THE LOOKING GLASS
April 2013 Issue Two
EXPERT OPINIONS The Challenge of ‘Club Drugs’
GAMBLING A hidden problem in substance users?
CAREERS Top tips for those applying to the Clinical Psychology Doctorate
INTERVIEW We put Professor Jon Cooper on the couch www.facebook.com/TheLookingGlass2012
ON THE COVER 3 Feature: Gambling - a hidden problem in substance users? 9 Careers focus: Applying to the Doctorate in Clinical Psychology 11 Expert opinion: The Challenge of ‘club drugs’ 20 Interview: On the couch with Professor Jon Cooper
INSIDE 2 Welcome 7 Feature: Using voodoo for exams: a recipe for success? 13 Reviews: Psych-related iPhone Apps 15 News and Events 17 Editorial: Junkies and potheads - moral weakness and medical illness 19 Blogspot: Do you think you’re prejudiced?
The Looking Glass
WELCOME Welcome back to the second issue of The Looking Glass! Our first issue was a smashing success. We had a fantastic response with hundreds of you logging on to have a read, across the globe, with readers as distant as far flung Peru, Russia and Uganda (see the map below)! Closer to home, weâ€™ve had lots of lovely positive feedback from several people at the IoP and we feel inspired to continue on our quest to keep you informed, engaged and entertained. Members of the editorial have even been haunting various events around campus, introducing the magazine and giving out copies. We appreciate all feedback (good and bad) so get in contact if you want to let us know what you think of the IoPs very own student publication. So, following our initial success, what have we got in store for you this time around? Well, several of our articles this week look into drugs and addiction, with Analucia highlighting the failure to recognise problem gambling amongst those with substance use disorders in her article on page 3. We also have Dr Owen Bowden-Jones, a consultant psychiatrist and Chair of Addictions at the Royal Society, offering an expert opinion on club drugs and the problems they create. We are also initiating a new collaboration in this issue with iConcipio (turn to page 6 to find out more about them). A member of their team, Dr Marietta Papadatou-Pastou, explores the placebo effect and whether we could harness its power for our benefit in other situations such as exams. Meanwhile, our career focus comes from Elena Panagiotopolou, who gives us her top tips for applying to the Clinical Psychology doctorate. In addition to all of this, reviews as well as updates on the latest IoP happenings in our news and events section. As always, we are looking for contributions for our next issue so if you have any bright ideas then get in contact at our usual address (firstname.lastname@example.org). But for now, put down the textbook, grab a hot beverage of your choosing, sit back and take a break with The Looking Glass.
The Looking Glass
Gambling: a hidden problem in substance users? Analucia Alegria D
rug and alcohol abuse and dependence (i.e. substance use disorders, SUD) are common problems that can lead to overall functional disability in individuals and overwhelming public health consequences. Many of those affected are also likely to present with a secondary condition that can adversely interfere with course and treatment of the primary condition, by delaying recovery and increasing the likelihood of relapse. Therefore, it is common that clinicians routinely screen for the presence of common comorbid psychiatric conditions such as depression or anxiety, in order to address the clinical picture as a whole. However, I wonder if other conditions that occur at lower rates in the general population but are shown to be prevalent in clinical populations with SUDs are also assessed and managed in this way. Gambling is a legal social or ‘recreational’ activity that has been part of human history since ancient cultures and the corresponding disorder is as old as the behaviour itself. Pathological gambling has been shown to be as prevalent as bipolar disorder and schizophrenia among the general adult population (0.5% to 2.0% in Western countries) although among clinical samples of
patients with SUD rates of pathological gambling had reached as high as 50% . Pathological gambling (an impulse control disorder or a non-substance-related addictive disorder) is characterised by preoccupation with gambling, lying and chasing one’s losses and is associated with financial and legal problems, family disruption, additional psychiatric and physical conditions, increased utilization of emergency and inpatient services and suicide. Interestingly there is evidence that pathological gambling and SUDs share comorbidity, genetic and physiological characteristics. In fact, there is some theoretical literature suggesting common aetiology between the two. Important to highlight is the impact of problem gambling in every dimension of the life of a patient with a SUD, including increased psychiatric symptoms, more severe legal, employment, and family difficulties and more severe social impairment, to mention a few . Having said this, it is reasonable to expect that clinicians or counsellors working with patients with SUD would be concerned about gambling problems affecting their patients to the same or greater extent that they are about depression or anxiety, right? Well… not necessarily.
Analucia worked as a gambling counsellor in New York and Madrid for a number of years. Her interest in problem gambling also led her to publish and give talks on the subject. After completing her MSc, Analucia is now a doctoral student in the Department of Child and Adolescent Psychiatry at the IoP. 3
The Looking Glass
In my experience, recruiting participants for a research project in a methadone-maintenance clinic in the US, I found that some substance abuse counsellors were not aware of the prevalence of gambling-related problems amongst their patients or the extent to which these affect their patient’s life. Screening for problem gambling was not considered during their intake assessment. Although the counsellors were well trained in substance abuse interventions and had reasonable knowledge of addictions as a whole, most likely, they had limited understanding about gambling problems, how to intervene or where to refer on to. Later, I found out that the situation was not isolated to this particular substance abuse clinic as many published reports and research studies revealed problem gambling to be under recognized in general practice and specialized mental health and substance abuse services. What is more, another American research study reported that substance abuse counsellors themselves were at increased risk of problem and pathological gambling! 
Gambling in the community Cultural and familial attitudes toward gambling play an important role in gambling in the community. For example, although forbidden by law, in some cases gambling is introduced by family or friends at early stages in life. A recent British survey among children aged 11 to 15 not only showed that more than 20% of children participated in gambling but also revealed that positive parental attitude and example was associated with early initiation into gambling . Additionally, availability of gambling in the community is increasing worldwide with time and with novel free on-line or remote gaming opportunities, with less than half of gambling websites offering information regarding responsible gambling and the problems that gambling may cause to a vulnerable individual in the long run. In addition, some types of gambling, like the National
Lottery, are supported and promoted by the government.
So, is the message to the community that gambling is a safe or healthy activity? It is possible that a clinician may not consider examining the extent of problems related to a patient’s gambling on the basis of the general acceptance of gambling within the community and the inoffensive effects on the majority of people who enjoy gambling as a form of recreation. Despite the inclusion of problem gambling in a clinician’s training curricula, does this attitude affect the mental health and substance use workers’ beliefs that excessive gambling may not be a disease in the same way that alcoholism is? Perhaps they would think: “Rather have cocaine-dependant patients continue gambling on sports than using other illegal drugs?” In short, it is possible that the high acceptability in the community, along with high availability and accessibility of gambling have a ‘normalising’ effect, with a direct impact on clinicians’ perceptions and attitudes towards gambling among substance abusers. Problem gambling: A Hidden Illness Problem gambling is known among health workers as a “hidden illness” because as opposed to when an individual consumes drugs, there are no observable or physical signs such as breath odour, residue on fingers or dilated pupils after gambling. Moreover when an individual starts developing a problem with gambling, the activity is no longer social but is often carried out alone and in secret. In a way, problem gambling may even be hidden from the person suffering with it, at least in the beginning. As often happens with substance use disorders, denial is highly prevalent amongst this group. Sometimes, it takes a gambler to lose their job and family and basically hit rock bottom to realize there was something wrong with their gambling behaviour and that, instead of gaining their losses back, they were in fact digging themselves a bigger hole. Naturally, this also means that many pathological gamblers do not seek treatment for their gambling problem and that, when they do, they come with very severe problems and complications in most of areas of their lives. It is for these exact reasons that it is important to screen for problem gambling in the first place. We know that patients will not spontaneously talk about their gambling activity or seek help if in trouble. The illusion of control (cognitive distortion where the individuals overestimates their level of control over events) may not only be applied by problem gamblers to ‘predicting’ the outcome of bets, but may have been extended to their own gambling pattern and led them to believe they can cut or control their gambling
The Looking Glass
1. 2. 3. 4. 5. 6. 7.
when they canâ€™t. Screening may be the only way to prevent problem gambling from escalating and allowing treatment of the problem at a more manageable stage, with fewer resources needed. As problem gambling is highly prevalent in the context of substance abuse, clinicians serving these patients are the most likely to have the opportunity to identify cases of problem gambling, educate them about this disorder and its consequences and motivate them to stop (or reduce) their gambling.
