Personal mental illness

[lna1011]

Do any of you have a past or current mental illness? I ask this because in the past I struggled greatly with anxiety, and it made me curious as to how many of us actually struggled/struggle with this. Jung's "wounded healer" is related to this. He explained that the most skilled clinician is one who has suffered from all sorts of illnesses and is being transformed by those agonies.

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[erg923]

He explained that the most skilled clinician is one who has suffered from all sorts of illnesses and is being transformed by those agonies.

While it fantastic that he thought this, this is actually an empirical question, right? Do you have evidence that this is indeed true?

 

[WisNeuro]

While interesting in a philosophical sense, many of Jung's theories are not backed up by any real data. Such as the typological personality types that became the Meyers-Briggs. That thing's psychometrics are absolutely terrible and do not map on to....well anything, even itself.

 

[smalltownpsych]

Marsha Linehan is one example of a psychologist who had psychological issues when she was younger and that experience helped her to develop an effective treatment for many of our patients. It is important to note that she kept her history private until she was widely acclaimed. Addiction treatment programs used a similar model for many years and there have been mixed reports, but that might be a good place to look for more evidence to either support or disconfirm the "wounded healer" hypothesis. Another point, is that it has been my experience that there exists a lot of stigma and bias against mental illness in this field and this is coupled with a lack of belief in recovery. In other words, if you have a documented history or acknowledge a history of mental illness, you will be scrutinized more closely than a peer who does not.

 

[Ollie123]

The literature in addiction is generally not favorable towards the "wounded healer" framework. The overall take-home regarding addiction treatment seems to be that recovered addicts are generally more rigid in their approach, more reluctant to consider harm reduction approaches and more likely to adopt a disease model that is not conducive to most modern treatments. There is no real evidence to support them being more or less efficacious, but this hasn't been thoroughly examined last I checked (at least not in a high-quality manner).

Of course, we're generally talking about paraprofessionals vs. professionals and there are a host of other differences between this and the situation described here, so the extent this applies to the OP's situation is very much up for debate.

I think you'll find a fair number of people in the field have at least some history of therapy for one struggle or another. Heck, given the prevalence rate in the general population, its more likely than not a significant portion of the field has at least experienced a depressive episode at some point. In my experience, severe issues that are ongoing during graduate school are fairly rare and generally something that significantly interferes with training (though I guess you never know if those are just the only situations where people learn about it...). I think its important for students to be at a place with their mental health they can manage the relatively significant stress of graduate school, but where that line should be drawn depends on the individual. Its definitely not something to "advertise" in your application materials though.

 

[WisNeuro]

Last I saw it's a little under a coin flip that someone will have had a diagnosable mental disorder by ICD or DSM criteria, maybe like 46%. I think major depression was about 17% lifetime prevalence. I imagine that the numbers may be skewed downwards in those with high education and professional degrees though.

 

[smalltownpsych]

The literature in addiction is generally not favorable towards the "wounded healer" framework. The overall take-home regarding addiction treatment seems to be that recovered addicts are generally more rigid in their approach, more reluctant to consider harm reduction approaches and more likely to adopt a disease model that is not conducive to most modern treatments. There is no real evidence to support them being more or less efficacious, but this hasn't been thoroughly examined last I checked (at least not in a high-quality manner).

Of course, we're generally talking about paraprofessionals vs. professionals and there are a host of other differences between this and the situation described here, so the extent this applies to the OP's situation is very much up for debate.

That was pretty much my take on the issue, although much of my info is second-hand from a colleague who is very knowledgeable about the research as I don't directly work in that field. What she tells me from her first hand experience aligns closely with what you have said and that it depends a lot on the individual's own personality factors and their own level of professional training. Also, my own research on 12-step groups attitudes towards professional treatment utilizing a cultural perspective points to some of the difficulties between integrating professionals and self-help groups. Basically, I found that there is often a lot of misunderstanding between the two groups which can lead to them working against each other despite having the same goals. Harm reduction vs abstinence is definitely a hot button issue. On the one side, the professionals see the 12 steppers as being too rigid and the 12 steppers think that the professionals are feeding into the addiction by supporting moderate use that they believe will lead to more dead addicts. My own personal perspective is that it is our responsibility as professionals to better understand the perspective of people involved in the recovery movement. The truth is that the limited research that I could find supports involvement in recovery as predictive of long-term positive outcomes in a variety of variables in addition to abstinence.

