Lessons from a Clinical Psychologist
I recently had the pleasure of connecting with Jo Johnson, a clinical psychologist and neuropsychologist. I learnt so much from her understanding and experience that I thought others might also benefit from hearing from her. Kindly, she agreed to sit down and answer a few questions for me.
AB: Jo, you’re a clinical psychologist and neuropsychologist. Can you explain what that means and tell us a bit about what you’ve done in your professional life?
JJ: Hello, a clinical psychologist is a psychologist who works in health-related settings, for example the NHS. Psychologists are interested in how human beings think, feel and behave; why we do what we do. A neuropsychologist specialises in conditions impacting the brain, like stroke or brain injury. Neuropsychologists assess abilities like memory, attention and language and help people adjust to the changes after a diagnosis or injury.
I worked in the NHS for eighteen years in the field of neurology. I have worked mostly with people with dementia, brain injury or multiple sclerosis. I left the NHS in 2008 as I wanted to prioritise my four children’s needs and that was increasingly difficult with a demanding job.
I’m currently employed by the local constabulary to provide anti-burnout training. This means I train large groups of police officers and staff to manage difficult thoughts and feelings.
I would love to do more psychological work within a Christian context. In a secular context, I feel I am offering a flimsy Elastoplast to address a life-threatening bleed. Most people seek psychological help because they are feeling overwhelmed by big emotions such as guilt, shame or a sense of failure and hopelessness. I long to tell them of the remedy that works, that Jesus Christ died to bring life and an antidote to those feelings.
AB: What has your work taught you about people and about the Christian faith?
JJ: That the Bible is right about human nature. Of all the textbooks, the Bible includes the most accurate description of how we flawed humans truly think, feel and behave. The Bible says we are created in the image of God but are also deeply flawed. It’s the only ‘textbook’ that explains correctly why we do what we do and why we can’t do what we’d like to do.
Many people who seek my help have been hurt because of the lies that are being pedalled as truth. Beliefs like the idea that we deserve happiness, that we must find our true selves, that you can have sex with whom you like without harm. By seeking happiness and pleasure as a primary goal, people lose what gives true meaning and suffer terrible self-loathing. I have learnt that the most attractive, wealthy and successful people are still hurting because their soul problem remains unaddressed.
AB: You like to make use of the acceptance and commitment therapeutic model (ACT). Tell us a bit about that and why you’ve found it helpful.
JJ: I love acceptance and commitment therapy, or ACT as practitioners call it. It’s one of the more recent versions of Cognitive behaviour therapy or CBT. CBT sensibly said that thoughts impact feelings. So, if I believe the thought that ‘I am stupid’, it will undermine me, make me less willing to speak out and perhaps force me to decline opportunities. Traditional CBT encouraged people to challenge negative thoughts with evidence to the contrary. So, I could argue I have two degrees, I wrote some books etc. For some, CBT is helpful, but increasingly the research suggests thought-challenging doesn’t really work.
ACT recognises that humans are flawed and that as a part of our condition we experience negative thoughts and feelings. The Bible says that too. The response of ACT starts with values. It says what helps people feel better is to discover what and who is important. Then, to focus on behaviours that move them towards those important things and people. It acknowledges that we find it difficult to behave well because of our undermining thoughts, urges and feelings.
For example, I have chosen each day to take my husband a cup of tea in bed. That’s one of my chosen committed actions towards what and who is important. But, even a tiny act of goodness provokes tricky thoughts and feelings. I feel bored because I’ve done it every day, anxious that I might make myself late. I have the urge to not bother. I have thoughts like, ‘He’s lazy. When did he make me a cup of tea?’ So, even these small acts of goodness create in me an inner rebellion. ACT teaches some easy tools to manage difficult thoughts and feelings so you can choose what you want to do and not be sabotaged by your inside stuff. These tools help but provide only a partial solution. Only the Holy Spirit has the power to change us from the inside out in a lasting way.
