Adult Autism Diagnosis, Long Term Health Conditions and Training as a Psychologist during the pandemic - with Dr Victoria Walker

Dr Marianne Trent (: 00:00

Coming up in today's episode, I am talking to Dr. Victoria Walker, a trainee clinical psychologist. We are talking about what it's like to have a long-term health condition as well as go through a diagnostic and assessment process for an autistic spectrum disorder condition. I hope you'll find it so useful. And of course at the end, Victoria will be offering you her top tips for reducing burnout as an aspiring psychologist. Hope you find it so useful.

Jingle Guy (: 00:36

If you are looking to become a psychologist, then let this your with this podcast, the psychologist with Dr.

Dr Marianne Trent (: 01:05

Hi, welcome along to the Aspiring Psychologist Podcast. I am Dr. Marianne Trent, and I'm a qualified clinical psychologist. So we are in the middle of application season for the doctorate in clinical psychology, and I hope that your own application form is going well. And similarly, the educational psychology route for funded places is also in the application stage as well. So if that is your bag, I hope that is going well too. Don't forget, if you would like to watch any q and a sessions for the compassionate q and a, which is where I give you my top tips and guidance for free about how to go about completing your clinical form, then you can watch the replays on my YouTube channel, Dr. Marianne Trent. I will give you the dates to look for so you know what you're looking for. So the first one of those took place on Monday, the 4th of September, 2023, and the second one is Tuesday the 3rd of October, 2023 at 6:00 PM Depending on when this episode goes out, that might well be around the time when this episode is going out.

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So do keep an eye out, look at the calendar of when you're listening to this work out, whether that is before or after now. So Tuesday the 3rd of October, 2023 at 6:00 PM and then the final one in this series of interview, compassionate Q and As is Tuesday the 7th of November, 2023 at 6:00 PM and this episode will definitely be out before that. But yeah, the replays are available on my YouTube. It's probably worth saying that I know some people will listen to these episodes years in advance. So the replays are always available. And there is a playlist called Free q and A sessions, and so you can check that out. If you would welcome some more tailored advice and support do consider coming along to the Aspiring Psychologist membership, which you can join with no minimum commitment for 30 pounds a month. And there will be some information on screen if you are watching that on YouTube or in the show notes.

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Or you can click any of the links in my social channels for more information. And do bear in mind, there is the free Facebook group as well, the Aspiring Psychologist Community with Dr. Marianne Trent. It would be remiss of me not to remind you about how wonderfully nourishing and helpful the Aspiring Psychologist Collective books and the clinical psychologist collective book is too. So the content for today's podcast episode is all about long-term health conditions and autistic spectrum disorder. I hope you'll find it useful for your own knowledge base, but also for when you're working in clinical or health populations where it might well be relevant. Hope you find it so useful, and I'll look forward to catching up with you on the other side. Hi, I just want to welcome along our guest for today's episode. I want to be also one of the very first people to introduce her as Dr. Victoria Walker. Hi Victoria. Welcome along to the podcast.

Dr Victoria Walker (: 04:19

Hi. Thank you so much for having me.

Dr Marianne Trent (: 04:21

You're so welcome. You are very newly doctor because you've just got to the end of your doctoral training as a clinical psychologist, haven't you?

Dr Victoria Walker (: 04:31

Yes. So I finished last week, which is a very strange feeling. So yeah, seeing Dr. Victoria Walker is going to take some getting used to, but with the caveat that I'm pending H C P C registration at the moment, the documents are on the way.

Dr Marianne Trent (: 04:49

Well, may they hasten themselves to you so that you can start claiming your band seven pay and start to walk in the shoes of those qualified psychologists. The shoes can feel a little bit big to begin with, but you've absolutely earned them. So well done to you. Congratulations.

Dr Victoria Walker (: 05:10

Thank you.

Dr Marianne Trent (: 05:12

And you are part of the cohort across the country who did your interviews during lockdown, aren't you?

Dr Victoria Walker (: 05:24

Yeah, so I interviewed for a couple of courses just before the lockdown was all implemented across the country. So we had our invites sent out maybe February, 2020 to say, yep, you've got your interviews, it's going to be in person at such and such a place. I think one had offered a lunch, which I was really looking forward to. And then in comes March and we went into lockdown, and then obviously the courses had to just completely pretty much overnight change how they were doing things. So I can't imagine how stressful that must have been for people who were organising the interviews. And I hadn't heard of Zoom or Teams at that point either. So it was a bit of a anxious way to find out on earth what was going to happen. But then, yeah, interviewed end of March, 2020, which feels a world away now and a very different time.

