Dr Philippe Gilchrist is a Senior Lecturer in Clinical Psychology at Macquarie University in Sydney, Australia. We caught up with Philippe to find out more about his role in the STRIDES study, his move from the UK to the land down under, the importance of an interdisciplinary approach to patient care, and the value of an alumni network.
How did you come to work on the STRIDES study?
The study looks at improving donor experiences within the National Health Service Blood and Transplant (NHSBT). There will be over 1 million people every year, and this is expected to be one of the largest trials ever conducted. The study will collect blood samples and questionnaire data from whole blood donors to address a wide variety of research purposes, including strategies to improve donor experiences and to establish a BioResource to help address a wide variety of health-related questions.
I was in the Department of Psychology at the University of Cambridge, just before becoming involved in STRIDES. This Department and the Department of Public Health and Primary Care are actually located quite far apart. Though I’ve always been interested in interdisciplinary research, especially cardiovascular psychophysiology, with a particular focus on mechanisms and interventions for vasovagal reactions. During my PhD, I was on an exchange in Australia and met with Professor Barbara Masser. She later met Professor Emanuele Di Angelantonio, who’s based at the Cardiovascular Epidemiology Unit (CEU) in Cambridge, at an international conference. They talked about our overlapping research interests, and Emanuele and I ended up working together. Small world! With Emanuele, in the Department of Public Health and Primary Care, I applied for support from the BHF with the Career Development Fellowship, which allowed me to help co-design the study.
Why the move from the UK to Australia?
A new opportunity came up. Also, the STRIDES study planning was nearly complete and heading for three years of data collection, so it would be three to four years before we collected all the results. So, in that sense, it wasn’t a bad time.
Another reason is that I was trained as a clinical psychologist, first in counselling and then in clinical health psychology. “Cardiovascular Psychophysiology” would be the catch term for most of my research. So, the move to my new role in Australia took me back to my core area of training. Australia is also very strong for clinical psychology, and ‘Lifeblood’, the equivalent to the UK’s NHSBT, is very research-active. This opens doors to build additional collaborations.
What are some of the psychological and behavioural challenges which occur after a cardiac event?
I used to work at a cardiovascular health improvement programme in Montreal; it was one of my placements for my clinical psych training. I was working in a hospital with people after a cardiac event. They’re given the support from a physiotherapist, a cardiologist, a nutritionist and a psychologist, so there’s a team of professionals helping people recover after an event. Sometimes I would give a little workshop; we would talk about stress management, things that worry people, and how people cope with the signals coming from their bodies after an event like that. There is a metaphor I liked from an old mentor of mine, from a long time ago:
Imagine you have a car. You’ve driven it to work for many years, with no problems, but one day, out of the blue, smoke starts coming out of the hood. The car stalls. You’re stuck in the middle of the motorway, late to work, and need to be towed to a garage. It’s a catastrophic event. The next day, you’ve got through it. You go to the mechanic and you ask them, “what was wrong with the car?” They tell you what was wrong and how they fixed it.
So you go on driving the car, but you notice all these sounds and noises and vibrations that you never noticed before and you’re thinking “what in the world did this mechanic do to my car?”
It’s like that with the body. It doesn’t matter how much reassurance you get after a cardiac event, some might be at risk to start to become hyper-vigilant, focussing in on things you would never otherwise. The problem is, you can easily, catastrophically, misinterpret those symptoms for something more serious.
It is difficult to navigate what is a realistic danger and what is excessive worrying which isn’t good for either your mind or cardiovascular health and recovery. That’s one reason why it’s so important to have cardiologists working with psychologists in patient care to find that healthy middle ground so that patients are not unduly stressed, but address their symptoms. You need both disciplines to work together to understand and prevent cardiovascular events, and then work together to manage them after they occur.
What do you think are the value of networks like BHF Alumni?
BHF alumni allows what I would call “cross pollination”. In the long term I’d like to continue working with cardiologists, epidemiologists, people I wouldn’t normally have an opportunity to work with. Clinical psychology can become a silo, as any discipline can, so working with cardiologists and cardiovascular epidemiologists has been great. Hopefully I’ll come across some fellow BHF alumni here in Sydney at some point.
What are your plans for the future?
I’d love to continue collaborating with everyone in the UK that I’ve been working with, and continue building this partnership with Lifeblood here in Australia, to do new projects looking at blood donor health and management. Our faculty is moving into the Faculty of Medicine at Macquarie which will present different opportunities. My biggest question is, “how can we improve patient wellbeing during medical procedures?” I’d invite fellow BHF alumni and potential collaborators in Australia and abroad to help me answer that question.