The Skeleton Cupboard:
The making of a clinical psychologist
By Tanya Byron
Published by Macmillan, May 2014
Tanya Byron is a well-known British clinical psychologist who has appeared on many tv shows about child psychology and problems with children. In her 20+ years of clinical practice, she has met people of all ages with all sorts of mental health issues and problems, and it is her early training placements covering the period 1989 - 1992 which are the focus of this book. In many respects she was thrown in the deep end, sometimes feeling only remotely supported by her clinical supervisors and basically left to learn how to put her theoretical knowledge into practice and actually help her patients.
The fact that she was so often able to do so in cases involving familial sexual abuse, transgender issues, sexual dysfunction issues, families struggling to come to terms with the impending death of sons from AIDS, anorexia and dementia amongst many others is a testament to her own resiliency of spirit, determination and patience. Not everyone can be helped and not everyone actually wants to be helped, however. Dealing with such heart-rending and often tragic circumstances is draining and learning a certain degree of detachment from the clientele is a skill which is necessary but very difficult to learn, as this brutally honest memoir demonstrates. The cases she describes are vividly portrayed and her own thoughts and feelings about her experiences are laid bare for the reader, as are some distressing yet formative experiences from her own life. As a young clinician, she struggled to avoid allowing her work experiences to overwhelm her through maintaining her network of close friends, but on occasions her own immaturity and "nit-picking" of her supervisors did, I must admit, irk me a little.
Many stories of tragedy and abuse are written by the person who suffered; this is the only book I can recall which has actually been written solely from the therapist's point of view. I am sure that both clinical training placements and supervisory support have changed in the intervening years, but this remains a remarkable look at this period in Professor Byron's career, and the cases she describes will stay with me for a long, long time. Individuals described have of necessity been thoroughly anonymised, amalgamated and details changed to protect confidentiality, by the way, as I would expect in a book of this nature.
Not an easy read, and in places incredibly distressing, but a worthwhile one nevertheless for anyone with an interest in mental health issues.