Expert Breakfast Report for 15 August 2018: Dr Sarah Fortune, Dept of Psychological Medicine

Dr Fortune is a Clinical Psychologist, who, in addition to having four children including twins, has studied at Auckland, Dublin, Oxford and the London School of Hygiene and Tropical Medicine. After a spell in the psychology of selling, she moved into clinical psychology and teaching psychology to medical students. She is also a surfer, likes to run, and is a keen photographer.

See New Zealand or You Haven’t Been Round the World

This day was the first (hopefully the last) day the primary school teachers went on strike seeking reasonable pay and conditions. As Dr Fortune has three children at Primary School, all at home for the day, we were particularly grateful that she was able to attend!

Dr Fortune's comment on maintaining health and well-being:
“What we know is that relationships and connections and getting up and getting dressed, eating a little bit of breakfast and getting exercise, and not drinking too much alcohol, and trying to get [adequate] sleep are all important for health and well-being.”

Sarah had somewhat unusual parents who, in the 1960’s, had decided to travel overland around the world in a Volkswagen station wagon, from where they lived in Southern Ireland. The fact that her father is a Chartered Accountant, and her mother a Historian made this decision a little more remarkable than it might otherwise have been, given that, in those days, if you had a job of this kind was generally a job for life.

They stopped in various places, including Cape Town, South Africa for some time, then carried on reaching Australia. There they met a number of Kiwis, who encouraged them to visit New Zealand, ‘You can’t say you’ve driven round the world unless you’ve been to New Zealand.”

An Unusual Family, Provisional Entry, Headmistress and Dean Disagree

Their idea was to spend some time in New Zealand continuing their rather substantial OE, and Sarah’s mother worked at Auckland University as part of that. Once back in Ireland, they realised they had changed a lot over the 6 or 7 years, whereas the Ireland of the 70’s was largely unchanged. In consequence, they made their way back to New Zealand, and Sarah spent her childhood mainly in Auckland. She feels that her Irish origins are ‘important in who I am’, noting that, of the three girls in her family, two are Psychologists and the other is a Forestry Scientist involved making ‘megabuildings’ out of timber.

At school at St Cuthbert’s College in Auckland, Sarah had read parts of some psychology textbooks her mother was using as part of a BA in Languages she was undertaking once her younger daughter entered intermediate school. Already interested in the topics she read about, this reading convinced her she wanted to do psychology, and she applied for provisional entry to university based on year 12 grades, but the school liked ‘relatively high performance students’ to stay on and contribute to school life through service committees and the like. In consequence, the Headmistress of St Cuthbert’s refused to countersign her application. However, the year six Dean agreed to sign and support Sarah’s application.

Too Young for Drinking Binge

Off to Auckland University at age 16, Sarah did a BA in Psychology, Educational Psychology, Russian Literature, Russian Art, Statistics and had a great time. The downside was that the drinking age then was 21, so for the entire duration of her degree “I couldn’t go in Shadows’ - an Auckland bar frequented by student. (Not that she was or is a ‘big drinker’, but the social aspect is attractive). On the last day of term the Shadows bar used to organise a tanker in the quad outside Shadows, and the challenge was to ‘drink the tanker dry’. [Ed: Not being allowed to take part was a major plus for a young person rather than ‘a downside’! - see https://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm].

Fast Food, County Councils and “Hell, no!” Air Freshener

Graduating at 19 years, Sarah felt not quite ready to undertake Clinical Psychology, though one of her lecturers had instilled an enthusiasm in the area, but, being also interested in research, with a curiosity about what people get out of work, which led her into Human Resources Management working for a commercial research company. “I had a fantastic time” asking people, for example, why they bought a particular car, what’s the difference between one type of fast food and another? (The upshot of that research was that the food just needs to be fast!). 

Clients included Burger King, Councils interested in such matters as why people use public libraries among many other matters, and a manufacturer of air fresheners.  At a meeting in a stuffy Board Room about air fresheners, she asked the Brand Manager if she used them herself, to which the response was, “Hell, no! I just open the windows.”

When she looked into her future, Sarah decided that she was not keen on spending it using psychological principles to persuade people to buy products that were not particularly good for them, or that they don’t really need.

Psychology in Ireland, Competition for Course Places

At this point Sarah decided to go for clinical psychology - and to study it in Ireland, making a successful application, to University College, Dublin under Prof Alan Carr, even though the course was very popular and many applicants were turned down. Dr Fortune talked about the fact that, as a student faced with a limited number of course places and a large number of applicants, you need to remember that you only need one of the places. This can be particularly challenging when you are living ‘up close and personal’ with other people with the same ambition. “So, hold on to that idea - I only need one of those places - what can I do to enhance my chances of me being successful, but not to the detriment of my colleagues.”

Clinical Psychology Practice, Tower Blocks, and Horses in the Lift

In a similar way to Medical practice, Clinical Psychology demands that you perform in a variety of settings, so a child placement, an adolescent placement, adult and learning disability placements, and older adults are part of the training. The placement process is quite stressful, requiring repeated minor adjustments to ones life, and being informally evaluated all the time.

One of her placements involved helping people in the Ballymun Tower Blocks. (Ballymun is an area on Dublin’s Northside). These Tower blocks arose in many cities in the 1960’s when the inner city slum areas were destroyed to be replaced with up-market housing, and the original inhabitants were given skyscraper type housing blocks to live in on the city outskirts, severely damaging their social networks, moving them to relatively inhospitable areas away from available work, and generally causing massive upheaval now recognised as very damaging. Drug use in Tower Blocks is rife, and ‘travellers’ now living in them house their horses in the lifts overnight, so the lifts are almost always out of order, not great if you live on the 26th floor. It all combines to make a’pretty distressed community’.

Dr Fortune also touched on:

  • Working in Limerick - Angela’s Ashes and the smashing of bookshop windows
  • Working in a locked ward psychiatric hospital
  • Decision to work with child mental health
  • Her commitment to equity - or as close as one can get to that ideal, e.g. in public access to health care
  • Her PhD in treating suicidal children, adolescents and their families
  • Over-management of Health Services
  • The advisability of doing your PhD in a different university to your first degree, preferably offshore
  • Post-doctoral Fellowship at Oxford
  • Working at Medical School in Leeds
  • Masters in Epidemiology and Statistics at London School of Hygiene and Tropical Medicine
  • Decision making on where best to apportion available health funds
  • “There’s no shame in hard work, but it’s better to get paid more for that hard work than less”
  • “Better to have a job with autonomy than being directed by someone else”

There were, as usual, some excellent questions from Member, such as the part played by social media on the suicide rate and the concept of contagion; self-harm and the school environment (only about 2.3% is accountable to the school itself); depression, assessment and stress in university; differences between psychology and psychiatry; the great range of possible career paths for a psychologist, as in most areas of medicine; the value of non-academic experiences for an academic person in maintaining mental balance and sometimes helping in the work environment, and lastly the importance in a high-stress environment, in finding the balance between "joining in on the collective . . . and over-talking mutual problems over which you have little or no control”.

Posted: Wednesday August 22, 2018