The Aspiring Psychologist Podcast - Working with Psychiatry, being part of MDT's, History of Mental Health & Practically Managing Risk with Prof Graeme Yorston

Episode Date: April 11, 2022

Show Notes for The Aspiring Psychologist Podcast Episode: 18Thank you for listening to the Aspiring Psychologist Podcast. Today is a guest interview with Professor Graeme Yorston, Consultant Neuropsychiatrist.I first met Graeme when I was an Aspiring Psychologist myself.  We discuss ways to practically manage and reduce risk, the history of mental health, being an integral part of the MDT and reducing burnout.   The Highlights: ·     Welcome & request for audio testimonials. ·       01:36: Why is working in an MDT important·       03:48: Intro to Prof Yorston: ·       Being part of the MDT: 04:28:·       Physically Managing & Reducing Risk:  05:00:·       Setting up the room: 08:20:·       Random skill I learned as an Aspiring Psychologist: 10:16:·       What Prof Y learned: 11:32: ·       Positioning yourself in a new MDT: 12:28:·       The growing workload for an aspiring psychologist: 17:29:·       Reducing burnout: 20:13:·       Managing during the pandemic lockdowns: 21:29:·       Toxic Teams: 22:24:·    Being part of research: 25:34·       The history of mental health: 28:02:·       Diagnosis in mental health: 34:24:·       Summary and Thanks: 37:58:·       Connecting with Professor Yorston: 39:21:·       Veronika: 40:46:·       Connect with Marianne & Compassionate Q&A: 42:35:Links: ·       To watch, like and subscribe to Professor Yorston: https://www.youtube.com/channel/UCGextEIemQgyDI3QsCXGkRQTo check out The Clinical Psychologist Collective Book: https://amzn.to/3jOplx0To check out The Grief collective Book: https://amzn.to/3pmbz5tTo check out The Our Tricky Brain Kit: https://www.goodthinkingpsychology.co.uk/tricky-brainTo register for the upcoming free 5-day challenge: www.goodthinkingpsychology.co.uk/aspire Connect on Socials:LinkedIn: www.linkedin.com/in/dr-marianne-trent-psychology Facebook: https://www.facebook.com/GoodThinkingPsychologicalServices Instagram: https://www.instagram.com/drmariannetrent/Twitter: https://twitter.com/GoodThinkingPs1 TikTok:

Hi there, it's Marianne here. Before we dive into today's episode, I want to quickly let you know about something exciting that's happening right now. If you've ever wondered how to create income that works for you, rather than constantly trading your time for money, then you'll love the Race to Recurring Revenue Challenge with my business mentor, Lisa Johnson. This challenge is designed to help you build sustainable income streams. And whether you're an aspiring psychologist, a mental health professional, or in a completely different field,

the principles can work for you. There are also wonderful prizes to be won directly by Lisa herself. And if you join the challenge by my link, you can be in with a chance of winning a one-to-one hours coaching with me, Dr. Marianne Trent. Do you want to know more? Of course you do. Head to my link tree, Dr. Marianne Trent, or check out my social media channels, or send me a quick DM and I'll get you all the details. Right, let's get on with today's episode. If you're looking to become a psychologist, then let this be your guide. episode. with Dr. Marianne Trent Hi, welcome along to the Aspiring Psychologist podcast.

Thank you for listening as ever and thank you for all of your super kind comments. They're really gratefully received. I'd really love any audio testimonials for the podcast itself or any of the books um just so that i know that you're really enjoying what you're listening to and i'd really love to have any audio testimonials you might be willing to leave me for the podcast itself for more information how to do that, go to www.goodthinkingpsychology.co.uk forward slash podcast or the link will be there in the show notes for you too.

