Sophie Westwood

Home  /  BLOG  /  Sophie Westwood

Book review: ‘Narrative Therapy in Wonderland: Connecting with Children’s Imaginative Know-How’ by David Marsten, David Epston, and Laurie Markham

July 26, 2017 Olivia's Place Comments Off , ,
Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia's Place Shanghai

Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia’s Place Shanghai

Narrative therapy is an approach that I regularly consider and apply in my clinical work with children, young people, their families, others involved in their education and community, and adults. I was first introduced to this approach during my clinical training at the University of Surrey in the UK, and it was my experiences working in Shanghai that led me to want to get to know it a little better. Working as a British clinical psychologist in downtown Shanghai with clients from the international and local community was a new experience for me and a fresh way of thinking about culture. I too, had attempted to integrate into a different culture and apply my British ways of working (and living) which provided a melting pot of emotions with confusion, curiosity, amusement, wonder, disappointment, relief, sadness, stress, fatigue to name but a few. After nearly two years of working in Shanghai and a growing interest in a therapy approach that takes a long hard look at the influences of relationships and culture, I took the plunge and travelled ‘down under’ to Melbourne last November to complete the week-long Module 1 Narrative Therapy training course. I was surprised to be the only clinical psychologist present but delighted to be in the company of the other attendees who mostly worked with people experiencing all sorts of difficult situations rendering them vulnerable to mental health difficulties. Our shared aim was to try to help them to move forward in their lives in a meaningful way.

Narrative Therapy in WonderlandMy journey with narrative therapy is in its early stages and from my current perspective, the essence of it involves identifying the stories of our lives that we give the most attention to, and exploring what other stories may have been forgotten, dismissed, or are yet undiscovered. It’s the onion metaphor of first peeling back the delicate skin followed by the thick sticky outer layers to expose those that are perfectly snug and hidden that comes to mind. One of the central ideas of narrative therapy is that we are all make meaning of ourselves, others, our lives, and the landscapes we inhabit through the way that we share and create stories, or narratives. For example, a young child that startles easily and prefers to hide behind their Baba’s legs when they meet someone new might be described as ‘shy’ or ‘nervous’ and this becomes a story about them. From this story alone, we might assume that this child is prone to anxiety, has an ‘anxious temperament’ and might have difficulty making friends when they start school. However, when we introduce greater detail to that story and other stories become entwined too, such as startling easily but only when big dogs are around and hiding behind Baba’s legs when his male colleagues come over for dinner but then giving everyone big smiles after a few minutes or so, there is room for alternative or different meanings. This meaning-making process is heavily shaped by our social worlds and we learn much about ourselves through the ‘eyes’ of others (Bakhtin, 1986). During narrative therapy work, a watchful eye is kept on the influencers of stories and how powerful they can be. For example, it might be helpful to explore what it means to be ‘normal’ in any given family, culture, community, or society. Acknowledging this power dynamic and deciding whether the expectations related to certain narratives are something that we might need to live up to, can free up energy, thoughts, and ideas for different and valued directions in life.

The book, ‘Narrative Therapy in Wonderland,’ truly continued to inspire my interest and enthusiasm for the application of this approach in my work. A few years ago, I had called a young person to tell them more about a therapy group to which they had been invited. When I asked them* if they had any questions, the only pertinent question on the tip of their tongue was ‘will it be fun?’ I believe one of the aims of this book is to answer that question and help those working with younger people (and those fully grown too I wonder?!) to consider why fun is an essential ingredient of helpful therapy. Each chapter is littered with case examples of how ‘fun’ can show up in a variety of ways. For example, following a child into whichever ‘wonderland’ their imagination currently occupies is an adventure that can never be planned and is sure to surprise. It is a humbling experience to be invited into a world where fantasy writes the script and a playground of opportunity presents itself with see-saws and roundabouts rooted firmly in reality. My role is to support the young person and important others to navigate a route or generate a map, whereby together we can find a way to ‘shrink a problem down,’ or ‘stand up to’ it to prevent it from bothering the young person. I have witnessed the birth of incredible ideas to do just this from young people that no textbook or therapy manual could have ever directly prescribed. That is, of course, not to say that those textbooks or therapy manuals aren’t helpful too, and I am often grateful for their guidance in clinical work. The beauty of being trained to apply psychological theory is that alongside the person or people with whom I am working, we can decide collaboratively, which is the best fit for them. I am often drawn to a narrative therapy approach because it is very much led by the client and the knowledge, skills, abilities, talents, and qualities they have of what could work best for them, and not forgetting the valued involvement of those around them.

