Autumn running and research FOMO

It’s a cool, rainy Autumn morning – finally. I’m inside, with the kitty, planning to do some work on the lit review before heading into uni to do more testing, reading and writing once traffic subsides.

Pearl Izumi
Pearl Izumi E:Motion Trail N2 v2. Love the red, black and lime combo.

My body is feeling quite sore, but a good “done lots of things” sore. On Friday I did a short walk/run with a friend around a bay that’s close to uni (very lucky, running by the water – lots of dog-, people- and boat-watching), on Saturday I did the usual parkrun (10 sec slower than my PB, dammit), followed by more home decluttering – the pantry looks lovely and manageable now (although how long will that last?). On Sunday I did some trail running (almost 10k very slowly, I came 3rd last in my age and sex category, but I enjoyed it a lot). I hit the trails in my new shoes for the first time, and they felt very grippy and secure, although more neutral than I’m used to (less arch support) which I’m not 100% sure about.

It’s sinking in that in just over a month I will be going overseas (North America) to present my research at two conferences. I’m still testing participants, which means I won’t have much time to analyse results and think about discussing the findings. (So I’m quietly terrified.) I’ll be spending some time in the US and Canada beyond conferencing. I’m going with a friend, and I think it’ll be fun – apart from becoming enlightened and covering our dear alma mater with glory,  I think we’re going to hit up some haunted/creepy places, catch trains, and trial some fine local fare (especially of the liquid variety).

Conferences are funny things. They make you pay to attend even if you’re a presenter – so, essentially, you are providing the content, and yet you have to pay for the privilege of being there and providing said content. Also, I’ve just found out that one of the two conferences I’m going to won’t be providing lunch this year – outrage!! And yet we do it, because it’s good experience, good “networking” (ugh…) and not least because the university subsidises the attendance of research students and academics.

Lately I’ve had massive research FOMO. My degree is a combined clinical and research degree, and my research as part of this degree will finish in a few months. I’ve been going to quite a few research seminars and colloquia, and I really wish I was sticking around to do more research – I have ideas on how I’d like to continue the research I’m doing, but it involves more experimental work of a kind that my current university is not really equipped for. Also, I don’t want to lose my clinical skills (hard-earned over the past three years), and I do really like clinical work. So the sensible option is to finish, get a job, and then think about coming back for more research later, which is something lots of psychs do. I just have to make my peace with not being able to Do All The Things at the same time…

Advertisements

Back to Stats

FullSizeRender
Tools of the trade: coloured whiteboard markers, eraser, Casio calculator of a vintage that makes me feel old, tissues, and mints because talking for hours requires minty fresh sustenance. Plus accidental e-reader.

It’s the first week of tutorials for the undergrads, and the first day of tutoring for me. I started doing university tutoring two years ago, not having done any kind of teaching before, and (mostly) loved it, so here I am, back again, doing it alongside research and other work.

I’ve tutored various 1st, 2nd and 3rd year units, but most of the time I stick with Statistics. Why Stats? Quite a few of the students I teach openly admit they’re scared Stats. So I give them a bit of a spiel at the start of the semester. Stats is important, obviously so if you’re running your own research, so you can make sense of your data and see how your hypotheses fared. But even if you don’t go on to run your own experiments, in any area of science or health science you end up in, you’ll be able to critically evaluate journal articles, for example about different treatments, and make up your own mind about the results*. And even if you don’t stay in science, if you get Stats you will find people who want to be your friends, because so many people are scared of Stats**. Stats is also relevant to lots of other areas, like marketing and politics.

Riveting stuff 😉

But I do think the above is true, and the reason I generally choose to tutor Stats over other areas is because I want to make it a bit less scary for the students, and hopefully get some of them interested in Stats. (And also, other more selfish reasons, like keeping it fresh in my mind for my own research needs, and also because the marking is more objective and straight-forward than in other subjects. And also professionally selfish reasons, like increasing the Stats literacy of the future Psychology workforce.)

 

* What I don’t tell them is that it takes a long time, and a fair bit of not only statistical knowledge, but also knowledge of research methods in general and also often of a particular area of research, to really be able to engage critically with a paper’s results section.

** You might prefer people to befriend you based on your stellar personality and sparkling wit, but as a fellow Stats enthusiast I’m certain you possess both of these attributes in spades.

The Real World! First External Placement

Hello! It’s been a while.

Mid-last year I was sent out into the Real World on my first external placement, in the neurology department of a large hospital. Got to see plenty of interesting presentations, both in inpatient and outpatient. I learned to use lots of cognitive assessment instruments, and I’d like to think that I improved my history-taking and assessment skills. I also got to shadow neurologists, neuropsychologists and techs, become very familiar with the ward, and see some interesting procedures, and some neurosurgery. This was a full-on assessment placement, meaning no therapy. This is somewhat uncommon for clinical psychology interns, but because of my love of brains and the nervous system in general, and because of my area of research, I decided to do it, even though it meant taking a 6-month break from psychological therapy.