This is all about collaboration. And another great piece of collaboration is when we work work as part of multidisciplinary teams also called MDTs and being part of an MDT and having had MDT experience is something which is really useful for any aspiring psychologist and it's something that often crops up you know for assistant psychologist interviews. I learned my trade in working in multidisciplinary teams when I was at St Andrews Healthcare. That was the first MDT team that I had been part of. And I was so fortunate that I'd been around such highly skilled and competent, caring, kind team members. And I learned a great deal from them. And they were, you know, kind and patient towards me as I developed my stripes as an aspiring psychologist too. So when I was thinking about reaching out to have a psychiatrist on the podcast,

my first thoughts were of a psychiatrist that I had worked with as an aspiring psychologist and so I was brave and I reached out and asked him if he would be willing to come along and record an episode for us and he was so kind and gracious and said that he would love to. So I am thrilled to introduce you to someone I knew as a doctor. And since I have moved on to past years new, he has gone on to become a professor. So you're going to be listening to me chatting with Professor Graham Yorston, who is a consultant psychiatrist. And today's episode is all about working with MDTs, but also about practical ways to manage risk as well, which is something that psychiatrists are really good at and something that I learned a lot from my time

working at St Andrews. I hope you find this episode really useful. And as ever, we welcome any comments, any questions. You can watch this on YouTube, but it is audio only. So you'll just have lots of nice pictures to look at if you're watching on YouTube. If you're listening on Apple Podcasts, please do rate and review. Be gratefully received. So yeah, I hope you find this episode useful. So welcome along. I just want to say hi and welcome our guest, Professor Graham Yorston. I'll let you introduce yourself. Hi, yes, I'm Graham Yorston. I am a forensic neuropsychiatrist. So I've had a wide range of experience in different areas of psychiatry, worked in different hospitals around the country, in Scotland and England, and different levels of

security. So from high secure, medium secure, low secure and currently working in a rehab setting in Northampton. Wonderful, thank you so much for joining us. Our paths first crossed when I was an assistant psychologist so when I was looking at how to thicken the dialogue of psychiatry and psychology. You were the first person I thought of, but I am a little bit daunted to have you here. I can't imagine why you'd be daunted. No, I think, you know, assistant psychologists do perform a really important part of MDTs. And I think it is difficult because, you know, particularly if you're a brand new assistant psychologist, you're quite young and everybody else in the team is usually a bit older and they may have years and years of experience. But there's absolutely nothing to be daunted by. Most people in MDTs are very nice and very welcoming.

They certainly are. And I always felt very welcome in the teams when I worked with you so thank you um I do remember you didn't really like my hair accessories at the time and you had a very valid very bad point don't you remember I had some sort of crazy chopsticks in my hair and you were like someone could easily poke you in the eye with those I was like hmm yes you may be right gosh I think the Alzheimer's must be catching up with me. I don't actually remember that. No, you mentioned it. Yeah, I mean, it's the kind of important issue of kind of risk awareness

that somebody right at the start of their career just may not think about things like that that could be used as a potential weapon in a secure unit where people have a history of serious violence. Absolutely. I did give it back to you, though. I did say, well, they could whip the pen out of your pocket as well, Dr. Yorston. And you were like, yeah, but then I'd know they'd done that. You wouldn't know if they're behind you. And I was like, all right, you're totally right. I never wore them again to work by the way very sensible i did take a pen in and you're absolutely right so pens are a potential uh weapon and in some of the the most uh acute wards in high secure hospitals uh you have to leave your pens in store and you are only allowed to use those little tiny

stubby pens that you know that kind of three or four inches long like you steal from asda not asda argos that's the ones we don't we don't condone stealing here they've switched them to pencils now you know you can still hurt someone seriously with a pencil and you know uh particularly if it's a really sharp pencil you can do a lot of damage um and certainly in one of the hospitals that i worked at um it was damaged to people's eyes that were the um was the kind of preferred doesn't sound the right quite quite the right word but um it was it was a not uncommon form of attack was to stab people in the eye with a pen or a pencil. So you're absolutely right to highlight the risk