Something else that I hope to introduce into my clinical practice from Marston, Epston, and Larkham’s writing is the ‘wonderfulness interview.’ During our first meeting, it can be tempting for all of us in the therapy room to devote all of our attention to the problem and the story of how it might have developed, what is preventing it from going away, and the ways in which it is negatively influencing or affecting a person’s life. This is important information to hear but given that narrative therapy aims to find out what is not yet known, forgotten, or dismissed, it’s worthwhile listening to a different sort of story or stories too. By asking questions about what is ‘wonderful’ about the young person affected by a particular problem, we start to learn about other stories in their lives that speak to who they are, what they value, and wish, dream and hope for. Certain skills, abilities, qualities, or knowledge might be known and can be particularly handy in calling upon in service of freeing up the hold that the problem has on a person’s life. You’ll notice that problems in this article have been written about in a certain way: it is ‘the’ problem, as opposed to ‘the child’s’ problem.’ This is an important distinction in narrative therapy because it posits that ‘the person is not the problem, the problem is the problem’ (White, 1984; 2007. For younger people, this means that they receive the message ‘I am a good and worthwhile person who is currently doing my best to deal with a tough problem that’s causing lots of trouble for me and other people.’ This can be a big relief for some young people (and parents) to hear when they have not been particularly keen on coming along to the first session in the first place!

So, as I sat on the phone talking with this particular young person about their potential attendance at the therapy group I answered, ‘yes, it will be fun.’ As my experience has developed, and as I continue to engage in a career that will always be about learning, I now feel I could answer that young person with greater conviction. I keep wanting to learn more about this particular therapy approach because it provides a helpful set of ideas for working with families and helping them to ‘team up’ against a problem or difficulty in an empowering and respectful way. The book reviewed in this article is an excellent addition to any psychological practitioner’s library and a captivating read.

If you are a fully grown (but maybe not self-defined as ‘grown up’!) adult, a lovely introduction to the world of narrative therapy has been written by David Denborough and it is called ‘Re-telling the stories of our lives.’ I recommend this for anyone interested in making a change.

 

References:

Bakhtin, M. M. (1986). Speech Genres and Other Late Essays. Austin: University of Texas.

Denborough, D. (2014). Re-telling the stories of our lives. Everyday narrative therapy to draw inspiration and transform experience. New York: Norton.

Marsten, D., Epston D., & Markham, L. (2016). Narrative Therapy in Wonderland: Connecting with Children’s Imaginative Know-How. W. W. Norton & Company, Inc: New York

White, M. (1984). Pseudo-encopresis: From avalanche to victory, from vicious to virtuous cycles. Family Systems Medicine, 2(2), 150-160.

White, M. (2007). Maps of Narrative Practice. New York: Norton.

*’They’ is the author’s preferred pronoun to signify gender neutrality (as opposed to the use of ‘him/her’).


Shanghai Psychology Team Trains on Emotion-Focused Therapy

June 2, 2017 Olivia's Place Comments Off , , ,

Dr. Leslie Greenburg recently visited Shanghai and conducted a series of trainings on Emotion-Focused Therapy (EFT). Dr. Greenburg co-founded the therapeutic approach of EFT, which is an evidence-based psychological treatment. Dr. Greenberg is presently a professor in the department of psychology at York University, where he is also director of the university’s Psychotherapy Research Center.

