constructing meaning. So in the we've used this very much a thread in the DCP guidelines and formulation the idea that essentially what a formulation is, is about co-constructing meaning and meaning is the thread that integrates whatever other aspects of the formulation you're going to be discussing, which is why we have some reservations in the guidelines about some of the more popular types of formulation at the five P I'm not a big fan of the five P myself, because the trouble is, it can just end up the list of factors.

This happened, this happened, this happened. And I think that's the stage before a formulation. I think an actual formulation is when you show how all these things hang together and the thread on which they hang together is the meaning that you've made of them. And so one of my favorite definitions of formulation is, um, an ongoing process of collaborative meaning making which in a way describes therapy as a whole, but it also describes a particular part of therapy, which you might at some point choose to summarize or write down or share, which is what we call the formulation.

Yeah. I think of your, um, longitudinal formulation, which I think takes up a whole page in your book as being really gold standard. And I, I can't tell the hours I spent studying that and trying to replicate that and bolt that on for my clients. Um, during my own, um, studies, it's just honestly really useful. Um, and your triangles

Don't think that was mine personally. That was some that was another author.

It's really useful. And your try your triangles as well. You know, they saved me, uh A lot time.

Yeah, yeah. Triangles are good. but I mean, there are lots of ways of doing it. And one of the other things I like to say is that I don't think we want to make this into too scary sounding a skill because actually we're all human beings. This is something we do automatically. We make meaning, you know, we try to make sense of our lives. It's a particular in a way of doing things, but I wouldn't want to think, or to be giving message that only psychologists can do this. Lots of professionals can do this. And indeed formulation is finding its going to the core competencies of the number of different professions and human beings do it, you know, our mums or our friends or, you know, authors novelly may also be in a broader sense, very skilled formulators. So it's a particular take, which has particular uses in service, I think on a general, you know, human skill.

Absolutely. And I think maybe the word scares people off. I think one of the

Yeah, it does scare people off. Yeah. Like here's something terribly fancy that I've got to be very good at, but

One of the most mortifying things that could happen to me, um, as an aspiring psychologist was when we were in ward round and the psychiatrist would turn to me and say, well, what's your formulation on this? And then they'd just be like tumbleweed moment. But you know, if they'd been able to say, what's your understanding of why this is happening now and why?

Well, that's all it means really. Yeah. And you know, one of the things that I always say is that formulation, isn't a thing that you have to produce or perfectly worked out at any given moment in a war round or in your notes or whatever. It's an it's, it's a process really we've discussed this and the guidelines, the distinction between formulation as an event, which is how you probably encounter on a course, you write it down, you submit it, it comes back with scribbles all over it. You resubmitted or perhaps you don't, perhaps it was very good first time round and formulation as a process because really that event is only a snapshot of an ongoing discussion process. Really. And meetings are always evolving. And when I was in training, I would be encouraging the trainees to be formulating in a sense, before you even meet the person, you will have some kind of information from the notes or referral. And obviously you have to hold that tentatively. It might be wrong and it quite often it's way off them, but nevertheless, it's a starting point and your understandings and their understandings, you know, evolve and continue and are always open to kind of reflection and change.

Mm definitely. That's certainly something that I learned to do. Um, during my fifth placement actually was to come ready, prepared to my first supervision session, um, with my on, you know, almost on day one, having read the files and come up with my own sort of idea of formulations, which, um, at the time felt a bit horrifying, but actually is, um, you know, real useful way for us. Yeah, yeah. Using that reading time, um, in a constructive way.

Mm yeah. And your first formulation is going to be very tentative and it might be a sentence, you know, it sounds like some difficult things happened earlier on in your life and recent events have brought some of those to the surface. I mean, that's, that's a useful, nearly all purpose formulation in mental health for when someone first presents or I, some funds say in training, you know, trauma in the context of attachment difficulties will cover vast numbers of mental health clients. Not, not all of them, but as a kind of, I wonder if this is a place to start formulation that's, that's not a bad place to start.

Absolutely. How I'm interested. How are you finding having stepped away from, um, more clinical work recently? How are you adjusting to that?

Well, it's, it's kind of D I miss clinical work. I do miss clinical work, but the reason I stepped away is to do something rather different, which was to, um, well, first of all, to finish the power threat meaning framework, which is this very, very ambitious project to outline a conceptual alternative, the diagnostic model of distress, uh, I'm the one of the lead authors along with professor Mary Boyle, who's another psychologist. And we it's, co-produced by group of psychologists and service users, survivors, all of whom have known each other for many years funded by the division of clinical psychology. And we were, uh, embarked on this Ludi ambitious task to, to think about not just how can we use formulation instead of diagnosis, let's say, or how can we use strong inform practices at a medical model practice, but what would complete conceptual alternative the diagnostic model look like?