 

[Ollie123]

That was pretty much my take on the issue, although much of my info is second-hand from a colleague who is very knowledgeable about the research as I don't directly work in that field. What she tells me from her first hand experience aligns closely with what you have said and that it depends a lot on the individual's own personality factors and their own level of professional training. Also, my own research on 12-step groups attitudes towards professional treatment utilizing a cultural perspective points to some of the difficulties between integrating professionals and self-help groups. Basically, I found that there is often a lot of misunderstanding between the two groups which can lead to them working against each other despite having the same goals. Harm reduction vs abstinence is definitely a hot button issue. On the one side, the professionals see the 12 steppers as being too rigid and the 12 steppers think that the professionals are feeding into the addiction by supporting moderate use that they believe will lead to more dead addicts. My own personal perspective is that it is our responsibility as professionals to better understand the perspective of people involved in the recovery movement. The truth is that the limited research that I could find supports involvement in recovery as predictive of long-term positive outcomes in a variety of variables in addition to abstinence.

Generally agree, though the major problem with that research has been that most is non-experimental so we don't know whether the recovery group is contributing to long-term outcomes or whether individuals likely to succeed are more likely to pursue these recovery groups (or better able to attend them). Research has generally supported that harm reduction is possible/preferred with certain subgroups, so I think this is a good example of where the attitude difference among paraprofessionals is counterproductive. That said, I fully agree its important to understand what motivates people to enter into the recovery movement - for better or worse there the "AA Culture" is widely prevalent even in treatment settings where it is not the official model, so its important we be able to understand and speak in those terms. Some (not all) of it actually meshes well with current EBP anyways.

 

[cara susanna]

The literature in addiction is generally not favorable towards the "wounded healer" framework. The overall take-home regarding addiction treatment seems to be that recovered addicts are generally more rigid in their approach, more reluctant to consider harm reduction approaches and more likely to adopt a disease model that is not conducive to most modern treatments. There is no real evidence to support them being more or less efficacious, but this hasn't been thoroughly examined last I checked (at least not in a high-quality manner).

Of course, we're generally talking about paraprofessionals vs. professionals and there are a host of other differences between this and the situation described here, so the extent this applies to the OP's situation is very much up for debate.

I think you'll find a fair number of people in the field have at least some history of therapy for one struggle or another. Heck, given the prevalence rate in the general population, its more likely than not a significant portion of the field has at least experienced a depressive episode at some point. In my experience, severe issues that are ongoing during graduate school are fairly rare and generally something that significantly interferes with training (though I guess you never know if those are just the only situations where people learn about it...). I think its important for students to be at a place with their mental health they can manage the relatively significant stress of graduate school, but where that line should be drawn depends on the individual. Its definitely not something to "advertise" in your application materials though.

Super interesting, thanks.

The VA has something called peer support specialists who are themselves recovered veterans. Lately I've been wondering what the lit says about them. They don't do therapy but some of them cofacilitate groups.

 

[futureapppsy2]

While it's typically sub-clinical, I've ancedotally noticed that a lot of psych grad students tend to have anxious personality styles (probably because they were anxious enough to work to be competitive for the field), so it wouldn't surprise me if there's a decent number with histories of clinical levels of anxiety or anxiety disorders as well. FWIW (which isn't much).

Ollie, do you know of any lit comparing licensed substance abuse counselors with and without SA histories? I know SA tends to be more pro-active about having (and advertising) clinicians with SA histories.

Personally, I find the "wounded healer" model kind of dangerous, because I think it can promote an attitude of "here's what worked for me, so it will work for you" rather than empirical, evidence-based clinical decision-making.

 

[Ollie123]

http://www.tandfonline.com/doi/abs/10.1300/J020v18n02_05#.VApIUPldUQM

A somewhat dated review on the topic. There have been a few more recent studies, but I haven't seen any that would lead to drastically different conclusions (though I can't say its something I keep on top of).

 

[smalltownpsych]

Another problem with 12step members being professional substance counselors is that it is counter to one of the most basic principles of the AA program.

 

[CaliMac]

Another problem with 12step members being professional substance counselors is that it is counter to one of the most basic principles of the AA program.

Take no sides? Non-alliance or promotion? No unapproved materials? Anonymity?

 

[CheetahGirl]

Do any of you have a past or current mental illness? I ask this because in the past I struggled greatly with anxiety, and it made me curious as to how many of us actually struggled/struggle with this. Jung's "wounded healer" is related to this. He explained that the most skilled clinician is one who has suffered from all sorts of illnesses and is being transformed by those agonies.