Three LIH Olivia’s Place Shanghai Psychology Team members – Dr. Sophie Westwood, Dr. Beth Rutkowski, and Ms. Veronica McKibben – attended his one-day workshop on Working with Shame with EFT. Ms. McKibben attended a further two weeks of training in order to develop in depth understanding and skills within the practice of Emotion-Focused Therapy.

The therapeutic techniques of EFT are based on the belief that emotions direct in the way people interact with the world. They guide our actions. They inform us of the things that we want. They help people grow and develop attachments.

The therapy focuses on regulating emotions in order to facilitate a change in behavior. Within a therapy session, an individual is assisted through the process of gaining awareness of their emotions. The therapeutic setting also allows people to experience emotions in a place that is safe and that may be challenging or even frightening to explore without support.

With training, therapists are able to help individuals identify primary and secondary emotions. An example of secondary emotion is when a person expresses anger, though she is actually masking sadness. People are then able to learn to understand, manage, and transform maladaptive emotions. This allows them the opportunity to access and utilize healthy, adaptive emotions, such as grieving the loss of a loved one or developing compassion towards a person who hurt them.

The psychological community of Shanghai was very fortunate to have the opportunity to learn these techniques from Dr. Leslie Greenburg. They will assist the LIH Olivia’s Place psychology team in their work with adolescents, families, and adults.


Lazy or “Demand Avoidant”?: Motivating Children with ADHD

November 9, 2016 Olivia's Place Comments Off , ,
Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia's Place Shanghai

Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia’s Place Shanghai

An article that recently caught my eye, on ADHD and motivation, was written by a guest blogger, Sherry Cramer, an Educational Therapist, and posted on Anne-Marie Morey’s ‘Bay Tree Blog’. Anne-Marie is also a North American educational specialist. She has a great blog and often posts interesting and useful articles and resources. I strongly recommend educators and parents to take a look at her ‘Bay Tree Blog’, http://www.baytreelearning.com/blog/

Difficulties regarding motivation and children and young people are common but there are some specific ways of thinking about this issue and tips and strategies for children with ADHD that can be helpful. Here is the link to the blog to read for yourself http://www.baytreelearning.com/blog/2016/09/06/motivation/
I am going to outline some of the main points and a few other things that I think are important on this topic below. All of the research references can be found in Sherry’s blog post.

Sherry begins by explaining that researchers have found two major circuits of connections in the brain that are implicated in motivational behaviour: the reward and executive circuit. Both, or at least one of these circuits, function differently in the brains of children and young people with ADHD. The reward circuit doesn’t receive enough dopamine to keep children with ADHD focused on their goals and thus they become distracted by their own desires and things around them. A smaller, and less active and mature executive circuit in children with ADHD means that they struggle with ‘executive-function’ based tasks that enable us to plan, organise, pay attention and manage our time. Sherry goes on to describe a variety of tools that help to set up the right environment, details some of the benefits and controversies surrounding medications, and suggests reading for behaviour modification strategies, self-management and building executive functioning skills.

With these difficulties in mind, it makes it easier to see why children with ADHD often find it harder to complete the tasks required of them. In addition to these underlying brain-based skill deficits, other factors such as level of interest (we all like certain things over others), complicated ‘hidden’ social rules, the consequences or rewards of doing something, and the fact that repeated failure of a task can raise anxiety and/or lower self-esteem, commonly influence motivation. Taking these and other factors into account can help to shift the perspective of ‘laziness’ to think about why the child or young person is avoiding the demands of the task. Take for example Jack (a fictional character with realistic difficulties). Jack is an 11-year-old boy living with his parents and sister at home in Shanghai. He has a diagnosis of ADHD and takes medication when he goes to school. Jack’s parents are concerned because he has always loved soccer and plays in a team with his friends at weekends. Lately though, Jack has been playing videogames more and says he ‘can’t be bothered’ to play soccer. When his parents do manage to get him out the door and on the way to soccer practice he moans about going and doesn’t put much effort into the game. Jack’s parents have been sensitive to his needs as a young person with ADHD but are unsure whether this behaviour is laziness or more related to the issues described above. What factors might be contributing to Jacks ‘demand-avoidance’? How do you think Jack’s parents could approach this situation? Is there anything Jack can do to help himself?

