“THERAPY CAN HELP PEOPLE MAKE SIGNIFICANT CHANGES IN THEIR LIVES”
INTERVIEW: Dr Angela Byrne | Clinical Psychologist
Dr Angela Byrne is a clinical psychologist working for Derman and at East London Foundation NHS Trust.
Can you tell about yourself? When did you start to work for Derman?
I was born and grew up in Ireland and moved to London in 1989. I first started to work in partnership with Derman in 2007. At that time I was working for East London NHS Foundation Trust in Hackney BME Access Service. My role was to try to make talking therapies more accessible and culturally relevant to local communities and, of course, Derman was a crucial partner in reaching the Kurdish and Turkish communities. We collaborated on numerous projects from awareness sessions and workshops in the community, to co-facilitating therapeutic groups and delivering training sessions for staff.
I left that job in 2014 to move to Tower Hamlets and it was very sad to say goodbye to all my wonderful colleagues at Derman. But we have a joke in Derman that it’s a bit like the Hotel California, you can check out but you can never leave. This is because so many staff come back or find other ways to remain connected to Derman. In 2016, Derman advertised for a clinical supervisor for the counselling team. I applied and was delighted to be appointed. I’ve been an employee of Derman ever since.
“People came hoping for safety and a better life but they faced many hardships here and a lot of disappointment.”
What does it like to work with Derman and Turkish speaking communities?
I am the only non-Turkish member of staff so it’s been a huge learning curve. I remember the first time I ran a mental health awareness session with Derman colleagues. I turned up with lots of powerpoint slides translated into Turkish, thinking I was being culturally sensitive. My colleagues had to patiently explain that talking through powerpoint presentations wasn’t really what worked for the community and that dialogue was much more effective and accessible to everyone, including those who don’t read and write. I have learnt so much from my colleagues and from the clients about what true cultural sensitivity looks like and this has helped me enormously in my work with many other communities. Working for Derman is wonderful, it really is like a family. My current role as a supervisor, means that I don’t get to work directly with clients but I really enjoyed working with Turkish-speaking communities. I was always struck by the creativity and resilience of the community in the face of many hardships.
“You only have to walk around Hackney to see what an impact the Kurdish and Turkish communities have had on the culture and life of the Borough and the city.”
On working with Turkish community, how do you see their psychological journey in London?
I have learnt that people in the community often suffered multiple losses and traumas before they even started on their journeys to London and I think that mainstream services don’t have enough awareness of this. They experienced many separations as family members often came at different times and were reunited, often after many years apart. People often experienced traumatic and difficult journeys to get here and then there is culture shock that comes with being in a new and unfamiliar environment, where you can’t speak the language.
People came hoping for safety and a better life but they faced many hardships here and a lot of disappointment. We mainly work with the first generation, who experience a lot of barriers in accessing mainstream services but we also think about the second generation, who experienced challenges of their own. They often had to grow up quickly and take on adult responsibilities at a young age, such as interpreting and translating for their parents and navigating two cultures in developing their identities.
However, I would also like to emphasise that the community has many strengths that helped them to survive, adapt and make a great contribution to the wider community. You only have to walk around Hackney to see what an impact the Kurdish and Turkish communities have had on the culture and life of the Borough and the city.
“We would like to encourage people to come at an early stage if they are feeling stressed or low in mood and not to wait until things get to a crisis point. There is no shame in seeking help, we can all suffer with our mental health.”
When Turkish community members should contact with Derman?
People can come for a variety of reasons to do with their mental health and wellbeing. We would like to encourage people to come at an early stage if they are feeling stressed or low in mood and not to wait until things get to a crisis point. There is no shame in seeking help, we can all suffer with our mental health. Of course, we are also here for people who have more long-standing problems too.
People often come for counselling because they are struggling with the impact of histories of trauma or of losses and bereavements. We have a specialist service for people with gambling problems and their loved ones who are affected. We also have a specialist project providing family interventions in collaboration with our colleagues at Imece Women’s Centre and Minik Kardes Children’s Centre.