Classifying problem gambling within the substance use disorders in DSM-5 may be beneficial in raising awareness and improving recognition of the disorder in clinics serving substance abuse patients. The substance use disorder workforce of DSM-5 has also suggested lowering the threshold to 4 from 5 criteria in DSM-IV, to help in the identification of problematic behaviour, especially among those unable or unwilling to seek treatment and to help in the delivery of early interventions .
Strategies for identification While many screening and assessment tools used to identify problem and pathological gambling are available for use, few are well known or widely used. Some screening tools developed specifically to be used in substance abuse clinics have been recently tested. One of these is the NODS-Clip, a quick and simple screening tool that consists of three items and has demonstrated good psychometric properties in clinical samples . This could easily be administered routinely at intake and follow-up assessments. For patients screening positive further assessment based on DSM criteria may be required.
In conclusion, clinicians need to be aware of the increased burden problem gambling put on substance abusers. By recognizing how gambling affects treatment outcomes and overall impairment and by routinely screening for gambling problems, clinicians may be able to identify gambling disorders as they are emerging, thereby enabling treatment that appropriately addresses the comorbid illnesses. Moreover, creating easy access to gambling and allowing gambling companies to advertise on UK TV and teen websites is only indicative of the underestimation of the addictive power of gambling by government and it remains the responsibility of researchers and the community to call this to the governmentâ€™s attention.
Weinstock, J., C. Blanco, and N.M. Petry, Health correlates of pathological gambling in a methadone maintenance clinic. Exp Clin Psychopharmacol, 2006. 14(1): p. 87-93. Petry, N.M., Gambling and substance use disorders: current status and future directions. Am J Addict, 2007. 16(1): p. 1-9. Weinstock, J., C. Armentano, and N.M. Petry, Prevalence and health correlates of gambling problems in substance abuse counselors. Am J Addict, 2006. 15(2): p. 144-9. Forrest, D. and I.G. McHale, Gambling and problem gambling among young adolescents in Great Britain. J Gambl Stud, 2012. 28(4): p. 607-22. Smeaton, M. and M. Griffiths, Internet gambling and social responsibility: an exploratory study. Cyberpsychol Behav, 2004. 7(1): p. 49-57. Volberg, R.A., I.M. Munck, and N.M. Petry, A quick and simple screening method for pathological and problem gamblers in addiction programs and practices. Am J Addict, 2011. 20(3): p. 220-7. Petry, N.M., et al., An empirical evaluation of proposed changes for gambling diagnosis in the DSM-5. Addiction, 2013. 108(3): p. 575-81.
The Looking Glass
Background iConcipio Ltd is an e-learning support provider based on web technology solutions. Our service is an online system, which addresses the psychological and educational needs of Higher Education (HE) students. Student mental health and academic performance is a central concern to HE institutions whose support services are currently stretched due to increased demand and budget reductions. As a result, there is a higher risk for problems to escalate and students to drop out – a figure which recently rose to more than 22%*. Recent fee increases add further pressure on HE institutions to show quality and value for money and to enhance "student experience" - an important influence on HEIs' ratings, intake and income. A more practical approach to delivering student support is needed urgently.
Our System Using our system, students in their private space can explore their difficulties in a variety of ways. They either answer an interactive questionnaire which helps identify the issues they are facing, or they go directly to a list of topics where they can choose which are relevant to them. Either route leads to a tailor-made set of animated videos. Alternatively, they can browse freely the available videos and choose the ones they are interested in. These videos present well established psychological or study skill techniques whose effectiveness has been demonstrated by extensive scientific research. Students can practice these techniques and over time, use a rating system to monitor their progress. There is also a social network which allows students to connect anonymously with others and provide mutual support.
Uniqueness iConcipio's system has an innovative and scientifically based design:
It is an all-in-one system
Designed specifically for students
Follows a needs-driven approach
Built on implicit and explicit psychological and educational techniques
Uses web technologies to offer an interactive system
Its content, layout, language, visual appearance and feel has been developed through a stringent three-stage process collaboratively with students and HE executives in order to best address their needs and expectations
Other facts about the system:
Reaches out to the majority of students
Anti-stigmatizes the experience of having difficulties as it offers instead a self learning solution
Gives the control back to the students and this reinforces their motivation to change, self- efficacy and confidence
Accessible by smartphones and other mobile devices
Vision We aspire to improve Student Experience
Mission Using web-based technologies, we offer psychological & educational techniques to promote personal effectiveness in addressing internal challenges and environmental demands
Milestones March 2011 iConcipio wins Best Pitch Prize in King’s College London’s Graduate Business Plan Competition June 2011 Company Incorporation July 2011 Awarded Proof of Concept Grant (Smart Award) from Technology Strategy Board (TSB) January 2012 Commissioned Mosaic Films, a BAFTA-award winning firm, to produce a demonstration of the system (demo) February 2012 Market Research via Online Surveys September 2012 Alpha Testing with Selected Partners in the UK
Students benefit from an immediate personalized resource, which they can use in privacy any time they want to improve areas of their personal effectiveness Counsellors can refer students to the system allowing them to concentrate on those with more significant difficulties and so manage the demand for their budget-constrained services HEI student services have access to data on their students’ mental health, can improve demand management, facilitate referrals and identify how existing services should be further resourced Overall, course completion rates will rise reducing financial losses whilst student experience will be enhanced advocating for better HE ratings, intake and income
Contact us Email: email@example.com Phone: +44 (0) 203 590 3970 Mobile: +44 (0) 7879 295667 Address: 1 Gloucester Street, London, SW1V 2DB
The Looking Glass
Using voodoo for exams: a recipe for success? Dr Marietta Papadatou-Pastou Jenny waited until the moon was full. She then sat down gently while the bonfires blazed around her and the drums were beaten. A snake was sacrificed and she muttered the spell. She was now certain that tomorrow’s exam would be a pass. Or would it? Can rituals such as voodoo, white magic or plain-old superstitions like using your lucky pen or wearing your favourite tie help you do well in exams, vivas, or job interviews? Research findings by medical researchers and neuroscientists suggest they can. You see, it’s all about expectations and associations. Rich findings have shown that cognitive factors such as expectation of clinical improvement, beliefs, memories of previous experiences and trust as well as classical (Pavlovian) conditioning can explain why patients report feeling less pain after the administration of placebo pills (pills containing no therapeutic substance) (Benedetti et al., 2005). Less pain has even been reported after having undergone sham knee surgery for osteoarthritis (Moseley et al., 2002). However, it is not only the subjective report of pain that is dancing to the placebo tune: a neuroimaging study has provided findings whereby the brain areas associated with activity in the endogenous pain modulatory system were activated twice as much in patients expecting a positive analgesic
The Looking Glass
