Josephine Stanton

I live in Auckland with my husband and three children. I work as a child and adolescent psychiatrist in an acute inpatient unit in Auckland, providing a service to the top half of the North Island of New Zealand and in a child and adolescent outpatient service in Northland covering urban centres and rural areas.

I come from a mixed heritage of people who emigrated from Scotland, Ireland and England to New Zealand in the middle of the nineteenth century. There are strong family traditions of commitments to education, service and taking up opportunities. I feel proud of the fact that both my grandmothers went to university, early in the twentieth century when few women did. I think it says a lot about the women that they were and the men who married them.

My mother tells me I talked about being a psychiatrist as a child, but I don’t remember that. I do remember planning to be a doctor from a young age. But in my mid teens, in the context of glorious adolescent omnipotence, I decided I would become a social worker instead and 'save people from themselves'. However, at that time the interest in the psychology departments available to me was strongly behavioural. I trained three different rats to press bars for pellets but my passion was not engaged. I was much more excited by the academic study of education, particularly with Professor Ivan Snook. He sparked my initial interest in epistemology with his exploration of how it can be possible to educate without indoctrinating. I was drawn to an academic career but felt that I needed to see something of life and so went to work in industrial relations for the local harbour authority.

Again, my passion was not engaged and I enrolled in medical school. Through my time at university I had done training and voluntary work with Youthline, a telephone counseling service for young people and had maintained an interest in therapeutic modalities, being particularly excited by narrative approaches to family therapy in the mid to late 1980s. It was not until a couple of years after graduation that I committed to working in psychiatry (in 1985). This was initially in an acute unit in a semi rural mental hospital. I was astounded about the lack of apparent interest in non-biological treatment. Over the intervening years I sought training and supervision in a number of modalities, initially and most substantially in psychodynamic psychotherapy but took up what opportunities I found to develop knowledge and skills in a range of approaches, such as IPT, CBT, DBT, NLP, hypnosis and trauma therapy. It was not easy to incorporate what I learned into my practice as I have always worked in the context of acute workforce shortage and have had very limited time for therapeutic processes. I was particularly excited by Motivational Interviewing, with its emphasis on drawing out the person’s thoughts and ideas. It was also applicable to a range of situations that I found myself in in my psychiatric work. I dabbled again with narrative therapy. However, while I valued the ideas, they were difficult to integrate with my work as a psychiatrist. At a book stand at a lecture by Michael White I bought Johnella Bird’s book 'The Heart's Narrative'.

What engaged my interest was the respectfulness that she wrote about and the methodology she described for bringing that respectfulness into every conversation. As I attended her workshops and read her work I struggled to get my head around her ideas but realized that it had potential for transforming my practice. As I developed embryonic understanding of her ideas and began to integrate them into my work I noticed a shift. I found the work and the people I worked with more interesting. I felt less weight of apparently insoluble problems. I moved away from feeling responsible for doing an assessment, developing a treatment plan and instituting treatment. I moved more into the position of someone making my knowledge and skills available for people to take up. People seemed to find me a lot more helpful.

Being able to work with Tania Windelborn as she also took up these ideas has accelerated the movement in my practice. We both value formal evaluations, particularly randomized controlled trials, of the application of Johnella Bird’s ideas to mental health work. However, we are both overstretched clinicians working in situations of intense need and this is not practical for us. Our current mission is to develop our own skills and make these ideas as widely available as we can to other clinicians. We hope that the momentum will build for formal evaluations.

Publications

1. Stanton, JM and Simpson, AIF: The aftermath: aspects of recovery described by perpetrators of maternal filicide committed in the context of severe mental illness. Behavioural Sciences & the Law. 24: 103-12, 2006
2. Stanton, JM and Skipworth, J: Obstacles to helpseeking. Retrospective accounts from perpetrators of intrafamilial homicide. Criminal Behavior & Mental Health, 15: 154-63, 2005
3. Stanton, JM: Talking to families about ADHD [comment, letter].Journal of the American Academy of Child & Adolescent Psychiatry. 44(2):111-2, 2005 Feb.
4. Stanton, JM: Talking to families about ADHD Journal of the American Academy of Child and Adolescent Psychiatry 42: 1386 2003
5. Stanton JM and Simpson AIF: Filicide Murder misdiagnosed as SIDS: A perpetrator’s perspective. Archives of Disease in Childhood 85 454-9 2001
6. Stanton JM and Simpson AIF: Filicide: A review International Journal of Law and Psychiatry 25: 1-14 2002
7. Stanton JM and Simpson AIF: A qualitative study of filicide by mentally ill mothers Child Abuse and Neglect 24 1451-1460 2000
8. Stanton, JM: Generational transmission of child maltreatment. Journal of the American Academy of Child and Adolescent Psychiatry. 38 (12) 1469 (letter) 1999
9. Simpson, AIF and Stanton, JM: Maternal filicide: A reformulation of factors relevant to risk. Criminal Behaviour and Mental Health 10 138-149 2000
10. Stanton, JM and Arroll, B: The effect of moderate exercise on mood in mildly hypertensive volunteers: a randomized controlled trial. Journal of Psychosomatic Research. 40 (6): 637-642, 1996
11. Stanton JM: Weight gain associated with antipsychotic medication: a review. Schizophrenia Bulletin. 21(3): 463-472, 1995
12. Stanton, JM: The Australian multicentre moclobomide trial. Australian and New Zealand Journal of Psychiatry 1993:27:158 (letter)

Tania Windelborn


Ko Parata te tangata
Ko Kahutianui te whaea
Ko Mamaru te waka
Ko Maungataniwha te maunga
Ko Kenana te marae
Ko Ngatikahu te iwi
Ko Tania Windelborn taku ingoa

I have been working as a nurse in CAMHS Northland Health for the past six years. During this time, taking up learning opportunities, PG studies through the University of Auckland provided a foundation. Later came tuition in therapeutic interventions, motivational interviewing, CBT, DBT, PMT and latterly the workshops of Johnella Bird.

What originally sparked my interest towards this way of working was the metaphor of weaving or raranga in the Maori language. Strong images of my mother making flax kete (baskets) came forward. She followed certain customs that were heavy in deep respect for the art.

The timing, collection and preparation of the flax had to be correct. The making of a kete is a stepwise process requiring patience and perseverance. Each kete had its own unique story and history - where the flax was collected, what prompted its making and what and who it was for. She would then with joy, skillfully and purposely weave each strand together all the while making it seem effortless. I knew that kete making was not a chore for her, she would waiata (sing) looking happy and relaxed. I watched in wonder as the natural resource was slowly moved towards a kete being created.

Johnella Bird’s teaching came at a time when I was questioning my nursing practice. The evidence-based practices are valuable ways of being helpful. However there were times that I felt stuck and needed more. Johnella Bird’s work opened up avenues and I felt them to be in accord with nursing philosophies; holistically orientated, considering the affect of culture, spirituality, gender, power and history whilst mobilizing personal strengths and resources to move towards agency.

It was refreshing to learn about a way of working that was not prescriptive. To have ways to stay orientated to each person being unique and skilful with much to contribute was invigorating. By asking meaningful questions, being open to the answer and then exploring the answer to understand fully what the person is meaning is energy giving, not draining. I felt more interested, curious and alert to what was happening in the room and what type of language I was using to work together for (at times) some small movement. I also experienced people being more interested in wanting to be in the room and felt their energy lift during the conversation.