By Kelly Watkins, Psychologist & CBT Therapist

Introduction: Beyond Buzzwords

Attending BIGSPD 2025 wasn’t just an academic experience, it was emotional, confronting, and, at times, deeply hopeful. Across three intense days, we explored what it really means to work relationally, to challenge systems, and to hold risk as human beings, not robots.

This wasn’t a conference about theory alone. It was a call to action. One rooted in compassion, curiosity, and the belief that things can change, if we’re brave enough to do it differently.

Day One: Language, Identity & the Mini-Revolution

Dr Mick McKeown opened with a challenge: “Just get on and cook.” In other words, stop talking about relational practice and start doing it. He introduced the concept of bullshitisation, based on David Graeber’s critique of meaningless work. Many of us recognised it immediately, the administrative grind that distances us from the people we want to help.

But Mick didn’t leave us in despair. He spoke of a mini-revolution already underway. A clawing back of purpose, meaning, and human connection. He urged us to do risk assessments like humans, not machines, and to confront the alienation that so often haunts this work.

Then came Dr Maxine Dennis, who turned our gaze inward. She reframed “ethnic minority” as the global majority, and invited us to reflect on our multiple identities, how they intersect, and how they impact every interaction.

Through the work of M. Fakhry Davids, we explored the concept of internal racism, the uncomfortable but necessary recognition that we all carry in-groups and out-groups. Change, she reminded us, begins with awareness and exposure.

Workshops throughout the day reminded us:

• Healing is nonlinear
• Growth is uncomfortable
• And language matters, not just in what we say, but in who gets to say it

Day Two: Mentalizing, Trauma & Holding Risk Differently

Day two deepened the conversation, with a focus on mentalizing, identity, and the power of relationship.

🧠 Professor Peter Fonagy returned us to the foundation: epistemic trust and mentalizing. That is, our ability to understand ourselves and others as having thoughts, feelings, and perspectives. He introduced three modes:

• I-mode: How I see myself
• Me-mode: How I believe others see me
• We-mode: Shared understanding and co-regulation

Fonagy’s warning was sharp: trauma shuts down mentalizing. And social media and AI increasingly exploit our vulnerabilities in this area. But in group therapy, in relational spaces, we-mode can be restored, through connection, co-regulation, and shared experience.

🌍 Dr Kathryn Gardner offered a crucial reminder that self-injury is communication. She urged us to abandon the term “superficial” and explore visible and concealed wounds not as data points, but as acts of meaning—each tied to identity, stigma, and safety.

📚 Dr Dan Warrender voiced what many feel but few say out loud: How much mental health do our services actually produce? He questioned the label “personality disorder” and emphasised the therapeutic power of uncertainty. “I don’t know,” he said, is a bridge, not a barrier. “I worry about you,” he added, can be the beginning of we-mode.

🧱 Professor Jason Davies turned the spotlight on staff trauma and the emotional labour of care. He explored the Triangle of Boundary Maintenance, the Social GRACES, and reminded us that burnout can be a system response, not an individual failing. Supervision, he argued, should be a space to explore pain, although managing the risk of supervision and reflective practice of turning into therapy by ensuring that trauma is explorred in the context of how does this connect to an individuals work. 

Other sessions tackled the complexities of autism’s “spiky profile,” and Professor Michaela Swales reflected on DBT’s evolution:

• Its long-term impact on adolescence
• Its relevance for ADHD and autism
• And the continued power of mindfulness and radical acceptance as tools for change

The message was clear:
💭 Identity matters.
🧠 Mentalising matters.
❤️ Relationship matters.
🚨 And risk must be humanised.

Day Three: Systems, Stigma & What Works

The final day brought systems thinking into sharp focus, how we design support, and whether it truly meets the needs of those it claims to serve.

Professor Brin Grenyer introduced a stepped care model, which tailors support to actual need rather than arbitrary thresholds. It was a hopeful model but stigma loomed large. Particularly around “personality disorder,” which continues to be met with avoidance, fear, and countertransference.

📊 We were reminded that up to 9% of the global population may experience ‘personality disorder’ and yet these individuals are disproportionately seen in emergency and inpatient settings, often receiving inadequate or delayed care.

Enter Project Air and the Gold Card Clinic—an early intervention service in Australia offering brief but high-impact support.

✨ Bartsch et al. (2024) found the model:

• Reduced repeat emergency visits
• Supported staff wellbeing
• And, contrary to fears, people didn’t keep cycling back through the service

The intervention is relational, flexible, and effective. It gave many of us pause, why aren’t we offering this everywhere? Especially in justice and community contexts?

Final Thoughts: Building Better Together

BIGSPD 2025 wasn’t just a conference. It was a mirror held up to our systems, our practices, and ourselves.

Across all three days, key themes emerged:

• 🗣️ Language must be co-created, not dictated
• 🧠 Mentalizing is a relational act, not a clinical skill alone
• 🫂 Risk needs to be held with care, not fear
• 💬 Relationship is where healing happens
• 🏥 Systems must change, but it starts with us

This space reminded me why I do this work. Not because it’s easy, or neat, or comfortable. But because somewhere in the messiness of trauma and healing, in the “I don’t knows” and the “I worry about yous”, we find each other.

And that, I think, is where hope lives.

👋 Let’s Keep the Conversation Going

Were you at BIGSPD 2025? What stood out most for you?
What would you like to see change in your service, your practice, your language?

Drop a comment or connect with me on social media. I’d love to hear your thoughts and keep building this brave, relational, human-centred future together.

📝 About the Author

Kelly Watkins (BSc Hons, MSc, PG Dip, PgD) is a Psychologist, Cognitive Behavioural Psychotherapist, and doctoral researcher in Forensic Psychology. Her work focuses on trauma-informed practice, relational care, and transforming the narratives we use in mental health.