We ask Oliver Markham, trainee CBT Therapist at Turning Point Talking Therapies, about his professional journey leading to Turning Point, his daily work and training, and about his passion for men’s mental health and the what should be done to help men get the support they need.
Can you detail your professional experience with before you joined Turning Point?
I did a degree in psychology, and then worked in learning disability services for about three years. I did some employment support for adults with Asperger’s. At 24, I went to work in the prison service, in Norfolk, as a trainee wellbeing practitioner. After that, I worked in Norfolk for another four years as a wellbeing practitioner; I worked as a locum practitioner, going around the country as a psychological wellbeing practitioner. I also worked in CAMHS last year, with children from 10 to 18, doing brief CBT work. And then this opportunity came up.
So you’ve had quite the journey. What did you have in mind when you started? Did you take your time to find exactly what you wanted to do, or did you experiment or take opportunities as they came?
There’s a bit of an idealised view with a lot of psychology graduates, about where they want to be and what they want to achieve. I think the reality is really difficult when you get there. I always had this idea that I’d like to work in mental health, maybe as a counsellor or a psychologist, but I didn’t necessarily know what that would entail. I suppose I had this semi-idea of the destination, but opportunities have come up along the way. In particular, getting into CBT wasn’t intentional. It was something that really resonated with me. I go the sense that things were aligning and it felt really right. I think I was kind of looking for something that, for me, I’m quite a practical person, and CBT brought what I liked about psychology and mental health into something meaningful that you can work with. There’s often these kind of lofty ideas associated to psychology by academics, but CBT is easy to understand, relatable – an applicable and real-life way of managing mental health issues.
Do you feel like it takes you on a completely different path than the one you imagined after graduating?
The course that I did was very abstract. A lot of it was research-based and kind of biological. There wasn’t applicability, and often I think, universities and colleges put all these ideas out there, but they don’t always translate in a way that’s meaningful for living your life. I think big part what I do now, it’s experiential, living day-to-day with and working with the person who’s experiencing problems. I’m working through the barriers with them, but maybe also going through my own stuff as well. There’s a real-world philosophy about it.
Can you tell us a little bit about what you do as part of your training?
I’m on a 12-month training course with the University of Sheffield. Three days a week, I’m in service. I’ve seen clients with a range of anxiety and depression such as OCD, social phobias. At university, it’s a series of theory-based, but also experiential activities – role plays, tasks. For example, we’ve done something called hyperventilation protocol: in a group of people, you’re given a straw, and you have to breathe through it for five minutes. That’s to get you to start having a panic attack. You’re experiencing, not quite, but similar symptoms to what your clients might experience if they were having a panic attack. We’re also taught breathing methods that would bring about palpitations, light-headedness. I really like this because it takes you to a place that you wouldn’t go to otherwise, and experience rather than standing as an onlooker. You’re going into what it feels like to be there with the person.
What is it that you enjoy or the most at Turning Point?
I tend to have a session in morning, another in the early afternoon, and finally one in late afternoon. I’m able to keep this a routine, which is helpful for my patients. Definitely the reason why I’m doing the job is the clinical work, and the prospect of change within the people I’m working with. For example, I’m seeing a person with phobia of flying, and she has managed to move forward from something that she’d never been able to face before. That is rewarding to experience that within session, and to be part of that experience. Beyond that, it’s a cool team to work with as well. Particularly at Turning Point, there are many different types of practitioners; relationship therapists, counsellors and short-term therapists. It’s really beneficial for shared experiences within the team.
How does it compare to your previous experiences?
Turning Point is a little bit more organic, a little bit more grassroots. It doesn’t seem as constrained as my previous roles, where there was a lot of bureaucracy. It’s also quite forward-thinking. The people who work here are relatable, and there’s a sense that a lot of them have experienced difficulties themselves, where they can really connect with clients. The work is really dynamic, interesting, organic. Even though CBT is quite a protocoled therapy, I think there’s an opportunity to bring yourself to it, and overall I feel I work in something that is important.
Do you have complex cases to tackle?
Working in Wakefield which is quite a deprived area, there’s a lot of abuse, a lot of post-traumatic stress, financial distress. The actual reality is there are no such simple cases, I don’t think it’s fair to say some are cases are less complex. I don’t think there’s such a thing as a simple case, because it’s people we’re working with and at any point, the game can change, new things can arise, difficulties can be overcome. As much as possible, my supervisor tries to support me to find cases that we can work on together, and where we’re able to do something meaningful in the time that we have.
Do you know what you will be doing once you’ve graduated? Are you going to take on cases that you’re not taking on at the moment?
