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One on one… with Lucy Johnstone

‘I knew I was in the right place’

02 August 2016

One thing that led towards a career in psychology
Like many people who end up in the helping professions, I was a very confused and unhappy child, adolescent and young adult. Difficult as those times were, they have given me a passion for what I do. For me, a psychology degree was very much a means to an end. I can’t honestly say that I have used much of it in my subsequent career, especially not the material that usually appears under the rather horrible heading ‘Abnormal Psychology’. I have learned far more about how people tick from psychotherapy, philosophy, theology and English literature. But once I got that treasured place on a course, I knew I was in the right place, and I was lucky enough to work alongside some inspiring clinicians and supervisors.

One alternative career path
When I was 17, I had a careers assessment. I was advised that my strengths were in writing and journalism, but was warned against doing anything in psychology-related fields. As you can see, I ignored the second piece of advice, but in fact I’ve ended up doing a good deal of writing anyway. And despite having been determined not to follow my parents into teaching, I also do a lot of training. I can’t think of any other career that would have offered so many opportunities.

One thing that psychology could do better
My children both did A-level Psychology but banned me from their revision because, as they rightly said, ‘If I put down those ideas, Mum, I’ll fail.’ Some of the syllabus seemed to be left over from the 1950s, and there was nothing at all about the service user/survivor movement, the growing body of evidence on the impacts of trauma and adversity, and so on. When I taught on the Bristol Clinical Psychology Doctorate, we found there was a great deal of ‘unlearning’ to be done – and that often applied to what the trainees had learned in university modules too. I recommend Cromby, Harper and Reavey’s Psychology, Mental Health and Distress for a fuller picture.

One thing that makes me cross
Most media articles, TV/radio programmes and campaigns around mental health. It is rare for any of these to avoid uncritical reproduction of the language and assumptions of the ‘illness/disorder’ model. These ideas are so deeply imprinted in public consciousness that many people – journalists are often the worst – simply do not understand what you mean when you suggest that states of extreme distress may not be best understood as medical illnesses. But see below…

One source of hope
We are close to recognising the traditional psychiatric model of ‘mental illness’ for the failed paradigm that it is. Research has failed to identify ‘biochemical imbalances’, genetic flaws, or whatever else is currently being promoted as primary cause. The service user/survivor movement is more vocal than ever. We have indisputable evidence about the causal impact of social and relational adversities in all types of mental health problems. And DSM-5 was an embarrassing mess, attacked by the world’s most senior psychiatrists for lack of validity and dangerous expansionism. We may be ready, at last, to make the much-needed move away from ‘What is wrong with you?’ to ‘What has happened to you?’ I feel proud that the British Psychological Society’s Division of Clinical Psychology has taken the bold step of calling for ‘a conceptual system that is no longer based on a “disease” model’.

One inspiration
My late grandfather, Canon Roy McKay. He was no respecter of persons, creeds or institutions, whether in relation to a particular bishop who might have aroused his disapproval, or to the Church itself. But on matters of principle he was absolutely unshakeable, and got into quite a bit of trouble as a result. He showed me that you shouldn’t be afraid to challenge orthodoxies.

One favourite book
Emma by Jane Austen is as near as you can get to the perfect novel. What an acute psychologist she was! Within psychology – I’d like to nominate Judith Herman’s classic Trauma and Recovery (1992). It’s a powerful and deeply political book about the profound impact of trauma, and the denial of its existence that operates at every level of society.  

One weight on your mind
For a large part of the last four years, I and a small group of professionals and survivor/campaigners have been involved in a Division of Clinical Psychology-funded project to outline the principles of a conceptual alternative to psychiatric diagnosis. It is by far the most difficult work task that I have ever attempted, and there have been many moments of exhaustion, confusion and doubt. I am nervous about how it will be received, but cautiously optimistic that we have produced something useful, even if it is only the first step in a long journey

Online only questions

One resource  
I strongly believe that mental health service users have the right to be fully informed about current debates. Nowhere is this more true than in relation to psychiatric diagnosis. Given the official admission that the entire system needs replacing – hence the ambitious RDoC project – there is no excuse for handing these categories down as undisputed truths. As things stand, few people can afford to give up their diagnoses altogether if they are claiming benefits or need to access services, and so on, but everyone should be able to choose whether or not they want to accept this particular version of their difficulties, or take on ‘mental illness’ as part of their identity. My recent book A Straight Talking Introduction to Psychiatric Diagnosis (PCCS Books, 2014) outlines these debates in an accessible form so that people can be enabled to make this choice.

One piece of advice to aspiring psychologists
It’s a wonderful career – go for it! But – a word of warning – don’t accept anything uncritically. Think for yourself and then be brave enough to act on it.