of me wearing chopsticks to work. So thank you for that. But it's an important area to consider, isn't it? When we're working with risk, especially not even when we're working in forensic services, you know, any setting we're working in, even someone we think we know really well could potentially be risky. Yeah, I think this is a really important point to get across. If you're working in a high secure hospital, then you're going to get a lot of induction about risk and you're going to be well aware that you're dealing with people who could pose a risk to you. But if you're working in an outpatient setting or an acute psychiatry inpatient setting, then that's the first point of contact that people will have with mental health services. So some of those people who do eventually end up in high secure hospital

have started in those services. So they might have all those aggressive tendencies. They just haven't been, no one knows about them yet. So you have to at least be aware of the potential for aggression and make sure that you're safe, make sure that you can get out of an interview room and not put yourself at risk in any way. Absolutely. I still remember setting up the room quite carefully I vividly

remember you dragging chairs around to make sure that you know you were going to be able to get out of rooms and the staff were if we needed to and that there were enough escorts or people trained in restraint when we were all trained in restraint weren't we but to be able to you know have the best possible outcome from any situation, it's about thinking in advance, isn't it? And planning for the worst, preparing for the worst and hoping it won't happen. Definitely, yes. And I think, so, you know, you've got to stay in control if you are in a hospital or any kind of healthcare setting of getting the room positioned before the person

comes in. Always looks a bit strange if you're moving furniture around once they're in. But, you know, get yourself so that you are closest to the door. And I have done that time and time again, all throughout my career. Even in children's services, I was always closest to the door because I've learned from you and from our late colleague Dr Wood how to you know how to ensure that your safety and the patient's safety is optimized. Yeah these are very important lessons I'm glad that I'm surprised that I was the first person to tell you about that but but it is those are important lessons that you know get into a good habit early in your career and always stick with it it'll just become second nature then you won't think about it definitely and one of my top tips that I learned was popular pop your diary on

your chair when you go and get the patient so they can't sit in your chair and it's all it's quite interesting when they try to or they give you your diary back and then you have to say I'm'm gonna see it there um it's a test of kind of social norms as well that sounds an interesting one I don't think you learned that one from me uh because I that's a really good uh tip actually I'd have to remember that one myself I can I have I have used useful um strategies as well um you also taught me um something um that you may not know that you taught me but I use every day so I often used to do um the notes um in our ward round sessions but sometimes you would do it and you were doing something on the computer and I thought how did he do that and you introduced

me to using the delete button to delete text that you've already typed just to hold your finger on it whereas before I met you I was backspacing every every single thing so every time I do that I do think of you. Good heavens me teaching someone that IT that sounds highly improbable but I'll take your word for it. You'll have to tell your children and they'll be delighted. Yeah back in the day I you know I was I was a relatively new adopter of information technology, but I feel like a dinosaur nowadays because it's all moving way too fast for me. Well, you were an influencer when it came to me and the delete key. So thank you. Have you learned anything along your career from a random source that's been really useful

or something that you can think of that you think, well that was that was really important for me or I use that all the time and you wouldn't necessarily have known that you were planning to learn it at the time yes I mean I think you know training as as a doctor is very much an apprenticeship so you know obviously a lot of your your facts your knowledge it comes from books and papers and things but actually how to deal with with people how to approach people how to interact with team members is very much um about seeing you know being in teams observing how those teams interact and then going yeah i like the way this person is is uh running you know his or her team and that's how I would want to be and equally um seeing people doing it not so well

uh and being a little bit too formal or whatever it might be I'm thinking yeah that doesn't I don't want to do it that way yeah absolutely and how to position yourself in teams can be so important can't it definitely I think this is one of the key issues for for assistant psychologists because you're coming into a team you probably don't know people very well the team may be very established and have been going along for years, good relationships. There might be people with years and years of clinical experience. And on your first day, you go into this ward round and see the sea of faces that you don't know.

How do you fit into that team? What do you do? Do you be a big personality and kind of, you know, introduce yourself at full volume? Or do you kind of just sit in the back row and be very meek and mild and hardly say a thing? And it's very difficult, I think, to break into that team and to be aware that that's, you know, that requires effort and work. And thinking about, I think, is important. I think the more that you make a conscious effort to think about, well, how am I going to do this? You know, the better it's likely to be. And every team is going to be different.

