Self care for caregivers with Dr Jenny Turner

Welcome to the Business of Psychology podcast. This week I am delighted to be bringing you an interview with Dr Jenny Turner. She is a clinical psychologist like me, and somebody I have the pleasure of knowing personally. Jenny's here today to talk to us about self-care and how to really nurture and look after ourselves as we do the difficult work often of being a mental health professional. This is something that Jenny is really passionate about, so she's a brilliant person to turn to if you find yourself feeling a bit buffeted by the storms that can come along with independent work as a psychologist or therapist, so I hope you're going to find this episode really supportive and restorative.

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

Links:

brenebrown.com

Links for Jenny:

Instagram: @drjennypsychologist

Sunstack: mindbodysoulpsychology.substack.com

Website: www.mindbodysoulpsychology.co.uk

Links for Rosie:

Substack: substack.com/@drrosie

Rosie on Instagram:

@rosiegilderthorp

@thepregnancypsychologist

The highlights

• Jenny talks about what she does in her independent practice 01:30
• I ask Jenny how her career wound up here 09:44
• Jenny talks about how she was blindsided by changes around pregnancy, motherhood and perimenopause 14:44
• Jenny tells us about the Brene Brown shame resilience training she did 25:56
• I ask Jenny why she thinks therapists and psychologists are reluctant to come forward for help? 34:08
• Jenny talks about what she thinks good support for therapists looks like and how people can work with her to improve their self-care 45:34
• Jenny tells us how we can find her 53:00

SPEAKERS

Rosie Gilderthorp, Jenny Turner

Hello and welcome to the Business of Psychology podcast. This week I am delighted to be bringing you an interview with Dr Jenny Turner. She is a clinical psychologist like me, and somebody I have the pleasure of knowing personally. Jenny's here today to talk to us about self-care and how to really nurture and look after ourselves as we do the difficult work often of being a mental health professional. This is something that Jenny is really passionate about, so she's a brilliant person to turn to if you find yourself feeling a bit buffeted by the storms that can come along with independent work as a psychologist or therapist, so I hope you're going to find this episode really supportive and restorative. I know that that's how I experienced the conversation. Just to pick up before we get started, Jenny does mention that she is certified in the Brene Brown program for Wholehearted Living, and this isn't something I'd actually heard of before, so I ask her a few questions about this and I imagine a few of you might find it really interesting, so I have provided some links to that and also some links in the show notes to how you can work with Jenny if you want to, because I feel like she's a brilliant person to have in your corner. Okay, so onto the interview.

Welcome to the podcast, Jenny. It is so lovely to have you here today. So would you start us off by just talking a bit about what you do in your independent practice?

Yeah, sure. I'm so happy to be here today. So I am a clinical psychologist and I am based entirely in private practice now, have been for about five years. I left the NHS in 2019. So in my private practice, at the moment, I predominantly work with people who are in a caring role. So that would be predominantly mothers, I must say, that is my primary client group. I also work with fathers. I also work with people who have other caring roles. So for example, other therapists, psychologists, anyone really who sort of identifies that taking care of other people is a big part of what they do with their time. And a big part of how I work is that I am very integrative, and I'm very relational based, so the work is absolutely about my relationship with my clients and exploring how that plays out and what meaning there might be there for a client. What, well, what each of us really might be bringing into the room that might contribute to our relationship. That's a big part of how I work, is that I am very much a believer in common humanity, in that whether we are a carer or whether we are receiving care, and in fact we are both, we are all both of those things all the time. We are all human actually, and we all struggle. We all find things hard. We all have big emotions. We all have nervous systems that respond to the world in the way that they do. And so all of that comes into my work with clients. So I hope to provide a really normalising experience. So a lot of people come in thinking I shouldn't feel this way. I'm particularly passionate, actually about supporting carers with the big feelings that society tells us we shouldn't have. Things like anger, rage, resentment, envy, grief, boredom, sadness, you know, all the things that society tells us if we're a good mum or a good psychologist, we should just feel endlessly giving and full of joy with that process. So I'm really passionate about providing a space for those inevitable other feelings that come up that are really often silenced.

I really love that and I love your kind of redrawing of the lines. I think often we're told, oh, we're a perinatal psychologist, or, you know, that we specialise in working with professional groups and that can feel really restrictive. And I think just hearing you talk about it there, it really makes sense to me to think more about the struggles that we're helping people with. And, you know, carers, that nice broad definition, I think have so much in common, that actually means that if we're separating them off into micro groups as we do when we talk about perinatal versus professional support, then we're not allowing our expertise to really flourish in the way that it could. Because you know, I've noticed so many parallels between the work I did in learning disability services and the work I do with parents and carers. So much. You know, often what a staff team needed was really similar in terms of validation and normalisation, as what, you know, mums and dads need from me now. So I think that's really sort of opened up a new way of talking and thinking about these things, which is really helpful.

