A Therapist's Mental Health

[mentalhealthinpractice]

“You are more than your body and your body is as it’s meant to be”

These are the words I would tell my younger self. Before I noticed my body as more than a means to function, I actually liked who I was. At school I was crippled by anxiety which made me stumble in conversations and withdraw. I am going to write a list of my brilliant traits that I did not value then but which make me the fierce woman I am today. Talking about yourself positively is not something deemed attractive in our society often, particularly as a woman, yet I think you HAVE to find positives you can draw upon when you are feeling low...so here they are. 

1) I am excellent at holding a conversation. You can be quiet or shy and I will find an opener or topic to draw upon that puts you at ease and helps you to feel comfortable with me. I am very expressive and have a genuine interest in getting to know people and this translates into how I communicate and how people respond to me. I have confidence now that, not all, but the majority of people who meet me will like me. Additionally my ability to interact well with others has served me very well in interviews 

2) I vocalise my beliefs even if these contradict those others hold. I organised a protest in year 5 because I did not want to be put in the same class as my sister (Love you Bekka) and wrote a letter to the Head Teacher at my Secondary School who I believed was forcing a friend of mine to leave the school. Even though the methods I took to vocalise my outrage could have been improved, I am proud that I was the kid who fought for both themselves and others. I obviously have failed to do this on occasions but I like to think that for the most part I do stand up for causes I believe in and will defend those I love.

3) I am creative. I have not always known where to focus my creative talent (an impromptu dance to CATS at my Primary School was perhaps not my finest moment) but I bring a creative outlook to much of what I do. When I look back to some of the lyrics and poems I wrote when I was a teenager, I am impressed with my ability to express myself and empathise with other people’s situations and feelings. The language is advanced and impressive. Even though singing has been something I was always talented at, my compositions and songs are playful and imaginative and to me, this makes them special and unique.

4) I am brave. I will often put myself forward to be the first person to do something that feels scary (presenting something, a theme ride etc) and I get huge satisfaction in both my ability to push myself to take this risk and also encourage others to do the same. 

5) I am determined. Once I am motivated to do something I am able to surpass so many limits that I could place on myself in order to reach this goal. I want to develop and so enjoy navigating my way to an outcome that I know is going to serve me and/or others.

[mentalhealthinpractice]

“Because you are fat”

N.B. I have tried to be extremely honest about my experiences in regards to mental health and my relationship with food in this post but I am aware that if you have had eating issues or are struggling with your own mental health and body image some of the content may be triggering.

The first time I remember becoming aware of my weight and body image was when, aged 10, I questioned why everyone else got to do different activities during P.E. and my friend and I had to run laps of Wandsworth Common. She said “It’s because you are fat”. I remember the shock that flooded me and the hurt that ensued. Already at this stage the word ‘fat’ was something extremely loaded and I knew I absolutely did not want to be seen as this. Many of my friends were developing much more quickly than me at this stage and there was me flat chested with braces, spotty, oily skin and yes, some additional puppy fat. 

The following year I started Secondary school at a girls private school and I really struggled to make friends, feeling so different to other children in my year group. I had never had an issue making friends before and it was a harsh reality to learn that not everyone likes me. I remember thinking that I was much uglier than other people in my class and that maybe this was part of the problem. Eventually I was adopted into a group of girls, one of whom was extremely self-conscious and who would regularly compare different body parts with me and ask the other two whose legs/nose/arms etc were the best. I often lost this game and began to notice and focus in on minor ‘faults’ I felt I had. 

About a year or two later I remember hearing about a couple of girls in my year who were throwing up in the toilets to lose weight and I thought maybe this could help me get skinner. A friend explained how she did this. I remember kneeling over the toilet, fingers down my throat, trying desperately to encourage my gag reflex to expel the contents of my stomach. About a spoonful of vomit came out and my eyes began to water. I tried again with no further ‘luck’. I tried on a couple of other occasions before deciding this method of weight loss was not going to work for me. I also read somewhere that Bulimia could cause infertility and that panicked me as even at this point in my life I knew I wanted children. I therefore decided that not eating might be more effective (without considering how this could also lead to my periods stopping). 

I became obsessed with how I looked. I began to wear make up, rushing to the toilet in between classes to put more coverup and eyeliner on. I actually wore so much but I think because I was considered a ‘good student’ and achieved academically, teachers turned a blind eye to my appearance. By year 10 I started giving other people my lunch on several days because I got this for free as part of my school bursary. Instead I would buy a chocolate bar which always was emphasised as a treat in my family but I think also gave the illusion that there wasn’t a problem because why would someone with issues around food be eating chocolate?  Ultimately a chocolate bar is going to have less calories in it than most meals and it always felt like an indulgence. I still sometimes struggle now not to compensate actual food for ‘treats’ or think that because I have had a fatty or sugary snack I should skip lunch/dinner. 

