Interview with Dr Martina Di Simplicio: ‘Build resilience mechanisms and a support team’

Dr Martina Di Simplicio is a Clinical Senior Lecturer in Psychiatry working at the Centre for Psychiatry, Imperial College London. She investigates the cognitive and neural bases of mental imagery-focused emotion regulation treatment in bipolar disorder and self-harm. Before joining the UK, she trained in medicine and psychiatry at the University of Siena, Italy. She completed her PhD at the University of Oxford, where she trained in cognitive behavioural therapy at the Oxford Cognitive Therapy Centre, and specialised on mental imagery-based techniques. She then worked as a Career Development Fellow at the MRC Cognition and Brain Sciences Unit and as a Research Associate at Jesus College in Cambridge.

 

Nan Fletcher-Lloyd) In terms of women in science, do you have anyone you would consider being an inspiration to you? Who are they and why?

Since I was a teenager, my hero was Professor Rita Levi-Montalcini, the Italian neuroscientist and Nobel Laureate. I guess she was the only woman scientist with an international profile that we would know of at that time. Moreover, her personal history as a young Jewish girl left on me this impression of dedication, resilience and stamina that makes anything feels achievable if you have a real passion for studying. I also loved that she was old, full of wrinkles and beautiful; a different kind of woman to what you would see every day on a magazine. I recommend the comic book with her story if you don’t know her. I once happened to be in a hotel in Siena, my hometown, where she stayed. I saw her from a distance, but I was too shy to approach her. I still regret that.

 

Nan Fletcher-Lloyd) During your career, what would you consider to be your most important achievement, and why?

Do you want the job interview answer or the real-life answer? Jokes aside, so far it has been developing a new intervention that targets self-harm in young people. We are at the early stages of treatment development, so there’s a lot of work to do, from testing efficacy to unpacking mechanisms etc., but our initial data are promising. Importantly, every time I present it to a clinical team or young people, the feedback I receive is that it could fill a gap in clinical need, which is the motivation to keep working on it.

 

Nan Fletcher-Lloyd) What do you find to be the most interesting aspect(s) about your field of work?

I am drawn to cognitive neuroscience because the gap between performance on a cognitive task and translation into clinical psychiatry is *relatively* small. Thus, my research can simultaneously observe phenomenology (i.e., try to get into the subjective perspective of what patients are experiencing) and dissect it into cognitive dimensions. As a field, we claim that if we get it right, by training or manipulating certain cognitive functions (e.g., attention to specific stimuli or working memory), we can revert the psychopathology, but we still have to prove it. This is a great challenge to work towards.

 

Melendez, Sylvana) Could you elaborate more on your work about future episodic stimulation and the clinical benefits of this research?

Episodic future simulation happens in your mind (and body) when you imagine a specific detailed future scenario. Think of one specific activity or event that you’ve missed out on due to Covid-19, and then visualise in your mind as vividly as you can how the first time will be when you will be able to meet that friend again, travel to that particular place, see a relative who is shielding. While you imagine this, you may catch yourself smiling, getting teary or feel your heart racing. This kind of future mental imagery can become dysfunctional, for instance, if someone can’t stop vividly imagining terrible future scenarios, which generate high anxiety. Similarly, one can train the adaptive use of future simulation to enhance motivation towards rewarding activities. For example, to help overcome anhedonia (a core symptom of depression), or to engage in helpful behaviours as an alternative to self-harm. In my lab, we are testing which specific components of cognitive processes can be modified by future simulation and what makes future simulation work therapeutically to improve mood or behaviour. For example, is it about the duration, about how much you repeat it, about the ability to engage somatic areas of the brain and elicit change in the sympathetic/parasympathetic system? I am also interested in translating this into digital tools so that people could use an app to practice future mental imagery.

 

Philipp Klocke) A career in science naturally involves setbacks and failures – what keeps you motivated and on track?

Probably that I remain really passionate and interested in my area of research, whenever I have to start writing or re-writing a grant application, the process of setting hypotheses and designing experiments is fun and makes me overcome the fatigue or disappointment from previous failures. The other important aspect is a good peer network of colleagues with whom you can bounce off ideas and get open, direct and merciless, but constructive, feedback. That kind of contact is more difficult over Zoom or Teams, and it is probably what I am starting to miss due to the pandemic.

 

Alessia Marrocu) Working in the field of mental health and psychiatry, have you found it to be led predominantly by men or women? Stereotypically, it seems that the mental health field attracts more women, and I wondered if you have experienced this to be true or otherwise.

You are right. There are more women undergraduate psychology students, mental health nurses and, probably, the same goes for psychiatry trainees, because, compared to other medical specialities, it has the reputation of a better work-life balance. However, you have to look at the top of the pyramid: as in other sciences, professors in psychology and psychiatry remain predominantly white men. The good news is that things are changing – our Division of Psychiatry led by Prof Anne Lingford-Hughes is definitely a good example. The critical point is looking at how many women get into a postdoc or their first independent research position compared to their male colleagues.

 

Lucy Bedwell) In addition to experiencing sexism in academia, women are commonly perceived to experience increased ageism in comparison to male colleagues. Have you observed any differences in the way younger and older female colleagues are treated and have navigated the world of academia?

Sadly, yes. It’s unspoken, often subtle and non-verbal behaviour, but, to some people, you will always be “a young girl” …probably until you are a professor nearing retirement, and they may not even be aware they are doing this. I think it’s a broader cultural aspect that means that women are still raised to be “nice girls” and it becomes an ingrained mechanism that shifts not just men’s but women’s own behaviour. I definitely catch myself reverting to that position when I am in meetings with more senior people, predominantly men. I quite like being informal (which might be associated with young age), but since I noticed that all my male consultant colleagues wear a suit, I always wear a blazer in the clinic or whenever I have an important meeting. The flip side of the coin is that women who are very assertive and direct can be more easily labelled as “angry”, particularly if they are from a BAME background. I am hopeful though that, as we talk more and more openly about this, things will continue improving for your generation. I am also curious about whether academia more equally led by women will become less hierarchical.

 

Melendez, Sylvana) Which advice would you give to women in sciences who are just starting their career?

First, build resilience mechanisms and a support team… your own “fan club” of other women (and men too) that is a safe space to lick your wounds after another grant rejection and who will boost your confidence ahead of an interview. And not just academics: my most useful interview preparation was a mock with two friends who work in industry. This will help you “market” yourself a bit better while remaining true to your values, as women are still known to be (as a general rule with its own limitations) more self-critical than men.

Second, make sure you say “No, Thank you” as much as yes, as not all offers are opportunities, but can be distractors, and other colleagues can take on that additional responsibility too.

Third, if you are striving for an ambitious career, make sure your partner is ready to have an equal share of domestic and childcare responsibilities.

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