Absolutely, and, and I'm so aware as well, I think because I reflect on myself so much that I could go and see a therapist or a psychologist for my struggles as a mum, or I could go and see a therapist or a psychologist for my struggles as a therapist or a psychologist. But actually I'm both. And not only is there overlap between the groups, in terms of the work that can be done, there's overlap within each person. You know, most of us in clinical psychology are women, and a huge proportion of us are also mothers, and so we are carers in so many different ways across so many different settings. And that feels really important to hang on to as well for the work. And certainly in relation to thinking about the limits of care that we can offer, you know, the boundaries we need where our nervous system says that's enough. You know, we need time. We need to receive care now. That feels really important to me, that sort of every time I've been asked to work with a niche in my career, it's lost meaning very quickly because so many people, and no one person is ever just the niche they're referred for. A person is a person and a person is in a family, and a person is in a societal system. And all of those things are impacting on everyone all the time and it's always made sense to me as a clinician to broaden that, zoom out and see what is the whole picture here? Like what, you know, yes, you might sit in this box in this category, but actually what's the bigger expanse of context that you're actually in. So yeah, that's how I tend to work is trying to think of all of that all the time.

I love that and I think it can be really difficult in independent practice to communicate that. I think you do a really good job of communicating it, but often people come to me and are struggling to define their specialism, and I'm often trying to move people away from those terms that we were given usually through the NHS or other public sector work, which are really trying to reduce people down to boxes. And I get, I try to help people think much more about what problems are you helping people to solve. Because I think we need focus, but we can't be sort of cutting people up and putting them into categories that don't fit them.

Yeah, I agree. And I think it's actually part of the problem or part of why people come into therapy, I think, is because they feel so compartmentalised and yet that doesn't fit with what their soul knows inside of themselves. That I am not this box and so I've always struggled with this sort of instinctively, you know, even before sort of reading up on it and doing training in the NHS, just as a newly qualified, just thinking, but yeah, this box is helpful, I get that. I get it's helpful to bring people in the door, but actually we need to scrap it almost immediately because it's limited in its usefulness, because people are so complex. Yeah, and that's what therapy, I think good therapy does that. It helps people embrace their complexity. It helps people integrate all these different aspects of themselves so they're not trying to just show up as the mum. They can actually show up as the mum who's also running a business, who also cares for clients, who also is caring for parents, who also is, you know, doing the school runs. You know, that's how we, you know, I always think of, I think I heard it from Gabor Maté, the idea that the word health, has sort of Latin roots in meaning wholeness, sort of integratedness, and I just think that's so important. And when our services that we offer require people to break off parts of themselves to fit in a box, it's almost counterintuitive to what we're aiming to do in good therapy I think.

Yeah, I couldn't agree more. And I often think the most damaging question that I hear in my practice is, do I have postnatal depression? I mean, how often do you hear that and how often do you say it doesn't really matter? That's just a word and it doesn't define you and your experience, and it's the same with hyperemesis gravidarum, and I know I've talked about a lot on here and on my substack. These things tend to limit people and stop them believing that they deserve help.

I agree.

Perhaps if we drop them, more people might come forward. But we're gonna talk a lot about the things that stop people coming forward, I think today. But just tell me briefly a little bit about how your career wound up here.