effect of a potent opioid compared to controls that had no expectations. At the same time, in patients that had taken the same dose of the potent opioid but were told to expect a negative analgesic effect the hippocampus was activated (Bingel et al., 2011). This is a fascinating showcase of the fact that neural responses associated with the placebo effect are specific to the direction, positive or negative, of the induced expectation! The mere fact of knowing that you are receiving treatment might also boost its effect. In another study, hidden post-operative administration of diazepam was ineffective for reducing state anxiety, whereas open administration (where both patient and prescriber know the administered treatment) resulted in a clear decrease (Benedetti 2003). Similarly, open application of deep brain stimulation (DBS) in the subthalamic nucleus was found to be more effective than hidden BDS in patients with Parkinson’s disease (Benedetti et al., 2004). The list is endless… What other factors mediate the effects? Is less more? Well, not in this case; four placebo pills work better than two placebo pills for stomach ulcer (De Craen et al., 1999). And do looks count? Yellow pills
as a placebo in this sense, can’t it? Does this mean that we can finally forgo studying and just rely on our expectations ‘to do the magic’ for us? Unfortunately, the size of the placebo effect ranges widely from study to study, and is rarely calculated to account for improvements of the magnitude of 40%... your passing grade. It can boost your performance, no doubt about that, but hard work is still key to good performance. Any other, evidence-based, tricks you might want to use? Spacing out your studying over time, studying in an environment that resembles the one in which you are going to be tested and literally testing yourself before the exams… in other words have a wild ride on make better antidepressants, and red pills are more the very well-documented effects studied in the field of effective as stimulants. cognitive psychology, also known under the code names Admittedly, the bulk of research on the placebo effect of ‘spacing effect’, ‘encoding specificity effect’ and has worked on pain and analgesia studies but inter- ‘generation effect’ (Anderson, 2000). esting results have also been obtained on its effects So, here is your true academic success story: study hard, over memory. In a study administering donepezil to space out your studying, work in a quiet environment, improve memory in patients with epilepsy no difference test yourself prior to exams... and be a believer! was found between the treatment and control groups. Both groups failed to show any improvements on standard neuropsychological tests. At the same time, both self-reported ‘better’ memory (Hamberger et al., 2007). Furthermore, the authors of a review of ‘brain-specific nutrients failed to find convincing evidence that several non-prescription compounds, widely marketed for enhancing memory, work better than placebo (Mc Daniel et al., 2003). Reported memory improvements in these studies are therefore of the same size irrespective of whether someone is taking the pill with the active ingredient or a dummy pill. A lot of fascinating research is still to come our way on that front so watch this space. So, can this placebo effect raise hope that you can pass an exam or a viva simply by doing voodoo? Well, strictly speaking we cannot talk about a placebo effect without the administration of an inert treatment – be it a drug or a procedure. The case we are presenting here is rather the nonspecific effects of cognitive factors, such as expectations of elevated performance and classical conditioning. You can become conditioned to believing that performance will be improved using this particular ‘lucky’ pen if this has happened before. But then again, the placebo effect is all about the psychosocial context or, in other words, the ‘ritual’ surrounding pill-giving or treatment administration. Any type of ritual can serve
Just don’t forget your lucky socks!
Marietta is the Head of the Psychology Department of BCA College, Athens, Greece, and a Research Associate for iConcipio, a web-based system with instructional videos designed to support students with their psychological and study skills difficulties and improve students’ personal effectiveness.
References: Anderson, J.R. (2000). Learning and memory. New York: John Wiley. Benedetti, F., Colloca, L., Lanotte, M., Bergamasco, B., Torre, E., & Lopiano, L. (2004). Autonomic and emotional responses to open and hidden stimulations of the human subthalamic region. Brain Research Bulletin, 63, 203–11. Benedetti, F., Maggi, G., Lopiano, L., Lanotte, M., Rainero, I. et al. (2003). Open versus hidden medical treatments: the patient’s knowledge about a therapy affects the therapy outcome. Prevention & Treatment. 6 (1) Benedetti, F., Mayberg, H.S., Wager, T.D., Stohler, C., & Zubieta, J.-K. (2005). Neurobiological mechanisms of the placebo effect. The Journal of Neuroscience, 25(45): 10390-10402. Bingel, U., Wanigasekera, V., Wiech, K., Mhuircheartaigh, R.N., Lee, M.C. et al. (2011). Science Translational Medicine, 3(70), 70ra14. De Craen, A.J.M., Moerman, D.E., Heisterkamp, S.H., Tytgat, S.N.J., Tijssen, J.G.P. et al. (1999). Placebo effect in the treatment of duodenal ulcer. British Journal of Clinical Pharmacology, 48 (6), 853–860. Hamberger, M. J., Palmese, C. A., Scarmeas, N., Weintraub, D., Choi, H., et al. (2007). A randomized, double-blind, placebo-controlled trial of donepezil to improve memory in epilepsy. Epilepsia, 48(7), 1528-1167. McDaniel, M.A., Maier, S.F., & Einstein, G.O. (2003). “Brain-specific” nutrients: a memory cure. Nutrition, 19(11), 957-975. Moseley, J.B., O’Malley, K., Petersen, N.J., Menke, T.J., Brody, B.A. et al. (2002). A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine. 347, 81-88.
The Looking Glass
ELENA PANAGIOTOPOLOU RECENTLY COMPLETED AN MSC DEVELOPMENTAL PSYCHOLOGY AND W ORKS IN BOTH RESEARCH AND CLINICAL PSYCHOLOGICAL SETTINGS. HERE SHE OFFERS HER ADVICE FOR THOSE LOOKING TO PURSUE CLINICAL PSYCHOLOGY AS A CAREER
Applying to the Doctorate in Clinical Psychology 10 tips to get you through the application process (plus a bonus tip for luck!)
linical psychology is one of the most popular fields in psychology and so applying for the Doctorate in Clinical Psychology (DClinPsy) is an incredibly competitive process. Every year, thousands of people compete for just a few places. Most of the applicants are well-qualified with some relevant experience but they might still not be successful in getting through, even to the interview phase. Applicants are carefully selected by several qualified clinical psychologists and therefore it is not enough to just fulfill the basic criteria. What you need to demonstrate is a deep understanding of issues relating to clinical psychology and the potential to perform at a very high level.
realistically capable of doing it. The application process can be very stressful and many people have to apply more than once to gain a place in the course. Therefore, before you start the application process it is worth being realistic about whether you fulfill the basic criteria and whether you are really committed to becoming a clinical psychologist.
So what advice might be offered to someone brave enough to face such a long and arduous journey? Through my personal experience and research on the topic, I gained a better understanding of the challenges involved in the application process and so I would like to share my top 10 tips First and foremost, you need to ask yourself (with an extra one thrown in for luck) to if this is what you really want and if you are help guide you through the process:
1. Demonstrate a good knowledge of what clinical psychology is and what clinical psychologists do. As I have already mentioned, the applications are meticulously considered by clinical psychologists and the least they expect you to demonstrate is a clear understanding of their role. After all, this is the role that you hope to one day carry out. So, how can you acquire this knowledge? Well, that brings me to the second tip, which is:
2. Work with a clinical psychologist. Unless you have had the opportunity to work with or under the supervision of a clinical psychologist, it will be difficult to express the understanding that they expect from you. Even if you are not actively involved, it will be very beneficial to simply observe the work of a clinical psychologist.
The Looking Glass
3. Demonstrate a good understanding of mental health service provision in the UK. Most clinical psychologists work within the NHS and as such it is important to demonstrate knowledge of the organization and how it functions. Given its constant flux, this can be quite challenging. However, the best way to gain an understanding is through work experience within the NHS (or equivalent settings).
