Ruth FitzGerald is the new UMHS Director of Counseling Services and is available to help all students as well as staff at UMHS in need of one-on-one counseling.
The UMHS Endeavour spoke to Ms. FitzGerald about her experiences in counseling people everywhere from her native Ireland and the Caribbean to Bahrain and Switzerland. We also discussed cross-cultural psychology, reflective writing, mental health counseling in non-Western cultures, how she can help medical students, and more.
Experience with international students
Ms. FitzGerald has many years of experience working with an international student body.
“Here at UMHS, I'll be responsible for all counseling matters and I'll work closely with the other departments in terms of really considering overall student welfare and student happiness,” she said. “I'll provide one-to-one counseling myself, and I'm also here to support staff as well, if staff ever feel like they want to talk about anything.”
What made her want to work at UMHS?
“I worked at a [Caribbean] medical university a number of years ago. That was a lovely experience. I really enjoyed working with the medical students. As a group of young people, I just found them very caring, very kind, very lovely people, and also very driven, very hardworking. That was interesting from a counseling point of view, because when somebody chooses to engage in counseling, it does require a little bit of work, a little bit of commitment. I found that the medical students were really prepared to give it that commitment, which was excellent.”
Ruth FitzGerald, UMHS Director of Counseling Services.
Photo courtesy of Ms. FitzGerald.
Experience in her native Ireland
Ms. FitzGerald was the Director of the Center for Therapeutic & Reflective Writing in Ireland. She trained counselors in the basics of reflective writing. She spoke about what reflective writing entails.
“Basically, the idea is using writing as a way of expressing our feelings and not just expressing them, but coming to a better understanding of them. With reflective writing, that's something we can do on our own and there are different exercises we can use to reflect back upon things. They could be things that happened that we wish we could change, or that we maybe wish we had handled differently. They might be decisions we've made, or we could be going forward into the future. Where am I right now and thinking about what I really would like my life to be. But through writing, in a way we're tapping into our unconscious as we're writing, without having planned for that to happen. Then it's when we look back over what we've written; sometimes it's quite surprising. Sometimes quite delightful. Sometimes it can be a little bit scary, but the process of reflective writing can be a very personal one. The main difference between reflective writing and therapeutic writing is therapeutic writing is very similar, except it can be used in a counseling situation guided by the counselor as a therapeutic process. We then use these exercises to help the client explore certain areas of their lives. Then we look at what has been written and use that as the basis for the conversation. I find it actually a very gentle way of allowing people to express themselves, because it's not easy coming into a counseling session with a complete stranger and thinking, ‘I need to open up to this person and tell them about all of my feelings.' A lot of people don't feel comfortable talking about their feelings, but writing about them can be a much gentler way into having the conversations then that are necessary.”
Work in cross-cultural psychology
Ms. FitzGerald has also done work in cross-cultural psychology. What are some of the key things medical students can learn from cross-cultural psychology?
“I think cross-cultural psychology is so important in all aspects of life and particularly for medical students who are going to be dealing with people from all different cultures. I think it's having that curiosity and that openness to other cultures, but really the ability to look at things not only from our own personal perspective. It's really interesting when we look at lots of research that's been done on culture and psychology and so on. We find that this research has been undertaken generally in the West by Western-trained psychologists. The conclusions are really only relevant to the West, but yet we tend to generalize them.”
She spoke about the tragic tsunami in Thailand back in 2004 as an example of needing to be sensitive to non-Western ideas about mental health.
“Though it was devastating to the country and so many people lost family members and the world was wonderful in terms of rallying to help and to provide aid and assistance. The intentions were excellent, but at that time, lots of psychological support was brought in from the West without any understanding of the culture in Thailand and with the very best of intentions, a lot of harm was done because in their society, it was quite taboo to see a counselor, to talk about private matters and so on. I just found that very interesting. It's really the idea that to approach situations just with this, from a distance, with a really open mind, not having any preconceptions.”
Mental health in non-Western cultures
Mental-health counseling is quite common in North America and Europe. However, it is not as common for non-Westerners to seek out mental health counseling due to cultural differences.
“Let's just say [someone] from the Middle East may go to see a counselor or a psychologist, but their concern is not just about how they will be perceived, but what impact is this going to have on their family? How will their family be perceived? It can be quite a far-reached thing, yes.”
Working with international students
Ms. FitzGerald has worked with a lot of international students throughout her career. What are some of the things she likes most about working with international med students?
“I'm always fascinated by different perspectives. I love the idea that we can all have a completely different opinion about something and just not agree at all, but still be interested in listening to the other person's point of view and then having that explained. I love to understand the rationale behind different perspectives and generally it's to do with culture. But yeah, it's just very interesting and in spite of working with all of these different cultures, I think for me, what I love is that regardless of culture, religion, whatever differences people might perceive; ultimately, we're all human beings. We all have the same needs, the same emotions. We have so much more in common, I think, than what makes us different. I find that really interesting and lovely.”
Research on culturally sensitive counseling & education
Ms. FitzGerald has conducted extensive long-term research on culturally sensitive counseling and education. She discussed highlights of her long-term projects.
“I think the highlight again would be going back to this understanding of different perspectives on things, but the importance of counselors and psychologists, the importance of them being able to adapt their approach to the environment in which they are working. The question of, this is my way, this is my views with everybody. It's a case of looking at ‘what am I dealing with’? What does this person need in order for this process to work really well for them and for me to be mindful of their culture and all of the influencing factors. The United States and a lot of the West is very individualistic. We're very keen to say, look, this is your life, you make your own decisions. You determine your own future. With collectivist cultures, that approach really backfires and causes a huge amount of problems within the family, within the community. Yeah. It's the importance of being flexible and being adaptable in our approach; that to me would be the biggest thing that came out of the research.