Okay. So yes. So I, well, how far back to go? Before I did clinical training, I was a research assistant for at, UCL in London for an institute called the National Collaborating Center for Mental Health, and we pulled together the NICE guidelines for mental health. So I came from a really research based background and guideline development for very categorical mental health disorders. And then I got onto clinical training at Salomon's in Kent, which I absolutely loved. I felt like I'd just weirdly come home to a place I'd never been before. Really enjoyed the integrative nature of the training at Salomon's and really enjoyed the systemic and psychodynamic elements of the training there particularly. And through all my placement experience, I got feedback that I was really good in CAMHS, you know, I dunno if you had this experience, but as a trainee, I just sort of spent the time like almost in a state of reactive shock all the time, like just learning all the time and someone said, oh, you're really good at this. And I was like, am I oh my..? Like, I almost couldn't grasp that myself, I was just reacting all the time. But I sort of went with that idea that I seemed to get from a few different places that I was quite good in CAMHS. So I went into CAMHS when I qualified and I worked in several different CAMHS over three or four or five years. And then I also went, moved from CAMHS into paediatrics for another four years, all in the NHS. And I made that shift from CAMHS to paeds for a few different reasons, but one of them touches on what we were just talking about in terms of the categorisation of mental illness, but also on top of that, the fact that children had to be, had to receive a label, before they could even see someone like myself, a psychologist, who could then deconstruct that label and get back to their actual struggles and what was the context of that? And I, and that just really hurt my soul to be part of that. It's so conflicting because of course we were doing good work and that's, that is the system, and we did do a lot of helping of young people, but at the same time, young people had to be so pathologized before they got to meet with someone that could de-pathologize them. It just seemed backwards to me, and so I tried to make the shift into pediatrics where it felt far less based on mental illness and more based on a person is referred because they have a physical health condition and they have emotional struggles or behavioral struggles associated with that. There was no need for a mental health or mental illness diagnosis in paeds, so it felt a better fit for my values and my ideology around mental health. Yeah. And then ultimately in both cams and in paeds, I burnt out, I would say. And we can talk more about that in a bit, but that was part of my story, was definitely burning out, in terms of under-resourced services and being very overworked and not enough boundaries and sort of emphasis on self-care, but that being entirely unrelated to the workplace. So self-care was something you just did outside of work and at work you were just expected to not, not need care, to just provide care all the time. And that, in my experience, that was doable for a certain number of years, and then it was not doable, it was not sustainable. And the shift to a different area of work, I'd been really hopeful and in fairness, it was different and it was more sustainable, and perhaps then my age came into it. So I was 39 when I left paeds, and I now know looking back that I was moving into my perimenopausal years and things change for us in our physiology and our nervous systems at that time. And so that's potentially what made that shift necessary for me to move into private practice for reasons of self care, self preservation, and to create a career that I could sustain myself in and sustain my health in. So yeah, that's how I've ended up here in a nutshell.

We've talked before about how you and I both felt a bit blindsided by those kind of physical changes, whether that's, you know, pregnancy and stuff that happens around that time or whether it was the perimenopause. And I know that for you, you kind of got both in one bundle, which is particularly tricky.

Yeah. I didn't know though, at the time.

Well, let's talk about that. Like what sense were you making of it at the time and what was going on for you?

So, I was probably about 38 when I decided I'd like to try to have a child, and this is part of a much bigger story, but I was in a significant relationship in my late twenties, early thirties, and then that ended and then I was single throughout my thirties. And I remember sort of at some point in my thirties thinking, oh, well that's it, then I probably won't be a mum, you know, I've sort of missed the boat. And if I'm really honest, not feeling particularly devastated about that, I'm not someone that's always grown up wanting to be a mum. But then in my late thirties, I did get into a relationship, one I'm still in now, and we had both thought we'd missed that boat due to our previous experience. And then we thought, well, let's give it a try. You know, 38 isn't too old, let's give it a try. And then I, and in fact leaving, just thinking now, leaving the NHS was part of that process as well, because I remember speaking to a GP, so I'm 38, I'm, you know, looking to have a baby. What do I need to know? And I remember so distinctly, he was like, folic acid, stop drinking alcohol and reduce like no stress, like reduce the stress in your life. And I remember just bursting out laughing and saying, should I quit my job then? And he was like, I thought he was joking. And he was like, maybe, you know, like if you are under significant stress, if you've got cortisol running through your body all the time, that is shutting down your reproductive systems. It's sort of saying it's not safe to have a baby now, so it's just another thing working against you. And so that really started the cogs turning. And I was very fortunate, I was, I had a lot of privilege as I still do today, and was able to leave the NHS and have financial security in order to build a private practice that was sustainable for me. So I did that and then was pregnant sort of by the end of 2018, early 2019. No, 2020. Yeah. So I had been in a private practice for sort of six months and then got pregnant and then, and then it was goodness, and it was covid. It was all sorts of things that impacted on my journey. But yeah, so your question was about sort of being blindsided. I was really grateful going into pregnancy to have had therapy in my past. So I'd had four years of psychodynamic therapy in my late twenties, early thirties, and that just still to this day feels foundational for my wellness and for my self-care. And I was also really grateful for having worked with mums. So the other thing I didn't say about CAMHS is, in part, trying to get away from this pathologizing of children, and in part, just because of my systemic way of thinking, I would end up working with parents and carers far more in CAMHS than I would work with young people. And so I had had a lot of work with mums who had described to me various aspects of becoming a mum and being a mum. And so I was really grateful for all of that knowledge going in. And I still felt blindsided by the actual experience, experiences of motherhood. So for example, I mean I could, this could be a whole series of podcasts, but for example, like the constant anxiety that I felt throughout pregnancy, perhaps related to the fact that I was 39 and therefore labeled geriatric, well advanced maternal age pregnancy in the NHS. And so there was, I would argue objectively more anxiety on behalf of the teams seeing me as well, which I was picking up on. So that was one thing that was really difficult to manage. And then add a global pandemic on top of that, and the uncertainty and anxiety around should I be going out to the shops? Should I be seeing people? Should I not, should I be touching things? Dah, dah, dah. Like, that was just really tough. Then my experience of my son's birth was that I did experience birth trauma. And I think this speaks to something you were saying before around people feeling they need a diagnosis to get help and that I’m just thinking on my own, I'm not sure I would've defined my experience of birth trauma as birth trauma because I was physically fine. I survived, I was healthy, my son survived, physically well and healthy and…

Sometimes, just to come in with, sometimes your professional experience, I think, makes that, because when, especially working in the NHS, you see people with really, really difficult stories and you've seen the very worst that people have to endure in life. And so then when we have our own experiences, we can be tempted to compare. And I know we talk a lot with our clients about how unhelpful that is, but it's really tempting, isn't it, to be like, well, that was trauma, but what I went through, that's not that.