The Jungian 'wound healers' are those with subjective agonies that have somehow transformed themselves to be quite productive citizens (like in the dynamic concept of sublimation). There are some concepts that fit during Jung's time (between WWI & WWII) when subjective trauma was ubiquitous (as in Eastern Europe during 1930s) but now we really do rely on the research to support those classical theories, especially if we want to communicate on the same level with other mental health practitioners.

And there's always the argument that you don't need to be a heroin addict to understand and treat substance use....likewise, you don't need to have deep-rooted anxiety or depression, or suffer from all sorts of illnesses to be an empathic practitioner. I'm sure some degree of suffering may help some become more determined, lead to greater desire and stay focused, but it is certainly not a prerequisite for one to be the "most skilled clinician."

 

[jadezomb]

Do any of you have a past or current mental illness?

To answer the original question: yes, I suffered from a few diagnoses as a child actually. My family environment was not the most healthy or nurturing. Lots of meds as early as 7/8 for depression, panic, and anxiety related symptoms.

As an adult, I definitely have some mild anxiety, especially mid-semester and around finals. But it is absolutely manageable thanks to a couple years of therapy and new coping skills I didn't learn as a kid. As for Jung's statement about transformation, I am not that familiar with this part of his work. I can say that as someone who has suffered from mental illness and has undergone a "transformation" of sorts, I think this might make me a better clinician. Having been on both sides of a therapeutic relationship, that is. I think it is really important to experience this relationship before becoming a therapist yourself. For me, it has been an invaluable experience. I also think we should work on our own stuff (or be working on it) before we help clients.

 

[CheetahGirl]

I think this might make me a better clinician.

Others will debate you on this point and I said the same in the past. The conclusion was that different forms of therapy require different kinds of being 'present' with the patient in the room, and some forms of therapy lend themselves BETTER to some types of therapists who have trained in certain ways and may (or may not) have had the need & recovery from some sort of mental health condition.

I did not have any experience with mental health practitioners prior to graduate school and considered myself otherwise healthy, both physically and psychologically; however I come from a combined program that encourages individual therapy for its trainees (as we all questioned our presenting problem?). Then I sought an externship that pretty much required your own individual therapy because of the trauma severity of child/adult cases that we were exposed to and treated...and on top of that, I had several major life events co-occur at that time giving me the impetus to seek my own therapist. It was transformational, but from relational and introspective perspectives. However, I chose to go there for support and to learn/understand more about "my own stuff" because of the type of population and therapeutic approach I favored. If I were hardcore CBT...eh...maybe it would not have been as helpful, and I may have sought alternative means of support (which I think may be somewhat suspicious and sometimes hypocritical if therapists flatly REFUSE their own therapy, but hey, who am I to judge?). But a lifelong history with mental health services from the patient's side is by no means a prerequisite and for those who have experienced it, you should be proud that you are determined, focused and have this desire to help others. We all have our own reasons for doing what we do.

 

[Nahsil]

As an absolute, I'd be really worried about this claim. As an intuitive sort of thing, it certainly makes sense that people who have struggled might develop strong empathetic capacity toward others who are struggling. But like people have said, I'd be very cautious about saying it's a "prerequisite" or that clinicians without a history of clinically relevant anxiety/depression/whatever else are somehow at a disadvantage.

Personally, some of the "psychological needs" that weren't met for me as an adolescent are synchronous with the kind of things I'd like to help people with. I do think there's something to the idea that Parker Palmer talks about, of "inner abundance" or personal motivation meeting "external need."

 

[MCParent]

I can say that as someone who has suffered from mental illness and has undergone a "transformation" of sorts, I think this might make me a better clinician.

I think the problem arises when people begin to think that their path is the path. IMO people who think that will be worse clinicians, not better, because they will have a bunch of countertransference issues when they see the person with "the same problem" as they had (hint: it's never going to be the same problem).

 

[starsinnight]

I think the problem arises when people begin to think that their path is the path. IMO people who think that will be worse clinicians, not better, because they will have a bunch of countertransference issues when they see the person with "the same problem" as they had (hint: it's never going to be the same problem).

I read this comment as not necessarily saying they are a better clinician than others without mental illness but a better clinician for themselves after treatment rather than without treatment. Atleast that's my interpretation. In any case, I definitely see a "wounded healer" as a problem. However, a healed healer (someone who has recovered or is in remission) -- is in my opinion, a better healer than a wounded one. Now the question of whether a healed healer is better than a never-been-wounded healer is comparing apples to oranges.