Ways she helps UMHS students
Many UMHS students may be unfamiliar with how counseling works. What can students expect when they come to see Ms. FitzGerald?
“First of all, a very warm welcome and no pressure whatsoever,” she said. “I mean, it's counseling. It's a personal choice. When somebody initially comes to see me, it's more about just creating a connection with them. Helping them feel comfortable and seeing what they need from the counseling sessions. That is just so different. It varies so much from student to student. Some students just want to come in and have a space for a little while to talk about how they're feeling and it may be that nothing more is necessary. They just need that time and that space to have somebody to listen to them because they don't want to do that to their friends because their friends are too busy. They don't want to do it to their family because they feel they might worry because they're far away and they can't be there for them. Just being there to listen sometimes. Sometimes it's to provide practical techniques to help deal with things like stress or insomnia. Sometimes it's to help get a perspective on personal relationships and maybe to help them make healthy decisions in terms of their relationships and the choices they're making. Whatever it is, I'm just there to see what the student needs and what's the best way of helping them to get that. ”
Experience with different cultures
Ms. FitzGerald has worked in places ranging from Switzerland to Antigua and Bahrain, all of which are totally different culturally. Her previous posts include Head of Wellbeing & Counseling at Aiglon College, Switzerland; Assistant Professor Education Enhancement & Counselor at American University of Antigua School of Medicine; and Director of The Coaching Psychology Unit at Bahrain Polytechnic University.
What is one thing she learned about culture in each of these places or different cultures, from a counseling perspective?
“I'd say in Switzerland, the big thing I learned was how resilient young people can be. I've worked in a mixture of universities, mainly universities, but some international schools. In Switzerland, it was an international boarding school up in the mountains and children as young as nine started boarding there. These would be nine-year-olds who are far away from their families. Their families might be in China or Russia. I found that was really interesting just to observe and to appreciate how resilient people can be. That was fascinating and lovely. In Bahrain, two things, I suppose there. Well, the first thing I feel I learned was just the importance of kindness there. The Arabic culture is a very kind, very warm culture. It's evident even with strangers. I mean, even just walking down the street and somebody walking by and that acknowledgement of it feels like you're making a connection with people, total strangers you've never met, but there's this warmth we share as fellow human beings. That was a beautiful experience. I love the Middle East for that. The other thing I was going back to what I was saying previously was just trying to understand things from somebody else's perspective. When I went to Bahrain, I'd never visited the Middle East before and in the West, we have these concerns about things like arranged marriages and we would find [the concept] of an arranged marriage to be quite disconcerting.”
She recalled how she learned to understand arranged marriages from a non-Western perspective.
“I remember the first time my female university students explained the rationale behind that. It was really fascinating because they were saying to me, well, our parents want to make sure that we're happy and that we're safe. They put a lot of time and effort into making sure the person we want to marry is suitable and is going to treat us kindly and is a good match for us in terms of interests and so on. They were horrified that in the West, we can just go out randomly, meet a stranger, nobody knows anything about them, marry them and who knows what's going to happen. Looking at it from that point of view, that actually made a lot of sense.
“There's a big difference between an arranged marriage and a forced marriage. A forced marriage, of course, they would've been against, but yeah. I mean, maybe we should know a bit more about each other before we decide to sign a contract which affects our future. Things like that.”
Working in the Caribbean was also eye-opening.
“Then Antigua—I think it was just down to the fact that they were medical students. All of the students are medical students and they have this deep desire to help others and to improve people's lives. That was really a beautiful thing.
How counseling helps others
Many have never had counseling and she assures people that counseling can help anyone going through big changes or just having a hard time coping with studying or personal issues.
“I suppose this is for any of the students who might be struggling or might be maybe thinking they would like to talk, but are feeling a bit hesitant. I think I have yet to meet a person who's never had to deal with some issue in their lives. We're all human. There are lots of things outside of our control. Things happen in life that we don't predict or that we don't plan for, but we all have something to deal with and it does help to talk to someone about it. I would just say don't hold yourself back in thinking, ‘I'm the only one who appears to be struggling here.’ Actually, we all are in different ways, but we're all very good at putting a big smile on our face and hiding it. But we all have things to deal with. We really do. I would just ask the students to remember that. If you think it might be helpful to come and talk, I would be delighted to [listen].”
How can UMHS students make an appointment with Ms. FitzGerald?
“Generally, the students email me at email@example.com or they are welcome to drop by my office and if my door is open, it means I'm not with another student and they're very welcome to just drop in. Otherwise, to arrange an appointment, yes, sending an email is the best way.”
Ms. FitzGerald is generally available from 8am to 4pm in St. Kitts.
“I'm also happy to work around student schedules. I mean, I know how busy the students are and how many lectures they have, so I'm quite flexible.”
(Top photo): Ruth FitzGerald photo courtesy of Ms. FitzGerald.
Scott is Director of Digital Content & Alumni Communications Liaison at UMHS and editor of the UMHS Endeavour blog. When he's not writing about UMHS students, faculty, events, public health, alumni and UMHS research, he writes and edits Broadway theater reviews for a website he publishes in New York City, StageZine.com.