So, as I say, you know, I've worked in a huge number of different environments, and the extent to which the medical model is dominant varies between teams, and therefore the extent to which psychological input into those teams is going to be absolutely integral or slightly peripheral is also going to vary. And I would say, you know, as a new AP joining a team, listen, observe relatively quietly. You don't want to be completely anonymous, but, you know, don't go in with a big personality and big opinions straight off because people are just going to look at you and think, who is this person?

So, you know, observe, be helpful to the team. So one of the things I've always done is occasionally make coffee so that absolutely everybody in the team is part of that rotor. No one is above going and making coffee for everybody else and that uh helps uh bonding um so again depending on how the kind of mdt meetings are organized um usually patients will be brought into those meetings and i think it works really well if right from the beginning as an assistant psychologist you say oh you know would you like me to go and get the patient rather than relying on on one person to do that and also I think understanding what the the model of of the

psychology input to the team is is it it a totally integrated approach? Are you there every week for every MDT meeting or ward round? Every CPA, are you there on that ward and it's your ward? Or is it more of a kind of referral model? And if it's a referral model and you're just going to occasional ones, then that's fine to then ask for referrals. But if you're in part of an integrated team, then there's nothing worse than if somebody in the team is saying it would be really helpful to have a psychology opinion on this to then say, all right, great, thank you. Can you do a do a referral please it is probably the thing that gets me uh not irritated it's not as strong as that but just frustrated more than more than anything else yeah i think it's tricky certainly in community services where i've worked you kind of can't

launch in straight away um but when you're on an inpatient ward and you're all there anyway you know it feels like you can come to the fore a little bit more quickly you know and and um yeah support on the ground um without additional forms that's it yeah i mean um so being aware of um i mean everybody is time pressured i'm not saying saying that any one professional group is less time pressure than any other, but particularly for nurses and doctors, you're constantly reprioritizing. And that is something that happens less, I think, in psychology. You're often able, you have a luxury of being able to kind of work through a kind of a to-do list without constantly having to put things, I've got to move this one forward and that one back.

At least that's my impression. Tell me if I'm completely wrong on that, but that's my impression. And so the kind of the urgency of things sometimes feels more than people from nursing and medical backgrounds. And just being aware of that really, I think, is important. Yeah, I think even since when I was working alongside you, the expectations on unqualified psychologists has gone through the roof. So I didn't hold my own caseload when I was working with you.

I was very much to support the psychologist and the psychology functions but also the MDT so you know I might have done the odd bit of neuropsych here and there I was doing you know the monitoring and the recording of all of the sexually inappropriate behaviors and the you know the aggression and reporting on those for the ward rounds and things but I didn't hold my own caseload. Whereas actually, what's happened in the time since I was an aspiring psychologist is that people are being encouraged to hold their own caseloads as well. And people are working, you know, sometimes even as much as, you know, 80, 90% of their whole time equivalent hours are face to face client times. And that is, that's a big pressure it's a big change and

the level of even the level of risk and responsibility that aspiring psychologists are being asked to hold these times you know in these times I grew into that responsibility and we're asking a lot more a lot sooner I think which gives you less room for a little bit of playfulness and less room to you know to make those mistakes and to learn by watching other people do it because there's more pressure on you you know like you said it's nice to come in and grow into a role but actually a lot of aspiring psychologists are finding that they're kind of being you know farmed out and put on the production line and expected to perform almost from day one and it's it's very difficult okay that really does sound like being thrown in at the deep end and um my sense is that uh that that is that is how i learned as a doctor uh and i think most other

people you know learn that the old kind of maxim of see one, do one, teach one. You see some procedure once, you're then expected to be able to do it yourself. And then once you've done one, you're expected to teach everybody else how to do it. And I don't think that's right. But certainly your pace of learning is much more than if you start off very cautiously and spend a lot of time observing. You're going to learn an awful lot more from doing than you are from watching someone else do. So, I mean, it's interesting that you're saying that. I perhaps hadn't realized that there'd been that change. So it's tough, but it will definitely, you know,

