The Bipolar Therapist: Speaking Out About Speaking Up

I have used a variety of therapeutic orientations in my psychotherapy practice behavioral, cognitive, brief, client-centered, psychodynamic, humanistic, and family systems. The list goes on, spanning more years than I care to admit. In helping clients to deal with difficult issues, I have added self-disclosure to this list. This serves to underscore that someone else has experienced what they are going through and encourages empathy between the client and therapist. The client feels understood without feeling “one down.

To some in the field of psychotherapy, the idea of equality and therapist self-disclosure is antithetical to good treatment. I know, because in the past I numbered myself among those who believed this to be true.

The latest evolution in my thinking, therefore, came as a complete surprise to me. As a wounded healer with a history of manic depression going back 30 years, as I became more comfortable with my recovery, I was able to bring this area of expertise to the treatment of others who also have mental illness. I recognize, and clients confirm, the helpfulness of working with a therapist who has been through what they have been through. It is one thing to understand how psychotic thinking impacts one’s ability to make rational decisions; it is quite another to know how the thought impacts one’s logical thinking.

Recently, I was asked by a client to speak to a court evaluator regarding the client’s visitation rights with his children. The client needed a place to sort out mixed feelings about his ex-wife and his role as a father. At one point the evaluator asked if we were doing any “deep work.” I had difficulty expressing that the client needed a place to sort out mixed feelings, not to delve into the deep recesses of his unconscious mind. I felt intimidated by the expression, “deep work.” Because we as therapists cannot seem to move past the status quo and the “tried and true,” I felt uncomfortable with my belief that wider self-disclosure and equality between therapist and client benefits treatment. Today, as described in the following case, my discomfort at self-disclosure has disappeared:

John, age 32, has had anxiety most of his life. He was acutely shy and would be diagnosed today with social phobia. In his early 20’s John began to experience panic attacks and became phobic to most social gatherings. He had few friends and was becoming increasingly isolated. We began therapy by cultivating a conversational dialogue. Though mundane, reporting daily details helped John to talk about himself in a manner that was non-threatening. As he became more comfortable, he gradually began to share feelings of how he felt about himself and his difficulty living in this world, shut off from others. I shared with him my own confrontations with myself at a younger age, my self-consciousness at social encounters, and the discomfort of trying to engage in and maintain conversations. I expressed to John several ways I had confronted my anxiety, suggesting he might find ways of his own to do the same, as we delved deeper into his emotional life and the beginnings of his difficulty with anxiety. My honest input of similarities between us dovetailed with his growing need to understand what happens in others so afflicted. He came to understand there are those who experience life in the same way as he and still find ways to cope. Our relationship began to signify his resolve to venture into the world on his own.

Today, John has been able to conquer his demons. Being able to share with him not only my past history, but my emotional experiences as well, has enabled him to let go of his fears. He realizes his fears are only as big as he has allowed them to be.

Self-disclosure and equality, along with a sense of connection and oneness, merge to create change. If allowed to emerge, clients bloom in an atmosphere of mutual give and take.

I get something from these relationships as well. I am transported to a mindset that is uplifting and satisfying. I feel fulfilled. This is not only important to my personal well-being, but it enhances my work as well. I have learned that as therapists, we listen. The question is, how do we respond?

3 comments:

Bipolar Disorder said...

A very honest, well-written account of what it is like dealing with bipolar disorder. Thanks for having the guts to put this out in the open.

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Jackie Champion said...

Hello! Thank you for sharing your thoughts about psychotherapy in your area. I am glad to stop by your site and know more about psychotherapy. Keep it up! This is a good read. I will be looking forward to visit your page again and for your other posts as well.
While some psychotherapeutic interventions are designed to treat the patient using the medical model, many psychotherapeutic approaches do not adhere to the symptom-based model of "illness/cure". Some practitioners, such as humanistic therapists, see themselves more in a facilitative/helper role. As sensitive and deeply personal topics are often discussed during psychotherapy, therapists are expected, and usually legally bound, to respect client or patient confidentiality. The critical importance of confidentiality is enshrined in the regulatory psychotherapeutic organizations' codes of ethical practice.
The psychotherapy practiced by therapists from these disciplines can come from any of the “schools” of therapy described above. While the dispensation of medication is reserved to psychiatrists and to some specially certified nurses, the quality of psychotherapy does not vary from one discipline to the next. It varies more as a result of the knowledge, experience and “style” of the individual therapist. Call us for help in locating a suitable therapist for your needs.

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