Let me jot all this down as the next empirical based research study I take on....

 

[AcronymAllergy]

I read this comment as not necessarily saying they are a better clinician than others without mental illness but a better clinician for themselves after treatment rather than without treatment. Atleast that's my interpretation. In any case, I definitely see a "wounded healer" as a problem. However, a healed healer (someone who has recovered or is in remission) -- is in my opinion, a better healer than a wounded one. Now the question of whether a healed healer is better than a never-been-wounded healer is comparing apples to oranges.

Let me jot all this down as the next empirical based research study I take on....

The way I'm reading and interpreting your comment is pretty much directly in line with my take on the issue as well. A "wounded healer," if we're going with a strict sense of the word "wounded," probably shouldn't be seeing patients who are themselves often in mentally/emotionally difficult places. Conversely, a "healed healer" (I like the terminology, btw), while IMO not objectively better or worse than a never-been-wounded healer, likely has unique inputs and, with appropriate training, should of course be in a place where they can then help others.

I also agree with MCParent, though, in that difficulties can arise when someone takes their own path through their difficulties as being the only path (e.g., "I healed from my trauma with prayer and support rather than exposure therapy, so everyone should first get prayer and support, and exposure therapy doesn't work."

 

[chman]

Purely anecdotal, but I would wager that the number of people (PhD and masters level) with either past or current mental health issues in the field is quite high. I would also wager that this is limited to certain kinds of disorders (depressive and anxiety disorders come to mind). It is natural to me that the field would attract those that find it relevant to them..

This can be helpful at times, I believe (the Marsha Linehan example is a good one). It is easier to empathize and gain insight in to issues if you have been through them IMO. However, as others have mentioned, it can also be quite a problem as well if one ignores evidence based practice based off of what worked for them. I would also say that most people who go far in the field have gotten treatment for their issues and are not in the throes of mental instability while practicing, and also don't advertise their strife..

Whether you think you can fairly and accurately treat others, do research, etc. with your own illness is really up to you in the end. Personally, I would never disclose this to schools I'm applying to or employers/colleagues unless I had to or until I was well established.

 

[researchgirl]

I'm pretty sure there is research to show that rates of depression/anxiety disorers among PhD students is higher than in the general public (but I'm too lazy to look for the citation, so, sorry). However... I think the Marsha Linehan story is the exception to the rule. Although we use our personal experience to inform our practice, when we develop or test new interventions we are primarily acting as scientists. No one would say a cancer researcher or oncologist would be a better scientist or physician if they had a personal history of cancer, although it might make sense that a personal experience with cancer would drive a person to become interested in that field. I think the same is true for psychologists.

 

[chman]

I'm pretty sure there is research to show that rates of depression/anxiety disorers among PhD students is higher than in the general public (but I'm too lazy to look for the citation, so, sorry). However... I think the Marsha Linehan story is the exception to the rule. Although we use our personal experience to inform our practice, when we develop or test new interventions we are primarily acting as scientists. No one would say a cancer researcher or oncologist would be a better scientist or physician if they had a personal history of cancer, although it might make sense that a personal experience with cancer would drive a person to become interested in that field. I think the same is true for psychologists.

I disagree to an extent... I agree that we as scientists ultimately are bound to evidence to determine the validity of treatments, hypotheses, etc. and it is certainly detrimental to let personal biases get in the way of that. However, where I diverge is that I think one certainly *can* gain insights they may not have otherwise had through real world experience. Scientists have done this throughout history. This can at least help with coming up with hypotheses to test in the first place. Yes, you're right that this insight won't make the stats or research methods any more valid, but coming up with the right research questions is certainly just as important. Your oncologist example is not quite analogous in that cancer has a set pathology requiring a strictly biological treatment. But even then I think one could come up with examples of how a researcher who had cancer could come up with better research questions. Maybe they have insight in to a possible mechanism of hope, or a time of day that medications made them less nauseous, etc. Yes, these things would need to be tested empirically, but ultimately may lead to better science.

 

[AcronymAllergy]

My take--thing is, there's nothing to suggest (as you've indicated, of course) that a personal history of mental illness is necessary to develop "better" research questions, or that it systematically/consistently improves this development. I can certainly understand the argument that it could, but at the same time, LOTS of things can lead to an individual improving their skills at developing appropriate research and clinical questions. Additionally, the converse is potentially just as viable--that a personal history with a particular condition could, theoretically, restrict one's views and lead to a perseveration of sorts on a specific line of inquiry.