4. Gain relevant clinical experience. To begin with, this will give you the chance to see whether working in this field is something that you want to and are able to do. If this career is not for you, it is better to realize it before you make a big commitment. Most people work for a couple of years before they gain a place in the course. Both paid and voluntary work is acceptable. Most of the times, people work as Assistant Psychologists but such positions can be very competitive and hard to come by. Contact with clinical populations is the important factor, so such contact for research purposes is also desirable.
5. Reflect on your work experience. Oftentimes it is not about the quantity of the experience but the quality and what you make out of it. They are not looking for someone who ‘knows everything’ but someone who shows the expected level of sophistication in their reflective abilities and the ability to learn.
6. Express your well-developed ideas in a coherent and fluent way. Your cover letter reflects your personality and demonstrates your writings skills, so you should write it very thoughtfully. After all, (written) communication is a fundamental element of working as a clinical psychologist and undertaking research at doctoral level. I would recommend having someone proofread your applicationif they are a clinical psychologist it would be even better!
7. Have strong references. References can make a difference between being shortlisted for an interview and being rejected. Therefore, you should carefully select the two people who will act as your referees. In order to choose the appropriate referees think of what each person can say about you and whether their knowledge of you is relevant to your ability to undertake the doctorate and pursue a career in clinical psychology. It might help if you get a reference from a clinical psychologist (although it is appreciated that this is not always possible).
8. Make sure that you will graduate with at least a high 2.1 (if you are still a student). It is critical to demonstrate that you are able to perform at a very high academic level so if you have a 2.2 classification in your degree you will not be considered further (unless there is evidence of extenuating circumstances). Realistically you need to achieve at least a high 2.1 (above 65%) to be considered for a place in the course.
9. Check your application for typos, grammatical and spelling errors. This may sound too obvious, but is very important. Applications pass through two phases in order to select the applicants who will get through to the interview phase. It is highly unlikely that an application with typos, grammatical or spelling errors will make it to the second phase.
“I found it hard to condense information in a precise and focused manner but reading the applications of others helped me structure my thoughts and formulate a better approach to these questions. As a result, I was able to portray my experiences in a relevant manner and present myself as a suitable applicant." Patapia Tzotzoli, DClinPsy trainee, CEO &Founder of iConcipio
10. Talk with people who have successfully got a place on the Doctorate. You can learn many things from them regarding their experience of the application process, the struggles they faced and how they managed to overcome them.
W ANT TO K NOW M ORE ?
And last but certainly not least…
11. Be prepared to apply more than once. Many applicants, who eventually get accepted, need to apply twice (or even more times). If you genuinely believe that this career is for you, then do not let an unsuccessful attempt discourage you or stop you from applying again. After all, this is an opportunity to show your commitment to becoming a clinical psychologist.
So, if you plan to apply for the Doctorate in Clinical Psychology, be aware that it is a challenging process that requires patience and determination, but gaining a place in the course is absolutely worth it. And of course, I wish you the best of luck!!!
Elena Panagiotopoulou recently completed her MSc in Developmental Psychology at UCL. She currently works as a Research Assistant at the BPS’s Centre for Outcomes, Research and Effectiveness (UCL) and as Parent-Toddler Group Assistant at the Anna Freud Centre. She also works as a Psychologist Associate for iConcipio, an e-learning support provider based on web technology solutions.
For more information about the application for clinical psychology courses in the UK: http://www.leeds.ac.uk/ chpccp/index.html
The Looking Glass
EXPERT OPINION Dr Owen Bowden-Jones 'In a recent Maudsley Debate, the discussion revolved around 'club drugs' and the problems they pose… In this issue we decided to explore this topic by seeking an expert opinion from Dr Owen Bowden-Jones. Dr. Bowden-Jones is from the Faculty of Addictions, Royal College of Psychiatrists and he kindly agreed to give his view on the challenge of ‘club drugs’.
The Challenge of ‘Club Drugs’ Over the last five years, the illicit drug market has undergone radical change. The popularity of heroin and crack cocaine has waned and younger people initiating drugs are choosing alternative substances. These new psychoactive substances are often called ‘club drugs’ and from a legal perspective fall into three broad groups. Illegal substances (e.g. ketamine), recently legal but now illegal substances (e.g. mephedrone) and currently legal substances (e.g. Benzo Fury). A new psychoactive substance is currently appearing on the European market on average every week, presenting significant challenges for both clinicians and policy makers. However, it is not just the drugs that have changed, it is also the way people buy them. Psychoactive drugs have usually been bought from friends or dealers but many of the new drugs, particularly the legal ones, are available to purchase online. A huge number of online sites have appeared offering substances labeled ‘not for human consumption’, yet clearly marketed for their psychoactive effects. Payment is by credit card and next day delivery is often guaranteed. The postman has taken the place of the dealer. These new trends raise numerous concerns. With so many new substances available it is impossible conduct a rigorous assessment of the risk posed. Instead drug services have to wait to see what harms, if any, befall users. There is also no current mechanism for collecting and collating evidence of emerging harm. Rather, the negative consequences of a particular substance are spread by users through online forums and by word of mouth between clinicians. The situation is further complicated by the fact that many of the substances are known by brand names rather than the chemical name. This means that many users have no idea what substance they are actually consuming. In addition, standard drugs screens (from blood or urine) by A&E departments or drug services are generally unhelpful as they don’t test for the newer substances. Previously, the legislative response to a newly reported psychoactive substance was for the Advisory Council on the Misuse of Drugs (ACMD) to conduct an assessment of potential harm and then recommend to government whether the substance should be classified and to what level (A, B, C). It is then up to the government to accept or reject the ACMD’s recommendation. The classification gives an indication of potential harm to users and wider society and is also linked to legal sanction for both user and distributor. The advantage of this approach is that it allows a scientific assessment of available data, leading to an evidence-based recommendation. This system has been undermined by the sheer number of new substances becoming available. There are simply too many to assess and the level of available evidence on which to base recommendations is often limited or absent. To tackle this, a new Temporary Class Drug Order has been introduced which allows a particular substance to be classified for 12 months to allow time for evidence to
The Looking Glass
emerge and be assessed. The first substance to come under this order was Methoxetamine, a drug marketed as a ‘safer’ alternative to ketamine. Methoxetamine has since been made a Class B substance. Other countries have faced similar challenges. The US has a long-standing Controlled Substances Analogue Enforcement Act (1986) allowing all psychoactive substances of a similar chemical group to come under the same restrictions. Consumer legislation has been another suggested approach, with vendors taking responsibility for the safety of the substances they are selling. All approaches have merits and drawbacks. Some have called for club drugs, indeed for all drugs to be legalized, pointing to the failure of the ‘war on drugs’ in reducing use or preventing organised crime. Alcohol and nicotine are of course legal, potentially harmful, psychoactive substances from which the government draws significant revenue. Could they be joined by heroin, crack, methamphetamine and ketamine? I suspect this is highly unlikely both due to political and cultural hurdles but also because these substances are clearly very harmful to many. But what about the newer legal highs? It is perhaps too early too judge. Speaking as a clinician, rather than a policy maker, I suspect that those determined to experiment with the emerging club drugs will continue to do so irrespective of legislation. For this group, the best approach is to provide the best and most up to date information available about possible harms so that the decision to use is a particular substance is as informed as possible. Who would have predicted that ketamine could lead to severe bladder damage or that GHB result in life threatening withdrawals. People don’t start using drugs to get addicted or experience harmful side effects. Understanding the risks is therefore important in determining behaviour. Perhaps, instead of a war on drugs, we need a war on ignorance.