Exactly. Was it trauma, was it really? And I, and yeah. And I remember reaching out to, I remember I was in an NCT group and every time there was a birth announcement on the group, the NCT facilitator would say on the route to everyone, congratulations, sounds amazing, and if you ever want to debrief about your experience of the birth, please get in touch. And to my knowledge no one responded, well on that group no one even acknowledged that this was being offered. And then when it came to my experience of the birth, I think it took about 10 days or two weeks, and I was texting her saying, I really feel like I need to think this through with someone. And it was that question, as you say of like, was this okay, what happened, or was it not okay? But I don't know, but what I know is that I'm crying every day, is that I'm like this is not what I imagined. This is not this beautiful baby bubble at home that I thought it should be. And even when there is joy, there are tears as well. Like it's this double-edged sword. And I was just again, so grateful for my previous experience of therapy, which normalised this idea that I might need help too. Like I might need another person to help me think through what's going on for me and make sense of it and contain it for me and hold my emotions with me and validate those emotions. And so that was really powerful, I think having that foundation of therapy and just that like, I think often that's what the biggest thing that people learn from therapy is, it's safe to ask for help, like from good therapy, because sometimes people don't have good therapy and that's a whole different topic. But when we have good therapy, we learn it's safe to ask for help. And what that has meant for me is that when I have struggled in motherhood, I have reached out for help sooner than I think I would've if not for that foundation. I have not allowed myself to struggle for as long before I've said. And it, and it's a lovely way of putting it actually. I don't think I needed to know, this is birth trauma, I need to speak to someone, I needed to be curious and say, is this okay, is this birth trauma? Like I need someone's help to even think this through and work out whether this is something I might need further support for. And I did in the end go on to have further, three step rewind hypnotherapy in relation to my birth trauma, which was very powerful, really useful. And then I also went on to have breastfeeding trauma as well. And so reached out again to a breastfeeding consultant that I also know through, knew through NCT. And again, I then, I mean, my goodness, I reached out to so many professionals. I reached out to a pelvic health physio as well, and I reached out to, in the end, sort of, my son was about two by this point, but I reached out to a motherhood specialist counselor and had a year of weekly therapy with this person as well in order to just begin to process this, to put all of this in a narrative, because I do think in those early years of motherhood, you are just responding all the time. There is very little time to stop and think and to make sense and to put a coherent story together and like, there's no time to barely sleep. You know, there's no time to eat nourishing food often. So, yeah, like I think it, yeah, I was, just to go back to your original question, just absolutely blindsided by the emotional realities of motherhood, and even with all of my experience, just the amount of silence in our society around the day-to-day realities and the emotional landscapes of particularly early motherhood, but really anytime during motherhood, it's astounding. It's truly astounding, and that is the other part of my personal journey that I'm so grateful for, is that in 2019 I traveled to the US to do training with Brene Brown's Company around shame, and shame resilience, and this has become, alongside my therapy in my late twenties, this has become another foundational piece for me in my life and my work and my mothering and my caring, and everywhere that I show up. And I think that's how I make sense of this silence now, and I think of it as a silence. I don't think of it anymore as, oh, I'm experiencing this and no one's talking about it, so it must just be me. I don't, because of my shame resilience practice, I know that's not true. I instead have different thoughts around, I'm really struggling with this, I know I can't be the only one. So there is this societal silence around this, and that is, again, just foundational to why I provide the service that I provide, because the more people that are talking about this, the better. You know, we just, we just need more people talking about this, whether privately or publicly, like owning their stories around this.

I'm really curious about the shame resilience training that you did. Because I've actually not heard of that before, even though I love Brene Brown. So can you talk a little bit about what that means and what you learned?