 

[psyman]

Purely anecdotal, but I would wager that the number of people (PhD and masters level) with either past or current mental health issues in the field is quite high.

I hate when people propagate this sort of sentiment. It becomes an anecdotal fact in many circles. And "mental health issues" is about as vague as it gets. (so is "quite high")

 

[WisNeuro]

Agreed, I have never seen data suggesting that PhDs are more prone to "mental health issues" when you've adjusted for other factors. Namely, once you adjust for things like job stress, hours worked, and elevated levels of responsibility, there aren't many orthogonal factors after those and SES variables are accounted for.

 

[chman]

I hate when people propagate this sort of sentiment. It becomes an anecdotal fact in many circles. And "mental health issues" is about as vague as it gets. (so is "quite high")

I don't think I'm really propagating anything. I said from my personal experience, and certainly didn't tout it is fact. I also did give some more specifics than just saying "mental health issues."

Maybe you have a different experience, and that's fine. That's great, actually. But I have talked to others and they seem to have the same experience as me, for the most part. Of course it would be nice to get some actual data for this, and a I would be all for that.

My take--thing is, there's nothing to suggest (as you've indicated, of course) that a personal history of mental illness is necessary to develop "better" research questions, or that it systematically/consistently improves this development. I can certainly understand the argument that it could, but at the same time, LOTS of things can lead to an individual improving their skills at developing appropriate research and clinical questions. Additionally, the converse is potentially just as viable--that a personal history with a particular condition could, theoretically, restrict one's views and lead to a perseveration of sorts on a specific line of inquiry.

Agreed.

Agreed, I have never seen data suggesting that PhDs are more prone to "mental health issues" when you've adjusted for other factors. Namely, once you adjust for things like job stress, hours worked, and elevated levels of responsibility, there aren't many orthogonal factors after those and SES variables are accounted for.

Good point (although I would like to say I was including masters levels clinicians in my anecdotal take). There are plenty of professions where there is a high rate of mental health issues (or "disorders" if you want, since people seem to take issue with my semantics): lawyers, doctors, dentists.. Whether it is jobs stress or the personality that is drawn to the job is certainly debatable, however.

 

[WisNeuro]

Good point (although I would like to say I was including masters levels clinicians in my anecdotal take). There are plenty of professions where there is a high rate of mental health issues (or "disorders" if you want, since people seem to take issue with my semantics): lawyers, doctors, dentists.. Whether it is jobs stress or the personality that is drawn to the job is certainly debatable, however.

The thing is that there is plenty of research on this in terms of variance accounted for. From what I've seen environmental factors take up more variance than intrinsic factors across profession. Although if someone has seen different research, I'd like to see it.

 

[chman]

Interesting article I came across. Seems to do a fair job of mentioning the points that came up in this thread on both sides (although I disagree with some of it, especially the part about Rx privileges).. If anyone has any other studies (other than a couple cited in here) that they have easy access to or can cite without too much digging I would love to take a look..

http://www.psychologytoday.com/articles/200909/why-shrinks-have-problems

 

[Rivi]

I would think that there is something to having recovered from a mental illness that is beneficial, but like others said, we need more research. I remember hearing that substance abuse counselors with a history of substance abuse were just as effective as those who were not (too lazy to look this up, but feel free to). I know when working with veterans, having a veteran status often builds rapport easier, although this can also backfire in some ways.

Edit: I recently stumbled across this article which may be of some interest, although it relates more to current quality of life:
http://www.ncbi.nlm.nih.gov/pubmed/23957765
"Research suggests that the person of the psychotherapist is important for the process and outcome of
psychotherapy, but little is known about the relationship between therapists’ personal experiences and the
quality of their therapeutic work. This study investigates 2 factors (Personal Satisfactions and Personal
Burdens) reflecting therapists’ quality of life that emerged from the self-reports of a large international
sample of psychotherapists (N 4,828) (Orlinsky & Rønnestad, 2004, 2005) using the Quality of
Personal Life scales of the Development of Psychotherapists Common Core Questionnaire (Orlinsky et
al., 1999). These factors were investigated as predictors of alliance levels and growth (using the Working
Alliance Inventory) rated by both patients and therapists in a large (227 patients and 70 therapists)
naturalistic outpatient psychotherapy study (Havik et al., 1995). The Personal Burdens scale was strongly
and inversely related to the growth of the alliance as rated by the patients, but was unrelated to
therapist-rated alliance. Conversely, the factor scale of therapists’ Personal Satisfactions was clearly and
positively associated with therapist-rated alliance growth, but was unrelated to the patients’ ratings of the
alliance. The findings suggest that the working alliance is influenced by therapists’ quality of life, but in
divergent ways when rated by patients or by therapists. It seems that patients are particularly sensitive
to their therapists’ private life experience of distress, which presumably is communicated through the
therapists’ in-session behaviors, whereas the therapists’ judgments of alliance quality were positively
biased by their own sense of personal well-being."