Your view We are inviting responses to Dr Bowden-Jones’s article. What is your opinion of club drugs? What do you think are the biggest problems facing drug control, given the prevalence of new drugs available via the internet? What are your views on legalisation of drugs? Your views could be printed in the next issue of The Looking Glass. Send us your views to the usual email address: firstname.lastname@example.org
The Looking Glass
Psych-related iPhone Apps: ‘if you haven’t found it yet, keep looking. Don’t Settle.’ – Steve Jobs
My faith in the use of new technology for the betterment of the human race has never genuinely been shaken. I’ve always had a weakness for quirky new tech, irrespective of claims from those such as Professor Ken Robinson that most children’s brains today experience a bombardment of information from the innumerable mediums of electronic wizardry and dizzying array of permeating media now available (http:// www.youtube.com/watch?v=zDZFcDGpL4U). I agree with Ken that ADHD, and it’s over medication in the US, may have its roots in this formidable technological force. However, my taste for social and moral discourse has recently been hijacked by Professor Lucy Yardley’s stimulating talk on LifeGuide (http:// www.lifeguideonline.org) and UBehave at the Health Psychology Division seminar series at Guy’s. The former is Lucy’s open source software that allows budding researchers and clinicians like you to create your own online DIY interventions and self-management programs. The latter creates interventions for mobile phones.
So this got me thinking about what iPhone apps are already out there and how useful they might potentially be to the busy minds of IoP students, researchers and clinicians? While I’m aware that many of you, perhaps on the quiet, already possess the not so intellectually challenging Angry Birds app, I thought that an assessment of free, faddy, and fantastically functional iPhone apps was timely.
Films, books and more Here is a run down of my ‘top three’ free apps. I will briefly mention those that are moderately interesting, but pay little attention to those that are, quite frankly, fit only for the proverbial rubbish-tip (for which there are many). Grading for each app ranges from 0 (laughably bad) to 10 (utterly ingenious) based on my subjective impressions of usability, overall utility, pretty graphics and, most importantly, cost. My search strategy terms on iTunes were easily replicable: “psychiatry”, “psychology”, “mental Health”, “nursing” etc. However, I’m afraid there was nothing systematic about this particular review.
1. HeadSpace As a recent student of Mindfulness-Based Cognitive Therapy (if you’re not already a mindfulness convert check out Kabat Zinn, 2002) I was blown away by this fantastic bit of kit. For those that don’t know, third-wave contextualistic psychological therapies are in vogue, challenging the ontological roots of thought content-based approaches like CBT. HeadSpace is not affiliated with any brand of therapy but designed by an ex-Buddhist monk, Andy Puddicombe (a nice chap with seemingly good charitable intentions), who successfully conveys the commonly misunderstood practice of meditation to a layman audience. The animated allegorical videos on HeadSpace’s free 10-day programme, aside from being dead cute, actually resonate at a level where you feel the rationale for audio-guided mediation exercises makes sense, forming a fantastic introduction to this ancient practice. Plus, if you’re very forgetful like me, you can use mediation reminder alarms and for moral support gauge how many other people within the meditative community are listening to Andy’s dulcet tones at any one time.
Overall verdict: Andy’s cute, though profound, introduction to Mindfulness steals a whopping 9/10! So guys don’t delay… Get yourself some Headspace today!
The Looking Glass
2. 3D brain 3D brain is probably the tidiest bit of app media in all apps bunch. This natty, colourful illustration allows you to grasp the basics of the basil ganglia, while looking down from the parietal region through to the medulla oblongata, all using simple rotate and zoom -in functions to learn about 29 distinct brain structures. If you’re more interested in the brain when things go wrong you can also learn more about the impact of brain damage and brain disorders using case studies. It’s great for wet-behind-the-ears bio/ neuropsychologists, but no doubt rudimentary for you clever neuroscientists. Whilst quirky and educational it is likely to be a bit of a 1-minute wonder. Nonetheless, in my view, it is the best of a bad lot. Comparatively, most apps generally appear to lack a certain degree of sophistication and practical use within our specialist areas. (Hopefully this damning overview will spark entrepreneurial ambitions in some of you to help us better harness this technology for clinical or research purposes!)
Overall verdict: This colourful bit of cortex stimulating software dazzles at first encounter, but its woefully simplistic function means it screeches in at second place 6/10.
3. The Animated Pocket Dictionary of Psychiatry The creators of this app boast 100-plus neurology, psychiatry and other medical terms that are illustrated by truly wacky 3D ‘life-like’ animations. Frustratingly, only some of this dictionary is actually free. This highlights some key issues when it comes to ‘free’ apps. Firstly, what apps truly are free? Secondly, what increase in quality can you expect on parting with your pennies? Finally, how long will the app be accessible for (since my updates say I cannot download some of the new apps on my iPhone)? My search indicated that in many cases money is being, or is trying to be made, which is, of course, fair enough. In the case of the Animated Pocket Dictionary of Psychiatry, despite my aching disappointment at the unexpected cost I thought, like 3D brain, it was a highly novel, educational and amusing app to play with during a swift coffee break between lectures – but that’s probably as far as this ephemeral romance lasted for me. Overall verdict: As much as I enjoyed the amusing, though seemingly limited number of free animations, I didn’t instinctively dive for my wallet to find out more. I quickly realised that the generic YouTube app-derived videos provides a much richer variety of free videos describing these concepts anyway, sorry but it’s 4/10 from me.
So, what did I learn from my brief foray into the world of apps? Aside from other basic dictionaries, several noteworthy apps exist including the ‘UK Clinical Trials Gateway’, which you can refer to when searching for all registered research trials; ‘AtMyPace Statistics’, for those stats-averse people who probably ought to have listened a bit harder in lectures; ‘APA journals’ to keep up-to-date with those all important psychology publications from across the pond; and not forgetting KCLs very own app, with the slightly disturbing function of always being able to locate your ‘friends’ anytime, anywhere when on campus. Joking aside, we often talk about identifying gaps in the research literature and here I think we are seeing a colossal gap in app technology where the IoP should avoid getting left behind. Unknown to most people, the IoP possesses its own all singing, all dancing online platform for questionnaire/survey construction called Selectsurvey.net (http://www.survey.iop.kcl.ac.uk/Login.aspx). However, the college has not produced any related apps! Have we missed a trick here? Just think what a resourceful method this could be in terms of data collection and, indeed, interventions! Okay, sales pitch over… conclusively, there is not much out there in the way of free apps and what there is, though slightly novel and amusing, does not surpass the likes of angry bird in many cases. In a world captivated by new technology, perhaps it is time to think about how apps can best be utilised both as a valuable resource and a research tool.
Anthony Harrison is a Doctoral Student in the Health Psychology Division at Guy’s Campus
Seen a good film, read a good book? Why not review it for The Looking Glass? We are interested in works in any media that have relevance to psychology, psychiatry and neuroscience, however loosely! Send your reviews to email@example.com and check out page 20 for submission guidelines. The Looking Glass
News and Events
Inspiring Women: Professors of the IoP On 14th March 2013, Professor Shitij Kapur, Dean of the Institute of Psychiatry (IoP) opened the ‘Inspiring Women: Professors of the IoP’ event to a large gathering of staff, professionals and PhD students. The event included a photographic exhibition of IoP women professionals, as well as a Q&A session with Professor Dame Sally Davies, the Chief Medical Officer (CMO). Professor Dame Sally Edwards is the UK government’s principal medical advisor and professional head of all Directors of Public Health. She is also Chief Scientific Adviser for the Department of Health. This event was held in line with International Women’s Day to highlight role models, inspiration and the gender gap in today’s society.