Yes, so it was a… well the in person part of it was the three day training, three full days, and it was very experiential. So we were in a group and we essentially took all of the concepts that Brene Brown writes about in her books that you probably have read about and the language that Brene used was we got them into our bones rather than into our brain. So to read a book is to get the ideas into your brain, but to sit in a group and to experience shame in that group, and then experience the process of putting the practices into place to respond to that shame, that is to get that knowledge into your bones as Brene Brown would say. But as I'm talking, I'm realising that it wasn't just the three days, it was also lots of reading, and I think you have had to reread all of her books leading up to it and do sort of assessments online. And then post those three days, there was an online, about six or seven weeks of online activities, online group activities, creativity activities, and again, assessments. So, yeah, so it was essentially a combination of the two books that a lot of people have heard of, Daring Greatly and Rising Strong, but broken down into a curriculum, an experiential curriculum. And so essentially it is about vulnerability and it's about shame, and it's about both things that exacerbate those experiences and things that we can do to build resilience and navigate through those experiences. And so the way Brene Brown talks about shame is that shame is universal, we all experience it, but because shame is so shameful in its nature, we don't talk about having shame, and so we don't know how to manage it when it comes up and it can feel very, well this is part of a shame resilience practice is knowing for yourself what shame feels like in your body. And so, I was about to say, shame can feel really sticky. It can feel really like you get trapped in it, but then I realised that's just my experience of shame. For someone else it might feel different, it might feel spiky, or it might feel just like a black hole, or it's a really important part of the practice is to find your own language with what shame feels like for you. And essentially without this knowledge that everyone feels shame, ironically, the message shame gives us is it's just you, there's something wrong with you. And so when we, whenever we have a thought like that, whenever we think I'm a bad mum, I'm a terrible mum, everyone's doing it better than me, or, God, I'm such a rubbish psychologist, why can't I hold a boundary? Everyone else can do that better than me. Whatever it is you're thinking, whatever area of your life that you're thinking it about, when you have that thought of, I'm the only one that struggles with this, everyone else is doing it better, that is shame. And that is the first part of shame resilience practices, identifying shame and calling it what it is. And then the second part is providing yourself with compassion and empathy to sort of normalise that shame experience and get out of those thought traps of, I'm the only one. You sort of consciously remind yourself, oh no, this is shame. Shame will tell me I'm the only one, but I'm not the only one. And part of that is, Kristin Neff's work on self-compassion and mindfulness and common humanity and self-kindness, and part of it is talking as well to other people about your shame, but they have to be trusted people. So part of the training with Brene Brown was like working out, how do you know if your shame is safe with someone? And how do you know if someone, someone's reaction to your speaking your shame is actually their shame trigger being set off, which then wants to silence you because you've disrupted something uncomfortable in them. And so that has just been invaluable learning for me to sort of, and now very much, it's almost like being through the matrix and seeing interactions in terms of shame triggers going off and when you get this really sort of shut down reaction from someone, I now no longer think, oh, I shouldn't have said anything. I think, I've said something valid and perhaps someone has had a shame reaction and that's meant they have to shut me down. So it's a compassionate model. It's really powerful.

That's so powerful. And often shame is that thing which underpins those tricky social issues that we might struggle to formulate. So, you know, thinking about, you know, why do we have this silence around the difficulties that people in caring roles often go through. Because I don't think this is just motherhood, is it? It's all that other stuff we started talking about at the beginning as well. All of those people's difficult experiences are just shut down and silenced by society. And just hearing you speak then, I was like, well, yeah, because often when they do raise them, they do trigger other people's shame responses. And so it's not safe as a therapist to just be like, be open about this all the time. It's not the world we're living in. So it's really tricky and, and working out a path through it is really difficult as well.

And working out a path through it where you can remain compassionate and you can remain connected to yourself and to other people, and where you can remain courageous in terms of stepping up to do the thing you want to do, because that's often when shame will rear its ugly head. So, for example, in motherhood, shame, we often talk about, when I try to do self care and motherhood, I feel mum guilt. My experience of this training tells me that that is not what we are feeling. We're not feeling guilt, we're feeling shame that these are two distinct emotional experiences. And the training that I've done tells me that if you have guilt, to respond in one way is really helpful, if you have shame to respond in that same way is not going to be helpful. So we need to be really clear around what it is we're feeling. And yes, that is, it's a massive, massive part of why people don't take care of themselves, why they don't seek care from others, why they don't talk about experiences that are really difficult. It truly is like being through the matrix and suddenly seeing that it is inherent in so many interactions, in so many thought patterns that we might have. Yeah, it's been really life changing for me, and that's why I use it every day for myself, and I use it, I mean, every client that I work with. We don't always do the full curriculum. So it's a sort of training that can be offered as a full curriculum with workbooks and things. I tend not to work in that manualised way. I tend to just draw on elements of the theory. But I don't think I've had a client in five years where I haven't broken down the basics of shame resilience, and kept coming back to it because it's a practice again, it's to get it in your bones is to practice it every day. There isn't, you don't graduate from shame resilience. You just keep plugging away at it every time shame comes up, which is often. If you are living a full engaged life out there doing things that are important to you, you are going to feel shame. That is the way of human life.