Dr Marianne Trent (: 06:27

Absolutely. And you've gone through all of your training with probably lots of things being remote, I guess lots of your clinical placements have been in person, but perhaps sometimes aspects of that have been remote as well.

Dr Victoria Walker (: 06:39

Yeah, it's been a bit of a mixed bag really. So for our first year, all the teaching was online. So I mean, I wouldn't know what the experience would be like cause I've never been a trainee clinical psychologist before, but I can imagine it's very different to the cohorts that are starting now and all get to meet in person. So we had to start that online. The placements that we had were mixed. Some people were in person, some people were remote. I was mostly in person for my placements. I did want that. I wanted some time out the house. I wanted some time to meet people. But I guess one of the things that came through from Covid is that there was ways that you could work from home if you needed to or if you wanted to. So there has been aspects of my placements that I've been at home, which I think has brought a different set of skills. I think our cohort has developed in a way that we had to respond to such a changing world, that we have a set of skills that is almost unique to people who started training in 2020 that we had to very quickly move from just being in person to being online to then sometimes being in person, sometimes being online, responding quite quickly to change. So yeah, quite a different experience.

Dr Marianne Trent (: 08:05

Quite different indeed. And given that this was 2020 March, 2020, and we've all been navigating online, we should have had a better experience today with my mic, shouldn't we? I should have been able to sort it out by now, but for those of you not party to the frustration that poor Victoria's had trying to put up with me trying to sort out my AirPods. Yeah, it's a bit embarrassing, but yeah, when it's clients, it's tricky, isn't it? Like trying to help them get online, trying to help yourself get online and trying to make sure the sound quality's good enough and the internet connectivity and all of that jazz. It's a big deal and it's a lot of change, a lot to juggle. Somebody messaged me recently on my socials, I think it was even in the last week, and about the doctorate in clinical psychology and said, is it online only or is it taught in person?

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And I said, actually, it's, I dunno, of any courses that are doing online only as a provision. And I said I would have some concerns about it being an online only provision because it feels like there's lots of important things to learn about being in a team when you are actually in a team and about being in a room with service users and families and people of different ages and also your supervisor. But I guess when I gave that answer, I hadn't really considered the impact on your cohort and probably the cohort after you having been through quite a mixed bag of online and your thoughts, could the doctorate be taught as an online only qualification?

Dr Victoria Walker (: 09:49

That's a really good question, and yeah, I've got a few thoughts about it. I would think in theory, yes, as our cohort had all of our teaching online in the first year, and we were very much assured that the quality of the teaching would be the same, and there was a lot of benefits to having it online. Obviously the world outside was very unsafe at that period of time. And speaking of someone with a long-term health condition, I was very aware of that. I was on the vulnerable list. I still chose to go in person to some of my placements, but with a lot of p p E and risk assessment in place. However, I know for some people that would not have been an option at all. So I know there was quite a bit of discussion maybe a year or so ago about courses maybe having a bit more flexibility about their online provision as I think once things started to settle down, a lot of courses went back to completely in person and lost a bit of their flexibility in having an online offer, which I think does impact people with health conditions, neurodivergent people, people with caring responsibilities.

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So I think it can be done. I think there's something there about flexibility and choice about what works best for people. We do that in our day-to-day jobs. We make adjustments, we speak to employers about things that we might have flexible working arrangements. We might have hybrid working arrangements. So there's a part of me that thinks that maybe the doctorate could also keep some of that flexibility as well and have that as options for people who may need it.

Dr Marianne Trent (: 11:38

So it might just be a case of, let's see what the future brings.

Dr Victoria Walker (: 11:43

Maybe. As I think from covid, we've obviously managed to really up our technical provision. And yes, there's hiccups sometimes, but we do have those options. We, so we're doing this now, we're doing this online. One of the most recent placement that I had was in an employee psychology service, and that was a trust wide service and provided nearly 100% online. Yes, there was some colleagues that would come in, but because it was a small team in a large trust in a large geographical area, it was offered primarily online to increase access. So I think that the things that we are adopting in our clinical world, we can also put in place in the training world too.

