What to Do When You’re Already Supposed to Know What to Do

By Meghan E. Wood, M.S.

When people openly discuss mental health their first piece of advice is usually to seek out professional help. Whether that’s through a psychiatrist, a counselor, or a psychologist, the consensus is that professional help is the best way to treat mental illness.  However, what happens when you’re the one struggling with mental health and you’re also the professional?  

As someone who has struggled with depression and panic disorder for most of my life, this has often been an internal struggle I face whenever I am at my lowest points.  I’m a “mental health professional” with years of training, and why can’t I fix myself? Why do I still struggle on a daily basis with listening to the psychoeducation I give clients about loving themselves and living authentically?  And it’s never enough that I’m my own worst critic, but in addition friends and family members who want to help question why I can’t just “get over it” or try deep breathing. Suffice it to say, all of this usually combines to create the perfect storm of overwhelming self-doubt that doesn’t usually cure my depression or panic disorder despite how I wish it did. 

How then do we as mental health professionals cope with our own mental health struggles?  In typical therapy fashion, I don’t know if I have all the answers. Personally, I try to remind myself that I’m not alone. I read blogs like this one or seek out resources in the form of videos, TEDTalks, or other narratives in which people who are going through the same struggles as I am tell their stories. This personal research helps me to see that I am not the first nor the last person to struggle and it often provides me with ideas for reframing my situation or asking for help. Furthermore, I have two or three deeply trusted friends who are also mental health professionals that I often feel safe and comfortable reaching out to and sharing what I’m going through. They never meet me with shame or criticism and for that, I have been so grateful. 

Overall, I think the thing that has helped me most in my times of struggle is the process of making meaning out of suffering.  While it’s not a novel concept, it’s one that I struggle with constantly. I heard it best explained by a former supervisor who purported that suffering leads us to growth, which leads us to new and better opportunities than we had previously been exposed to.  This has certainly been the case for me. Each time I have suffered and sought help, I have come away with new knowledge and insight about how I want to contribute to the society around me at large and what that means for me and my life. While this is not an Earth shattering revelation, it bears repeating that without challenge and suffering and turmoil we would cease to grow as people; and while there is something to be said for contentment, the opportunity to come into a new consciousness as a result of overcoming challenges is also exhilarating. 

Fyodor Dostoyevsky said it best in Crime and Punishment when he wrote, “Pain and suffering are always inevitable for a large intelligence and a deep heart. The really great men must, I think, have great sadness on Earth.” To become great often requires trials and tribulations, but that does not mean we have to go it alone. Reach out, seek help, and above all know that (despite your status as a mental health professional) you are not immune to the same affliction of human suffering that we all experience. Take comfort in your humanity. In fact, it just might be the thing that makes you best suited for this profession above all others.

Defenses and the Anxieties They Protect

by Sean Blackburn

I look at the clock. Ten minutes left in session. “Oh my gosh”, I think to myself, “how am I going to get through these next ten minutes”?

The man sitting across from me is in the middle of telling me how awesome he is. He wants me to know the square footage of his house, the kind of cars that he and his family drive, how much money he makes, and how much he thrives at work. Any comment from my side is instantly countered with another story meant to communicate to me how great he is.

I can’t get through to this guy. “Why is he so fixated on me knowing these things about him”, I ask myself.

At this moment I think back to my training as a clinician. “Don’t try to get to know the defense.” I remind myself. “Try to understand the anxiety that the defense is guarding”.

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We do funny things when we feel psychological pain. In order to avoid acknowledging the reality of our hurt, the unconscious part of the mind comes up with a myriad of ways to feel safe during that pain. Psychologists refer to these attempts as mechanisms of defense.

The man sitting across from me, whether he is aware of it or not, is enacting the defense mechanism known as grandiosity. He needs me to think of him in a larger-than-life way in order to feel safe in the room.

Like the magician who uses distraction to get the audience to look at something flashy in his left hand so that they don’t notice what his right hand is doing to set up his trick, we all  are capable of using the same levels of misdirection in relationships to keep people from seeing what we don’t want them to see: our pain, fear, anxiety. The problem with this use of misdirection is that it prevents authentic connection with others; the authentic self is being hidden rather than being seen, loved, and accepted. 