I’ll be a fully-qualified member of staff, so I’ll be taking a full case load – we’re probably looking at 20 to 25 patients a week. This will include people with PTSD; that’s something that I’m not particularly experienced with, and I’ll also work with sexual trauma. I’ve been interested in working with EMDR, which is eye movement and desensitisation. It is a particular type of treatment that involves reprocessing; it basically involves therapists moving their hands back and forth and the patient following their fingertips. The idea is that when we’re experiencing trauma, we don’t process it properly, within a memory. That’s something I got really interested in. I’ll be running groups and get involved. At Turning Point, practitioners all get to choose an area they’re interested in, an area of expertise or area of particular interest. Personally, I’m interested in working with young people, men’s mental health and staff wellbeing. I’ll work on developing community links, setting up events and improving accessibility and engagement for those subgroups.
Regarding the topic of men’s health, what needs to be done to help raise awareness?
There needs to be an ethos change and a cultural change around what it means to experience mental health issues as a man. The change probably is needed at a societal level, but I suppose smaller changes will need to come first. First, we need to look at the workforce we employ. We’re predominantly female in a lot of mental health services. When you’re presented with male issues or a male perspective on certain issues, it might be really hard to relate to a female that can’t share or doesn’t seem to share those viewpoints. At Turning Point, we’re about a 50/50 split, but at other services I’ve worked at, it’s been as much as 90/10 female. A lot of males will disengage from feedback, telling me they just couldn’t relate to the person. Sometimes it comes down to something as simple as gender. Right now there’s a large movement towards recruiting people who aren’t necessarily graduate trainees, but also people who have experienced mental health issues themselves. Another point of emphasis is getting the message out, finding accessible ways to communicate, going into workplace environments, thinking cleverly about our campaigns. There’s a really good government campaign at the moment: “Man up”. Andy’s Man Club as well, which is something that’s taken off certainly around here, a charity that runs every Monday and they meet up and talk about issues. I think it’s about how we encourage people to engage in therapy; there’s a lot of stigma around men being weak. I had a session last week where a man started crying. He said to me, “I felt like I wanted to leave the room. I felt like that was it. I didn’t want to be here anymore.” We need community-level involvement and action, change the way that we advertise, liaise with GPs, get peer support workers on board, have dedicated ‘champions’ in services. We need to be able to show to men: “this is how therapy helps me”.
Do people in the local Yorkshire county still have still have misconceptions towards therapy?
In certain areas, there’s a high level of deprivation, but there’s also kind of a disconnection, in rural towns, there’s a disconnection from the big cities. You get the sense that some of these towns have been left behind. There’s a prevalent sense of traditional working class mentality where people don’t talk about these issues and just get on with things. It’s seen as a weakness. My parents are both working class, they often tell me, “it is a hard life. Don’t complain about it. Stop whinging. Stop moaning.” Mental struggle isn’t seen as valid as a physical, social, or financial struggle. For a lot of people, getting through the day and making sure there is food on the table is a bigger worry than mental health.
Last month was Men’s Health Week, is there anything you would like to bring up on the topic?
I would say that, for me, men’s mental health is often kind of covert. In the groups of men that I work with, we shy around the issue of mental health. We banter, we make fun of each other and we don’t deal with the elephant in the room. I’ve worked with 17-year-old men facing college; I’ve worked with 85-year-old guys facing the end of their life; professionals and non-professionals; mental health affects men as much as it does women, but one of the things of being a man, which I have experienced, is that you’re alone with this. It obviously isn’t – we have thousands and thousands of referrals of men. But we need to somehow hold on to the idea that it’s not something we have to live alone with. It’s about trying to find the way in which people feel they can voice that without that shame.
If someone is in a difficult situation, what would be your advice for them?
Therapy can be immeasurably helpful. It’s really frightening at times to share your problems with somebody else. But I suppose I’d be bringing it back to how things are right now and how they could be. I know from my own experience, and I know from the people I work with, that therapy can, alongside other things, can be the thing that makes a real difference. Even when you’re getting up every day thinking, “I can’t do this anymore, I don’t want to leave my house because I’m anxious, I just can’t cope with this,” there’s still a light at the end of the tunnel. You have to be a bit experimental; this might work, this might change things. For me, it always goes back to – how are things right now? Do you feel like this is getting better on its own? Do you feel like you can go on like this, or are you willing to consider that things could change? Sharing it, even one hour a week, means that someone else is on board with you. They might not be steering the ship, but it means that there’s someone else in the back helping you to feel like you’re not alone with it. Think about what is there to lose; it might really be the thing that cracks the nut.