Dr Marianne Trent (: 12:34

Okay. Yeah, treat people as individuals and modern individuals at that that are operating in 2023. We've got, generally speaking, the right technology. Most people have navigated attend anywhere or Zoom or teams or something like that. And yeah, I guess let's make sure that, I guess it's some of that inclusivity argument, isn't it, around levelling the access to the profession and making sure that people can show up in a way that works for them. And I know from speaking with you via LinkedIn in preparation for this, that you had some quite big changes yourself during certainly the last year of training. Did you want to tell us a little bit about that?

Dr Victoria Walker (: 13:24

Yeah, sure. So I came into training with a preexisting health condition. It's called ulcerative colitis. It's in the Crohn's family of people that don't know. It's a disease of the gut. It's not curable, and it can really vary in terms of how it impacts me from just a bit of sort of gastrointestinal discomfort all the way through to hospitalisation. So it can really vary on how it impacts things. There's also periods where I'm in remission, but I have not been lucky enough yet to get to a clinical remission. It's just always sort of been at an okay-ish place or it's gone bad. It's not necessarily been in a really, really good place. So I knew that prior to training and had all the discussions required with the course staff and with the line manager to put in place things like reasonable adjustments on the course and on placements.

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However, something that through a bit of a spanner in the works was when I was doing my research project. So in your final year, you work towards your large scale research project, which is hopefully something that you really passionate about. You completely delve into it for two and a half years. And I did mine on exploring suicidality, autistic traits and camouflaging within women with anxiety. And I began to see a bit of myself in it, if I'm honest. It had been inspired by my clinical practise prior to training and during training, as I delved into the research into autism, into autistic women, into camouflaging, I began to see parts of myself that I had recognised but hadn't made those links. And that then led me to request an autism assessment, which then was confirmed that I am autistic in March this year. So when I was right in the throes of writing up my thesis, so that was a really big, I wouldn't, well, bombshell maybe isn't the right word, because I'd obviously thought it could be a possibility or I wouldn't have gone for the assessment.

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But it still was something that shook my world quite a bit. As I then started to question pretty much everything about how I had even got to this position, had I faked my way here, lots of really self-deprecating questions started to happen all while I was trying to write a thesis that could determine my future essentially. So that was quite challenging, but as I say, sort of six months after that diagnosis, I'm really glad that I did do it, and I'm in a much better place with it now. I see it as something that's actually helped me. It's helped me to call things out. It's helped me to be brutally honest when needed. It's helped me to empathise with service users in places that I've worked where often it was young women who are quite misunderstood that I would work with, and we develop a good rapport, we develop a good connection. And then once I've started to look into the literature about how people with similar neurotypes do make connections, it's then made me see it as a strength that has difficulties, but there's absolutely strengths within it too.

Dr Marianne Trent (: 17:03

Gosh, what a journey you've been on, and there's so many questions I want to ask you, but just in terms of our listeners' own knowledge base, how does adult assessment and diagnosis work in a nutshell? Are we talking a referral from the gp? What are we talking about exactly here?

Dr Victoria Walker (: 17:28

So I did things maybe a little bit differently. So I had heard all the horror stories about the waiting lists, and there was a part of me that just wanted to get this known, get this done before I finished and before I qualified. So I rang a private service through a psychologist who had actually done some teaching on the course, rang him, and we had an initial phone consultation. And what he said to me was that he thought an assessment would be helpful, but that he wasn't prepared to take my money because as an N H SS employee, I was entitled through my line manager to be referred for an assessment. So I did that. I approached my line manager, which was a little bit scary to approach my line manager to say, oh, I think I might be autistic. Can you refer me for an assessment, please?

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But I did do it, and I was referred to the local service through my line manager that took a few months to get an appointment through. And then once I had that appointment, I basically got told that as someone who's a trainee clinical psychologist, I would know too much about the assessment process. So the standardised tests wouldn't really apply to me. So it was more done through an interview myself and an interview with my sister and looking through some of the symptoms that are listed in the D S M. So it was more done as an interview process. So quite different, I think, to what a standard assessment would be. It was about four hours in total of having long and difficult conversations to then come to in my final appointment to say, yes, we can make that diagnosis based on the information that we have.

Dr Marianne Trent (: 19:20

Okay. Thank you for clarifying that. It sounds like that was an occupational health kind of referral rather than necessarily a medical N H SS referral from your gp.

Dr Victoria Walker (: 19:32

So it was done with the local autism service, but because done through line management, it was more of Yeah, yeah.