The last section of Sherry’s blog posts focuses on how parents and educators can plant the seeds for personal motivation to thrive, and the skills that they might need for nurturing this growth. I echo Sherry’s advice and encourage those that are interested to read the books that she has recommended: they are often books that I recommend in my clinical practice.

References:
http://www.baytreelearning.com/blog/ http://www.baytreelearning.com/blog/2016/09/06/motivation/


A New Therapy Available at LIH Olivia’s Place Shanghai: Helping the Brain to Heal Itself

October 12, 2016 Olivia's Place Comments Off ,
Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia's Place Shanghai

Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia’s Place Shanghai

As one of the clinical psychologists at LIH Olivia’s Place Shanghai, I work with children, young people, families, and adults. Much of my time is spent offering talking therapies and behavioral consultations, conducting different types of cognitive assessments, and delivering training sessions and workshops to schools and other organizations in Shanghai. I recently completed extra training in a therapy that I think may be of great interest, and even help, to individuals within our community.

In July, I travelled to Hong Kong to complete the first part of the accredited training for Eye Movement Desensitization Reprocessing therapy. Because the name is so long it is often known as EMDR therapy. EMDR is used to treat a range of emotional and mental health difficulties such as trauma and low self-esteem, and reduce symptoms related to disturbing past experiences that the brain has not been able to process properly.

I first became interested in EMDR a few years ago whilst working for a talking therapies service in the National Health Service (NHS) in the UK. One of the therapies on offer involved asking clients to sit comfortably and follow the clinician’s fingers, from left to right, with their eyes. I thought this sounded a little unorthodox but in the knowledge that the NHS is an internationally renowned health service that only funds evidence-based talking therapies, I endeavored to keep an open-mind and learn more about it. Since that time, I have attended seminars and workshops and now, can offer it as a therapy. I will share a little of what I have learnt with you…

Like many therapies, EMDR aims to help people overcome the emotional distress and symptoms they are experiencing as a result of disturbing life experiences. During EMDR, the brain works hard to unblock the emotional pain that remains from past incidents or events, and this can happen remarkably quickly. The EMDR therapist uses different protocols and procedures to do this, one of which involves moving their fingers from left to right. The purpose of this is to stimulate activation, or processing, between the left and right brain hemispheres. Indeed, the EMDR therapist has a variety of methods from which the client can choose to stimulate this brain activity, to make sure that they feel comfortable and the therapy is as effective as possible. During an exercise for my EMDR therapist training, I found that following the therapist’s fingers was too distracting and I preferred to be tapped on my knees. I also had options such as listening to sounds or using a machine that vibrated on my fingertips. I was asked to do this whilst holding different aspects of a difficult memory in mind and there were other strategies used to help me to feel safe and relaxed if I needed it.

You might be thinking, how does EMDR work? The answer is not fully known but a researcher from Harvard has proposed that it could be connected with the biological mechanisms involved in Rapid Eye Movement (REM) sleep, helping us to process memories and disturbing feelings. Sounds strange? Well, after completing my training and seeing the beneficial effects, I find it helpful to think of EMDR as just another way of helping the brain to process disturbing or traumatic experiences, in the same way that more traditional talking therapies can. EMDR has been shown to reduce post-traumatic stress symptoms in a number of research studies and millions of people have been successfully treated over the past 25 years.