“Just hold your nose and jump right in” The CMO spoke about the challenges of producing an annual public health report distinctly different from those of predecessors. Therefore, at the end of last year the annual report incorporated a new visual technology, cartograms, developed by Daniel Dorling. On these maps, the size of places relates
The Looking Glass
not to the geographical area but to population size. She also addressed the annual report with a scientific approach, therefore affording those behind the scenes, such as the scientists and the medical professionals, the credit they deserved. The annual report also focused on a chosen introspective topic - infection control - for which a panel of experts were gathered to discuss the issues faced. One challenge was finding the ‘voice’ to represent the concerns of these medical experts. With the press conference only last week, her team arranged a mixed panel of experts enabling them to provide a united voice and cover all bases when questioned by journalists. She concluded that, although challenging, the press conference was an overall success and the government are now taking this report into consideration. Developments are expected over the next few weeks to move the situation forward. Next year’s annual report will include children, how to get a good start in life and build resilience, and public mental health with early diagnosis, early intervention, stigma and mental health in the workplace all focused on.
enabled her to be successful in her career today. At 22, she had given up her medical career to become the wife of a foreign diplomat and spent four years in Madrid. She told how this period in her life enabled her a pause to reflect and ultimately decide to return to her medical career. In her words, the ‘giving up’ was her main motivation. She quickly rose up through the ranks with the help of hard work and words of encouragement from others. Opportunity was something she definitely seized and she took risks in making decisions.
“I like having influence, not power, and making things happen”
Certain decisions have had a catalytic effect on women in the work place, such as the decision to only shortlist medical schools as biomedical research centres if the school holds a Silver Athena SWAN award. Athena SWAN is a charter for women in science, addressing gender inequalities and issues surrounding unequal representation of women in science. Dame Sally strongly believes that this is the only way to get institutes Dame Sally continued on to to think about their policies and share the pivotal moments that
want women not only for their skills and abilities but also to regard the decision as an economic one. The closing chapter of the Q&A session came to focus specifically on gender gap issues and the underlying causes. The CMO expressed multifactorial reasons such as childcare issues and role models. She also believes mentoring or having a mentor could perhaps address this gender gap, given the right kind of chemistry between mentor and mentee. The interview struck a chord with Katie Davis, `Msc Mental Health student at the IoP, who remarked, “I found her talk about life decisions and mentoring quite inspiring, and I do agree with her philosophy of taking risks and full use of opportunities that come your way”. With influential ideas from the interview, the elegance of the photography from the exhibition and the exchange of thoughts and comments during the networking lunch, it was indeed an inspiring event.
“The best leaders are authentic ones”
IoP Library Refurbishment Rhianna Goozee As of the Easter bank holiday weekend the IoP library has closed and isn’t due to reopen until later this year. But don’t panic, in the meantime there are several procedures in place to ensure you can still access the resources that you need to! Books that used to be shelved on the upper floor at the IoP library have been transported to the WEC library (yes, you will have to venture all the way across the road!). These books are available for lending as usual. For access to theses, a request service will be in operation at the WEC Enquiry Desk and any interlibrary loans can also be collected there.
resources and a number of improvements in support and student services. In addition, the library will connect to the new reception and Education hub areas that have recently been launched.
You may not be aware but the IoP houses the largest collection of psychiatry texts in Europe and with the refurbishment underway it waits to be seen if on reopening in September 2013 the new library can showcase this unique collection in the way it deserves. As anyone who has braved the trip across to the WEC library (which was recently refurbished) will agree, chances are it The closure is part of a much needed refur- will. bishment that aims to produce an entirely For more information on the transfortransformed library service with a single mation project and accessing resources team operating across two sites with a gradthroughout the closure visit: http:// uate, research and clinical emphasis. The www.kcl.ac.uk/library/transformation/ plan is for more study spaces, better interdhfaqs.aspx net connectivity, with increased technology
Regius Professorship awarded to King’s College London Jorge Palacios Queen Elizabeth presented this prestigious award – the first ever Regius chair in the field of mental health and psychiatry – to the Institute of Psychiatry at King’s in January this year.
60 in total), it was decided that 12 chairs in So, now the question remains, who total be awarded – two for each decade of amongst the many professors at the IoP Queen Elizabeth’s reign. will be assigned this honorary title? There are many strong candidates, and just Upon hearing the announcement, Profesbrowsing through the King’s website, or sor Shitij Kapur, Dean at the Institute of even walking through the canteen during Psychiatry, said: “The Regius Professorship lunch hour, you’re bound to bump into a is a wonderful recognition of all that we few. Soon the announcement will made, have stood for, and done, for nearly a hunand one of them will take the chair, no dred years. The Chair acknowledges our doubt representing the Institute of Psychipioneering work and the vital tasks that atry - and its high standing amongst menstill lie ahead in tackling mental illness. tal health institutions around the world Our excellence is underpinned by extraorwith the dignity and responsibility the dinary individuals, who have changed the chair represents. landscape of mental health research and treatment. The IoP would attract to this post the most eminent psychiatric scholar Got some news to share? Been to an of our generation, able to lead future adevent in or around the IoP that you vances in science and care in psychiatry.”
The Regius Professorship dates back to 1497, when the University of Aberdeen was awarded a professorship of medicine. In the 1540s, King Henry VIII awarded a number of professorships to the Universities of Oxford and Cambridge, including those in Civil Law, Greek, and Divinity. In the last century, only two other chairs have been awarded, to mark the 200th anniversary of the birth of Charles Darwin, in 2009. Prior to this the most recent professorships awarded were in the 19th Century, by Queen Victoria. Therefore, to mark The Queen’s Diamond jubilee, it was proposed According to the gov.uk website, where the that six new chairs be awarded. professorships were announced, the title Candidate universities submitted a full does not carry a bursary, but is a chair beapplication and the entries were assessed stowed by the Queen purely to honour by a panel, who judged on the basis of the excellence. Each institution must assign excellence of the university’s work in the the title to an existing professor from withproposed discipline and the recognition in the chosen department or appoint a new the discipline has gained. Due to the great professor to take the chair and hold the number of worthy applications (there were title.
want to share with us? Send your news stories to
firstname.lastname@example.org Alternatively, if you know of an event coming up or are organising an event you want to publicise, get in contact and we will send along a member of the editorial board to cover it!