Dr Marianne Trent (: 19:40

Thank you for illuminating that. And then anybody else who might be listening might be like camouflage masking. What does that mean? Could you guide us through that a little bit?

Dr Victoria Walker (: 19:51

Yeah, of course. So camouflaging has been coined as a way of divergent people taking on traits from neurotypical people, so as in people who aren't autistic to fit into their world essentially. So when we talk about masking, it might be that at a young age, especially, especially neurodivergent women, they will take on the mannerisms, the facial expressions, the social chatter to get them through because they will observe very, very closely the interactions that other people are having, see what goes okay, see what doesn't, and start to build around their social circle essentially. So they might not feel necessarily connected to this social circle, but because they've assimilated. So essentially they have observed enough, they've taken on enough of those mannerisms, of those social niceties that they fit in, they go under the radar. They seem like they're doing okay because they smile appropriately. They'll give you an all right level of eye contact.

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They might come across as quite articulate. I know I sometimes don't, but I'm unmasking at the moment. But that's why a lot of autistic women don't get recognised until later in life because they have developed that social masking, that social camouflage to get through. But the problem is, is that there's such a high cost to that. That's such a huge cognitive load on somebody to be constantly looking at what other people are doing, questioning yourself, am I giving too much eye contact? Oh, I should probably look away now because I've noticed that person X looks away after they've said two sentences. You are doing that all the time, and that has such a high cognitive and emotional load. So then what will often happen is once that social situation is over, the social expectation is low crash burnout sitting quietly. For me, I sit and rock something that I hadn't really recognised as something that was me just trying to regulate after a social situation that I would just sit in complete silence by myself and just rock.

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And this could be for hours, but because that was hidden, no one saw that and no one saw that that was a problem. But because I'd then go to school the next day and talk to people, I was reasonably bright. I wasn't the brightest, but I was reasonably bright so I could slip under the radar. I think for me as well, my camouflaging and masking was supported slash promoted through being a performing arts student. I was a shy child, shy, introverted, however it was called at the time, and it had been spotted. It had been spotted by school that I was shy, that I preferred to sit by myself and read a book. So my parents with the best intentions, sent me to a stage school, which I loved. I really enjoyed it. I essentially learned the script on how to be a person, which sounds a bit melodramatic, but essentially I did, because I got to read so many scripts, sing different songs, start to learn about situations and how in the script people would respond if someone was sad, this is how someone could respond, and then that's how other people would respond to that person's response.

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So when I think about it now, it definitely contributed to me developing my masking, developing my camouflage.

Dr Marianne Trent (: 23:49

Thank you. That's really, really illuminating. And also a point sounds quite distressing. Did it feel distressing when you're rocking or did it feel soothing?

Dr Victoria Walker (: 24:01

Initially? It would feel distressing because I think that was when the emotion was the highest. So I would come home from a day at school or nowadays it would be a day at work, a day at uni, if there's been a lot of social load, and it would feel quite distressing. My body would be in quite a heightened state. But as I would start to rock, and that would be me regulating, that would be me bringing myself back down to then re-engage in activity or re-engage in family, family, life, social life, all of those sorts of things that were kind of expected to get on with. But yeah, so it didn't feel distressing to rock. It was definitely me trying to regulate myself, but the emotion would usually be quite high when I would start.

Dr Marianne Trent (: 24:55

Great, thank you. And how has this cropped up for you during training or with clinical groups and maybe even since diagnosis? How does this play out for you within the clinical work you do?

Dr Victoria Walker (: 25:11

Yeah, I guess for me, I've got a bit of an eye for neurodivergence, which I didn't necessarily know why I had this eye for it or interest in looking for neurodivergence before getting the diagnosis. I would find myself sort of drawn to people that maybe weren't treated that well in services and start to ask questions and think, well, have we not thought about autism? Have we not thought about a D H D? And start to ask those questions. I didn't necessarily have the answer, but I just felt a need to ask questions. I think as well, I've got quite a strong sense of justice, and I think that's something that has massively influenced my clinical work. I know quite a few psychologists can sometimes step back a little bit from social justice work and they will have absolutely valid reasons for doing, but for me it feels that when I see injustice in the world, I feel like I have to do something about it.