ACT fits well with the Christian faith and is a helpful model of therapy for Christians. The tools have helped me and can be adapted to use with many difficulties including clinical depression, addiction, OCD, trauma, gender confusion and also with everyday struggles like relationship conflict, over-eating or jealousy.
AB: In your work, you’ve often helped people think about identity. What are your key observations after many years of these conversations?
JJ: As a clinical psychologist, an exercise I frequently use in therapy is the ‘I am’ exercise. You can try it. Simply write out ‘I am’ five times. What are the first things that come to mind when you complete that sentence?
For me, it would be:
- I am a mum
- I am a psychologist
- I am a writer
- I am clumsy
- I am healthy
I see a diverse range of people in my clinic. They all come because they are experiencing high levels of psychological distress. The problem can often be traced back to one or more ‘I am’ beliefs.
Our ‘I am’ beliefs are central to our identity, the ways we have come to think about ourselves. They might be to do with my job – I am a psychologist. They might be roles I have – a youth leader, a pastor, a housewife, a mother. They might be things I do – I am a writer, a runner. They might be to do with my mental or physical health – I am depressed, I am healthy, I am disabled, I am infertile. Or my physical appearance – I am fat, ugly, pretty. Or my abilities – I am useless, I am clever. ‘I am’ beliefs show what you hold in high esteem, even if you don’t perceive yourself to have it!
I see people who’ve defined themselves by their success at work. Then they retire, are made redundant or are sacked. Others might pride themselves on being healthy and invincible or strong, and then they are diagnosed with a long-term or terminal condition. I might pride myself on some of my roles like wife, psychologist, mother. But sadly, every ‘I am’ is vulnerable to being lost or undermined.
1 John 5:21 says ‘Dear children, keep away from anything that might take God’s place in your hearts’ (NLT).
My ‘I am’ beliefs give me clues about the things that could potentially become so important that they may take God’s place. Many of them are not objectively bad. In fact, my family, work, health, and abilities are gifts from God, things he intends for my blessing, skills I could use in his service.
As Christians we need to be careful since anything we put after ‘I am..’ has the potential to distract us from God and also to destroy us if we lose them.
When we become saved, Jesus Christ swaps his righteousness with our sin and shame. As Christians the only safe ‘I am’ is ‘I am in Christ’. No one can change that. Nothing can separate us from the love of God in Jesus Christ.
Any other ‘I am’ that gives me a sense of value or self-worth is vulnerable and its loss might make me psychologically vulnerable.
AB: You’re also a novelist and have used fiction writing to explore some big themes. Tell us about your books.
JJ: My novels are psychological suspense. I am told that they are fast-paced with satisfyingly flawed characters and always a good twist. They are all free of smut, bad language, blasphemy and violence. I’ve just published Surviving Her, my second novel which explores the theme of emotional coercion. My first, Surviving Me explored depression, neurological illness, and suicidal thinking. I’m working on a third called Surviving Him about dementia and adolescence.
AB: If you could pass on a few key lessons to pastors and others who help support people, what would they be?
JJ: I think the most helpful thing anyone can do is to listen without agenda and then acknowledge a person’s pain. Often, we think we know what it’s like to stand in someone else’s shoes, but if we don’t listen we can’t understand. Most people who seek help are in emotional pain. We might need to tell them what they want will harm them or that they have created their situation, but it is rare to find a situation where we can’t first affirm their deep pain.
If the pain is a result of loss – loss of a person, role, hopes or dreams – we can reassure people their pain shows they cared. We can also confirm that emotional pain is natural and not hurting would be abnormal.
I also feel it’s helpful if we can all acknowledge our own struggles. The Bible tells us we will suffer and experience trouble. We all experience difficult thoughts, feelings, and urges. If we can be open about our own struggles, others will be able to be open about their own. This builds authentic communities where people are safe to share burdens, confess sin and grow. Shame and sin thrive on secrecy and a desire to pretend.
The most recent research has highlighted self-compassion as a positive thing. We are called as Christians to show compassion, but often we are harsh with ourselves. We can model self-compassion and help people see when they are self-beating.