Derman takes a holistic approach, so we see mental health in the context of people’s social circumstances and a very important part of our service is welfare advice, which helps people achieve stability and reduces stress. We also have health advocates, who work in GP practices and have an essential role in helping people communicate with their GPs.
We have a great group programme where people can connect with each other. These include activity groups, such as handcrafts, film and discussion and walk and talk as well as groups for depression, behavioural activation and relapse prevention, where people can learn skills and get the chance to explore what might be keeping them stuck and how they can move forward. Although we mainly work with the first generation, we also sometimes have second generation people who prefer to come to Derman for counselling because of the cultural understanding of the therapists, which they find lacking in mainstream services.
“I believe that therapy can help people make significant changes in their lives. It did that for me.”
What are you most passionate about in therapy and your role as Clinic Lead?
I am very passionate about equality of access for all. I am very much against seeing people or communities as ‘hard to reach’, when actually many services are hard to access. Derman is proof that, when a service is genuinely accessible and culturally relevant, people will come in large numbers. I feel that it is our duty as professionals to adjust and adapt our knowledge and skills to the needs of each individual and not expect people to fit into boxes in order to receive a service.
“When you ask people, they will always say that what was most important was being listened to, understood and not judged.”
In your past therapy experience, what did you learn about the talking therapy and the change that can occur for people?
I believe that therapy can help people make significant changes in their lives. It did that for me. I suffered from depression when I was younger and having therapy really helped me so much and made me want to be a therapist.
Over the years of working as a therapist, I have seen people make remarkable changes in their lives but I don’t think we should always measure success by change. Sometimes things don’t change but our relationship to things may change and that can be just as significant, for example, we may stop blaming ourselves for things that we cannot control. The most important factor in the success of therapy is the therapeutic relationship. When you ask people, they will always say that what was most important was being listened to, understood and not judged.
One to one therapy is what we usually think of when we say ‘therapy’ but I am also a big fan of groups. I think they are so much more than the sum of their parts and the sense of connection and support they create is so valuable. This is especially true when people are living with the effects of violence and abuse, which can include isolation, stigma and shame. Coming together in groups, realising you are not alone and sharing experiences can be really empowering.
WHAT ACTIVITIES DO YOU RECOMMEND FOR OUR MENTAL HEALTH?
I think connection with others and meaning and purpose in life are so important to mental health. What this looks like for each individual will be different. Obviously, connection with people who make us feel bad won’t be helpful, but having a close relationship with someone we can confide in is very protective. This is hard at the moment, given the restrictions on physical contact due to the coronavirus but we need to explore other ways of staying connected.
Routine is very important, especially when struggling with depression. I know myself how hard this can be when you don’t feel able to get out of bed but also how important it is. Try to build in activities that give pleasure and a sense of achievement, no matter how small. The mind and body are closely connected, so exercise is very important and, again, very hard to achieve right now but we must find ways, even if it’s just simple stretching exercises.
WHAT BOOK DO YOU RECOMMEND RELATED TO MENTAL HEALTH?
Can I be greedy and have two?
- Trauma and Recovery: From domestic abuse to political terror by Judith Lewis Herman. This ground-breaking work takes a feminist perspective and locates the experience of trauma in a social and political context. Many survivors have testified to the power of this book to help them make sense of their experiences and contribute to their recovery.
- Taking Care: An alternative to therapy by David Smail. It might seem strange for a psychologist to recommend a book that talks about an alternative to therapy, but I think this book is truly relevant to the times we are living in, despite having been published in 1987. David Smail was a critical psychologist who was concerned with the impact of social inequality and injustice and the limitations of therapy in being able to address this. In this book he makes the case for taking care of each other in ways that require social and political change and that could not be more relevant to the current crisis caused by coronavirus.
Finally, I never really recommend ‘self-help’ books because I think they don’t work and can reinforce unhelpful ideas e.g. that mental health problems and recovery are the sole responsibility of individuals and that if we can just think differently, learn skills or follow advice, then we can transform our world. So, I think that the books that really help our mental health are the ones we love to read and find pleasure in reading, so these could be novels or any other genre we enjoy. Personally, I am a great fan of poetry and often turn to it in times of trouble. Some of my favourites include Irish poets Seamus Heaney and Eavan Boland.