Mental Self-Help: What It’s Like To Be A Therapist And A Patient


I am certainly not a unique snowflake when I describe myself as someone who struggles with mental health. Like many, I have been coping for years with generalized anxiety disorder and periods of intense clinical depression. I am also in recovery for anorexia nervosa, which I was diagnosed with senior year of high school, and which, despite constant therapy, medication, and an incredibly supportive network of family and friends, continues to be a struggle for me, especially during times of great anxiety. These illnesses do not define me; they are not, and never will be, all I am. Yet, they are crucial to understanding me as a person, and as a clinician.

Yes, you read correctly. My name is Kate. I am a 23-year-old woman living in Cambridge, Massachusetts. I am a full time student at the Simmons College Master of Social Work program in Boston. As part of my field training for my degree, I work three days a week as an unpaid intern at a residential facility for teenage boys with substance abuse issues, co-occurring mental health disorders, and trauma histories. I am a therapist in training. And I have a mental illness.

Here’s the thing: I am one of those lucky people who works in a field where I am expected to have a lot of answers for a lot of people most of the time. I carry a tremendous amount of weight and authority when I speak about my job, my clients, my time, and my education. People listen to me, and quite often, think I know a lot more than I do. It is a privilege to sit with people who are in pain and have experienced events that would shock and horrify most folks; to hold their hurt for them, and to collaborate on how they can change their lives. Being a clinician is powerful. Sometimes, this feels really, really good. Other times, I liken it to riding a bicycle with malfunctioning gears while headed down a melting ski slope, and simultaneously juggling knives.

There are days where I actually choke on my own spit when I introduce myself as a clinician, or when I have a constant chorus of pitchy voices in my head telling me that I am a complete fraud as I attempt to navigate with my client a sense of purpose and completeness in their work in the program. There are plenty of days when my anxiety contributes to a raging headache, when every single thing I eat or drink gives me horrific stomach pain, when I have heart palpitations, cold sweat, and chills entering a group I am leading. And, there are many days when I cannot allow myself a moment of peace to indulge in the serenity and patience with my being that I encourage my clients daily to utilize. When I look at myself in the mirror and see a disgusting, horrible person, who is failing at every aspect of her life, who has frizzy hair and a terrible, deformed body, and who can’t even do basic math. There are mornings when I feel completely unable to get out of bed. Afternoons when I stare off into my day planner or my computer at work, forgetting what I was supposed to be doing a minute ago, frozen in the perceived failure of this woman I have created in my head. The one who’s afraid to eat her lunch in front of coworkers, lead her afternoon group, go downstairs for a napkin, blow her nose, ask a question, cough too loudly, take her medication with the door open, ask for more time, say no, say yes, say “I don’t know,” or even worse, “I can’t.”

The fact of the matter is, I am a person who struggles with an anxiety disorder, an eating disorder, and with depression. I am also a person who deeply and truly wants to help those who are experiencing their own oppression and disenfranchisement, some of which is familiar to me, and some which I could not fathom experiencing in my worst nightmares. These are not mutually exclusive identities, but they like to butt heads. Though I know I am not alone in my dual status as a social worker and a person with mental illness, I oftentimes feel erased, and forced to gloss over this part of myself in thinking about my work. But I cannot continue to do so. I am a mentally ill social worker, and I want to be represented. I want a narrative for this type of existence, and I want to end my own shame and self-doubt due to my condition. I want other social workers, who struggle with depression, anxiety, bipolar disorder, schizophrenia, eating disorders, sensory disorders, trauma, PTSD, self harm, and all other illnesses and conditions which we feel we must hide to be successful in our field, to come together and support one another. I want to end the notion that those in the mental health field are perfect specimens who are self-actualized, experience immaculate emotional health, and zero risk of mental illness. I am certain there are many of us who are in this leaky, splintered boat together. I want us to be seen and heard.

I am often told, by the less polite part of my brain, that I cannot possibly be a functional or effective clinician when I can barely handle my own issues, that I have no business trying to help anyone else when I am, at different times during the week, a client myself. That being said, I have never felt more at home than when I sit with a person who is willing to trust me with their story, with all of the pieces of their life – every ugly, dark part of themselves they would like to abolish, the waxing and waning of their cautious guard in my office, energy than cannot be contained or fear that cannot be expressed. I carry my clients with me wherever I go. I honor their stories and their experiences and hold them close to my heart, even years down the road after closing with them. I have learned immeasurably from providing services to them. I owe them a tremendous amount.

I appreciate this struggle and this privilege because I have been on the other side of that relationship many times in my life; giving a perfect stranger a peek inside the world inside of me, taking a breath, beginning to speak, and hoping for the best. I have tended to these therapeutic relationships and been blessed by the social workers in my life, who have contributed to the woman I am today by giving me the space in their room to explore what I need, and to own every part of myself, even the pain, and the hatred. It is this gift, as well as many other elements, that have contributed to me ending up on the other side of that room, asking the questions, being seen as the “expert.” How I will continue to balance myself as an individual who has suffered and continues to heal, and a professional social worker who helps facilitate healing in others, I am not sure. What I do know is that I can no longer be afraid to explore my illness in relation to my work, nor pretend it doesn’t exist. I cannot be afraid that I will fail my clients, only that I will fail myself by losing compassion for the person I have fought to be. I cannot be afraid that I am not worthy of this position, or that I am ineffective in my work with clients, because I am still learning and growing, and will continue to do so for my entire career.

All I can do is let myself cry on a bad day, be patient with the woman in the mirror who seems to be failing at every part of her life, who has dark circles and frizzy hair, who lacks spatial reasoning and can’t remember to return phone calls. She has worked hard to be where she is. She has climbed through the minute crawlspaces of the darkest moments of her life, fed herself when she did not want do, regrew muscle, hair, and physical health, and learned to take a breath when she feels like holding it. She is giving back to a world that has given her so many tools, and so many reasons to get up every morning. She is late for a session.

“So,” I say, hoisting myself up in a desk chair, eyes clear. “What would be helpful to talk about today?”