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I have to learn more. I have to say something. I have to listen to people who know more than me who are saying something. I do feel like I really immerse myself in those worlds. In the neurodivergent world, we talk about hyperfocus, and that's something that has absolutely been a strength for me through my assistant roles, through training, that once I'm on something, I will focus and I will get it done. I've always been praised for being really organised and have been asked before, how are you so organised? What do you do? I've been asked to share my calendars with people as a glowing example of what a calendar should look like. And for me, that's just second nature. I can't think of a workday where I'm not putting slots in my calendar that are very clear that this is what I'm doing here and this is how long it's going to take.

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I don't like having a vague open calendar. I like to have things very organised and very ordered, even if the work itself isn't ordered. As I've worked on inpatient wards, for instance, where the work isn't ordered, it can be quite unpredictable, but I use my calendar to organise my time, and that's often been something that people have really picked up on. I think all of my placement supervisors have put something somewhere in my report about how I'm very organised. I'm always very well prepared, but that's just something that is second nature to me I don't have to think about.

Dr Marianne Trent (: 27:49

So if people wanted to learn more about those sort of approaches, I think it's like job planning and time. If you find everything, feeling a bit, those kinds of approaches that can help try and give some order to the chaos. Is that what you mean, Victoria?

Dr Victoria Walker (: 28:07

Yeah, essentially. And it's something that managers that I've worked with in the past have said that you don't really need to much job planning or support with managing your diary, because I've always just been able to do it, which I understand that some people find it really, really difficult. And I try and help where I can. I really try and help friends, family, for instance, if they're struggling with organising things, I try my best, but I think sometimes that means I just jump in and do it for them because it's quite hard to explain what's going on in my brain sometimes.

Dr Marianne Trent (: 28:40

Yeah. Okay, I hear you. And in terms of wanting to help others and wanting to support others, is it fair to say this has sort of evoked something within you for wanting to see people represented in the profession?

Dr Victoria Walker (: 28:57

Absolutely. I sort of came into clinical psychology after switching from doing the drama and performing arts route, and I switched to clinical psychology as a route a little bit later on after a lot of thought and a few things happening in my life. And then when I got my diagnosis of my health condition, it was about a week into a brand new job where I'd just started in the N H Ss and assistant psychologist. I was like, this is it. I'm on the path. And then I was hospitalised a week into the role with this mystery illness that I had been sitting on for five weeks thinking, it's fine, it'll go, it'll go. I'll be all right. Don't tell anybody. Don't make a fuss. You're going to ruin this job if you do anything. But then it got so serious that I was hospitalised, and then I got the diagnosis of ulcerative colitis after a pretty horrendous hospital stay.

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But then I started to worry at that point, well, how on earth can I be a clinical psychologist if I'm going to be in and out of hospital for the rest of my life? And I was devastated that I'd just started a brand new job and I was so worried to go back to work after that period of sick. I went back way too early after being in hospital because I was just so scared of the consequences of how I was going to be seen. Was it going to be like, oh, she's just been here a week and she's already off. Whereas I went back way, way, way too early. I was still in a lot of physical pain, really not well at all, but I did go back and then very quickly encouraged to go back off again. But I think that was something that fear just sort of sat within me that is this the profession for me?

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Am I going to be safe here? Am I going to actually be able to do all the things that I'd set in my mind that I was going to do? We can get very fixed, I think, on the aspiring route of that. Well, I'm going to do this AP position, I'm going to do it for this long, and then I'm going to move on, and then I'm going to apply for the doctorate, and then this is how it's all going to go. And we sort of map it out about how it's going to happen. And I was terrified that this plan that I had quite rigidly in my head of what was going to happen wasn't going to happen. Thankfully in that job, I was so well supported. Occupational health were fantastic. Reasonable adjustments were put in at a blink of an eye, and my supervisor was honestly the most wonderful supervisor, and I really, really flourished in that role.

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I then moved roles as assistants do. I moved role to get some more experience elsewhere and had a terrible experience. So yeah, moving into a different role where I wasn't supported as well, that then started the cycle all over again of should I just drop this career? Can I do this? There was bullying in that role, not just for me, but for other people. It was not a friendly environment. And unfortunately, we do hear that too often in the N H s that there are those teams where bullying does happen. So it was not ideal for that to happen. I did experience discrimination based on my disability quite publicly, which again made me think, how on earth can I do this? What if I get sent on a placement when I get on the course and they don't manage it very well? What can I do?

