Should You Get a Therapist for Your Therapist?

The title is tongue in cheek, of course. It can be expensive enough to pay for one’s own therapist as it is; nobody should have to pay for the therapist’s therapist, too.

Some time ago, I came across an article in The Conversation titled “Psychologists are starting to talk publicly about their own mental illnesses – and patients can benefit.” In it, authors Sarah Victor and Andrew Devendorf discussed a survey they had conducted to assess the rates of mental illness among mental health workers. They noted that 48% of mental health professionals are diagnosed with mental illness and that 80% have experienced psychological problems. Devendorf and Victor asserted that these percentages are “similar to rates of mental illness in the general population.”

These figures for both the general population and psych professionals struck me as frankly astonishing, but they made more sense when I learned they were based on lifetime prevalence and not a point in time. According to population samples from America and New Zealand, about half of people from these two countries will meet the criteria for a psychiatric diagnosis over the course of their lifetimes, but that doesn’t mean that half of these countries’ populations have officially received a psychiatric diagnosis from a psych provider.

Interestingly, in their research paper, Devendorf and Victor painted a more troubling picture than in their article, having written, “Overall, rates of mental disorders within clinical, counseling, and school-psychology faculty and trainees were similar to or greater than those observed in the general population” (emphasis mine).

In other words, mental health professionals are just as messed up as, if not more than, the rest of humanity.

Psychologist Robert Epstein observed, “Mental health professionals are, in general, a fairly crazy lot.” Then, he went on to write, “This may sound depressing, but, as you’ll see, having crazy shrinks around is not in itself a serious problem.”

No, Dr. Epstein, it is a serious problem. But I will get into that later.

Dr. Todd Grande, a licensed counselor who runs a popular Youtube channel on all things mental health, confirms that mental health clinicians tend to have poorer psychological well being than the average person. Among his peers, he has observed drug use, anxiety, depression, and PTSD. Apparently, his audience frequently ask if psychotherapists have worse mental health than average, with the expectation that they do (which is telling indeed). Dr. Grande decided to make a video response to this question, and here is a quote:

[A]re counselors more likely to have a mental disorderthan someone in the general population? Now, this is really one of the most frequently asked questions that I get around mental health clinicians and mental health, and really, the idea here is that a lot of people believe that mental health clinicians are more likely to have a mental disorder than somebody in the general population. And I would agree with that. I think the research shows that fairly clearly, although, again, there’s not a lot of research to go on here, but in my experience, I would say this is true. I would say a mental health clinician is probably more likely to have a mental disorder than someone sampled from the general population.

Based with my own past experience working on a mental health team in a prison setting, I readily agree with Dr. Grande’s assessment of his peers. I remember a psychologist who was literally bug-eyed with anxiety. An older counselor who looked like the life had been drained out of him. Tired and frustrated therapists who complained about their clients. In strong contrast, the prison chaplain was cheerful and glowing as though with inner light.

For what purpose do we need a therapist if the therapist also needs a therapist?

If you had car problems and wanted to go to the nearest mechanic in town, but then you found out that his wife drops him off at work because he can’t fix his own car… how would that affect your decision to use his services?

What if you went to a dentist for dental pain, but upon meeting her, she smiled, revealing broken and rotting teeth? Would you still follow her to the dental chair, sit back, and open your mouth for examination?

There is a saying that people go into the field of psychology to try to figure out their own problems. This is usually used in a derogatory sense, which is somewhat unfair. Going into a field of study that strikes close to home is not necessarily problematic. Most people are attracted to a career path that they can relate with. I’ve observed eye doctors wearing glasses, nutritionists with a history of eating disorders, and so on. There is value, I think, in people that encounter life problems and overcome.

The problem with the field of psychology is the lack of overcoming. This field does not have the answers for its students’ suffering, and this is precisely why the level of mental illness within psychotherapeutic ranks is not lower than that of the general population, which is what one would expect if they were doing things right.