 

[MCParent]

I tried to find papers on therapist mental health treatment experiences and patient outcomes, incidentally, just because I was curious. I couldn't find anything. But the search words were pretty generic ("therapist mental health treatment" is going to get a lot of false hits on google scholar) so maybe I missed some. You'd think the common factors people would have researched that.

 

[WisNeuro]

The psychology today article is pretty flimsy. First, it relies on mostly research on psychiatry, not psychology. It doesn't do any comparison against other high stress professions, instead relying on general population comparison when it does even deign to present comparison research. And lastly, it relies on anecdotal evidence for most of it.

 

[ela]

Geller, Norcross and Orlinsky edited a book on therapists in therapy:

http://global.oup.com/academic/prod...F2282F6ABECC4687CE892F89712A5C?cc=us&lang=en&


Some other refs:

Bellows, K. F. (2007). Psychotherapists’ personal psychotherapy and its perceived
influence on clinical practice. Bulletin of the Menninger Clinic, 71, 204-226.

Norcross, J. C. (2005). The psychotherapist’s own psychotherapy: Educating and developing psychologists. The American Psychologist, 60, 840-850.

Norcross, J. C., Bike, D. H., & Evans, K. L. (2009). The therapist’s therapist: A replication and extension twenty years later. Psychotherapy Theory, Research, Practice, and Training, 46, 32-41.

Pope, K. S., & Tabachnick, B. G. (1994). Therapists as patients: A national survey of psychologists’ experiences, problems, and beliefs. Professional Psychology: Research and Practice, 25, 247-258.

Sandell, R., Carlsson, J., Schubert, J., Grant, J., Lazar, A., & Broberg, J. (2006). Therapists’ therapies: The relation between training therapy and patient change in long-term psychotherapy and psychoanalysis. Psychotherapy Research, 16, 306- 316.

 

[SublimeNature]

Several schools of thought here.

1! Don't go into psych to fix yourself. <-- rant over

2) Yes, with over 50% of the population suffering from mental illness at some point in their lifetime, you can bet that a lot of psych professionals and students have experienced a Dx, if even for a short time. (No, I'm not citing that if there is no grade and no publication credit involved).

3) Anxiety can be debilitating so you will know first hand how awful it can be to deal with such an affliction. <-- makes you a more empathetic and understanding clinician

4) Grad school will make you experience psychosis, depression, anxiety, and an adjustment disorder. <-- now you're dual Dx- YAY, did I miss anything?!

5) Para-professionals have been found to the some of the most effective healers. (again, not citing, see the above reference and search EBSCO).

Short answer, don't go into psych for the wrong reasons, but if you love it and can relate you will make an exceptional clinician.

 

[MCParent]

Geller, Norcross and Orlinsky edited a book on therapists in therapy:

http://global.oup.com/academic/prod...F2282F6ABECC4687CE892F89712A5C?cc=us&lang=en&


Some other refs:

Bellows, K. F. (2007). Psychotherapists’ personal psychotherapy and its perceived
influence on clinical practice. Bulletin of the Menninger Clinic, 71, 204-226.

Norcross, J. C. (2005). The psychotherapist’s own psychotherapy: Educating and developing psychologists. The American Psychologist, 60, 840-850.

Norcross, J. C., Bike, D. H., & Evans, K. L. (2009). The therapist’s therapist: A replication and extension twenty years later. Psychotherapy Theory, Research, Practice, and Training, 46, 32-41.

Pope, K. S., & Tabachnick, B. G. (1994). Therapists as patients: A national survey of psychologists’ experiences, problems, and beliefs. Professional Psychology: Research and Practice, 25, 247-258.

Sandell, R., Carlsson, J., Schubert, J., Grant, J., Lazar, A., & Broberg, J. (2006). Therapists’ therapies: The relation between training therapy and patient change in long-term psychotherapy and psychoanalysis. Psychotherapy Research, 16, 306- 316.

