Can first-hand experience of a mental health problem help therapists to better help their clients?

Now that’s an interesting one. I would have to say, on balance, yes and no.

I myself have experienced episodes of depression and anxiety and I have also bared witness to family members struggling with addiction, psychosis and schizoid affective disorder. So you would think, on balance, that I would have a good head start as a psychotherapist working with clients who report very similar symptoms.

It is true that my personal experiences have had a significant bearing on my choice of current profession; however, with experience, I can see some of the pitfalls of ‘over identification’. Is it always possible to remain subjective when the client seems to be telling ‘your story’? Can one always retain professional distance if this is the case?

In my experience to date, I have paid particular attention to these obstacles and have discussed such transference issues at length with my supervisor. I guess this is not a challenge specific to therapists as it appears to be human nature to identify and empathize with others. It does however require self-reflection as it is not the norm for therapists to self-disclose whilst working with a client who will be quite unaware of the subtle identification process that might be going on.

I would also like to note how my own struggles with mental health have, I believe, benefitted my professional development as a psychotherapist. I have discovered that theory and formulation does not necessarily equate with desired outcomes, i.e. improved mental health and wellbeing. When I have attempted to stick rather rigidly to particular ‘models’ of therapeutic intervention, I have often hit a brick wall. I have essentially lost touch with the client and my own subjectivity in my attempt to remain the objective scientist. To counteract this effect, I now approach every client with a blank sheet, essentially encouraging myself to be mindful of everything that is happening within the room so as to respond authentically and holding theory, skills and my own subjective reality on an equal level.

Finally, I would like to thank all my clients to date for giving me greater insight into my own inner world. It is often assumed that given my training I must be super adept at managing my own life’s worries and problems. I do my utmost to ‘practice what I preach’ but at the end of the day, I am human and I’m glad to be able to identify with others’ difficulties. Without this personal insight I really don’t know how I would be able to do my job!

Mindfulness as a powerful adjunct to cognitive behavioural therapy

Presently there is a lot of talk about the practice of Mindfulness in the media as one of the ‘new’ forms of treatment for depression and anxiety. Ironically, mindfulness as a form of meditative practice is in fact as old as the hills. It is only recently, that evidence-based studies have brought to the fore the powerful effects this practice can have in reducing some of life’s most difficult problems – rumination and worry.

I have been using mindfulness techniques myself for about 6 months and I for one can testify to the beneficial effects they have had on reducing my own inner world. It is important to note here that I am not implying that I no longer find myself caught up in worries and pessimistic thoughts. In fact, I think I have become even more aware of how often my mind tends to lead me down this old familiar path of negativity. The effect  of practicing mindfulness has led me down a completely different path, one where I am able to relatively quickly spot these thoughts as they float into my consciousness and then take a decidedly different course of action. In the past I would only become aware of such intrusions after having acted on them in some way, whether it be to try and ignore them or to act in a way that would suggest that such negative thoughts were truths rather than thoughts or opinions.  Now I am not only able to spot them as they arise, I am happy to let them be, safe in the knowledge that they are just that – thoughts.

The practice of mindfulness appears in theory to be a very simple meditative act but the truth is it is a difficult and sometimes elusive skill to acquire. I have started to introduce mindfulness into my private clinical practice with great effect. Those who fully apply themselves to regular (daily) practice do appear to reap the benefits associated with a grater sense of self and greater ability to let unhelpful thoughts pass by without engaging or trying to escape.

As a cognitive behavioural therapist, there can be a tendency to stick with the evidence-based route, helping clients to challenge negative and unhelpful thoughts. Having incorporated mindfulness into my practice, I now recognise that this approach is not a one-size fits all solution to the problem of depression and anxiety. We cannot ever truly eradicate free thought, which in itself can be a great tool and without which we would lead much less richer lives. We can however, choose to cultivate that part of ourselves that is innately human; the ability to observe our own thoughts. Coupled with a non-judgmental acceptance of our inner ‘chatter’, we might just find ourselves on the path to better mental health and greater contentment despite the ever more chaotic and frantic world we find ourselves in.