The Looking Glass
Editorial Junkies and potheads: moral weakness and medical illness
‘Junkie.’ ‘Cokehead.’ ‘Stoner.’ ‘Wino.’ ‘Smackhead.’ The list of pejorative terms for those who abuse substances and suffer from an addiction is endless. Even though substance use disorders (SUD) is recognised as a mental health problem diagnosed within the DSM-IV and ICD-10 and defined within medicine as a chronic disease of brain reward, motivation, memory and related circuitry, many still see drug addiction as a moral failing. Whilst stigma and discrimination have, and still do, play a role in all mental illnesses, it seems that drug addiction carries its very own flavour of stigma. A stigma associated with blame and shame that is perhaps more deeply ingrained and has permeated all areas of society, including the people who work with and treat those with substance use problems. For many, drug addiction does not primarily conjure up the thought of an
illness but is seen as a crime, a moral weakness, a character fault or even an inevitable outcome of particular social circles. Of course, many mental health problems now categorised within the DSM and thought of by many (though not all) as medical illnesses with biological roots have in the past been categorised in a variety of other ways. The history of placing ‘nutters’ in prisons and asylums, lumping criminals, the ‘criminally insane’, mentally ill individuals and those not conforming to social standards (homosexuals, young unmarried mothers... ) all in the same bag is well known. We have come a long way with research and campaigning playing a role to help alter such attitudes. However, whilst a number of campaigns (such as Time to Change) have been set up and may be successful in decreasing stigmatizing attitudes towards mental illness, drug addiction has not received the same treatment. Ce-
The Looking Glass
lebrities are not applauded for coming forward to announce they have an addiction in the way that celebrities such as Stephen Fry and Ruby Wax have been for sharing their experiences of bipolar disorder and depression. They are more often victims of pity, blame and mockery in the media. Of course, there are a number of additional factors that influence public and private views of drug addiction. Government policies, such as those produced by the UK Drug’s Policy Commission that ran from 2007 and 2012, may oppose stigma and discrimination towards drugs users. However, the views given in these reports are in conflict with the criminalisation of drug use and the militant language used to describe the ‘fight’ or ‘war’ on drugs. Those who carry, use, supply or sell many of the substances that have addictive properties are in fact breaking the law. Therefore, such individuals may be seen pri-
marily as criminals. Of course, not everyone involved in drugs is addicted in a medical sense but all are tarred with the same brush. Accountability for actions and assigning responsibility is also complicated, as many would suggest that individuals choose to take drugs, at least at first, and so are to blame for the related problems that they develop. Such individuals may be seen as weakwilled and morally flawed, not sick. These sorts of attitudes may be seen amongst the very people who are supposed to help those with SUD. Even amongst professionals there may be the sense that mental health problems deserve sympathy whereas drug users ‘bring it on themselves’ so are less deserving of help. Professionals may also have lower expectations for recovery for individuals with a drug problem. Indeed, mental health workers and researchers, in my experience, often have the same attitude of blame towards those who misuse substances. Worse still are the problems faced by those
with substance misuse problems comorbid with other mental health illnesses. For such individuals it can be a challenge simply to access treatment. They may be told that they are not eligible for generic mental health services as psychotherapy or other treatments are not going to be effective before they can tackle their substance use problems. Conversely, referral to substance abuse clinics results in them being told they must first tackle their mental health issues before they can address their addiction. The focus becomes which problem to treat first? This results in individuals being shifted from service to service without receiving treatment. Perhaps over time attitudes to addiction will change. A host of newer ‘addictions’ are being posited and are viewed in a different way to substance misuse. Facebook addiction, sex addiction, shopping addiction... Whilst people debate whether excessive behaviours in these areas are medical addic-
tions, it is clear that they can carry severe negative consequences, destroy relationships and may have dire financial consequences in the same way that drug addiction or alcoholism can. Yet, they do not carry quite the same connotations that substance misuse does. There are no easy answers to some of these problems. Of course, research is necessary to develop a better understanding of why people initiate drug use, continue to use substances despite negative consequences and often relapse following periods of recovery. What is important to remember is that those diagnosed with SUDs are struggling, in need of help and unlikely to recover whilst they are viewed negatively by society and those who are treating them. In particular, it is important that those seeking help receive it and do not fall between the gaps when their addiction presents alongside other mental health problems. Rhianna Goozée
YOUR LETTERS AND OPINIONS Write to us at email@example.com to let us know what you think about the magazine or to respond to articles. You can also use our Facebook page to post comments and opinions.
The Looking Glass
On the Couch with… Professor Jon Cooper
The IoP, Europe’s largest centre for research and post-graduate education in psychiatry, psychology and the neurosciences, is home to hundreds of research students who come from a variety of backgrounds and are attracted to the Institute due to its reputation for research and teaching. Professor Jon Cooper has carried out research at the IoP for over a decade but more recently he was appointed as the new Head of Graduate Studies (Research). He therefore plays a huge role behind the scenes, influencing and, hopefully, improving provision for students in both support and facilities. We think he is someone that students should get to know and so Emma Palmer met with him to discuss his career and how he plans to ensure research students enjoy their experience here. Jon Cooper started his academic career by completing a BSc in Anatomy and Cell Biology at the University of Sheffield (whilst moonlighting as a mortuary technician to help pay off his overdraft!). He later moved to the University of Bristol to undertake a PhD on the pathways that control eye movements, which has nothing to do with what he researches now.
self-defined ‘House Dad’, which inspired him to move away from diseases of aging and to work on ‘horrible diseases that kill children’ (more formally known as lysosomal storage disorders) in San Francisco (UCSF and Stanford) where he also worked on Down Syndrome.
I have multiple roles. In addition to running a lab in which we are trying to understand and treat lysosomal storage disorders (especially Batten disease), I’m now the Head of Graduate Studies, which is a continuation of my previous roles and very much linked to student support.
Finally, he returned to the UK and began working at the IoP in 2000, starting with a lab that consisted of just him and a laptop. Over the last 13 years, the lab has grown into a large and successful group and Jon has taken on further responsibilities…but we’ll let him tell you the rest!
I previously co-ordinated the IOP’s personal tutor scheme for PGR students and was also in charge of postgraduate skills development. The idea was to provide a broad range of skills training and support, to equip students to be better able to cope with whatever life may throw at them.
He then went ‘post-docing’ first off in a position at Cambridge working on neurotrophins and their role in the cholinergic basal forebrain. Following this he landed a spot at the Max Plank Institute in Munich to learn about generating genetic mouse What exactly do you do at What I do now as Head of models. the IoP and what should stu- Graduate Studies is an extenHe then spent some time as a dents know about your role? sion of that, but with a bigger 19
The Looking Glass
perspective. Effectively I’m in charge of monitoring the Institute’s provision for PGR students, how they are progressing and how they are being supervised. It’s a case of trying to combine maintaining high academic standards with supporting PGR students the best we can. In your new role as Head of Graduate Studies, what are your plans to improve the research student experience? There are multiple things that I would like to do, and improving the student experience is certainly one of them. With our personal tutor scheme we are already doing well at this, but not wishing to be complacent, we need to
look at ways we can improve things further. We have been streamlining and updating the induction process and will hold these sessions four times a year. We also want to encourage students, who have come here to do an MSc, to stay and do their PhD here, rather than losing these great students to our competitors.
then they have somebody else to go to for advice. The IP is unique amongst the Schools of KCL in offering a personal tutor to PGR students and we lead the field in this respect. Of course, you are also an active researcher. Can you explain a bit more about your lab and what they do?
Certainly; the lab researches a group of, thankfully, very rare diseases that are inherited in which children have a mutation in a particular gene affecting the lysosome, which is essentially the waste disposal unit or recycling centre inside cells. The diseasecausing mutations are in genes that either make an enzyme, which should be chewing things up that aren’t wanted any more, or in a transmembrane protein that is important for lysosome function. The end result is that waste material builds up in the lysosome and children will become blind, lose the ability to walk, talk and feed themselves, have severe epilepsy and will die prematureWhat you think the Institute ly because there are no treatdoes well? ments available. Sadly, my own PhD experience was rather negative, which is one of the main reasons why I have a big commitment to try and support students better. When I had difficulties with my supervisor, my Head of the Department simply said “Yes, he can be difficult”. Although there was a little more advice than that, there wasn’t a great deal more. I would like to think we can do much better these days, and there is no reason why we can’t do very high quality research at the same time. We have great facilities here to support students, who can be happier and better equipped to make the most of their time here.
