Guest Post – Dr Kristine Abercrombie tells us about her journey as a therapist and a patient

It is my pleasure to welcome Kristine to guest blog this week. It was meant to be! Kristine posted on a Facebook group I am also a part of and I just wanted to work with her straight away! So I was greatly pleased to hear her positive response to write something for my blog.

Kristine explains, how self-care came before her career, how she dealt with loss, where her psychology career took her all those years ago, and where she is now.

Let’s read about her journey…

My Journey from Naivety, to Frustration, Confusion and Disempowerment – Reflections Five Years on

When writing, I often find as I imagine many writers do, the material which comes to mind surrounds something I am experiencing in my personal or professional life at that time. I have been thinking a lot this past few weeks about how it feels to be returning to my private practice providing online and telephone psychological therapy.

Nearly a year ago I made the decision to not take on any new clients, and take some time out from myself and my family. As you will read in my blog as well as being a clinical psychologist, I am also someone who has been suffering from chronic illness in the past 11 years. As you can imagine, this in itself brings its own continuous self care needs, and very sadly, I lost a very close friend, my grandmother, my uncle, and an aunt and her partner, in the past year and a half. So some slowing down was definitely needed!

On returning to practise, a blog I wrote this time five years ago keeps coming to my mind, so when Karin very kindly asked me to write a guest blog I thought sharing this, with a bit of – five years later – reflection could be insightful. I will share my prior blog first, with a little bit of an epilogue at the end.

Read my original post here: My journey from naivety, to frustration, confusion and disempowerment (written december 22nd, 2013)

Sixteen years ago I started my journey through the academic and clinical world of psychology. Little did I know it but I was on a journey of a lot of fun, learning, adventure, love, personal and professional development and subsequently pain, suffering and a journey of development that I could never have even tried to comprehend.

It is this journey that transported me from being a curious, empathic, educated, competent, albeit naïve human being and health professional, to someone with deep insight into what it is really like to feel the disempowerment, frustration and suffering of a chronic illness.

When I think back to my first experiences as an assistant psychologist, particular memories come to mind. For a year and a half I worked in a neuropsychology department, and had the pleasure of working with a lot of really amazing people diagnosed with neurological disorders, or categorised as having ‘unexplained medical diagnoses’.

The doctors I worked with for the most part really did have the best of intentions at the bottom of their hearts. We were working within a system with limited resources, restrictions and also within the realms of western science. In as much as doctors and patients would obviously like to think western medicine has most of the answers, there is so much about the human body that we do not yet understand.

In my humble opinion, Western medicine looks at parts of the body separately rather than having a more holistic approach, which would perhaps enable a more comprehensive understanding of the complex functions and interactions within this unbelievable organism.

As clinical psychologists/neuropsychologists our role was to provide a comprehensive assessment of a person’s cognitive functioning and emotional well-being, and work with the rest of the neurology team to help provide the best care possible to each individual patient.

Best care – it means so much when you’re a clinician, often working with limited resources, time, and in a world of medicine which still has much to learn. there are so many people you would love nothing more than to be able to significantly improve their lives, both psychologically and physically, but for various reasons it is not yet possible.

As a patient best care has taken on a whole new meaning for me; the limitations of the medical world leave me frustrated and angry, disappointed and sometimes quite frankly mad. Although I know that most of the health professionals I see are doing their best, I see how frustrating it is to:

wait on extremely long waiting lists;
see a doctor you feel doesn’t really listen;
get so many different opinions from so many different professionals;
feel at times you understand your condition more than they do;

and frequently leave appointments feeling more frustrated than you were before you arrived.

I feel I now have an opportunity to see things from both perspectives; the well-meaning yet at times frustrated doctor, to the often disappointed, saddened patient who tries to stay hopeful among much adversity. When doctors are:

under so many time pressures;
do not have all the answers;
things are not black and white;
do not know how to help or can’t help, their own feelings of being disempowered can get projected onto us.

We as patients understandably want answers, treatments that work, doctors who are empathic and truly listen, and a medical science which is more holistic and developed.