What would it look like to make a, the giant leap away from medical model understandings towards well, towards what that was the task we set our self, what would a very different way of identifying patterns of distress look like? So we, five years later, we emerged with this massive document. I think you're going to supply the links in the chat to the website. And the reason I gave out clinical work was because I and Mary both in the end had to spend virtually two years sitting in front of our computers and actually making sure this down was reached a stage where it's ready to be published. And since then, it's quite unexpected to become my job. So I do a lot of training and writing and traveling and talking and, uh, podcasts and all sorts of things in relation to the path meaning framework. So, you know, I've missed and cowork and I found something to replace it, which is kind of related and equally important actually. And in some ways it summarizes all the thinking I've done throughout my career. And the same is true. I think of the other people who are involved in the project,

It sounds like fascinating stuff. And absolutely when this goes live, we'll pop any links in the show notes so that people can access this really young, really useful. And there's seminal seminal stuff. You know, it's, it's an exciting time, um, to be, to be putting that out there. Um, is there any other advice that you would offer for aspiring psychologists?

Um, well, first of all, I mean, you know, clinical psychology, isn't the be all and end all, you know, it's, it's hard to get on a course if you don't, there are other options you could end up working in a very similar way from some different career path. You know, I think it's a great career path, but I think people become very fixated on this is what I must do. They, and one of the paradoxical effects of that is when you get onto a course and find it's not perfect, it can feel quite frustrating and disappointing, you know, so realistic expectations. There are other options. I think, I think the other thing I would say is, I mean, critical thinking is so important, which is, again, something I've always believed. So you will have to read and believe and study and say certain things in order to get onto of a course in order to do your psychology degree in the first place.

A, a lot of it in my view is completely wrong. possibly most of it. I have fundamental disagreements with a lot of the core tenets of clinical psychology practice. So really, really, really don't necessarily what you are told. Think about it, explore alternatives, you know, develop your own star, your own beliefs, question, everything you've been told. It's all up for grabs. Really. We are at quite an exciting time. I think in what we call mental health. It's not a term I like actually, but the experiences we call mental health and how we understand them, we are at point of very rapidly shifting understandings, which is great, but that means really being able to challenge ourselves and things that we've always thought and believe without question. So questionnaire, everything is uncomfortable, but I think in the, in the end it gets you to a better and one interesting place.

Yeah. And it certainly can, um, facilitate more strategic conversations, can't it? Which is yeah. You know, we, we are good at rattling cages, um, in the psychology profession.

Well, some of us are, some of us are some of us a bit too happy not to rattle cages in my view.

I think what I see as, as people are progressing through their roots, um, towards becoming, um, you know, trainee psychologist or whatever, whatever type of psychology they want to become is something alluding to what you've said there is that they become more, yeah, more confident in their own way of seeing the world and, uh, less, you know, less affected or less asking or, you know, less striving for input from others. And they just feel ready to hold their head up interview and say, well, this is how I see the world. This is how I understand it using this, that approaches, but this is my take on it. And I think that's really powerful.

Yeah. Yeah. It, it, it is. It is. And the framework, I hope gives people quite a lot of leeway to think about how they might want to understand their work, you know, the assumptions behind their work, the difficulties people come present with because it's a set of ideas. It's really not a sort of how to manual it's about as far as you, the way you can possibly get from, let's say a stereotypical, you know, IAPT based really rigid manualized approach, which I have to say, I'm not in favor of, right. The other end of that spectrum is something like the framework. And the message really is look at these ideas and think about how they might make used to you and how they might be useful to you. And one of the things we've done in the framework is to try and move beyond formulation as such.

So, uh, formulation, I think, as I said, is an extraordinary, useful tool within services. We've deliberately used the term narrative in the power threat meaning framework because it is broadly speaking, a narrative based approach. The simple answer to what do we do instead of diagnosis in framework terms is we use narrative based understandings. But if we broaden narrative to include art, music, poetry, dance, you know, community rituals, legends, understandings, then we can include a whole range of ways of understanding a healing distress, which historically have always been around which cross culture still are around and validate all of those as well with a out needing to, to package and package it in, you know, actually very westernized, narrow, westernized way as psychology or psychotherapy or psychiatry. So that allows us, I think, to accommodate and learn from, and work much more comfortably alongside non westernized understandings of distress without feeling the need to colonize them with our own psychiatric categories or psychological categories, you know, in both cases, those may be inappropriate.

Yeah. So when I presented the framework recently actually to a group of, uh, third year clinical psychologists and, uh, trainees, one of them said to me, so how would I, you know, use the framework and this setting that I'm hoping to work in? So I said, well, you can use it, how you like, we don't have the answer, try it out, let us know, you know, write it up. If it seems to work, this will contribute further to the framework. So this trainee said, that's extra. You mean I'm allowed to do high. Like I don't have to come up with, you know, some massively detailed according to the manual version, that's so refreshing. And I found that comment a little bit depressing actually, because really, you know, to be steered into, you know, expert driven, narrow manualized ways of thinking at quite an early stage of your career and being told you have to do it this way is not a helpful starting point. I think,

I think there's definitely some overlap there with, um, you know, what we're doing to our aspiring psychologists on the way up, especially in services where there's high demand and lots and lots of client hours in an IOP service, for example, you know, our, our aspiring psychologists are burning out. They're feeling disillusioned. They're not being well supported. And that's a, I know it's a separate conversation, but it's really important.

