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How many parenting books did I read before the birth of my children?

Zip, Zero, Nada.

Based on my belief that parents have been having babies and raising children for generations and that I what I was bringing to the table was probably going to be “good enough”.

However, I love this book and so wish I had had it on my bookshelf when I was a new Mum.

Dr Natalie Flynn is a New Zealand based Registered Clinical Psychologist and contributes to the WowMama blog https://wowmama.com/.

In this book Natalie approaches those really sticky, big emotion, button pushing issues faced by new parents – should I leave my baby to cry themself to sleep? Breast or bottle? To immunise or not? And many others. She presents the research and in some cases, the lack of research around these issues. She does this in an informative, respectful way, allowing the reader to form their own conclusions and then make decisions for themselves and their baby accordingly.

In doing so, Natalie manages to take out a lot of the emotional push and pull that can weigh so much on new (sleep-deprived!) parents. She gives power and autonomy back to parents to make decisions which work for them and their families.

Nigel Latta describes it as “the one book every new parent actually needs” and I agree.

This book took my understanding of “adversity” and tipped it on its head. I love when books do that.

Meg Jay is a Clinical Psychologist practicing in Virginia, USA. Her beautifully written book takes the form of a series of short stories, or case histories, if you will. Stories of people who have experienced some form of adversity during childhood, such as violence or drug use in the home or the loss of a parent. Meg details what they did to cope with those things, coping methods which to grown-up eyes can look “unhelpful” but which speak to the very human drive to survive.

My job puts me in the very privileged position of hearing stories of adversity from everyday, ordinary looking people. I’d gotten used to – too used to – seeing these adversity stories as “risk factors” that leave people vulnerable for a range of mental health issues and a bunch of other stuff.

This book presented an alternative: That right alongside adversity is resilience. That for every person who sits in my office, yes, there is adversity. But there is also strength, courage and probably several other factors which means they have been able to survive, get through and continue to be.

Right alongside adversity, is resilience.

Trees need wind, rain, and storms for healthy development. So do people.

Biosphere 2 is a research facility in Arizona, USA built in the 1980’s. The goal was to develop a completely enclosed environment capable of supporting human life with the idea that perhaps one day Biosphere 1 – that’s the earth – would not be able to support human life. Or, perhaps relatedly, humans would try to colonise another planet. The technology developed inside Biosphere 2 could be used in either case. Long story short, this research project failed. “Biosphere 1” is a highly complex and inter-connected system which the researchers could not replicate. Many unanticipated challenges occurred, one of which involved the vegetation inside Biosphere 2.

A wide range of vegetation was planted inside Biosphere 2. The trees grew more quickly than in the outside world but would then die off and collapse. It was thought that the weather patterns inside Biosphere 2 were important. Biosphere 2 could produce a gentle breeze but could not generate more extreme wind, rain or storms. It turns out that winds and storms are necessary to a young trees development. During such weather trees stretch and bend and develop a structure called “stress wood” which allows for further bending and stretching. This stretching and bending it turns out, is vital for a trees healthy growth and development.

This story got me thinking about how what happens in the garden. Initially a seed is planted, it is kept in a hot house, in a propagator tray. It is watered daily and possibly given specific nutrients. As the seed begins to grow, the seedling is moved to progressively larger pots, giving it the room to grow, while keeping it inside the hothouse. As the sapling grows it may be placed outside for some time each day to “harden off” or get used to the elements outside the hothouse. When the tree is ready, it is planted in its permanent position. At this stage, wise gardeners place two stakes on either side of the young tree and tether the tree to it. This will provide some protection as the young tree experiences its first winter storms and spring gales. Eventually those stakes in the ground will rot and fall away and a healthy strong tree is left which can withstand all but the most extreme weather events.

It strikes me that growing people is much the same. When our babies are small, we hold them very close, provide all that they need and protect them from as much of outside as we can. As our children grow, we slowly, bit by bit allow them out into the world, and allow them to experience some of the “stormy weather” out there.  Eventually, our children are ready to be out there full time but we don’t just let them get on with it. Parents remain, like the two stakes in the ground as a support. And I’ll stop the metaphor there before it gets too dark.

All of us have been out there in life’s weather and experiencing life’s stressors. We have therefore, developed skills and resources to assist us to be resilient in the face of stressors. We have discovered our own internal resources for coping, things like being flexible, persistent, or patient. We have learnt skills for managing stress, like problem-solving or making hard decisions. We have gained resources like healthy relationships which will see them through tough times.  Alternatively, if we try to avoid or deny these metaphorical storms, we do not discover our personal attributes which make us resilient. Neither do we learn strategies that add to our natural resilience. Likewise, if we try to protect others, such as our children, from life’s storms, we are denying them the opportunity to develop their own resilience.

It is stress that allows us to discover and build resilience.

Is the stereotype of therapy still “lie down on my couch and tell me about your childhood / mother / dreams”? If so, we’ve come a long way from Freud at the end of the 19^th century. I’d like to explain some of the body of research that sits behind what I do everyday in my office.

