Mentally Ill Therapist

[WonderWanda]

Should someone with significant mental health disorders of their own be practising as a therapist?

I have looked into this briefly and there are suggestions that mental health conditions are at higher rates amongst psychologists and psychiatrists. It could be argued that a therapist who has experienced issues for themselves would be more understanding and empathetic towards their client's struggles. In cases of of experienced anxiety or depression I can see how this might be beneficial.

Currently there are no restrictions on any mental health conditions that would prevent a person from practising as a clinical psychologist.

In cases of schizophrenia, BPD, psychosis etc, all of which that can leave the affected person detached from reality or with a warped view of events, is it ethical that they be allowed to treat others? I don't see how.

I have a friend married to a consultant psychiatrist and he is the most abusive, batshit crazy person I have ever met

Well you can't discriminate against someone who has a disability, which those illnesses are.

I suppose it's similar to the 25 stone cardiologist my dad once saw at the local hospital. Having the knowledge and teachings doesn't mean you have to put them in to practice for yourself I guess.

I know a community psychiatric nurse who isn't very well mentally, but she is very empathic and compassionate with her clients, and she ensures they get the best care available. I think one can have a mental health issue and still be able to treat others.

I think so long as they're taking medication (if appropriate) and have regular supervisions, it is fine. I've had HCPs disclose diagnoses of things like bipolar to me (no idea why!) and it has made no difference to the treatment they've given.

It really depends on how well managed their mental health is and how self reflective they are.

Anyone can start to be a poor therapist if they become burnt out/ have too much personal stress going on/ are unwell just like any other human being. And that may make it harder for them to practice than, say someone with a long term mental health condition who has it well managed and under control, who is maybe more likely to take the care of their mental health seriously.

I work in a field where we employ former service users and it promotes participation and engagement, creates a good and ethical culture in the organisation and as an employer keeps us to task in creating good support systems for all of our employees. So my feeling would be with the right support, regular supervisions, and good self care, boundaries and self management I don't see why not.

Therapists have an ethical duty to maintain their (physical, mental) fitness to practice and to take themselves out of practice when they aren’t. Of course that relies on someone knowing that they are compromised emotionally to the point of not being able to work competently which is partly what supervision is for, and they should of course access therapy themselves as appropriate.

I agree, but being obese doesn't necessarily mean his surgical skills are any less and the results of his aptitude in his work are tangible eg. the patient survives a triple bypass.

Whilst I think we shouldn't discriminate against disablity, should it be taken into account if there could be an inability to perform the role?

I believe pilots have to undertake psychological evaluation for this reason.

Why would the nature of their ill health impact on their work? If they are well enough to work, it doesn't matter what they are well enough FROM

@Jellycatspyjamas I'm glad you have touched on this. The reason I mentioned conditions such as BPD is because self awareness can be compromised, so there could be a scenario where someone thinks they are fit to work but actually aren't.

we do have an ethical responsibility to our patients to put them first (in terms of the therapy), to maintain appropriate boundaries, to treat appropriately, to not practice outside our area of competence. Some of those professional responsibilities are monitored and enforced by authorities or colleages or licensing boards.

Some mental health conditions might make that harder or impossible, others would not infringe those rules. Imagine a therapist with periodic depression? As long as they take their meds, don’t overwork, do their self care the patient would be unaffected or even benefit from knowing. Ditto for a therapist with PTSD.

A therapist with a major personality disorder is another thing but those are not always diagnosed.

@dirtyblond I think mental health issues have the potential to impact on everyone and anyone's work.

One of my best friends is a qualified psychotherapist and is one of the most mentally unstable people I know.

If someone has bipolar or episodes of psychosis which is well managed and they take treatment then yes, of course.

Schizophrenia is less clear cut as this tends to mean that people have ongoing symptoms which never fully resolve and they often are impacted cognitively e.g poor memory, focus etc which isn't great for working in healthcare.

With EUPD (previously known as BPD) again it depends. I think what makes me hesitate about this one is that people with EUPD often have interpersonal differences for example being unboundaried, strong emotional responses, complex emotions towards others etc which would make it difficult to work truly impartially as a therapist but again, not impossible with the right support, supervision etc.