That's so profound. I'm like, how do I follow that one? But yeah, it's so true and so well articulated and I think we could all stand from doing some work around that, even if it's just starting with reading the books and then seeing how we might progress with that to get it into our bones. It's certainly something I'll be looking more into because yeah, shame comes up in every piece of the clinical work that I do. And actually in every coaching practice that I have as well. I think it is there all the time for all of us. But thinking about, you know, working with other therapists and psychologists particularly, why is it you think that that group, even though we know this, because we do this work with our clients all the time, why are we reluctant to come forward for help?

I think this is really multifaceted. I think there are so many reasons. So one of them is what we were talking about earlier in terms of, almost in terms of our job title as clinical psychologist. So there's this, this element of the care that we provide for others needing to be clinical, like clinically relevant. It needs to in, in the real world, that means fit a diagnostic category. So we unconsciously often believe that the people who need to speak to someone like us have a clinically defined mental health difficulty. That from the get go, I think is a really big barrier to people who are clinical psychologists believing they might also need help. And this is something I am, like so passionate about to the point where I'm having a bit of an identity crisis as a clinical psychologist, if I'm perfectly honest, that I actually don't, people can work with me if they have diagnoses or they can work with me if they don't, and they can work with me in terms of healing from a particularly difficult time that might meet a diagnosis and they can work with me in a preventative way. That they sort of see some red flags and they are relatively well and they want someone to think through how they stay well. You know, these are all valid ways of working with me. And yet most of our experience, particularly if we've been in the NHS, is that in order to speak to a clinical psychologist, and also, this is part of the sort of referral hierarchies in the NHS, isn't it? Because we aren't the first line carers in the NHS. To speak to a clinical psychologist, you had to have already suffered for so long that a GP felt it was valid to refer you, waited so long in your suffering before you saw another member of the team, possibly two or three members of the team, and then you might get through to seeing a clinical psychologist. And I think that all of this is internalized in us, in so many of, I can't speak for everyone, but I do think it's internalized in so many of us in a really unhelpful way. And so I think that's the voice we're hearing when we are like, oh, I can't possibly need help. It's those un until unexplored ideas of who we think needs help and who doesn't need help, but, and it comes back to my idea of common humanity. We're all human. Humans need help. Humans are, I believe, biologically wired for both giving care and receiving care. And our biology, our nervous system cares not for what our job title is. Our nervous system knows that we are human and that we need care and that we give care, and that there needs to be a balance between those two things. And our nervous system doesn't care if we meet a criteria for a particular diagnosis or something like that. So I think that's a massive one. Let me think through some of the other ways. I mean also just in terms of our training in that, it's very rare, not, well, I actually don’t know the numbers, so I'm just gonna put my hands up there, but it's certainly not every training course that suggests it will be useful for people training to become therapists, to have an experience of their own therapy. And where there is, some courses mandated, but very few I believe, and where they are mandated, they will often say you can choose whichever form of therapy you wish. And there is just experiential differences between getting six to eight sessions of CBT than there are getting years, potentially of weekly psychodynamics, psychoanalytic, integrative, relational, systemic therapy. And so I think, again, this has just been part of the messaging that we've received, that it's not, it's not, you’re a carer, that we are training you to be a carer. And again, this isn't even language that is used, but I think it should be used, we're training you to be a carer. You don't need to consider your care needs alongside this role, it's just implicit. I don't think anyone ever said that out loud to me, but it was just implicit.

I think it's implicit in all the structures as well. So doing my MBA, we'd often talk about what it takes to make cultural change. And so much of that is the implicit stuff. You know, whether, you know, depending on what model you use, whether you think about it as symbols or objects or structures, it's all of these things. And when you are telling somebody you don't need your own desk, you don't need a containing therapy room space, you don't need a car parking space. You don't need a decent salary. You could be paid an honorary expenses only salary in your first years in this profession. I just, it blows my mind. How are we ever going to produce people that understand what it is to receive proper care, let alone then be able to deliver it. Because you know, I know people don't always like this message, but I do believe if you are not able to receive care, you are not able to give it very well. And so I think there's a myth that you can be a great clinician if you are not taking care of yourself, I don't think that's possible. And I'm saying that as somebody who I think has delivered less than optimal care in my time. You know.