help people decide more quickly if they're in the right career and if it suits them. And there is that, isn't there? There is burnout in our profession as a mental health professional, especially during the pandemic, you know, because there wasn't any working from home when there's patients to go in and support who are living in inpatient units it's very difficult how's your experience of burnout been in the profession and how to support and nurture members of the team to try to reduce burnout yeah I think it is very important um and it has been very very tough I mean my my current job as I say is a rehab unit. And we're trying to, all the time, help people become reintegrated into the community. And to then try and do that

when they were literally were not allowed outside the hospital, the kind of, there was the national guidelines and then the local public health guidelines that said, actually, you're a hospital, therefore your patients aren't allowed out. And that was for months on end. And it was very tough for the patients. Absolutely amazingly well in coping with that. But it was also tough on staff because it meant that they were having to be constantly thinking of new things to do to stop people getting bored and to try and you know recreate some of the things that they would be doing if they were in the community

so we had about a million and one barbecues and things and you know just trying to keep fresh was a real challenge but I think burnout generally is is an important issue um it's people do talk about it but uh often slightly reluctant to talk about their own problems I've certainly had problems in my own career at times where things got very difficult and uh you need to be able to talk to someone if if you feel things building up, if you're not enjoying your work, if you, you know, you kind of wake up in the morning and just think, oh, God, I can't, I don't want to go in, I can't face it, then that's a problem and you need to talk about that.

And there's usually resolutions to these things. And it may be that, you know, a change of scene, a change of team. I mean, I think we're both lucky that we've worked with great teams and great team members. But sometimes teams don't function very well. And if you're in one of these, let's call it a toxic team, they do exist. It's horrible. And sometimes the only thing you can do is get out of that as quickly as possible or at least limit your kind of

exposure to the toxicity so absolutely talking to your supervisor and being kind of open and honest about things honesty is always the best policy you know people worry though if I kind of worry or sound like I'm moaning then I might not get a good reference but it's far better to be honest I think and and deal with with problems you know that you can get you can get bullying you can get inappropriate attention all sorts of issues can arise and and you have to deal with it I think you have to deal with it. I think you have to deal with it. Yeah, I love that idea actually about thinking about maybe it's not me, you know, maybe I'm okay.

Maybe the problem is the environment here. Maybe this is a toxic team. And people often say to me, well, I'm a bit worried about just having like a six-month post or a four-month post on my CV and how that looks. And it's like, actually, no, you're the golden goose. You have to look after you. And if this isn't a good fit for you, it's okay to say no, it's okay to say actually, I'm going elsewhere, because this is not okay for me. This is not how I, you know, like your values of how to treat people. This is not how I think it's okay to treat people.

And I'm going to vote with my feet, you know, I'm going to use my voice. And if saying no is not making a difference, you can be empowered and you can make different choices to go elsewhere. Yeah, absolutely. And it is tricky. I think it's maybe, well, in some ways it's slightly easier towards the end of your career or once you've had a few years under your belt because you've got some experience to draw on, at the start of your career, it's very hard to say, actually, this just is not working for me.

But, you know, trust yourself and, yeah, follow your instincts is what I would say. And if it just feels horrible when you go to work, that is not normal. It's not right and you shouldn't put up with it absolutely i'll have to say working with you was not a toxic environment i really leaving leaving um st andrews was really difficult for me from a really supportive really cohesive really big and broad team um to then going somewhere very much smaller in the NHS, where I was the only assistant, there was one qualified forensic psychologist, it couldn't have been, you know, tiny little healthcare building couldn't have been more different. And I really mourned for all of you when I left, you know, it's still it's important to build different portfolios of your

work across the across your career but um yeah it's really difficult hard to replicate what what you guys are offering in terms of experience and nurturance as well and really good staff parties glad you enjoyed those yeah no St Andrews I would say um at the time you were there most of the time that I was there was a fantastic place to work uh and I know that it helped many kind of psychologists go on to bigger and better things. It was a great place to do research and just make those kind of first footsteps towards, you know, just having a bit more on your cv than just clinical work getting involved in research is is so important and my current uh post at St Matthew's Healthcare