I'm a mental health nurse working in a community psychosis team. We have a truly wonderful peer worker who has experienced psychosis and continues to have some voice hearing and anxiety. He is incredibly compassionate, therapeutic and our service users find sessions with him really valuable. He is currently training as a counsellor and he'll be great.
In the past when he's relapsed he has taken time away from work.

@pikkumyy77
This is the crux of my enquiry really. I have a close friend who recently got her masters and wants to work with children. She was diagnosed with BPD 7 years, fast forward to now she has had many failed relationships, very black and white thinking, risk taking behaviours, fear of abandonment which are all textbook in relation to the condition. Her behaviour can be erratic. She is a good friend but can be 'needy' and sullen if she perceives something incorrectly, which happens a lot in her romantic relationships.

I really do question how ethical it is for her to be treating children when she hasn't been able to keep her own thoughts in order. I suffer with anxiety myself so I'm not 'mental shaming' just outlining some detail.

BPD do you mean borderline/EUPD or Bipolar?

EUPD

What is her Masters in? And what sort of work is it?
Psychology?
She'll be getting supervised so her Supervisor will surely notice if there's any weird dynamics going on.

Oh good, I am so glad I am here for the weekly BPD bashing. Go on OP, you tell all of us unboundried, emotional vampires what's for. Just what we need is another kicking by arseholes on the internet 🙄

If you think she is a danger to her clients then report her? But I think you are unaware that EUPD/BPD is not a life sentence and not sociopathy or malignant narcissism. The founder of Dialectical Behavioral Therapy (DBT) Marcia Linehan had BPD and yet her therapeutic work and teaching has helped literally thousands of people.

I have a friend married to a consultant psychiatrist and he is the most abusive, batshit crazy person I have ever met

Same here. Really hoping it’s the same person.

I don’t know OP. Lack of adequate oversight / supervision is a huge issue in talking therapy.

She is one of my best friends so I definitely don't think she is any of the things you just said. Your response and how personally you have taken this thread is on you.

The reason I mentioned conditions such as BPD is because self awareness can be compromised, so there could be a scenario where someone thinks they are fit to work but actually aren't.

I do think this is where good clinical supervision, independent from organisational management, is essential. I do worry about the recent trend for inexperienced therapists being accepted on to supervision training. I think you need a wealth of practice experience to be able to adequately supervise another therapist, to recognise signs of instability etc and challenge that. I’m not convinced that 2/3 years post qualifying gives you that, but it’s another income stream in a very insecure profession, so people do it.

I used to work with someone who DREAMED of being a therapist. She was very sweet and very caring and was all round lovely. She wanted to help people.
She wasn't however, remotely stable! She was very emotional, cried regularly in the office, would have to leave the room to calm down every time something was "bit much", took everything personally and was actually quite draining to be around. There's no way she would have been able to sit and listen to people's traumatising stories.

Unfortunately, a lot of people that have been through trauma and MH problems want to help other people through it, which is lovely but it's usually the type of person you really wouldn't want as your therapist.

The spectrum of 'mental illness' is vast.

No, someone who is suffering psychotic delusions absolutely shouldn't be treating patients in that state - but nobody should be doing any job in that state, and it's extremely unlikely that they would be.

But most mental illnesses don't have psychosis or delusion as a symptom, and even if they do, it's unlikely to spring out of nowhere without warning.

There is no reason why someone who has had a nervous breakdown, for example, couldn't be a psychiatrist, and there's no reason why someone with a condition like depression or OCD couldn't be a psychiatrist - just like there's no reason someone with eczema couldn't be a dermatologist.

@pikkumyy77 She doesn't have any clients yet and I wouldn't necessarily say she would be a danger so I wouldn't want to report her or anything like that. I do think her perspective on things can be skewed at times which I would assume is essential to work in therapy. I just question how well placed someone who has exhibited questionable behaviours and the thought processes behind them is to treat others, particularly vulnerable children.