Well, it's kind of, it's kind of related because that comes out of particular. I would say ideological strand of clinical psychology, doesn't it that these very narrow versions of C B T you know, which is not CBD practice as a whole are somehow more evidence based, whatever that means. And we've deconstructed that term in the framework. What counts as evidence who decides, who benefits from it, whose voices are excluded and Simon by and so on, and actually IOP is not producing good outcomes. Well, I don't think that's a, and I think it can be, as you say, quite a damaging experience for those who are persuaded, they need to, they have to offer a kind of assembly line version of this intervention for this narrowly defined problem.

Yeah. People are saying to me, and I I'm sort of here now, but I don't even know if I want to do this now. Yeah.

You know what, that's, that's a shame. I mean, and that's worrying and it's part of a bigger, and also very worrying trend where, you know, I think it's about individualizing distress, to be honest, people who turn up at IOP services have very good reasons to distress, which are very often have much broader roots than their negative thinking, whatever it is you're supposed to target. That's you know, so actually we are missing the main point often.

Absolutely. Have you got any advice that you wish you'd been told or that you'd give to your younger self Lucy?

Um, don't work so hard. , it's too late for that. I'm a bit of a workaholic and, uh, and this is a more personal thing, you know, I, I, I wish I'd gone half time when my kids were young and so on life was quite stressful, but I mean, otherwise I've always been very pleased. I've had the career I've had, I, I think it's suited me really well. And you know, of course there are things I, which I'd learned sooner or done differently, but I mean, that's, that's part of the process, isn't it?

I think at any point of our lives, and especially when we're working with clients as well, doing a bit of a joy audit can be really useful looking at where we're getting joyful or enjoyable experiences. And that's certainly something that I hold onto. Um, it's really important, you know, if we're, if we are all working no play, then it's not, , it doesn't feel much fun.

Indeed, indeed. And you know, I've had an awful lot of fun and joy through my work, but actually I've probably time Scott that had a balance with the rest of my life.

Is there anything that you wish I'd asked you that we haven't?

I think we've covered most things, to be honest, and I think we've covered most things. And as you say, there are, you'll put some links for anyone who wants to follow up any of these thoughts or ideas.

I certainly will. Where can people get hold of copies of your books, Lucy?

Um, I've sent you some links. So, I mean, they're available on the usual places. The rather unethical places that we are tend to go to, cuz they're just easy and cheap and quick, but, um, piece several, uh, my two most recent books, the one on the path, meaning framework with Mary Boyle and the second edition of the book on diagnosis are, are available through PCCs books, actually more cheaply than on Amazon.

Very good advice. I'll make sure that I pop the links to that in, um, in the show notes, but honestly, Maryanne who was in her mid, um, early to mid twenties, um, meeting you today at 40. I just, you know, for incredibly lucky and to have held your book in my hands and it's shaped my career and now go on to shape other people's careers. You know, thank you from me to you for all the other aspiring and qualified psychologists across the land and the world. Um, you know, what you, what you have done really matters. And it's really helped us shape things with, with our clients as well. People you'll never meet, but your work has touched them and benefited them.

Well, that's lovely to hear. Thank you. Sorry. It's taken 15 years for us to meet, but thank you. And good luck to everyone watching.

I should have asked sooner!

Maybe you should.

Uh, but thank you very much and you, everything I hoped you would be, and yeah, I will, um, you know, look connecting with you in future and I will definitely get a hold of a copy of your book. Thank you, Lucy.

Thank you so much for listening and thank you to our guest, Dr. Lucy Johnston for so, um, generously giving us her time to think about these very important issues. Um, I hope that you will find it thought provoking and it will resonate with you. As I record this, there are spaces available on the aspiring psychologist membership. If you'd like any information on how to join the membership and how to be part of my world, then please do checkout. Um, my Dr. Mary Ann Trent, which you can grab in the show notes, um, or via any of my socials, depending on when you are listening to this, we have the final compassionate Q and a, um, to support people during this, um, tricky application and interview season.

Um, so it is scheduled to take place on Monday, the 9th of May, um, at 7:30 PM UK time. And that will be happening across all of my socials, um, streaming, um, simultaneously. So, um, if you have an interview or, you know, some one that does then do direct them, um, that way you can also watch on replay and you can also, um, watch all of the previous, um, Q and A's that I have done by heading to my, um, link tree. There's a playlist there. Um, or ultimately you can go straight to the good, the psychological services, YouTube page, and check out the, um, the playlist there, which is for Q and as for aspiring psychologists. Right? I think that is all of our bits and pieces covered for today. If you would like to leave any sort of audio testimonial for the podcast or of the other content that I'm involved in, I would be thrilled, um, to include it within the podcast episodes. Thank you for being part of my world, stay kind to yourselves and I will catch you very soon. Take care.