The defense for the unimpressive state of their average mental health usually runs as follows: psych workers have so much stress, are exposed to trauma, and have little support. Well, a lot of other career fields have equivalent or arguably worse problems than psychotherapy. For example: soldiers, firefighters, police officers, anesthesiologists, surgeons, paramedics. Added together, the number of people in these professions way outnumber mental health clinicians, yet they have not succeeded in bumping the mental illness rate of the general population above that of mental health clinicians.

When a psychotherapist is unable to overcome his or her own problems, how exactly can he or she help others with theirs, other than offering a compassionate presence and friendly ear, which a friend can do for free? The sheer exhaustion, frustration, and occasional cynicism I personally observed in former colleagues no doubt had something to do with the observed inability to effect much positive change in clients.

On their website, Paradigm Treatment, a behavioral health organization from Los Angeles, argued that mentally ill psych workers who overcome can become great role models — which is true. Then, they wrote glowingly about how a man with schizophrenia went on to become a successful psychologist. But, when I actually read about this man, Frederick Frese, the picture looked entirely different. He never did overcome his schizophrenia through his clinical knowledge, instead relying on an antipsychotic regime for stability and still succumbing to relapses every so often. This “highly successful” mental health professional even has to hand out a card telling people to avoid blunt criticisms in order to not trigger his symptoms! Furthermore, his four children suffer from depression and are on psychiatric drugs.

People generally crave advice from people who excel in a relevant area. Psychotherapists are an exception for some reason.

When we hear of a centenarian in good health, aren’t we all curious about this long lived person’s diet and other lifestyle tips? Who would we rather ask for financial advice: a Warren Buffet type or a hobo? Why are people drawn to psychotherapy, when practitioners frequently don’t even want to give advice – and when they do, they don’t necessarily have outstanding personal qualifications in the area of interest?

Going back to the original article, titled “Psychologists are starting to talk publicly about their own mental illnesses – and patients can benefit,” let’s talk about the part where patients can benefit. I agree – patients indeed can benefit from knowing about psychotherapists’ mental health struggles. They can benefit by realizing these people can’t heal themselves and hence they should consider looking elsewhere for help.

References:

1. Devendorf, A. & Victor, S. (Apr. 29, 2022). Psychologists are starting to talk publicly about their own mental illnesses – and patients can benefit. The Conversation.https://theconversation.com/psychologists-are-starting-to-talk-publicly-about-their-own-mental-illnesses-and-patients-can-benefit-177716

2. Victor, S.E., Devendorf, A.R., Miller, R.H., et al. (Jun. 22, 2022). Only human: mental-health difficulties among clinical, counseling, and school psychology faculty and trainees. Sage Journals, 17 (6). https://journals.sagepub.com/doi/abs/10.1177/17456916211071079#tab-contributors

3. Kessler, R.C., Berglund, P., Demler, O., et al. (Jun. 2005). Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62 (6). https://jamanetwork.com/journals/jamapsychiatry/fullarticle/208678

4. Caspi, A., Houts, R.M., Ambler, A., et al. (Apr. 21, 2020). Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study. JAMA Network Open, 3 (4). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2764602

5. Dr. Todd Grande. (Jan. 19, 2019). Are Counselors/Therapists More Likely to Have Mental Disorders? [Video]. Youtube. https://www.youtube.com/watch?v=8ewbOOMJNhY

6. Epstein, R. & Bower, T. (Jul. 1, 1997). Why Shrinks Have Problems. Psychology Today. https://www.psychologytoday.com/us/articles/199707/why-shrinks-have-problems

7. When Your Therapist Has a Mental Disorder Too. (Nov. 1, 2017). Paradigm Treatment. https://paradigmtreatment.com/therapist-mental-health-disorder/

8. Psychologist Overcomes Paranoid Schizophrenia. (n.d.) Schizophrenia.com http://www.schizophrenia.com/newsletter/697/697overcome.htm

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