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I felt safe Telling particular people about my diagnosis for them to be used against me was heartbreaking. So then I moved jobs again and again was really well supported. So it can really, really influence how your experience goes on, how well you're supported when you do have a health condition. So I knew from my bad experience that this wasn't okay, and I did take things further with it. There was relevant actions completed, but I thought, this can't happen again. This shouldn't happen again. Because one of the big things that I had experienced in that role was as an assistant, I had very little protection. My clinical work was very protected, but my emotional protection, I didn't have any standing as a band for assistant psychologist. I felt very exposed and very, very vulnerable. So that made me get onto a guest, a social justice sort of movement that I had in my head. When I get onto training, this won't happen again. Quite a big idea, but it has to go from somewhere, doesn't it? So when I started training, that's when I wanted to start to influence things, to make things different, to start being more open about my health condition and hopefully help others to do that as well. So then that's when the ball started rolling with the work that I ended up doing.

Dr Marianne Trent (: 33:45

Thank you for guiding us through that. And I'm so sorry to hear what you experienced, but I think you so nicely encapsulated there that sometimes people will be well aligned and well placed to support us well and to support us optimally. And sometimes through no fault of our own people won't be, but it's not always that the answer for why that's problematic lays within ourselves. Sometimes it's just systemic. And actually we can just respond to that by taking ourselves and moving ourselves elsewhere and knowing that it's not us that's the problem. It's an organisation or it's a cultural set up in an organisation. So I would really urge our listeners to feel like if they feel like they are a square peg in a round hole or a round peg in a square hole, to think about actually maybe not pathologizing yourself as the problem. Maybe it's it's a service, maybe it's the culture, and you might well find that you are really, really happy elsewhere.

Dr Victoria Walker (: 34:56

Absolutely. The jobs that I've had where it has gone well, I've been encouraged to flourish and use my strengths. And when things have been more difficult, take the time to rest because then I'll be even better once I've had that rest to try and prevent that burnout to try and prevent the fatigue that comes with my condition. They're easy things to do. And I think sometimes in some of the cultures that we experience in the N H S and in other roles that we forget that some of the things that people need are quite straightforward, but they can make such a huge difference to people. And absolutely when things go wrong, we will blame ourselves. We'll say, there's something that I did, it's to do with me. I can't do this. But you absolutely can when you're in the right place and when you're well supported, you can do it. That's not to say there's not challenges along the way. There absolutely have been, but in the roles I have had, they've absolutely formed how I got onto the doctorate, how I've got through training and how I've managed to pop out at the end relatively unscathed.

Dr Marianne Trent (: 36:11

Thank you. I think people are going to find it. It's so refreshing to hear you speak and so interesting and useful as well. In times of learning points, just in case people aren't familiar with what ulcerative colitis is, could you tell us a little bit about what that is? Do we know what causes it or is it autoimmune? Just guide us through a little bit of that, if that's okay.

Dr Victoria Walker (: 36:36

Yeah, sure. So it's an autoimmune condition. It's a lifelong non-curable condition where something has in the immune system decided to attack itself. And where it forms that attack is in the large intestine that differs from Crohn's disease, which usually more people have heard of, which can impact anywhere from the oesophagus all the way to the small intestine. So ulcerative colitis is localised to the large intestine. So what ends up happening is that as it's attacking itself, the lining of the intestine starts to ulcerate. That's where the ulcerative comes from. So you get ulcers, you get sores, and you get abrasions essentially along the intestine. So the things that are in the gut to try and protect us tactus that they're not working as well, there's not necessarily a known cause for it. There's, I think with most autoimmune conditions, they say it's a mix of sort of a genetic and an environmental trigger. However, when I was researching autism for myself, I found a really, really large link between ulcerative colitis and other gastrointestinal disorders and autism. So there's a part of me that has a little bit of a soapbox to stand on that maybe we should be screening for autism in the physical health sphere a little bit more as there is such a huge link between experiencing autoimmune conditions. And neurodivergence

Dr Marianne Trent (: 38:12

Heard that as well. And I think it's something around, so what I've heard is that stress and trauma affects all of our muscles and our body and our systems and our structures, and our gut has what's called smooth muscles in it, striate muscles. And the way that stress and trauma and trying to manage our own internal systems work is that that will affect our striate muscles. And one of the ways we can make sure that we're relaxing ourselves is to not clench our fists like this, to sit and relax and take a breath. And that encourages all of our dry muscles to relax, which is part of our gut. And so I've definitely heard that link before because the theory is that people on the autistic spectrum would find situations more anxiety revoking and like you said, would be doing more that masking. So they might be highly distressed or trying to blend into a situation and someone else might not know what's going on. But it's that duck and the legs analogy. It looks very serene, your job plan, your meticulous calendar, but actually there's a great deal of work going on in the background that people wouldn't be aware of, and that has an impact on the body as well as the mind