It is also important to acknowledge that Western medicine has over the year’s undergone immense transformation with Incredible life-saving and life improving treatments increasingly available for a wide range of medical problems, and with doctors demonstrating unbelievable skill, knowledge and technique. I imagine all of us both patients and doctors, have had either their own lives, or the lives of their loved ones, saved or significantly improved, on numerous occasions throughout their lifespan by the incredible advancements in the medical world.

It appears that as conditions become less clear, more uncertain, with less favourable prognoses, and chronic in nature, both patients and doctors can end up in a disempowered position, trapped within the medical system they wholly rely on, attempting a complex dialogue, entrenched in considerable emotion, whilst trying to work together to achieve the best outcome possible.

Perhaps it is only by truly acknowledging our shared humanity, fraught with limitations in addition to numerous strengths, that we can begin to move forward, working more collaboratively and openly; Enabling us to transcend together from a journey of naiveté to frustration, to one from naiveté to collective empowerment, even alongside the profound adversity and uncertainties inherent in life.

When a client and I find ourselves ‘stuck’ during psychological therapy, I could do one of two things: I could go off and try and find a solution by myself; or I could bring it to my client, acknowledge that we are both struggling somewhat to find a way forward, reflect upon this and try to find a solution together (Whilst I also engage in clinical reflection, individually and within supervision). Fortunately, the heart and soul of any psychological therapy, regardless of what treatment(s) are being implemented, is the therapeutic relationship, which means collaboration, openness and honesty is central to everything I do. I have often wished a doctor would just say to me, ‘I really don’t know how to move forward here, why don’t we have a good think together about where we might go from here’. And of course also listen to and take on-board my response.

In my opinion an acknowledgement by doctors of their understandable human limitations, in addition to those of the organisation one works for, and the medical world as a whole, would go a long way to helping patients and doctors to become joined in their shared goals, rather than separated by their shared frustrations

Reading this blog again actually made me quite sad…

A lot has happened in that time, for all of us! Whilst I practice gratitude daily, we cannot deny that the NHS is not being funded to enable it to do its job and austerity is taking its toll on our society. All of the amazing people who work in the NHS and social services are doing their best to help their patients; often risking their own health needs in order to do so.

However, in the same way we all have to manage many difficult things in our lives, the fact is this is the reality we currently live in. Whilst I keep optimistic that things can most definitely improve in the future, all we can really do at the moment is make the best of what we have.

As therapists and clinicians, we can make sure we do our best for our clients, whilst also looking after ourselves. As is often said, we cannot look after others if we do not look after ourselves first.

As members of communities, online and in person, we can continue to discuss important issues, raise awareness, be respectful of difference, show others that they are not alone, and that it is okay to reach out for help, whether to a friend, somewhere like Lifeline or Samaritans. Perhaps central to all of this is being compassionate and loving towards ourselves and others.

As patients, I believe we are at a time where it is becoming more important than ever to advocate for ourselves, and our loved ones. I know this is something I continue to struggle to do, and I know how the medical system works; so I can only imagine how difficult this must be for others who have not worked in the healthcare arena. I imagine we have all had that feeling when you go to see your general practitioner or consultant, for psychological or physiological reasons, to only leave feeling disappointed and as if you have wasted their time. Although it is not always easy – far from it – we can try to ask for what we need, whilst also being empathic to the limitations being imposed on our healthcare professionals, who ultimately for the most part do have our best interests at heart.

As a Psychological Therapist returning to practice, and someone who continues to be faced with frustrations surrounding the health care available, I feel I have to be careful not to enter into what many of us therapists refer to as RESCUER MODE.

Great empathy is, I believe, an amazing thing to have, but in order to help clients most effectively, looking after ourselves in the process; we have to remember we are not there to RESCUE them.

We are there to provide an environment, a safe space, where we can work together as a team, to ultimately help them help themselves. Furthermore, when we are patients and getting physical or psychological treatments, it is important that we acknowledge the part we play in this joint role.

Although this part can be extremely difficult, I believe in the long term it helps us feel more empowered, even when facing some of the most difficult of life experiences.

Whether a healthcare professional, a patient experiencing psychological/physical difficulties, or both a clinician/carer and at least at times a patient – as I imagine many people reading this blog will be – I would love to hear your thoughts!