Am I correct that that only one of these that measured patient outcomes (rather than feels about whether personal therapy for the therapist was good or not, or what kind of therapists therapists choose to go to) was Sandell et al., and they found no benefit and a nonsig trend toward a negative effect for long-term psychoanalytic therapy for the therapist?

 

[WisNeuro]

No, I remember reading most of these in grad school, you're right.

Also point #5 above definitely needs a citation, I would argue the evidence is mixed, at best.

 

[racek]

Do any of you have a past or current mental illness? I ask this because in the past I struggled greatly with anxiety, and it made me curious as to how many of us actually struggled/struggle with this. Jung's "wounded healer" is related to this. He explained that the most skilled clinician is one who has suffered from all sorts of illnesses and is being transformed by those agonies.

I'm of the belief that those with 'lived experience,' as it is sometimes called, can become the most proficient healers (keeping in mind that, as MCparent wrote, no two people's experiences are exactly alike). There's a lot of literature on this. You just have to look in the right places and use the right search terms. May take time to find them, but you will if you look. Start with 'wounded healer,' 'lived experience,' 'peer support,' 'recovery movement.' Mainstream psych is starting to catch on, but as some of the posts from others on this thread demonstrate, there's a long way to go.

Some here have asked you for evidence. Personally, I think it's a shame that people in this profession learn to shut down others' ideas if the person doesn't have a reference list of RCTs on hand. It's one thing to examine studies that exist. It's another to demand data that doesn't. That is really quite the power play and a true Catch-22, and this sort of thing will only hurt the profession by scaring away truly creative people (whose ideas might for empirical hypotheses down the line, but that's not the point). There are many factors, especially economic and political factors, determine what kind of science gets funding --i.e., what data exists-- and what data do not. So while this could be an empirical question, no one should be expected to have data to be able to simply discuss an idea.

If we're an intellectual/academic discipline, we should still be allowed to simply think, after all.

 

[MCParent]

I disagree. Statements made without evidence can be denied without evidence.

I've seen papers on things like handedness and proclivity toward stargazing; people research whatever they want to. I do not buy that an absence of any work in this area reflects some sort of system problem with funding etc.

 

[smalltownpsych]

I disagree. Statements made without evidence can be denied without evidence.

I've seen papers on things like handedness and proclivity toward stargazing; people research whatever they want to. I do not buy that an absence of any work in this area reflects some sort of system problem with funding etc.

I disagree with your disagreement just to the extent that the poster did not say there was no evidence; rather, it was stated that there is some research just not necessarily RCTs. My own dissertation was in this area and when looking at an anonymous group that is non professional, an RCT is not something that can be conducted, but to say that means a recovery group has no evidence for efficacy is not accurate.

 

[clip.clop]

Linehan is excellent, but shouldn't be used as anecdotal evidence for such a broad statement. There are far too many factors mediating and moderating the relationship between "person with mental illness" and "better clinician" to suggest that having suffered is, in and of itself, enough to predict being a better clinician (however you might define that).

 

[MCParent]

I'd put my money on this chain of testable hypotheses:
-therapy is a novel situation. Novel situations promote anxiety.
-people who have had therapy have had some exposure to the therapy situation.
-people who have had therapy are generally a little less nervous to start doing therapy.
-supervisors notice that difference and it affects first impressions.
-the actual benefits of prior therapy disappear after a few weeks of training (since everyone is getting expsoure) but the first impressions persist, leading to the idea that those with experience as a patient are better at being therapists.

 

[WisNeuro]

An RCT could be fairly easily constructed to answer this given the funding. I'm with MCP, there is no real data supporting the wounded healer hypothesis besides mayhaps some low n qualitative studies. Not saying there isn't anything there, but there is not much to say it's there, and much more to suggest other factors play a much bigger role.

 

[QAsPsych]

I've seen papers on things like handedness and proclivity toward stargazing; people research whatever they want to. I do not buy that an absence of any work in this area reflects some sort of system problem with funding etc.

If you don't believe that funding in psychology is biased towards certain types of work, you're living with your eyes shut.

 

[WisNeuro]

If you don't believe that funding in psychology is biased towards certain types of work, you're living with your eyes shut.

I didn't see him as saying that funding was equally spread across topic areas. Rather that if someone really wanted to do some research on proof of concept of this particular topic, it could be done in various ways without much funding. Plenty of research is done without multi-million dollar grants. He was merely saying that the notion that the only reason that the "wounded healer" idea wasn't a known fact because of lack of funding was somewhat preposterous statement.

