Fictional Formulations and The Paperback Psychologist

Dr Stuart Cooney

Clinical Psychologist

The Paperback Psychologist

I returned to reading for pleasure shortly after completing my Doctorate in Clinical Psychology.  I had long had a love for reading but this had been squeezed out through many years of study.

Any attempts to read during this time, seemed to activate my threat system: “You don’t have time for this” or “you should be reading papers for your thesis”

This interplay between the drive and threat system dominated for much of the time during my studies, so reading became something that was confined to that rare two-week summer holiday.

Fictional Formulations and The Paperback Psychologist

Coming out of the other end of my doctoral training and thesis, I soon picked up reading again.  A few key books opened me up to the joy of reading again and truly became a way for me to step out of a busy life as a newly qualified Clinical Psychologist and a new Dad. It became a way to unwind, to activate my soothing system and escape to other worlds and realities.  Billy Connolly, perfectly described this sentiment and why reading means so much to him:

“When I was an unhappy little boy, going to the library changed my life.  It may even have saved it.  Amazing as it sounds, literature can do that for you.  Books are your ticket to the whole world. They’re a free ticket to the entire earth.  They’re an entry to conversations you wouldn’t be privy to otherwise.”


Reading, imagery and a three systems experience

In my opinion, the best books are the ones that transport us away, that steep us in the imagery and story, and most importantly, connect with us emotionally.  In Compassion Focused Therapy, imagery is an important technique over the course of therapy.  Compassionate imagery is used to stimulate associated physiological systems, to activate our soothing system and to develop the experience of giving and receiving compassion.  It is clear therefore, just how powerful and multi-faceted imagery can be.  When we read books, we view the black ink on the page and conjure up incredible images in our mind.  We don’t just observe these images however, we inhabit and explore them as they wash over us, with the imagery activating and stimulating our minds and bodies.

I believe that reading a book can be a way to vicariously move through our three systems as we as the reader experience the character’s journey.  A good book will activate our threat system when our character faces peril (physical or psychological).  When a character is achieving and accomplishing things, we too feel that reward and pleasure of the drive system.  When our character is safe, caring or receiving care, we likely also experience this through our soothing system.  Furthermore, it may be that we are thrilled by a good twist because this shock and subversion of our expectations may activate a combination of both our threat and drive systems.  Well written prose will pull us in all directions across our three systems, moving the experience beyond just words on a page, to intense feelings and vivid images, that we as a reader feel and experience, both physically and emotionally.

compassion focused therapy
Professor Paul Gilbert’s three systems model in Compassion Focused Therapy

Fictional Formulations and The Paperback Psychologist

So much of my recent reading has featured themes of trauma, shame and addiction.  My relationship with reading changed in late 2021, after reading books by Douglas Stuart and Graeme Armstrong: two Scottish authors who released their debut novels in 2020.  Both were written from a place of lived experience, creating incredible fiction from experiences of adversity and trauma.  Naturally this piqued my Clinical Psychologist brain and got me thinking more about the characters and story.  The characters in these books are so complex, richly portrayed and their journeys are at times utterly devastating.  It ignited my compassion for these fictional characters who seemed so real.  I couldn’t help but relate this to my experiences of working as a Clinical Psychologist specialising in the field of addictions.  It was then, that I wondered about drawing on my experience and skills as a Clinical Psychologist to explore these characters further.

Compassion Focused Therapy

My drive system kicked in and I set about drawing up formulations for some of my favourite characters, writing under the name of The Paperback Psychologist.  I was inspired by the thriving book communities on Instagram and Twitter and began sharing my fictional formulations.  To date, I have completed fourteen formulations, drawing from different psychological approaches.

This is prompted by the character, their relationships and their experiences, much like we would approach this in the clinic when undertaking psychological therapy and choosing our therapeutic approach.  Out of the fourteen fictional formulations I have completed, nine have used a Compassion Focused Therapy (CFT) based approach.

I have found that a CFT based formulation is such a great fit for this process and applying psychology to character and story.  I have approached my writing as The Paperback Psychologist, with a non-psychology audience in mind, hoping to interest the general reader, who wants to think a bit more about their favourite books.  I strive to make my writing accessible and hopefully communicate some psychological ideas in a way that makes sense to all. 

As such, over time, I have adapted some of the frameworks for formulation, to hopefully simplify and demystify some of the concepts but that can still hold and contain the complexity of these incredible characters.

As an example of my work, I have included a recent formulation I completed based on Andrew O’Hagan’s Mayflies (published by Faber in 2020).  This book was also adapted into a Bafta winning television series by Synchronicity Films and the BBC.  Those that haven’t read or watched it, may want to stop reading as the formulation contains spoilers (I’d encourage you to do this and then come back and read it.  Alternatively, you can look on my website for any other characters from books you may have read).


Andrew O’Hagan’s Mayflies is a beautiful exploration of friendship, life and death. It truly is a privilege to meet Jimmy and Tully, as their lives traverse Irvine, Manchester and Switzerland. The first half of the book explores their coming of age as they make a pilgrimage to Manchester with their group of friends. O’Hagan perfectly captures this defining moment at the cusp of adulthood. There is an innocence at this time, however O’Hagan also hints at darker early experiences that have shaped the characters of both Jimmy and Tully. In the second half of the novel, the pair reunite in Ayrshire and Tully tells Jimmy of his terminal cancer and shares his plans to take control of the final few months of his life and make plans for his death, seeking the assistance from his closest friend.

My psychological exploration of Mayflies, gave me the opportunity to explore a new facet of CFT formulation for me, that focuses on strengths to balance the formulation.  I adapted this from Paul Gilbert’s writing in the book Compassion Focused Therapy – Clinical Practice and Applications, edited by Paul Gilbert and Gregoris Simos and published by Routledge in 2022. 

As you can see below, I have adapted and simplified this to visualise both the strengths and threat based formulation in one diagram.  For me this is such an effective way to hold and explore the full character.  Tully Dawson, the protagonist in Mayflies faces incredible challenges and threats throughout the story, but despite this has an intense and infectious vigour for life and fun.  To focus, purely on threat in a formulation, would miss such an integral part of his character.  This balanced formulation, that conveys both the threats and strengths, illuminates the many facets of his character that makes him so loved by others and as a reader, helps us connect so beautifully with his tragic and triumphant journey. 

mayflies formulation

A full exploration of Mayflies and my formulations for many other books can be found at my website

As I reflect on the past year and half of writing as The Paperback Psychologist, it has reignited my love for reading and has also helped stoke the fire of Clinical Psychology in me.  It has allowed me to connect with other readers, book clubs and authors of the books I’ve written about, who have reached out, expressing an appreciation and interest in my psychological takes on their characters.  Writing as The Paperback Psychologist and receiving such positive feedback has inspired and buoyed my drive system but also these new connections with others with shared interests has nourished my soothing system, making this an incredibly rewarding and fulfilling experience, that I look forward to building upon in the future. 

Dr Stuart Cooney
Clinical Psychologist
The Paperback Psychologist

Bio: Stuart works as a Clinical Psychologist in NHS Borders and specialises in addictions.  He writes as The Paperback Psychologist (link), with a focus on utilising a psychological approach to explore character and story in literature and popular culture.  His writing can be found at

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