In this moment I have a choice: join with him in how he wants me to see him—at which point I risk strengthening the defenses he has in place that helps him avoid his anxiety—or stay mindful of the possibility that he’s actually feeling the opposite of what he’s showing me: scared, insecure, small.

I choose the latter. Reminding myself of the fear he might be feeling in the room helps me to stay grounded during his need to be admired. It allows me to stay curious about his authentic self and to find levels of compassion and love for what might have created that anxiety in the first place.

In the end, my goal is to find a way to communicate to his anxiety that it’s safe to be known, that I don’t judge it or the defenses that he uses to keep them safe. If I’m able to do this change becomes possible for him. Challenge accepted!

A Constant Comrade

by Jeremy Cooper

“The Sound of Silence”, by Disturbed, leads many to ponder what they have just listened to. Take a listen to the song and perhaps read along with the lyrics.

Follow me on a thought journey through the song…

Think through darkness and think through it being an old friend. In simply thinking of darkness, I imagine much more of yourself became involved than simply the idea. Darkness invokes a deep place in our being, a place of depth that is often laden with cobwebs.

Explore the felt sense of darkness and be mindful of the voice that tells you to hold back. Imagine for a moment that this song could speak of just you. There is a resistance to think that any part of us would want to hold back, change course, or want to abandon ship. That very phrase “burn the ship” invokes this notion that whatever we are about to do, there is no turning back; a point of no return. And yet, we often feel an inner struggle between who we say we are and what we are accomplishing.

Perhaps what we are hesitant to touch is what lies in that darkness. It’s as if you are shouting for someone to hear you, and no one can. You try to speak out to whomever will listen, to come near you and show compassion, but instead it stays inside and eats away at you. Perhaps this song was meant to speak for society, for our close dear ones, or perhaps it speaks to what we are not willing to acknowledge.

Go back to your old friend -- how could they be your old friend? How could a space that holds so much fear, anger, shame, guilt, worry, and disappointment be dear to you? To call darkness an old friend is entirely paradoxical. In fact, go survey a crowd of people and watch their reactions when you mention this song. We have a drive that prevents us from acknowledging that darkness. Be curious about what motivates you to push past the darkness. All these things are worth noting and worth exploring.

There is not a place within you that is just a void, a black hole. Each space within you is a place of meaning and substance, a place that can turn to motivation. Perhaps darkness is more of a comrade than a friend -- someone who has joined alongside you through the journey. Now you must recognize the comrade that has been there all along.

In her book Entering Night Country: Psychoanalytic Reflections on Loss and Resilience, Stephanie Brody explores what it is like to tread into that darkness. The night country, as she calls it, is the liminal. The liminality is a “transitional space”, a space between space and time through which, by means of the therapeutic relationship, two entities can cross through a boundary that is both of ourselves inwardly, and new to our awareness. In this liminality we gain the opportunity to suspend preconceived notions, space, time, expectations, and journey back in time while also holding on to our awareness. It is the innate ability to listen and hear all the “contradictory realities” and turn it into a coherent sense of self. To feel as if you were many, yet still one self. This process, how ritual-esque, sheds light on our own capacity to go to and from our different experiences and metabolize them into one singular experience. 

So, when those moments come to you in the fright of night, in the quiet whisper behind you, or when you feel it inside you, I urge you to ponder curiously. Invoke the courage to wonder more about that voice. This is a journey for self, but it does not to have to be by yourself. Find others that can go with you as you journey toward what might be in the darkness.

Many Rooms

Therapy…what’s it about? What goes on behind those closed doors? What goes on in the minds of those therapists, or their patients? Many questions and fewer answers. This blog is an experiment that will explore those questions, and more. Each week we’ll have a new post from someone on the Richland Oaks team that will give us a peak behind those closed doors (all sensitive information will be kept confidential of course). We hope you find the conversations here interesting, challenging, encouraging, and stimulating - we’d love to hear from you in the comments section.