 

[QAsPsych]

I didn't see him as saying that funding was equally spread across topic areas. Rather that if someone really wanted to do some research on proof of concept of this particular topic, it could be done in various ways without much funding. Plenty of research is done without multi-million dollar grants. He was merely saying that the notion that the only reason that the "wounded healer" idea wasn't a known fact because of lack of funding was somewhat preposterous statement.

That may be what MCP meant but it's not what the person he was responding to was saying at all; you have already in this thread dismissed the type of studies that are easily done with little funding ("low n qualitative studies"). RCT's are not cheap, proof-of-concept studies are rarely taken seriously in the field, and people in this field often dismiss much of the easier to do research out of hand.

Separately I don't think this question is very interesting or worth funding, myself. But the statement that there is not a strong funding bias informing our evidence is preposterous to me.

 

[WisNeuro]

Seriously, I used to do MRI/fMRI research, I know all about low n studies with little to no funding. But there is a difference between well designed low n proof of concept studies and poorly designed low n studies with serious problems with generalizability. I have yet to see any compelling research in support of the wounded healer hypothesis. If someone were to cite some in this thread, I would gladly read it.

 

[MCParent]

The journal Training and Education in Professional Psychology is filled with good- to well-done studies on therapy process that don't have funding or just have small foundation grants. J Coun Psych, JCCP, JCLP, and other journals publish them too. They're everywhere.

I didn't jog through dissertations in looking for any prior work on the topic; because I actually do think this is an interesting topic that might be something fun to do this week.

 

[smalltownpsych]

The wounded healer hypothesis is really too broad and I think part of the problem with testing such a hypothesis is that there can be both benefits and problems associated with having personal issues that align with those you are treating or even researching. My objection to some of the tenor of this discussion is that there can be a bias against the individual "wounded healer" which is also why the anecdote of Marsha Linehan is so important. I don't believe we will ever find that a "wounded healer" is better than a clinician or researcher who hasn't had the same degree of personal struggles because that is probably not the reality; however, the converse of that would be easy to prove and that worries me.

 

[futurepsydoc]

After reading the thread, I thought toss out my own thoughts, as I thought the topic was rather interesting.

Initially, I could see the face value of the "wounded healer, " especially in terms of understanding/empathizing w/ a patients current difficulties. As many have pointed out, it is incumbent on the provider to protect against overtly rigid or myopic views when considering treatment approaches and developing a comprehensive treatment plan.

From my point of view, I needed to operationally define "wounded healer." I mean Jung was an interesting individual who contributed a great deal to the field during his time. I do not view his research, or perhaps scholarship is more apt, as scientifically rigorous. While I concede the limitations of his era, I tried to find a more simplistic and objective definition that is consistent w/ his notions.

I see being "wounded" as existing on a continuum of severity, whilst at the same time existing in one or more domains (i.e. mental health, physical health, social, occupational, etc.). Bearing that in mind, I think the current severity of the wound and the domain in which it exists determines the impact of the wound on clinical ability and judgement - thus giving a sense of whether being a "wounded healer" vs. "healing-healer" vs "healed-hearer" could be an asset. Yet, I would hypothesize that the it is not only these factors, but also the interaction between severity of current wound, location of current would (i.e., domain), and the severity of the patient's experience and pain that would dictate the degree to which said "wound" would be helpful or not. From my perspective, moderators would the professional's self-awareness, willingness to acknowledge impairment/limitations, ethics/morals, and strength of training become key. Can they use their experience to help the patient or is it a liability?

Overall, I think Acronym put the most interesting concept out there - the "healed healer." If think a therapist's having overcome a personal issue of any kind (i.e., mental illness, physical illness, loss of a loved one, etc.), gives them a unique perspective regarding that issue and likely helps with instilling hope, so long as they themselves are actually "healed."

Last, as far as the prevalence/incidence rates for psychiatric disorders go in our field, I honestly don't have clue. Anecdotally my observations tell me that Obsessive Compulsive Personality traits are common in our field (i.e., Call me Dr. Obvious), symptoms of Generalized Anxiety Disorder are frequently reported, and episodes of Adjustment Disorder can occur at various points of training in manner that is quite predictable - dissertation proposal, comps, dissertation defense, match day, during internship, during post doc, EPPP.

Have a good one....

 

[futureapppsy2]

Eh, I'm really iffy about classifying adjustment disorders as "mental illness," tbh. And yes, anxiety may run high, but does it actually meet the criteria--including the impairment criterion --for GAD? Same thing with OCPD traits versus clinically impairing OCPD.