Trouble in Mind

A neuropsychologist muses on brains, books and being happy

A Career As a Neuropsychologist: Your Questions Answered

Neuropsychology requires a long training, so make sure it is right for you!

Deciding upon a career is never simple, especially if it involves years of training before earning the first dollar. I often receive e-mails from students asking me questions relating to a career in neuropsychology, and in this post I will answer, as best I can, the main ones. If you are thinking about becoming a neuropsychologist, if you haven’t already, read my previous post of November 3rd, 2011, titled “So you want to be a neuropsychologist?” Then come back to this post! But a note of caution; these are simply my opinions, and as training programmes and entry requirements differ from country to country and even from university to university within countries, it is essential that you find out what your preferred university requires.

Question 1. What are the skills needed to train as a clinical neuropsychologist?

Answer: In general terms, you will have the academic ability (brains and stamina!) to complete a doctorate, or in some countries a Masters degree, and a willingness to learn about research. You will be fascinated by how the mind works and eager to learn more about the brain and behavior. When you meet people, you find what they have to say interesting, and they respond to this by telling you more about themselves. You love working with people and you may even like working in a hospital environment! You will be a good team member with the ability to contribute but without having to take center-stage. You will have strong ethical values. If you like to gossip with your friends, you will be very clear about the importance of confidentiality in a work environment, and indeed in your personal life when confidentiality is appropriate. You will know how you are going to finance yourself during the training period. You will have good personal support systems in place. You will have dealt successfully with any psychological problems that you have had in the past, and learned from your experiences. You will have a good sense of humor and be more of an optimist than a pessimist (although a balance is fine)! You will enjoy very hard work. You will be content to earn, in your career, a good salary but not a massive salary. (For the same amount of blood, sweat and tears, there are other careers with the potential to make you much richer financially).

Question 2. What courses should I take to best prepare me to apply for a neuropsychology programme?

Answer: This will depend on the specific requirements of the programme you want to apply for, and these vary across states and countries. Usually you will require good passes in biology, statistics, neuroscience and a range of psychology courses. In addition, any practical experience you can gain, perhaps through voluntary work in a rehabilitation center, or a telephone crisis counselling service, will be useful, and for some programmes a requirement. The best advice I can give you is to read the material provided by the neuropsychology programme and if possible arrange to meet with a faculty member. The requirements will probably be different for entry into a research neuropsychology doctorate and a clinical neuropsychology doctorate programme. In some countries, after graduating with a research doctorate you can then apply for a clinical neuropsychology internship.

Question 3. I am passionate about neuropsychology but I am worried that I might not be able to cope with the emotions working with brain-damaged patients will bring up.

Answer: This is a good question and one that shouldn’t be taken lightly. However, good clinical psychologists and clinical neuropsychologists do feel empathy for their clients and patients, and this is the characteristic that allows them to connect with their clients. If you can gain experience in a voluntary capacity before applying for a training programme, this is advantageous. Working for a telephone counselling service, assisting in a rehabilitation center, psychiatric institution, hospice or nursing home, will give you an indication of whether you can control your emotions enough to work constructively with clients and patients. Sometimes you will have to lock yourself in the bathroom and have a good cry, and sometimes you will lie awake all night, upset by a patient you helped that day. This is perfectly normal at first and not a reason to believe you could never work in these areas.

If you view clients primarily as an interesting problem to solve, you might be better to seek a research career in cognitive neuropsychology. This is also a wonderful and exciting career, and there is no shame in realizing that hands-on clinical practice is not for you. Indeed, neuropsychology progresses because both clinical neuropsychologists and cognitive neuropsychologists are working in concert. There is also considerable overlap, and whichever path you take, you will need to have some skills in the other area.

But if you want to work with people in a clinical setting, whether in a hospital, rehabilitation unit, or private clinic, then you need to be able to take control of your feelings. The balance you are trying to achieve is to be calm, insightful, and empathetic, without losing your objectivity and without making your and your family’s lives a misery when you go home at night! An “entry” requirement of most training programmes is that students have dealt with stressful personal issues before they enter the programme. For example, students who have suffered from an eating disorder, clinical depression, or have been a victim of abuse, need to heal themselves first before beginning the rigorous and stressful training required to become a clinical psychologist or neuropsychologist. It is essential that you are honest with yourself and with the training programme you are applying to, about these issues. If you have overcome a personal problem, this can make you a better psychologist.

Training programmes in clinical psychology and neuropsychology include courses, workshops, and work with clients under close supervision throughout your training to show you how to cope positively with the emotional aspects of the work. Throughout your career, you should always have your own clinical supervisor with whom you meet regularly to discuss your emotional responses to your clients and their problems, and how you are addressing these. Your supervisor is the person you should off-load onto, not your family and friends!

As you become more experienced, you will find it is easier to deal with emotional situations, and this is how it should be. You will no longer choke up when you meet a young mother whose five-year-old is in your ward waiting for an operation to remove a brain tumor. You will feel for them, of course, but you won’t find yourself thinking about mother and child all weekend. And even the most experienced clinicians can occasionally find themselves more emotional than is healthy over a client. If it is only occasionally, that is OK. When this happens, talk it through with you supervisor.

If you ever get to the point where you find yourself regularly irritated by the client’s tears or their need to talk about how they are feeling, or you are bored by your work, then it is definitely time to talk seriously to your own supervisor. This may signal the beginning of burnout, and that is not good for your clients or you. (Becoming frequently and excessively emotional over clients after years of working as a clinician, is another sign of burnout).

The Rewards: So prepare well, and if, after you understand what lies ahead you still feel passionate about neuropsychology, I can confirm from my own experience that you are about to embark on an amazing and fulfilling career that will offer you new and fascinating things to learn every day of your life, opportunities to meet and connect with courageous patients and stimulating and wise professionals, the chance to contribute to future discoveries in neuroscience, and the satisfaction of knowing you are helping to make a difference in the lives of your clients.

 Follow me @jenni_ogden  Check out my website

Jenni Ogden, Ph.D., is a clinical neuropsychologist and author of Trouble in Mind: Stories from a neuropsychologist's casebook, and the text, Fractured Minds.

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