I think that's how I can say it as well in that I know the times when I have not been receiving enough care that the quality of the care I've been able to provide, and I know the quality of the care I can provide when I'm more looked after. And once you have had that experience, I don't think you can come to a different conclusion really than the one we've come to that we, we genuinely, as human beings need to balance up that caregiving and care receiving. Yeah, we just do, and I totally agree with what you're saying about all the structures in the NHS because not only is it the training, but then we go into this huge organisation that really devalues the carers. Even though that is entirely, they are entirely, the whole employment team is carers. And I've often said this through my experience in the NHS, the NHS runs so often on the goodwill of the people pushing the people who work for it, pushing themselves beyond their boundaries. And I've seen this time and again, it's happened to me, it's happened to colleagues, it's happened to, you know, other professions within the NHS that I've seen. And yeah, it's, it's really, the messaging is really, just filters through everything. That one thing that would come up time and again for us was that we didn't have appropriate administration support. So we were not only doing the job of a psychologist, but we were doing the job of an administrator. We were answering phones, we were typing letters, we were stuffing envelopes, we were going to the post office and all of that would just need to be part of our job, even though it was never part of our job description. So from the get go, we're, we're being hired to do a certain job and boundaries are being broken all over the show. And where in my experience when I pointed that out to management, when I said, I'm being asked to do more than I'm, than I was employed to do, and it's impacting on the service I can provide, then that was very quickly turned around to make it that there must be a problem with me then.

Yes.

So, for example, I've had referrals to occupational health when I have raised the systemic difficulty and, and breaking of safe boundaries in the NHS, I have myself been referred to occupational health and that has made no sense to me whatsoever, but that is the only language that I have, and I know I need to put my hands up and say, this is a postcode lottery in the NHS, there are many very healthy services in the NHS. Some of the ones I have been involved with, it was not possible to have a conversation about the boundaries of the role being safe and conducive to effective care. That just wasn't a possible conversation. It was while you are here, you are to do everything you are asked to do. You are not to say no, you are not to question whether it's the best way to do it, almost. You are to work overtime if that is required, which it always was because there always seemed to be a focus on seeing clients. So like, some elements of the care role would be valued. So seeing clients was valued, but writing notes for clients, writing letters for clients, writing assessment reports for clients, that sort of all had to be shoehorned in to magical time that didn't, wasn't really that sort of side of things wasn't valued. So it was…

I think this is so interesting and my MBA gave me so many perspectives on why that is the case. And you know, the most obvious one is what gets measured. And so often in these services, the only metric that people are looking at is waiting list time.

Yes.

And so many crazy systems have been built to try and appease a metric, which was just not fit for purpose for our services. You know, plus a lot of cultural stuff around, you know, what's valuable, what's not valuable in the context of ridiculous levels of cuts and underfunding. Particularly, you know, my experience in learning disabilities, the cuts to social services and what that meant for we were all doing, and I'm sure it was very similar in CAMHS and paeds. But anyway, we could definitely talk about that all day. And I we've got a lot more to say here. But I also know that you provide support for therapists. So could you say a little bit about what you think good support for therapists looks like and how people could work with you if they want to improve their self-care?

Definitely. So good support for therapists. Goodness. I mean. If you are in, if you are working in the NHS, then I think good support for you looks like seeking support outside of the NHS, as well as building networks of like-minded professionals within the NHS. But I really do feel like it is important to get outside, to sort of observe that system from the outside and have a space to do that. And so that's where, that's where I think seeing a professional in private practice can be really useful. It's an entirely safe space outside of the system that allows you to look back in on the system and see what is working for you, what is not, what boundaries are possible for you to set, what boundaries are possible for you not to set, and help you weigh up, you know, whether this is a healthy job to stay in, whether there needs to be changes in terms of hours that you can commit to, flexible working arrangements, that sort of thing, or whether you would like to make a decision to move yourself out of that system. I think it's really hard to have, in my experience, it's really hard to have those conversations openly with other people working in the NHS. And I think that goes back to what we were saying before around silencing and shame and other people’s shame triggers being set off by someone saying, is there another way to do this? Is there, is there a healthier way to do this? So yeah, I do think that it's an underused resource for therapists to pay to see a therapist themselves that can help them think through this stuff. And also what's really important is that none of us come into this profession with a blank slate of experience of caring and giving care. So none of us, you know, we come from our own childhood experiences of receiving care and giving care. I again, I dunno any statistics on this, but anecdotally, so many of us go into caring professionals because we have some adaptations, shall we say, in our caring and caregiving and care receiving nervous system wiring because of our earlier experiences. Perhaps we needed to provide unconscious emotional care to a parent. Perhaps we needed to provide physical care to a sibling with a disability. Perhaps we needed to, you know, just at the very least, this is so common, become an exceptional young person so that we wouldn't put additional pressures on parents who were struggling. And I don't mean to pathologize parents in this, because this, then this comes full circle to the fact that we're also here talking to mums who are also psychologists and everyone is doing the best they can. And this is, and then again, like part of the shame resilience practice is to take that zoom lens that just says you are the problem, and actually zoom out to know like, we live in a society that makes this really hard for carers. And so none of us have come through this societal system unscathed. None of us. You know, even the sort of like very British idea of like, keep calm and carry on. You know, we've been sort of conditioned to not be in touch with all of our feelings, particularly the harder ones. And it's the harder feelings that we have, the anger, the resentment, the shame, the grief, the overwhelm. These are the feelings that are giving us signals that we are living out of alignment with the healthiest version of ourselves we can be, that we are living out of alignment with our values, perhaps that we're living out of alignment with what's important to us. And when we've all grown up in this society that has on average told us, be quiet about those feelings. Don't tell people about those feelings. Suck it up if you have those feelings, push them deep down inside yourself. Our caregiving, care receiving nervous system wiring has to adapt to those messages. And so it does adapt. And then we go out into the world and we're adults and we're offering care to others, and we get a lot of fulfillment from that. There's absolutely nothing wrong with that, and yet we still often feel like it's never enough, like, you know, and then we start breaking boundaries in our role as carers. So how many times have we said, right, that's it. I'm full, and then we've taken on one or two more clients, or you know, and that's the thing about moving into private practice as well. Like I hope I'm not coming across like, oh, in the NHS it's really hard. And then in private practice it's really easy because it's not the case at all.