School was the easiest option for me to try and reduce the amount I ate because we always ate dinner at home as a family. I did however try on occasion to spit food out, having seen this as a suggestion on pro-ana websites. I had to look at the content for some of these recently for some Counselling training I was doing and I felt so incredibly sad thinking about the sheer hate someone has to feel for their bodies to use these sites. I had started self-harming and in one of my lowest moments cut the word ‘fat’ into my calf. I remember having one weekend being unable to leave my bed, feeling so incredibly low and with the knowledge and experience I have now, I realise I probably was experiencing depression but did not recognise it as this at the time.

When I think back to how I felt about myself during most of my school years the main feeling I remember is disgust. My eating was certainly disordered but I am not sure my behaviour fit the category of one specific eating disorder. The problem, I believe now, was how I saw myself as a whole entity.  I still ate enough to look healthy but I was miserable. I felt trapped, isolated and judged. I remember thinking I just had to ‘get through it’, to make it to the end of school then I would be okay. My self-perception did hugely improve by sixth form when my relationship with my parents began to strengthen and I began to share with them parts of my life. However I do feel a sense of loss for the amount of energy I gave to something that ultimately doesn’t define me. I wanted to hide all of who I was and indeed I did often hide in school toilets or music rooms, away from those who I thought would be ashamed to be associated with someone like me. I am frustrated at my inability then to notice the qualities I do have and so I am going to write some of these here.

[mentalhealthinpractice]

Robots in the Therapy Room

There are multiple reasons for wanting to write about my own mental health, as someone who works as a counsellor and psychotherapist. The first of these is because I feel that the warm, genuine relationship I seek to build with my clients is so markedly different to that shown in the media. I am pretty confident that the reason I was informed at the hairdressers today that I now have strands of grey is due the rage I feel when I see yet another counsellor on TV treat their clients as strange, unpredictable creatures they wish to be rid of the second the clock hand reaches 50 minutes past the hour. This alienation contrasts so deeply with my own experience of counselling and the genuine admiration and care I have for the people who place their trust in me to hold them in their deepest moments of pain.  The strength and resilience I have seen by some of the children and adults I have worked with inspires me every single day. Therapy is a parallel process and in the same way clients will often introject parts of their therapists, each therapeutic relationship I have had has challenged and shaped some part of me.

Being an external processer and not currently having my own counselling I also wanted to find an avenue to process some of my own thoughts and feelings. I used to carry a sense of shame when I felt I was not coping well or able to manage my own feelings of anger/sadness/fear, particularly once I started training. I felt that because I was helping other people manage their own complex feelings I should know how to do this for myself. I soon learnt that there are huge numbers of therapists who struggle with their own mental health. With books like ‘The Wounded Healer’ and the common (but also not completely untrue) belief that many therapists want to go into the industry because they want to find healing for themselves, it is not surprising that many clients do not receive adequate treatment. I was scared to tell my counsellor about the depression I was experiencing last year due to a fear of not being considered fit for practice. However I learnt from her and others that this is exactly what you should do when you are struggling with your own mental wellbeing - speak to someone and get support. 

As I began to think about it, I realised that I am not sure I would be able to fully trust someone who did not reveal at least some parts of themselves that is less than ‘perfect’. I remember vividly a time my counsellor got my name wrong and although I was a little hurt at the time, it normalised her. She is not a robot and can also make mistakes and have ‘off days’. I also hope that the clients I see experience my own humanity and congruence as we build a therapeutic alliance together. Whilst the sessions are theirs and the focus is on their thoughts and feelings, there is no way I can seek to build a trusting and open relationship if I am being dishonest with my own feelings or reactions as these arise. 

It is also important to differentiate which emotions belong to you and which have been transferred from clients. Many Mental Health practitioners experience vicarious trauma, where empathic exposure to extreme pain or trauma from clients can sometimes lead an individual experiencing some of this as their own. Learning self-compassion has been one of the most valuable lessons I have learnt. Oh - and creating boundaries. Now I fucking love saying no when I know something isn’t going to benefit me.  It is unbelievably liberating and my personal counselling experience helped me practice this self-love and respect until I felt safe enough to exercise it in my relationships. 

I am still so early into my practice and still have so much to learn but I thought I might start sharing some of my own experiences and bring my own struggles to the table. I won’t blog about any clients themselves but rather my reactions, thoughts and emotions to the topics that arise. I also want to describe my attempts to feel confident in my own skin, something that has been a constant challenge for me since a very young age. This lack of self-confidence still leads me to ‘spiral’ or ‘catastrophise’ and experience intense feelings of guilt or anger when I don’t reach the unrealistic expectations that I place upon myself. I want to explore this openly and hope that by sharing this often hidden part of myself, its weight will be less heavy.