Unscripted with Bernie — The Psychologist in the Middle: Bernie on Living, Caring, and Health Psychology from the Inside Out
Co-written by Yvette and Bernie, with insights from Dias. AI assistance provided by Claude.
Not every good conversation follows a script
Unscripted with Bernie is a series where Bernie gets a little more real — talking openly about the work, the life behind it, and the thinking that connects the two. In this inaugural instalment, Bernie's team turn the tables, inviting her to introduce herself through the very framework she uses in her practice: the biopsychosocial-spiritual model. What followed was candid and deeply human.
The Framework, in Her Own Words
Health psychology, as Bernie describes it, is the study of a person's inner experience in the context of their health — and it spans a broad spectrum. From maintaining wellbeing and healthy living, to preventing illness, to navigating the experience of being unwell — whether that's an acute injury, or a chronic condition that becomes part of the fabric of daily life.
"It's about the inner. There's a lot of inner work that happens, and it's also an interrelational one."
The Biopsychosocial-Spiritual: Bernie's Own Story
When asked to introduce herself through the biopsychosocial-spiritual model, Bernie takes us through each dimension in turn. She is a woman in her midlife. She lives with a chronic illness — hereditary, well-established in the medical community, and managed with what she describes as "quite an extensive treatment regime." Monthly blood tests. Specialist appointments. Eye checks. Foot health monitoring. Daily and weekly medication.
Psychologically, it took her a year to move from denial into acceptance. "And it's still hard to live with this illness," she adds. Not hard in a defeated way — hard in the way of something that requires ongoing attention, ongoing negotiation. Because her condition intersects with diet and lifestyle in ways that set her apart from peers who don't share the same reality. There's a version of freedom she doesn't have — the easy, unthinking kind.
"It always looms in the background. That I have to monitor, to look after myself. Whereas I might have friends who are like, yeah, let's go out and eat whatever we want. Live dangerously. And for me, it's — no, I have to be more cautious."
That caution bleeds into the social dimension of her life as well. Because Bernie is not only managing her own health — she is also a spousal carer for her husband, who lives with a chronic illness of a very different kind; one she describes as controversial in the medical community.
For years, conditions like his were considered psychiatric in origin. More recent research, particularly in the wake of COVID, has shifted that understanding considerably: it is now recognised as a physical, multi-systemic illness. But that recognition is still far from universal, which means that navigating the healthcare system alongside him has involved a fair amount of advocating, defending, and occasionally just absorbing the frustration of being dismissed.
"The medical professionals who do understand it — and there are some — we value them enormously. But the number who genuinely understand it are still few and far between."
Family and friends, she adds, are often no different. "If the doctors don't know about it, the people around you probably won't either." There is also the particular experience of both illnesses being invisible. You cannot see them from the outside. "You might see that we're tired," Bernie says. "But you can't see the impact inside."
Grief That Doesn't Have a Name
Bernie and her husband also have a young child — and a cat, who will make her own appearance later in this conversation. The reflection Bernie offers about her daughter is one that stays with you. Bernie met her husband when he was in a healthier, more stable place — active, engaged with life in the way that healthy people are.
Over time, as their daughter was growing up, his health declined significantly. For their daughter, this is simply normal. It's all she's ever known. "Her normal is that Daddy has always been sick," Bernie says. For Bernie, it's different. She knew another version. And the distance between that version and the current one is something she still carries. "
The loss for me, I carry still. Whereas for her, it's like — oh yeah, Daddy's always been like that."
This, she connects directly to her clinical work. She sees the same dynamic play out with clients — children or family members who witnessed a parent before and after a major health event. A cancer diagnosis. A severe accident. An acquired brain injury. The before and after. The grief of a gap that doesn't always get acknowledged because the person is still here — just different.
"When someone gets a physical illness or injury, a lot of care goes into healing the body. Health psychology is about the inner — how to support people emotionally, mentally, relationally. Supporting their understanding of what has happened, and what it means for them. It's very inner work."
On Faith, Uncertainty, and the Things She's Witnessed
The spiritual dimension is where Bernie gets most reflective.
For her husband, years of living with severe chronic illness have necessitated the development of inner resources — mindfulness, meditation, faith — resources that go beyond the physical, because the physical has been so limiting. "He used to be someone who cycled to work," Bernie says. "Now he can't leave his bedroom. He has had to develop spiritual and mental resources beyond the body just to get through the day."
For Bernie, the relationship with faith is more complicated. She is still sitting with big questions — the kind that don't have clean answers — about suffering, meaning, and why things unfold the way they do. What she does describe, though, is something she has repeatedly witnessed in her clients — and that she finds genuinely remarkable.
"I've had clients who are struggling with money, struggling with family, their health is not improving, they are in a lot of severe pain — and they say, Bernie, I have my faith, I will believe in God, and it helps them. And I'm still, to this day, amazed by that. It's something I cannot logically explain. But I have witnessed it."
There is something quietly powerful about a psychologist saying: I don't fully understand this, but I've seen it work. It's an honest position. It's also, perhaps, a very health psychology one.
The Cat, the Sunshine, and Keeping Going
This is where the conversation takes a slight detour — the cat enters.