um that's one of the things that I've been trying to do is is get uh and encourage uh assistant psychologists to to be involved in very simple little research projects i mean it doesn't have to be some massive international collaboration study just you know a case report um getting that done as a poster um or uh kind of writing up an audit all those kind of things just gives you a bit more on your cv it also yeah helps helps build relationships and um however um i'm a great believer in research and and and the the advantages really that research brings to to helping you think about about anything really um obviously if you're writing a paper it will be about that particular topic but it's how you approach any topic um in in your career is important i think yeah absolutely and you know research is so

important it's one of the key aspects for aspiring psychologists and it's you know you get separate points on your forms um for research so i did my first piece of published research was at st andrews and if dr yorston as you were at time, you know, professor had asked me to get involved, I'd have snapped your hand off. I can't believe I didn't ask you. I'm always asking. I've written it up for you. But this is one of the advantages. You know, you can approach people and say, do you need any help with writing up this research? Because then you get your name on a paper, which is amazing. Amazing. And research is useful for the now but what leads us on quite nicely to the next area

of conversation is it's really useful to reflect upon as well and to help us learn about what went before us and what people's previous assumptions were about mental health and this is really a specialist area of interest for you as well do you want to tell us a little bit about why and what I'm talking about yes that's a very nice lead in. Thank you very much. Yeah. So I've always been interested in the history of psychiatry. I think my very first paper actually was a history of psychiatry paper. And I just always believed that it's important to have a full understanding of what ideas about mental health problems and diagnoses are now. We have to understand how those ideas have evolved over time. And for some disorders, it goes right back to ancient Greece and ancient Egypt and

early China and India. So they're very very very long route to some of the mental disorders others are very modern and unless you you have some understanding about that it's very difficult I think to to to fully grasp the importance of you know of diagnosis and and why words are important. So, as I say, I've been doing interest in that all my life. Just in the last six months, I have started a YouTube channel on the history of mental health. If I'm honest, I probably wouldn't have done it if it hadn't been for the help of my son doing all the technical stuff. But we've so far put out, I think it's nine videos on a wide range of history of mental health topics. And they're quite unusual.

I think looking at other videos out there, we're definitely trying to aim for them being quite academic. So there's lots of references to papers and in the kind of the about section of the videos, I do include a kind of academic reference list. So they are meant to be understandable to the general public, but to be of particular interest, I think, to people working in mental health. Well, I've watched two of them so far and honestly find them really interesting. I think it's really useful to have the theory behind it, but from an expert as well, from someone that gets it in the modern context and can portray it in a really relatable way. It's really unique. Yeah, I think they're quite good. And in terms of kind of viewing figures,

it's interesting that, you know, it's building. And also just looking at some of the other videos out there on very similar ranges of topics, some of them you kind of realise that this person has really just read out a Wikipedia entry, almost word for word. And that's okay. And that's often where I start. If it's a topic I don't know much about, that's usually my starting point. But I will definitely try and add a bit more context. And what I will always try and do is talk about how ideas have changed over time.

And that's particularly interesting, I think, for more recent history. So I've done a couple of videos on one in particular, I think, Rosemary Kennedy, the sister of President Kennedy. And she had probably a kind of mild learning disability, might even not have been below the kind of diagnostic threshold if she was formally tested. But at the time, there was huge stigma associated with that and some you know terrible old-fashioned phrases that we you know it's really hard to speak them out loud nowadays feeble-mindedness morons all this kind of terminology was was in the medical and psychological literature there were people writing papers about this um and suggesting that uh they should be compulsorily sterilized. And in the US, there were 60,000 people were sterilized because they were thought to be unfit for breeding.