Dr Victoria Walker (: 39:34

A hundred percent. And I guess for me, thinking about the body and mind links that I hadn't really known that much about before getting into psychology, it makes so much sense now though, doesn't it? When we experience anxiety, we get a bad tummy, and for me it's a little bit different because it's an autistic anxiety. So there's differences there in that it's not necessarily a pathologized anxiety, it's that I'm trying to fit in a world that's not built for me, but that still creates an anxiety response in the body. And so when I get a poorly anxiety tummy, unfortunately with ulcerative colitis, it's quite different. It's a bit different. So there is sometimes a coexistence of ulcerative colitis and I B s, for example, so I may get quite similar i b s symptoms. But alongside that, when you have the ulcerative colitis symptoms, although it is localised to the large intestine, you can get ulcers on your eyes, on your mouth.

(: 40:35

One of the most distressing things for me is when I get ulcers on my eyes because there's no hiding them. People can see when I've got one of the ulcers on my eyes, they're really uncomfortable. One eye will get really, really red and inflamed, and it just makes me feel, so I feel like I can't look people in the face or in the eyes. So I'm already thinking about eye contact as an autistic person, but when I've got this swelling on my eye, I'm thinking about it even more going, they can tell I've got a really swollen eye, what they're going to think about me, whereas in reality, they're probably not thinking about it at all, or they might notice it and be like, oh, I look sore, and then not think about it ever again, whereas I'll think about it all day. So those are more visible symptoms, even though it's technically a non-visible illness, there will be some visible symptoms. Sometimes There's also things like fatigue, joint pain that I can really struggle with, which are the more non-visible symptoms and can be a bit more difficult to explain. But again, there's such links, isn't there? I guess with Neurodivergence that there will be fatiguing effects from masking from camouflaging. So it all intertwines and gets very messy, but it's something that isn't, neither of them are curable. Neither would I want them to be. It's just something that I have to manage.

Dr Marianne Trent (: 41:54

Thank you again, and I hadn't realised about the eyes and the sores can crop up in other parts of the body, so thank you for sharing that with us. But that sounds really painful and very uncomfortable for a variety of reasons, but many people would really struggle to work at all with this condition, especially during a flare up. So real hats off to you for not only working, but working at an incredibly high level, and you're about to start a qualified role as well.

Dr Victoria Walker (: 42:28

Yeah, so thank you. I sometimes can't believe it myself, and it's very strange sometimes when I speak to people and when I've hosted workshops, when I've hosted webinars and things like that and talk about disability and the things that I've been through, I get some really lovely comments and some really lovely feedback that, oh my goodness, the imposter syndrome comes in when that happens, of that, oh my gosh, you're an inspiration and that you've done so well and all of that. And yeah, I'm so pleased and I'm so privileged, and I feel so honoured to have done the things that I've done. At the same time, it's not been easy and it's not been something that I necessarily feel inspirational for doing. I just feel like I've managed to make a set of pretty rubbish circumstances and try and use my values and try and use who I am as a person to forge a career that I hope that as I'm more vocal about these things, that we can change some of the things that gate keep the career.

(: 43:35

So yeah, when I go into my next post, I'll be working with older people in an inpatient service. Inpatients can keep me away. I just enjoy working in that environment. It's very challenging. But again, there is aspects of structure within it. So you'll have your morning meetings at the same time every day. There's routines on the ward that are kept to, so some of the environment might be challenging, but I've enjoyed inpatient working every time I've been in an inpatient service because I do feel more contained, even though there's sometimes chaos, but even more so than I would in necessarily a community setting, which may feel a little bit strange from an autistic person so that they like being in a bit of chaos, but it works for me.

Dr Marianne Trent (: 44:22

Well, congratulations on your new role, and thank you for guiding us through the steps involved in having a long-term health condition yourself, juggling all of that, and then also your steps in recognising autistic traits in yourself and then going through diagnosis and assessment, such a big episode, but a really, really interesting and useful one. If people want to learn more about you and your work and what you are hoping to help people achieve, where's the best place for them to do that?