Apart from the high standard of research across a broad number of fields, I would like to think we can also offer our students a good PGR experience. The physical facilities have improved greatly during my time here, like the refurbishment of the Wolfson Lecture Theatre and the new Education Hub. Importantly, we also provide our students with a personal tutor during their studies. If students have a problem, that for whatever reason they don’t want to discuss with their supervisor,
I work on a particular group of these diseases called neuronal ceroid lipofuscinosis or Batten disease, which are part of the larger family of lysosomal storage disorders. One half of the lab focuses on trying to understand what has gone wrong in these diseases. The other half of the lab spends its time trying to ‘fix’ these diseases by working on different kinds of therapies. Obviously these last few years have been financially
difficult for England as a So if you hadn’t been a rewhole, have you noticed an searcher would you have effect on funding and re- become a vet? search? No, I was never smart Absolutely. Funding is hard to enough. If I hadn’t been a find at the best of times (but researcher I would love to is a particular problem when have ended up doing someyou work on rare diseases) thing more creative in film. and in recent years its defi- Who knows? I would probanitely got more difficult. This bly have ended up being eimeans you have to be more ther a film director, editor or resourceful and you end up cinematographer. forming networks of people and putting grants together You’ve said you have lots of with them. You have to be roles here at the IoP and also more creative and you also that you have a family, so have to be very resilient. You how do you balance the have to realise that in terms commitments? of writing grants only 10% of what you apply for may get funded. It’s important not to take the rejections personally.
Good question! It’s a question of focusing on what needs to be done… Yes I’m a dad of three boys ranging from 6 to 17, who also keep Why did you decide to go me busy. Although it’s challenging, I’d rather be active into research? and have plenty to do, which I was of the James Herriot keeps you fresh and keeps generation, when ‘All Crea- you moving forwards. tures Great and Small’ was on the TV. I first wanted to be a In your opinion, what are the vet, but in retrospect that most important goals? in actually would have been one neuroscience to date? of the biggest mistakes I could have made. Fortunately, I didn’t get the grades I needed to become a vet, so I did basically what I was interested in, which is finding out how things work or how they go wrong. I became interested in the brain because I figured we would never properly understand it, so there would always be something interesting to do. I was motivated to become a researcher essentially out of curiosity and I was interested in the structure of things, how this relates to their function and, in the case of disease, to their dysfunction.
Above and beyond any scientific discovery, it’s making that link from work done in the lab to helping people who are struggling with a disease. That’s the biggest challenge we face in trying to understand any disease and bridging that gap from the lab to the real world is the most important goal we can have. From a personal perspective, bringing new young researchers into the lab and seeing them grow as scientists during that time is also very rewarding. The aim is to empower them to be the scientists of the future.
YOUR LETTERS AND OPINIONS Is there a senior researcher you’d like to see on our couch? Do you have burning questions you would like to ask them? Send your suggestions to us at firstname.lastname@example.org
The Looking Glass
Blog Spot FEATURED BLOG FROM EMMA CLAIRE PALMER
Emma Claire Comments ...on science and mental health.
DO YOU THINK YOU’RE PREJUDICED? Do you think you’re prejudiced? What would you think if I told you I was 24, female and studying for my PhD? Does your opinion of me change when you find out I have a mental health problem? 1 in 4 people in the UK will suffer from a mental health problem at some time in their lives, and yet there is still a huge amount of stigma associated with this form of illness. The passing of the Mental Health Discrimination Act on the 28th February 2013 has brought the topic of mental health stigma once again to the forefront of mental health debate. Many people still see having a mental health problem as a sign of personal weakness, or that the sufferers are dangerous people. These beliefs were translated into laws which discriminated against those with mental health problems. The Mental Health Discrimination Act abolished these outdated laws that stated members of the house of commons could be automatically removed from their seat if they were sectioned under the Mental Health Act for more than six months, removed the total ban on ‘mentally disordered persons’ undertaking jury service and upended legislation which stopped persons from being a director of a public or private company “by reason of their mental health”. The battle to recover from a health problem is, for the most part, an internal and personal one. For example, only I can truly understand why I get upset and panicky about ‘irrational’ matters; one person’s minor annoying molehill is another persons’ anxiety-ridden mountain. I have been taught the skills I need to eliminate my anxious thoughts using Cognitive Behavioural Therapy (CBT); this is form of talking-therapy where one identifies the triggers and ‘unhealthy’ thought processes that can lead to feeling unwell and teaches you how to overcome them. I also take anti-depressants to help keep my mood positive, and I take beta blockers (medication used to slow the heart rate) when I need a bit of extra help to calm down. However, none of this would help half as much if I didn’t have my family and friends supporting me, it makes dealing with my problems much, much easier to cope with. I know I can open up and talk to my partner about feeling upset because of something that is objectively not stressful and he will listen without judging me. Unfortunately, not everyone with mental health problems has this kind of support. Many people have no-one to talk to, or are made to feel weak if they open up about how they’re really feeling. This is a huge problem, because the stigma which surrounds mental illness can be one of the biggest hindrances to patient recovery. If the general public are educated about the best and worst ways to approach and discuss mental health problems, it could make a huge difference to those who suffer from them. I am fortunate that I made the first step and actually went to see my doctor about how I was feeling. This led me to treatment, and I am really happy to say I am well on the way to recovery (though I do still have the odd meltdown about burnt food and dishwashers I have forgotten to unload). However, if people continue to endorse a negative view of mental illness, many will suffer in silence and refrain from seeking help altogether, for fear of being labelled as ‘mental’ or ‘crazy’. Mental Health charity ‘Time to Change’ run a campaign called ‘Time to Talk’, which is endorsed by celebrities such as Steven Fry and Frankie Sandford of ‘The Saturdays’. This fantastic campaign encourages members of the public to openly discuss mental illness. It’s their hope that once a frank and honest dialogue has begun, mental illness won’t be seen as such a ‘taboo’ subject, and in time social stigma will diminish. Mental health problems don’t have to be scary to talk about. As stated before, 1 in 4 of us suffer from them, so it should be a much more commonly addressed issue. Simply saying ‘How are you?’ can be enough. Showing you care and are available to talk can be all suffers need…it can get a bit boring chatting about nothing but mental health issues, but its nice to know someone is open to the conversation should it arise. The passing of the Mental Health Discrimination Act is a fantastic step in the right direction to ending mental health stigma, but we still need to educate the general public if these stigmatising beliefs are to be removed from general conversation.
Look out for more from Emma at http://emmaclairepalmer.wordpress.com/
The Looking Glass
CALL FOR SUBMISSIONS The Looking Glass is now accepting submissions for the next issue!
We are looking for feature articles, reviews, news items and any other creative ideas you might have. We will also print letters and responses to any previous issues. In particular we are interested in articles relating to the special theme â€˜Women in Scienceâ€™. So, if you have any ideas for articles relating to women in psychiatry, psychology and neuroscience or articles about gender psychology, then get in touch. We want to explore some of the issues surrounding women in science disciplines, as well as celebrating female contributions to psychiatry and mental health. So, get writing and send your articles to:
email@example.com For more detailed submission criteria visit our Facebook page: www.facebook.com/TheLookingGlass2012
Editor Rhianna GoozĂŠe
Editorial Assistants Jorge Palacios Analucia Alegria Andres Herane Vives Anthony Harrison
With thanks to Dr Marietta Papadatou-Pastou Elena Panagiotopolou iConcipio Dr Owen Bowden-Jones Leng Song Emma Palmer Prof. Jonathon Cooper
Thanks to everyone who has helped to support us in producing the second issue and promoting The Looking Glass