And obviously, that went to its furthest extreme in Germany, where people with mental illness, mental and learning disability were killed, were murdered. Thousands of them, 300,000. So it's important to know. So that's just about within living memory. 1930s, obviously the war, the war period, there are fewer and fewer people around that actually remember that, but the kind of folk memory, if you like, of ideas and stigma lives on. And, you know, even within my career, I can see changes in the way mentally ill people have been regarded,

the way psychiatry is, you know, viewed by other members of the medical profession. And if I'm honest, you know, I probably would have shared some of those ideas at medical schools, like, who wants to be a psychiatrist? You know, that's terrible you know you never do anything very much you never cure anyone um would have been the kind of rhetoric back in the the 1980s and uh it's been uh you know over the last 30 40 years there has been a gradual move a gradual acceptance that the mental illness isn't something to be ashamed of. And I think, you know, particularly in maybe in the last 10 years, we're gradually moving towards this greater acceptance, but there's still a long way to go. There's still a lot of those ideas that were still there, you know, in the 30s, 40s, 50s. They're still there, they still affect people's thinking. Thank you you it's so

interesting and i love the breadth and the depth of your experience which i think is what your competition do not have um because you know you've earned your stripes absolutely and there's something to be said about aspiring psychologists learning that breadth and that depth as well isn't it and learning about the importance of the theory. Absolutely, yeah. So, you know, one of the things that a lot of assistant psychologists talk about is diagnosis. And obviously that's not necessarily a word that is the right word for psychology, but it is the way doctors work and have done for probably 2000 years. So you've got to at least understand what a diagnosis is. And sometimes I get asked

questions like, what is the official diagnosis? And that one always prompts a little bit of discussion from me as I say, well, you know, a diagnosis is just an opinion. And even if we say, well, they fit the criteria of DSM or ICD-10, those are just our current ideas on what the criteria should be. And those have changed over time. They've changed, you know, over the last 50 years and certainly over longer periods of history so so a formulation actually is a more valid individualized way of thinking about a person but everyone's always interested in diagnoses so you have to to fit your uh you'll be willing to at least accommodate a diagnosis in in formulations yeah i mean diagnosis is really useful because it you know like you said it gives us an

understanding of how best to understand someone's difficulties and what might be a robust evidence based treatment plan but it doesn't define somebody no and that's the that's the big downside obviously of of diagnoses um and uh it it puts people into boxes and we're dealing with individuals and uh so whilst i would always uh have a diagnosis for a patient you know i also make sure that i have a lot of information on their early development, their pre-mortem personality, so that, you know, you're saying, well, this is the diagnosis, but then this is the individual with this diagnosis and how it has affected them. Yeah, I think it's really useful to discuss with people as well what their diagnosis means and how they feel about it. So I work a lot

with developmental trauma, I should say people who have had developmental trauma experiences and a lot of them are diagnosed with borderline personality disorder or emotionally unstable personality disorder and they really aren't okay with that because they've already been through awful awful things you know pretty much from the point that they were conceived. So then to be labelled with EUPD feels like a real kick in the guts. And so it's a useful conversation to have. Absolutely, yes. So I always discuss diagnosis with patients, whether they remember it, whether they want to remember it is another thing entirely. But something as incendiary as EUPD is such an important diagnosis. But also, you know, helping patients understand that, you know, what that actually says to other people who will be

reading that diagnosis. And sadly, it's, you know, it's not going to, you know, people are going to think oh right uh difficult patient um and they and i think it's useful for patients to know that that diagnoses are going to evoke emotional responses in in other health care professionals definitely i have loved speaking with you today and i honestly feel like i could speak to you all day um but we tried to keep these episodes at about 30 minutes so we're going to need to draw it to a close have you got any final points or kind of um questions or observations that you want to make yeah no just really um you know work hard at becoming part of the the team as i say make the coffee go and get the patients um but you will