As a clinical psychologist, I offer a range of talking therapies according to the client’s needs and often work in an integrative manner, meaning that I can draw upon different therapeutic strategies and tools. EMDR is a great resource for my therapy tool-box because I can offer it as a stand-alone therapy or as part of course of therapy involving different therapeutic approaches. I can offer EMDR therapy to children, young people, and adults. If you would like to know more about EMDR please take a look at the EMDR Institute Website Frequently Asked Questions page: http://www.emdr.com/frequent-questions/ . If you are interested in EMDR therapy at LIH Olivia’s Place please contact us.

References:
Eye Movement Desensitization and Reprocessing: Basic Principles, protocols, and Procedrures (Second Edition) by Frances Shapiro (2001; The Guildford Press)

The EMDR Institute, Inc http://www.emdr.com/


Clinician Profile: Dr. Sophie Westwood, Clinical Psychologist

June 16, 2016 Olivia's Place Comments Off ,
Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia's Place Shanghai

Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia’s Place Shanghai

Dr. Sophie Westwood is a Clinical Psychologist at LIH Olivia’s Place Shanghai.

Dr. Sophie Westwood is a registered Clinical Psychologist with the UK Health & Professions Care Council (HCPC) and a chartered member of the British Psychological Society (BPS), Division of Clinical Psychology (DCP) and Child and Young Person’s Faculty. Sophie has an undergraduate degree in Psychology, a post-graduate certificate in evidence-based psychological treatments and a doctorate in Clinical Psychology. She has worked in a variety of mental health settings with people of all ages. Sophie works at LIH-Olivia’s Place offering psycho-educational and neuropsychological assessments, psychological therapies to children, and their families, and training and workshops to educators and health professionals. She speaks English.

 

How long have you been in China?

I moved to China with my husband in January 2015. We had visited China on holiday 10 years previously and although we enjoyed our vacation enormously, I had never imagined that we would be returning to live and work in China!

 

Why did you choose to work at LIH Olivia’s Place?

After an initial visit to LIH Olivia’s Place I was very impressed by the child-centered facilities and ethos of the company. I was particularly drawn to the mission of helping children and their families to access therapeutic input regardless of their financial circumstances, and I was welcomed into the role by a team of warm, supportive, and professional colleagues. I have since thoroughly enjoyed meeting children and families from all over the world and feel very privileged to be in a position to listen to their stories and work with them to facilitate change.

 

Why did you choose your field?

I began studying psychology when I was 16 years old and I enjoyed learning about how we can scientifically measure and understand human behavior. At university I volunteered with people with intellectual disability at an evening activities club whilst studying for my Psychology degree. I enjoyed supporting people to engage in games and activities that allowed both volunteers and club members to share their experiences and have fun together. I decided to follow my dad’s advice and choose a job that I would enjoy, and so I chose a career working with people, applying psychological theory help build a life that is meaningful for the individual.

 

What are some of the most rewarding experiences you have had in your chosen profession?

This is a really hard question as there are so many to choose from.

 

What’s your favorite thing about living in China and working at LIH Olivia’s Place?

The culture. I love living in a culture that is so different from the UK. Even though Shanghai is a very modern Chinese city, I love to see people eating their xiaolongbao, queueing up for steaming baozi on the street, and watch the washing being hung out from every window and on nearly every road whilst cycling to work.

 

At LIH Olivia’s Place I value being part of a working culture that is accepting of our cultural differences within the staff team and embraces the diverse skills, knowledge, and experience that each of my colleagues brings to the team. I feel very lucky to be working for a company that values evidence-based interventions and is working extremely hard to translate this into offering high-quality health care in China.

 

What would you like to be doing in 5 years’ time?

One of my life goals is to learn a second language (I’m afraid to say that even after 7 years of French at school I still can’t construct a sentence!) and so I hope that I will either still be living in China or perhaps South America or Spain. One of the most exciting things about being a clinical psychologist is that because there are so many ways in which we can work to support people experiencing a broad range of emotional and psychological difficulties I know that I will always be learning and challenging myself.


Top