Dr Victoria Walker (: 44:59

Yeah, so there's a couple of places. I'm on Twitter or X, what do we call it now? X. So Twitter slash x. I'm there at Victoria, Emma w I'm on LinkedIn. You'll find me as Victoria Walker. I may put doctor in front of it once the H C P C registration comes through, but Victoria Walker's just fine. And I also have a Facebook group called Pre-Qual Clinical Psychologists with disabilities and or Health Conditions. That's where I started the idea for having a mentoring scheme. You can contact me at the moment through some of the mentoring schemes that are within that Facebook group and also ones that I advertise on my Twitter slash x, but I will be taking a little bit of a step back from some of those things as I go into Qualified Live, but I can absolutely signpost you to the right place.

Dr Marianne Trent (: 45:58

Thank you. And I feel like I should explain that I insisted on giving you your doctor title. As I understand it, you are able to use Doctor from the moment that you pass your Viva, but it's that you're not able to call yourself a clinical psychologist until you get your H C P C registration. So if anyone's done anything wrong there, it is me, but that is absolutely what I was doing at this stage. So thank you. And if you've got any, what's your top tip, shall we say, for reducing burnout in aspiring psychologist Victoria?

Dr Victoria Walker (: 46:33

I think to stay in tune with your values and express them, and I know values is a bit of a buzzword, knowing your why. So I think that's what values come down to. It's why you're doing what you're doing. And I think that's the thing that can identify whether the thing that you're doing is in the direction that you want it to be. If something is niggling at your values, is challenging your values, you're more likely to burn out. So that's a sign. If something in your experience or in what you're doing at the moment feels wrong in the gut, let's go to the gut again. It's a very powerful place to be. If something doesn't quite feel right in your gut, it suggests that it's niggling at one of your values. It's niggling at your why you are here. That means it's something to change, whether that's through supervision, whether that's through talking to a manager, whether that's through making a move, whether that's through some form of discrimination that's happening, happening, there's something that's not right. So I would always check in with the values, check in with your why you are here, because then that's often the sign that's the gateway as to what might be causing that burnout.

Dr Marianne Trent (: 47:43

Really wonderful advice. Thank you. And thank you for the time that you've given us so generously today, and thank you for getting in contact with me to pitch this episode to me via LinkedIn. Yeah, I love it when people do that because having a bottom up process can be so useful into hearing what other people think will be useful and what other people will absolutely find useful. Indeed. Yeah. Just want to say thank you again and wishing you very well with this next stage of your career, but let me know if I can do anything that might be useful for you in future.

Dr Victoria Walker (: 48:27

Oh, thank you. Yeah, it's been lovely to talk to you today. I could probably talk for hours about all of this stuff. So yeah, if anyone did want to contact me, please go ahead and I'll chew you here for hours and hours about all of this stuff. So yeah, thank you so much.

Dr Marianne Trent (: 48:40

I'll make sure I put all your contact details in the show notes as well. And if you're watching on YouTube, they will be on the screen and will have been when we were doing all the Twitter X. I don't know either. The web address is still Twitter, but I don't know. I like the Bluebird, what can I say?

Dr Victoria Walker (: 48:58

Yeah, yeah, it's not as nice now.

Dr Marianne Trent (: 49:01

No, no. But yes, thank you very much. And yeah, wishing you all the best with the next stage of your career.

Dr Victoria Walker (: 49:08

Thank you so much.

Dr Marianne Trent (: 49:10

Oh, how absolutely lovely was Dr. Victoria, and I love calling her Dr. Victoria. I hope that you found what we had to talk about today useful. And like I said, if you have got any ideas for bottom up or even top down, you might be above where I'm at in my career. But if you've got any ideas for future podcast episodes or things or resources you'd find helpful, do please get in contact with me. You can either do that via LinkedIn, Dr. Marianne Trent, or by contacting me via any of my socials or the details in my show notes. Yeah, please, if you're finding this podcast helpful, do please leave me a rating and a review, which you can do via Spotify or Apple or both. That would be marvellous. And if you find this content useful and any of the other content helpful, please do consider buying me a little cup of herbal tea, which you can do by clicking on the link in my socials. Be kind to yourself. I'll catch up with you very soon. Our next episode of the podcast is available from 6:00 AM on Monday. Thank you for being part of my world, and I'll speak to you very soon. Take care.

Jingle Guy (: 50:37

If you're looking to become a psychologist, then let with this podcast.