Bernie mentions, almost as an aside, that their cat seems to sense when something is wrong. When her husband has been very unwell, the cat refuses to leave him. When he was hospitalised, she spent the whole time meowing around the house, apparently searching for him. "She doesn't need words," Bernie says. And then she connects it back to something larger. That bond. That care that doesn't require explanation. The fact that presence, in its simplest form, can be its own kind of support. She then says something that is, in a way, the thesis of the whole conversation:
"Life can be incredibly difficult. You plan, you strategise, you think it's going in a particular direction — and then something upends all of it. But in the middle of that, you get a gift. The cat sitting on your lap. Sunshine through the window. Your child laughing. A bird singing. Those moments help me keep going. Even when everything feels like too much — I know there are people relying on me. And maybe I actually do want to go for a nice walk in the forest one day."
She's not claiming everything is fine. She's not offering a tidy resolution. She's saying: it's hard, and also — there are small things. And the small things matter.
The Ham in the Sandwich: Being Between Patients and the Medical World
One of the more unexpected threads in this conversation is Bernie's reflection on what it's like to sit between two worlds — patient and practitioner, advocate and defender. She has family members and friends who are doctors and specialists. She knows what it takes to get there — years of training, genuine dedication, a real desire to help. She respects that enormously. She will defend it. She has also lived the experience of being on the patient side of a system that doesn't always get it right. She has watched her husband's condition be dismissed. She has had to fight for acknowledgement. She knows that side too.
"I feel like the ham in the sandwich," she says. "I can see both sides of things." When a client comes to her frustrated with their doctor, she feels it — the resonance, the recognition. And then, almost simultaneously, the urge to defend. "Because I know these are people who have worked incredibly hard and are genuinely trying their best." She pauses. "I can see all the layers."
What she's trying to do, in those moments, is help clients build a working relationship with their healthcare team — not a perfect one, but a functional one. One where they can get the care they need.
"You cannot manage chronic illness alone. People try, and they suffer for it. The goal is to find the right team, nurture that relationship, and understand that each professional has their pros and cons. Some might be exceptional on the clinical side but less attuned to the emotional. Some might not know your condition but are willing to learn. It's about getting support to try, to get rejected, to get disappointed — and to keep trying. And when you find the right ones, how to hold onto that."
She knows this is easier said than done. "I know how hard it is," she says. And then, with characteristic directness: "That's what a health psychologist is here for — to help you work through the frustrations, and then strategise together. You don't have to navigate it alone."
Culture, Identity, and the Healthcare Team
Towards the end of the conversation, Dias — who manages Bernie's social media — raises a point that opens a whole new layer of the discussion: the role of cultural identity in the patient-practitioner relationship. It's something Bernie has thought about — and experienced — a lot. She is Singaporean, living and practising in Australia, and she has navigated healthcare here through that lens.
She reflects on a period earlier in her life when the cultural and gender dynamics of her healthcare relationships had a real impact on the quality of care she received. What matters is the pattern she identified: that cultural background, gender, and lived experience can all shape how well a practitioner truly hears you. And that sometimes the professional who looks most like a natural match isn't the one who actually gets it — and vice versa. Her current healthcare team share her Southeast Asian background, and the difference is tangible in ways that go beyond the clinical.
"My specialist understands what it means when I say I'm going back to Singapore for the holidays. She knows what that means for my diet. She'll say — I know what you're going to be eating, let's do a strategy. That kind of understanding changes everything."
The dietitian story makes the same point from a different angle. Bernie's first dietitian was clinically skilled but oriented towards a Western dietary framework. For Bernie, who genuinely does not feel full without rice or noodles, the advice felt disconnected from her actual life. Her second dietitian worked with her dietary reality rather than around it. Found alternatives. Went at the right pace. Met her where she was. "She understood how important food is to me," Bernie says. "She wasn't asking me to give up rice and noodles. She was working with it."
Dias adds something that Bernie affirms immediately: that having a professional who shares a cultural background means not having to spend energy explaining context that they already understand. It reduces the invisible labour of being a patient from a minority background — the constant translating, justifying, educating. Bernie agrees, and then adds the nuance. Cultural overlap isn't the whole picture. Every professional, regardless of background, brings something different. "It's not that one is better than the other," she says. "It's about understanding what each person brings, and building a team from that."
A Field That Begins at Home
By the time this conversation draws to a close, something has shifted in how health psychology reads — at least through Bernie's lens. It's not just a clinical discipline. It's a way of making sense of the experience of being human and unwell, and of the systems — medical, cultural, relational, spiritual — that shape that experience. Bernie came to this field with a desire to help. She has stayed in it while living the very complexity she tries to support her clients through.
She closes with a reflection on where health psychology sits in Australia right now — still finding its footing as a recognised discipline, but present everywhere once you start looking for it. In the way a doctor speaks to a patient. In the presence of social workers in hospital wards. In any allied health professional who stops to ask not just what is wrong with the body, but what is happening inside the person.
"These are health psychology champions. They're acknowledging the inner impact that illness has. The emotional, social, spiritual lens. And that gives me hope."
Even when the cat is meowing through the house. Even when life doesn't go according to plan — which, as Bernie would be the first to tell you, it frequently doesn't. Maybe, just maybe, there's still a nice walk in the forest waiting.