also sometimes make the coffee you know absolutely no definitely not so um you know if there's any psychiatrist listening to this then do not expect people to make coffee for you be willing to go and make it so it's it's although usually that the psychiatrist is the uh the unelected leader of the team, there's no real reason for that. There's no management responsibility that says, oh, the doctor has to be in charge. But that's just the way most teams work, not every team, but the way most teams work. being aware of that and working with it and with the uh being aware of the kind of the history of how psychiatry psychology and other professions have developed and all work together i love it it's been such an interesting episode and been a pleasure to speak to you how can people um get um get connected with you where where are you at with your youtube channel youtube search putting

professor graham yorston or history of mental Health that will lead to my videos and that's probably the easiest way to get hold of me. I think my son's even opened a TikTok one for me but I don't really know what's on that yet, I don't really understand TikTok but I'm not doing any dancing, safe with that one. So that's probably the easiest place to see me. Lovely. Let's have a practice. What should people do when they get to your channel? Oh, yes, they should. Now, what is it called again? Subscribe. Yeah, so subscribe.

And like. And like. And comment. So comment is important. One of the things you do have to be aware of, though, is you have to develop a thick skin. So there's overwhelmingly positive comments so far, but but by gum there's a few absolutely horrible ones so you have to learn to kind of uh not focus on those which is you know it's important in life to be able to do that

so like subscribe and click on the notification so that when the new ones come out it goes you somehow know about it miraculously where the wonder of technology i love that honestly do it do and do it for this channel as well because this one's good too it's been an absolute pleasure to reconnect with you and wishing you all the best with your youtube channel and beyond and book writing and all of those good things are going to be coming imminently thank you so much for joining me. And thank you for inviting me. It's been a pleasure. Hello, my name is Veronika Kosova. I live in Edinburgh, and I just graduated with a Master's in Psychology of Mental Health. Marion recommended me the Clinical Psychologist Collective when I was

networking on LinkedIn, and I must say I love it. It is one of a kind. It's like a window into the lives of people on the path of becoming a psychologist. The stories are unique, honest and filled with a kind of intangible wisdom only personal storytelling can uncover. A common thread in the stories I valued most was to be compassionate not only with others but with myself too. Also not fixating on becoming a psychologist but enjoying life, grow and the final results will come as a byproduct. Marianne thank you for taking the time to correlate all the stories. The book is a true gem and I think every aspiring psychologist should have a copy on their shelf. Thank you! Then let this be your guide Filled with lessons and experience

That will help you get qualified So come and take a look It's right here in this book It's the Clinical Psychologist Collective It's the Clinical Psychologist Collective Thank you so much for listening. I really love to connect with you over on socials. LinkedIn is Dr. Marianne Trent.

YouTube is Good Thinking Psychological Services. Facebook is also Good Thinking Psychological Services. Twitter is Good Thinking PS1. Instagram is Dr. Marianne Trent. If TikTok is your jam, I'm also on there too at Dr. Marianne Trent. Being well supported during a psychology application season is so important. We have got one final date planned for a compassionate Q&A, which is going to be taking place on the 9th of May, Monday, the 9th of May at 7.30pm UK time. And that is free to attend. If you would like to watch any of the replays from the three previous episodes then you can do so by going along to good thinking psychological services on youtube

and then if you click the playlist compassionate q a you'll be able to find the three previous episodes there hope you will find it useful and as ever, we'd love any feedback you've got on any of our free resources. If you are finding this podcast helpful, please do talk about it on social media, tag me in, tag your friends, do all of those good things. And I will look forward to catching up with you on our next episode, which will be along on Mondays at 6am UK time. Thank you so much. I had to be on your way to being qualified It's the Aspiring Psychologist Podcast With Dr. Marianne Trent My name's Jana and I'm a trainee psychological wellbeing practitioner.

I read the Clinical Psychologist Collective book. I found it really interesting about all the different stories and how people got to become a clinical psychologist. It just amazed me how many different routes there are to get there and there's no perfect way to become one and this kind of filled me with confidence that no I'm not doing it wrong and put less pressure on myself. So if you're feeling a bit uneasy about becoming a clinical psychologist I definitely recommend this just to put yourself at ease and everything will be okay. But trust me, you will not put the book down once you start.