In the first few decades of the 20^th century psychological research and therapy focused on behavioural psychology. With ideas about training behaviour – think Pavlov and his dogs – being applied to human behaviour.  In the 1950’s and 1960’s Psychologists such as Aaron Beck said: hey, we humans also do this thing we call thinking. This led to the development of the cognitive-behavioural therapy (CBT) model which states that way we interpret situations (our thinking) influences how we feel and behave. Initially this model was applied to the treatment of depression (Beck et al, 1979). Since then this model has been applied to a wide range of mental health disorders and other behaviours and research has shown CBT to be a significant improvement on previous therapeutic approaches (Butler et al., 2006).

CBT is vastly different from the earlier models of psychotherapy in several ways. It is focused in the present, on what the problem is today. It is collaborative, with the emphasis being on the client and therapist working together, on mutually agreed goals. It is active, absolutely no lying down on a couch! You are far more likely to be writing, practicing strategies, role-playing and coming up with stuff to do between the therapy sessions which will help move you towards your goals.

Since the conceptualisation of CBT psychologists have continue to think about and explore other avenues for helping people. This led to many newer therapies which still use these characteristics of CBT although have different models. Dialectical Behaviour Therapy (DBT, Linehan, 1993) focuses on the importance of regulating your emotions. Acceptance and Commitment Therapy (ACT, Hayes et al. 2002) has its base in language acquisition and processing and emphasises the importance of engaging in meaningful activities. Metacognitive Therapy (MCT, Wells, 2009) explores our thinking about thinking. Each of these models also includes a mindfulness component. Research has shown us that these new models are about as effective as traditional CBT (Dimijdjian, 2016). Meanwhile, there are other factors at play which determine the effectiveness of therapy, such as characteristics of the therapist (Novotney, 2013) and the relationship formed between therapist and client (Horvath, 2001).

So, what does this mean when I work with someone? Following an assessment, I provide you some sort of explanatory model for what’s happening for you, based on one of these therapy types. The model will talk about the interaction between your thinking, emotions and behaviour. Equally important though, is how we work together through therapy. To be effective, therapy needs to be an active process set in a warm and collaborative relationship.

References

Beck, A. T., Rush, A. J., Shaw, B. F., Emery G. (1979) Cognitive Therapy of Depression . The Guildford Press.

Butler, A. C., Chapman, J. E., Forman, E. M. & Beck, A. T. (2006) The empirical status of cognitive behaviour therapy: a review of meta-analyses. Clinical Psychology Review, 26.

Dimidjian, S., Arch, J. J., Schneider, R. L., Desormeau, P., Felder, J. N., & Segal, Z. V. (2016) Considering meta-analysis, meaning and metaphor: A systematic review and critical examination of “third wave” cognitive and behavioural therapies. Behavior Therapy 47 (6).  

Hayes, S. C., Strosahl, K. D., Wilson, K. G. (2002) Acceptance and Commitment Therapy: The Process and Practice of Mindful Change. The Guildford Press.

Horvath, A. O. (2001) The Alliance Psychotherapy: Theory, Research, Practice, Training, Vol 38(4),  365-372.

Linehan, M. M. (1993) Cognitive Behavioral Treatment of Borderline Personality Disorder. The Guildford Press.

Novotney, A. (2013) The Therapist Effect. Monitor on Psychology Vol 44, No. 2.

Wells, A. (2009) Metacognitive Therapy for Anxiety and Depression. The Guildford Press.

When I thought about it, Clinical Psychologists perform a large range of jobs.

Some of us do lots of assessments, using clinical interviews, questionnaires and tests to understand behaviour and mental health problems. Some of these assessments end up as reports for the courts or other government agencies, like ACC. Some of us do lots of therapy, working with individuals or groups to make changes. Some of us remain in Universities teaching and engaged in psychological research. Some of us move into management. Some of us specialise in working with particular groups of people, children or older persons for example. Some of us specialise in certain problems, such as Eating Disorders, or antisocial behaviour. And some of us, although admittedly not very many, become media personalities.

The thing that binds us together is our training. A Clinical Psychologist will have completed three or four years as an undergraduate student in psychology before going on to post-graduate study. Once in post-grad we complete three years training as a clinician alongside a research degree: either a Masters or a PhD. This is why some of us have the title “Doctor” (those with PhDs) and some of us don’t (those with Masters). At the core of our training sits the “Scientist-Practitioner Model” which states that we need to be trained as both scientists and practitioners. We understand and use the scientific method. We use assessment and treatment methods which have been proven to be effective. And when we begin to work with someone, we generate hypotheses about what is happening for them and then seek to test them through our assessment and treatment. Don’t worry – I do this in my head and try very hard not to sound like a robot when I’m talking to someone.

Me? I primarily work with adults, aged 18 and over. I work a lot with people suffering from anxiety and depression, although I am able to help with other problems too. I have discovered a real love of therapy. I love talking with people and happily do it all day long. And watching people make the changes they want to make is one of the great joys of my life.