This interview is part of our Faces Behind HCC series. The contributor has chosen to remain anonymous, but shares a deeply personal journey into counselling, spanning decades of experience in mental health and pastoral care.
Tell us about your background?
Almost forty years ago I started training as a psychiatric nurse at Friern Hospital.The hospital, previously known as Colney Hatch Asylum, opened in 1851 and was the largest in Europe at that time. From the outside it was an imposing building, and the environment inside was just as formidable. There was a strong sense of being locked in – and it was a very different world that existed within its walls. This was to become a personal and professional connection to a part of history.
At the time of my training, the care and treatment of those with mental illness was under strain, and in an effort to break out of older styles of practice and restraint, mental health nurse training embraced curricular reforms. The training was grounded in the person-centred model by Rogers; with a focus on the use of interpersonal skills, self-awareness and reflective practice. This moved away from the traditional medical model of training that had previously been dominant. Alongside the theories of Freud and Bion, and others, we also studied group dynamics and learned about the work of therapeutic communities, and poignantly, the dynamics and impact of institutionalised care. Social attitudes and political thinking were changing, and a significant shift in mental health treatment preferences were being reflected in newly proposed health-care reforms.
However, the training experience was invaluable, and I learned about containment – in many different forms. Within this large institution were countless personal lives and stories. We each have a constellation of connections to those we are forever attached, but without history people can disappear, and many patients of the hospital had become disconnected from personal relationships and their own personal histories. Some were lives lived in the institution. There was a sense that some people had been forgotten, and even though every life held meaning and value, I was confronted with some form of mourning and loss in a variety of different ways. Casement said that when meeting ‘another’, we both change – a deep rapport surfaces in the form of feelings we have towards the other, and noting this response can be the most dynamic way in which the other’s voice reaches us – this was a powerful tool in working in the field of mental health.
Can you tell us a little bit about your career after qualifying?
My career after qualifying was in community mental-health working in both individual and group-work; this was in connection with a North London NHS Trust. The clinical areas I worked in had strong links with the Tavistock and the Institute of Group Analysis, and I was fortunate to receive clinical supervision from both these institutions, and also continued in my own professional development with further training in these organisations. I joined the nursing sub-committee of the APP (now the APPPS), which I am still a member of: it was made up of like-minded NHS practitioners that sought to incorporate psychodynamic thinking into their clinical practice.
In recent years I began working in a pastoral capacity in a church, specifically with women, following some studies in theology and pastoral counselling. I was considering going in to chaplaincy. I created a confidential space in which women might come for emotional support, a space to be listened to and to think together, without judgement or advice being given. This work grew, and I arranged external supervision for the work from a psychotherapist. I was aware of the potential for isolation in the work, and of the danger in working beyond my competencies. Deciding to train at HCC came out of this awareness, and it has felt like coming home – a marriage between what went before and the present, and what is ahead. I suppose I have wanted to train as a psychodynamic counsellor all of my working life.
How did you find the training, considering your existing experience in the mental health field?
Training with HCC has been deep and rich. It has required an investment of self and some degree of courage to fully engage with – it is a whole experience – and is different from any other walk of life. My training group has been essential, and an absolute highlight of my training experience. It was so wonderful to be in a group to think ‘together’, enabled by the theory and skills tutors. I really valued this ‘inter’ aspect of the training – the relationships formed with, and between, those you train with. Insights arrived at between people, which I suppose is the essence of the counselling work.
What did you enjoy most about your training here?
Being with one another. Knowing that we have all changed.
Something which has developed for me throughout my training is understanding ‘containment’, and how failures to contain can lead to potential harm, distress and feelings of abandonment for clients that we work with. In human terms, containment is a form of personal ‘holding’. A person is ‘held ’in order to recover. I have felt held throughout the training, change has been both quiet and dramatic, and I am in a different place now to where I was at the beginning! Of particular note is the way in which the structure of supervision unites and brings us – as practitioners, together; a sense of being provided for, and of professional belonging.
What could we do better- a bit of feedback maybe?
Perhaps a bit more thinking and discussion around ‘endings’ might be beneficial. Preparing to end starts at the beginning. There is something special about the finality of the process of ending, and we prepare for and prefigure the ending in numerous ways. The importance of mourning has become significant to me in the twists and turns of a career that has demanded an attitude of self-reflection, but has also demanded aspects of me in the work. When thinking about mourning, we often think about death or other aspects of profound loss, but a sense of mourning can be also present with every change, every end, and every new beginning.
Having qualified, what are your plans going forward?
I would like to continue the connection with HCC and am delighted to have joined as a staff counsellor. I also continue as a pastoral worker with women. Looking ahead, for me, there is much to be gained by taking some time to ‘take things in’ and consolidate what has been learned, while finding my feet and my own style as a counsellor.
How do you rest and practice self care?
I spend time with the children and walk the dog; the cat walks herself. I have a faith; I love reading, films; and I paint; and try to enjoy the detail of every day life.