While clinical neuropsychologists are experts in assessment in a neurological context (i.e. when there is an organic basis for perceived deficits, such as stroke, traumatic brain injury, etc.), all psychologists are trained to do some types of cognitive assessment in the general population. Cognitive assessment is a core aspect of any psychologist’s training and duties, and yet it’s not very common in the popular perception of psychologists – certainly not as much as therapy is. Many psychologists also do capacity assessments.

Before starting in my course, I’d considered doing a Master of Clinical Neuropsychology instead, due to the aforementioned love of the brain. And I continued toying with the idea of doing this later on in life. However, this placement made me reconsider, to my surprise: I found the short-term nature of involvement with patients, and the fact that you don’t typically do any treatment yourself, unsatisfying. That being said, I do very much enjoy doing cognitive assessments, so ideally I’d like to work in an area needing both therapy and some assessment.

To respect confidentiality, I’m not going to talk about any specific cases. But I thought I’d write about the general process of getting a neuropsych assessment, as I understand it from this placement. It is possible that this process is different in other settings where these assessments are often done, such as brain injury units.

1. You, or your family, develop concerns about a change in some aspect of cognition or behaviour: increased forgetfulness, problems following directions, recklessness or impulsivity, lack of concentration, speaking/reading/writing difficulties, not coping with job or education demands, etc. Maybe your family have concerns about your capacity to manage finances, consent to medical procedures, or manage day-to-day life.

2. You see your GP, who does the first-line investigations, but if these do not suggest an immediate answer/solution, will refer you to a neurologist. (Or to another type of specialist if a non-neurological problem is suspected.)

3. The neurologist will often get some further investigations done (e.g. neuroimaging), and if appropriate, will then make a referral for a neuropsychological assessment. A neurologist may also make such a referral following a stroke, or for chronic diseases affecting the nervous system such as multiple sclerosis, Parkinson’s disease, etc.

4. For the assessment, you come in for 1-2 sessions, during which a history is taken from you and (preferably) a close family member as well, and an assessment is conducted, tailored to answer the referral query (which is sometimes really vague: “X may be prone to being taken advantage of by others”; “please assess cognitive function”) and taking other factors into consideration, such as your English language fluency, general cognitive status, if an interpreter needs to be used, physical impairments such as missing limbs, blindness, pronounced tremor etc. The assessment consists of a test battery – different tasks that look at different aspects of cognitive function such as memory, speed of information processing, attention, verbal abilities, reasoning, problem-solving, etc depending on the referral question and clinical judgement.

5. The assessment is then scored, and a report is written up and sent to the referrer, that typically includes a brief history, findings, and the impression (i.e. if the findings appear to support or not support a particular diagnosis, opinion regarding capacity, etc).

6. Feedback is often also given to the patient and family, with easy-to-understand major findings and general recommendations on what would be helpful in terms of managing day-to-day activities, given the pattern of deficits found (if any). Often the recommendations will involve having other investigations (e.g. sleep studies – if the patient reported having disrupted sleep), seeing other professionals (such as a clinical psychologist – for adjustment to a diagnosis, implementing day-to-day strategies, or if the cognitive deficits found seem more in line with depression or an anxiety disorder), or becoming involved in support groups (e.g. for MS, PD, etc).

7. There will often be a recommendation for follow-up testing in 12 months’ time, or sooner if further changes are noted.

And that’s all for today…I’m now almost at the end of my second external placement, in a very different setting – but I’ll cover this in a future post.

Season change

I much prefer autumn and spring to summer and winter – I see them as transitional seasons, which of course isn’t quite accurate, as every season is a transition. But in spring and autumn, it feels like the transition is somehow more extreme, and so it’s not as monotonous as three months of heat or cold.

This summer has left me battered and bruised, and I’m glad it’s now autumn. I can feel the cool change in the air, especially in the morning and at night, a touch of crispness. It feels like I’m slowly waking up – opening my eyes, moving on. This is not really a personal blog so I won’t go into the details, but the past few months have played havoc with my internal and external life. I hope now is the time to get some distance and heal.

My course continues and I still love it, although it’s hard at times. In this clinical rotation the emphasis is much more on process, a notion which is hard to describe. Basically it’s focusing on the dynamics in the therapy room between therapist and patient, rather than solely on the presenting problems. This is challenging for me as a novice therapist, as it is quite a confronting process, both for therapist and patient, as it involves pointing out the “backstage” elements of what is a constructed social interaction. Therapy is about being truthful, rather than being nice, but it’s hard to be truthful in a nice way at times. I’m also learning about different ways of “being” in the therapy room with different types of patients, which is also challenging. Being “nice, supportive therapist” will not get some (most?) people to shift.

There’s also only a couple of months until we are released into the “real world” for our external placements, which is quite scary/exciting. In the mean time, I’m also learning lots of neuro, and there may be some brain dissectin’ going on in the future. Not having done a human brain before, this is exciting.