No, you can absolutely recreate the same problems.

Absolutely. We take all of those internalized messages, because we haven't had a place like independent therapy to examine them, we take all of those internalised messages and we recreate the exact same conditions that we were in, in the NHS and, and then that's even harder for us and generates more shame because it's our fault we're here, but it's still not our fault, but to have a space, that’s why it's so invaluable to have that space to really objectively think this through. Like what are you bringing from your childhood? What are you bringing from your conditioning in society? What are you bringing from conditioning in your training in the NHS and what is true to you and your soul? And what can you let go of? And yeah, I don't know of any other process whereby… I mean, I think you can get so far with journaling, you can get so far with doing your own research, but caregiving and care receiving are relational dynamics and I think that's where seeing a relationally trained therapist or psychologist that has all of that contextual information and can hold the ideas about attachment with the ideas about nervous system regulation, with the ideas about trauma, with the ideas about societal messaging can really be invaluable to help you tease all that out in yourself. So I think that's a really underutilised resource for therapists.

Me too, and I love that you've made space in your practice available specifically to see those kinds of clients, those other therapists and other psychologists, because you know, as I teach about all the time, I think it's really important to have time to read and think about your specific client groups that you want to work with. And so knowing that you’re kind of dedicating a part of your time to those people, I think makes it a lot safer for people to come and be with you and be vulnerable. So. If somebody's listening to this and they're thinking, I would love one of those slots, or they want to read your amazing substack or get to know you better, where's the best place for them to come and find out about you?

So I am on Instagram. I think that's probably where I'm most active. My handle there is @drjennypsychologist. I'm also, yes, new to Substack. My substack is called Mind, Body, Soul Psychology. And where else? I have a website www.mindbodysoulpsychology.co.uk. And yeah, and I think in all of these places, it's an opportunity to get to know a little bit about me, and I'm definitely like really walking that line of like these are spaces where I actually most often talk about the care that I need and how I get that care, how I get those care needs met. And when I don't, why is that hard? I'm not, I'm not like, definitely not the psychologist sitting here saying, I'm an expert and I'm gonna help you to come through this and never have any problems with self-care again, like that's not the reality. And I think I want to reflect that reality, that this is a journey that we are all on. It's a, it's a practice. It's sort of lifelong commitment to considering our needs every day. And there is no amount of learning or previous practice that will get us to the point where we just master it. So I, yeah, hopefully, I, hopefully I'm approachable in those sort of areas where I tend to talk a lot about my own struggles and yeah, and I think that, I think that doubly makes it a safe space for clients because a) you know, I'm doing the work myself, and b) there's already so much more, so much normalisation that you know that you'll receive.

Yeah. And I think that where shame is likely to be a barrier, which is almost everywhere, that kind of vulnerability is necessary. You know, I know with my HG clients, they come to me because they know that they don't need to be ashamed of some of the darker thoughts, the darker muments, or even the physical stuff, which we just do not feel safe to talk about. That is why they come. And it's the same when I support other parents of children with special educational needs and disabilities. They know I've been in the trenches. and that's why it's safe to talk about some of the, you know, not so great things that might happen while we're there. So I, you know, I've always been an advocate for that way of working and if we feel able to, and we're not always able to immediately, but when we do feel able and safe sharing that, those more vulnerable moments with potential clients and with the public, I think is really helpful for breaking down some of that shame and some of that stigma. But I just wanted to say thank you for coming on, you've been a fantastic guest. I love what you put out, particularly on Substack because that's the platform that I am obsessed with at the moment, but you do some lovely work on Instagram as well, so I'd really encourage everybody to come and give you a follow and, and check out your content. Thank you so much for being with us today, Jenny.

Oh, thank you, Rosie. It's been an absolute pleasure. I've really enjoyed it.