I am a psychotherapist who see about 4-5 clients (individuals, couples, families) per day – with myriad of issues and problems ranging from mild to severe in various age groups, gender, and sexual orientations.

As mental health care professionals, we not only hear the sad stories, but to heal, we go deeper into the psyche of an individual, absorbing their pains and reflecting back hope. I still remember the day when I was an intern and my first cancer patient, an 8-year old girl died. Oh! How I howled and swore that I would never deal with chronic physical illnesses because I can’t handle death or the days, when I felt hopeless because despite my best intentions, my clients with alcohol or substance use issues relapsed or those initial days of practice, when most clients didn’t turn up again.

Over time, you become immune to many things. You learn to keep your emotions in check. You learn not to carry the cases home; you learn not to get affected. But still, at times, you get this case, where you don’t know what to do because none of the techniques are working; a case which conflicts with your belief systems; a cases which challenges you to change your style of therapy; a case that is so agonizing that it shakes you or a case that resonates so much with you that you struggle to keep boundaries. What about the time when you are dealing with your issues, intra or interpersonal and yet you go to your clinic with a smile on your face and give hope to your client? The time when you feel like a butter spread too thin on a slice of bread?

We struggle – with our personal biases, with our emotional turmoil and unresolved conflicts, with difficult clients, with failed therapy attempts, with legal and ethical aspects of therapy. We struggle with burnout and compassion fatigue, and yet we don’t seek help.

And if this wasn’t enough – add to it the current pandemic situation– a new illness, lockdown, social distancing, and uncertainty that has led to tremendous increase in mental health issues in almost everyone. For me personally, it has created two issues – shifting to online therapy and the usual stress that everybody is facing because of the lockdown.  

A few of you may agree with me when I say that connecting to a client face to face is way easier than when you are seeing them on a screen. The physical space that a clinic can provide with all its inspirational pictures, privacy and the “conventional tissue-box” is way more conducive for therapy than a poor connection, different lighting conditions and possibility of eves-dropping by family members.

Maybe because of my training and/or personality, I can explain things better with diagrams, flow charts and I love to give the Action-plan on a nice page that says – “Let’s make this happen”. Virtual therapy can be daunting especially in a country like India with poor internet connectivity, lack of adequate privacy at home and no ethical or legal guidelines to help you with. At a personal level, it takes time to adapt to this new mode of communication and one can naturally feel disconnected.

I often wonder, wouldn’t it make me a BAD therapist, if I am not dealing with my own issues and biases (and c’mon, anyone who tells me they are PERFECTLY STABLE ALL THE TIME – they are lying); or is it ethically justified to tell the client to feel or do something that I am not following for myself at all?

As I tried to wrap my head around these issues, I took to the internet and tried to find the prevalence of mental health issues in mental health professionals. Now there are numerous studies on compassion-fatigue and burnout, but a handful that talks about core mental health issues. The scary part is that these studies report that at least 50-80% of psychologists or psychiatrists interviewed report psychological distress, but only one out of five disclose it^1,2 and about 30-42% report suicidal ideation.³

As I look around in my circle of psychiatrists and clinical psychologists, I only know two who are seeking formal therapy because they are undergoing psychodynamic therapy training and both of them thank their stars that they did so. For others, either I don’t know because it is an often hidden fact or maybe they don’t go (including myself).  

Why do we do this? Why don’t we reach out?

• “Super-Therapist”:- Belief (own and that of others) that a mental health professional should have the necessary tool-kits to deal with every situation.

• Fear in Personal Disclosure:- Belief that a mental health professional needs to be strong and going to therapy means that they “themselves are losing it.” We fear that others including clients may judge us – “Oh! He/she can’t even deal with their own issues themselves, how will they help me.”

• Stigma attached to mental illness is internalized – we know how clients with mental health issues are often treated and we don’t want to be in the same boat. So we hide behind that comfortable blanket of secrecy wishing that no-one would notice.

• Unsupportive Mental Health Fraternity – Even our own fraternity looks down upon us if you seek psychotherapy. How many of you have gone to your senior? Mentor? Or teacher with mental health issues and they have warded you off, calling you a sissy and not suggesting therapy. I confess that I have committed the same transgression when I would the younger generation saying –“oh! These guys are just too over-sensitive. How will they make a good therapist”.

• “I-know-it-all”– Most doctors make bad patients and most psychologists would make bad clients – we know the skills. Who can do it better than us? We judge the therapist and their style? We don’t know whom we can trust and respect enough to go for therapy.

• Lack of Resources: Maybe not in Urban areas, but definitely in smaller town, there are hardly any qualified professionals you can turn to.

• “I am too senior”:- if you become a senior psychologist and most professionals around you are your colleagues or juniors. So whom do you go to?

What’s the Way Forward?

It’s not going to be easy to break out of these belief systems and cross the barriers, but I would like to say a few things to the budding mental health professionals:

• “Healthy mother, healthy baby”: Similarly, a sound and stable therapist will be able to provide that cocoon to the clients where they can delve deep into their issues and develop into healthy beings. Being in therapy yourself helps in two ways – One, you learn to help yourself, and recognize any therapy-interfering beliefs and behaviours. Second, when you make yourself vulnerable in front of someone, it helps you in developing empathy for the client who is doing the same in front of you.

• It’s scary, but if we don’t break stigma around mental illness, no one else will. Do you remember that story from Mahatma Gandhi’s life when he couldn’t ask a young boy to stop eating jaggery as he himself used to eat it. So if you have certain emotional or psychological issues – reach out for help.

• “Respect Thy Neighbours” – As a fraternity, we need to respect someone’s decision to seek therapy without being judgmental. When a colleague comes to you with an emotional turmoil, do not just suggest recreational activities, connecting with friends and families and taking some time-off – suggest psychotherapy, if required. Do not be afraid to do so because you fear they would get defensive. They very well might and you need to make them understand your rationale.

• You do “know-it-all”, but still a surgeon will never operate on him/her self. Self-therapy still hasn’t been proven to be the most effective method especially if the mental health issues are beyond mild. Use your knowledge to your advantage and let another trained therapist guide you in implementing it.

• Lack of resources can be a downer – but we are in the 21^st century – maybe give the mental health apps a try or seek a psychotherapist who will do virtual therapy (which I believe majority would be doing now).

• Support from the Fraternity: can be in the form of making therapy mandatory for all students aspiring to be become a mental health professional.

Remember, its OK to ask for help and it’s OK to be vulnerable – that’s what makes us humane. I am ready to fight my apprehensions, inhibitions and curb my judgments. ARE YOU?

PS: Please feel free to leave any comments and feedback - can be an addition, concern, query, disagreement.