"We are them" : exploring the experiences of clinical psychologists with lived experience of mental distress : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand. EMBARGOED until further notice.

Abstract

Lived experience of mental distress is common among clinical psychologists, yet sanism and silencing marginalise lived experience in the discipline. In Aotearoa/New Zealand, there is no formal acknowledgement of lived experience in clinical psychology. Additionally, a divide exists in academic and social communities between lived experience/mad perspectives and practitioner perspectives. Consequently, there is little understanding of the experiences of clinical psychologists with lived experience of mental distress, especially in Aotearoa/New Zealand. This research applied a Mad Studies lens to explore how clinical psychologists who have lived experience of mental distress make sense of the interplay between their lived and clinical experiences, within their professional contexts in Aotearoa/New Zealand. Reflexive Thematic Analysis was used to analyse data from semi-structured interviews with 13 New Zealand clinical psychologists with lived experience. Four themes were generated within a metaphor of ‘the psychologists’ uniform’; a powerful professional ideal which demands psychologists perform the characteristics of a ‘blank slate’ persona and carry a heavy sense of responsibility, alongside wisdom, insight, bravery, and resilience. Theme 1 outlines how the uniform creates an impossible ‘us and them’ binary that positions lived experience of mental distress as incompatible with the role of clinical psychologist. Themes 2 and 3 examine how participants navigate the dilemmas the binary and uniform create. Theme 2 explores the dilemmas, risks, and benefits of (non-)disclosure of lived experience, while theme 3 explores how participants flexibly embrace (adopt) and resist (adapt) the norms, knowledge, and practices of clinical psychology. Finally, theme 4 outlines participants’ perception that while the uniform is becoming more accommodating, further progress is needed for clinical psychology to become truly welcoming of mental distress, with suggested mechanisms for change to support this movement. Overall, this research finds that lived experience of mental distress is marginalised in clinical psychology, leading clinical psychologists with lived experience to engage in complex strategies to negotiate existing in an impossible position, and identifies lived experience as a potential mechanism for transformation in clinical psychology. It concludes with recommendations that lived experience be normalised and recognised as a legitimate knowledge base within clinical psychology, and that steps are taken for clinical psychologists to be safe to disclose, discuss, and make meaning of lived experience in their professional contexts.