Things I am loving right now: coffee, Swedish crime fiction (everyone in these books drinks so much coffee), and that it’s cool enough to wear leggings. Yes, sometimes it’s the little things that get you through.

How long is a piece of string?

Here’s the thing: changing careers is hard. Not just because of the need to pick up completely new skills, and hit the ground running, but also because everyone expects you to be unwaveringly enthusiastic about how you’re going in your new field. You feel a need to prove to everyone that this is not a mistake, that you’ll make it, that this is ‘it’.

So when the going gets hard, there’s still this need to keep smiling, because ‘you chose this’ and ‘if you don’t like it, why don’t you go do something easier’. This week, the going got hard. I’m trying to get my research off the ground, conceptually, and it’s like hitting my head against a brick wall. I have to bring something new to the table, so I had a couple of ideas that I thought would be pretty nifty to look at, and they are – but it turns out they’re also too involved for the scope of my current degree. It’s hard finding the ‘right’ idea: one that’s above all, interesting enough to sustain you throughout the degree, but that will also let you graduate at some point, and that’s also possible given the chronic lack of time. Not too little, not too big. (Hence the title of this post.)

While trying to get my research off the ground, I’m also trying to memorise hundreds of symptoms (plus changes from one diagnostic system to another), trying to learn different therapies and techniques so I can provide adequate treatment in the clinic, make weekly session plans, and prep for upcoming neuropsych assessments that we do throughout the degree. (And this is my ‘mid-year break’ – soon, coursework will start up again.) All these components are pretty much separate. Patients don’t (and shouldn’t have to!) care that you have to do research; the research supervisor doesn’t care that you have to do coursework; the neuropsych supervisor doesn’t care that you’ve had a hard clinical week and don’t feel like writing reports. And exactly zero people care that you also have to work for money. And the admin. Oh, the admin – it never ends, and I’m sure one day it will provide the subject for an absurdist play. So this is where I’m at right now.

I started writing this post a few days ago, but wanted to cool off a bit before submitting it. Now, looking back at it, I have to smile a little, because this really is what I want to be doing, and I do generally prefer to keep busy. But, the point is, there most certainly are bad days, and just because something is done by choice, there shouldn’t be an expectation (often self-imposed) of permanent cheerfulness.

Self-care

So, I’m now almost a full semester into my clinical program, and a few short weeks away from starting the first placement. I’ve learned a lot in the past few months – I’ve picked up knowledge and skills, and I’ve heard plenty of both inspiring and shocking things (which doesn’t mean I feel at all prepared, by the way). What I am coming to learn about providing psychological therapy is that, essentially, its purpose is to get people to do all the things they don’t want to do: face terrible situations they don’t want to face, perform actions that they really don’t want to perform, do things that are really hard and painful.

Because the training program is demanding, we are told to implement as many self-care strategies as we can, now as students, and as future clinicians, to avoid burn-out and damage to our own health (pity these things aren’t built into the program).

So I thought I’d run through some of the things I do for self-care, as a reminder to myself when things get even more full-on, and also for anyone else looking for ideas.

1. Live life.
There’s often a temptation to hole up and shut the world out while you get through study. At some point last year, I noticed that if I held back from social occasions or other fun things I would stay home, possibly mope, most likely procrastinate, whereas if I did go out/have a holiday etc, even though that would leave less time for study, I would be more efficient. So this year I’m doing things outside the course (within reason – as there are some hard limits on my time and energy).

2. Exercise!
I cannot emphasise this enough. I started running 6 months ago and I’m *very* slowly building up to 5km. (In honour of Dr. Isis, I now refer to this as “rundouchery”.) I believe that I finished 4th year with my sanity mostly intact because of exercise. It’s an antidepressant, anxiolytic, analgesic, promotes neurogenesis (= will make you feel good *and* SMRT!), and also can give you a goal to work towards. WIN.

3. Good food.
Get your 5-6 veg + 2 fruit a day and everything will be better, I promise.

4. Be around people.
Family, friends, pets, professionals – whatever your needs are, don’t isolate yourself, as tempting as it may be when you have a mountain of work to conquer. Let people know you’re struggling, and that you need help. Get the help you need, practical, emotional, whatever it may be. Spend whatever time you can afford with the people who make life good.

5. Games and TV.
I am a big fan of games that have defined points where you can leave, e.g. finishing a chamber in Portal or a chapter in a story-driven adventure game. Also TV shows that are interesting but don’t leave you hanging (like Elementary). Sometimes you need to ‘switch off’ for a while, without getting sucked in.

6. Maintain interests outside of study/work.
It’s good to have interests outside of professional ones, however, this I haven’t very good at. I haven’t written, drawn, painted, taken photos, gone bushwalking or caving in a long time – I hope to get back into this sometime soon.

This is what helps me – I’d be happy to hear about what works for other people, when the going gets tough.