Diagnosed with a mental health issues 15 years ago, first with bipolar and finally with schizoaffective disorder of the bipolar type, I’ve been in therapy off and on for that same amount of time. I’ve cycled through many therapists, some with a great grasp of what it’s like to have a mental illness, and others who didn’t have a clue. Therapists go to school for years, but how can anyone possibly understand mental illness without actually having a mental illness? Isn’t that like learning to swim without any water?
As someone in therapy, I’ve always wanted to say these things to therapists in order to help them understand me, and to let them know how I feel about them:
1. You’ve Experienced a Lot of What I’ve Experienced
Everyone has good days and bad days; everyone gets manic, depressed, or paranoid at times. I didn’t always have a mental illness; it was first brought on by drug use and the stress of 9/11, so I know that even before the initial onset of my mental health issues, I still experienced emotional shifts. We all get in a good mood when we get a raise, or depressed when a family member dies, and sometimes we’re paranoid that someone doesn’t like us. Take those experiences and use them to understand my mental illness, realizing that those with mental health issues experience these same emotions—except that theirs often come without reason, or for irrational reasons.
2. I Want Your Guidance, Not Your Advice
In his article The Best Advice a Therapist Could Get? Stop Giving Advice, Justin Lioi, LCSW discusses the importance of not giving advice to people in therapy. As a client I can tell you that most of the time I want therapists to just come out and tell me what to do, and a lot of other people want the same; however, as a therapist you don’t always know the full story—only what we want to tell you. So it’s best to leave direct advice up to close friends and family of the person in therapy. That being said, I consider the ability to provide guidance a key element for a great therapist. Guidance isn’t about giving answers; it’s about guiding people to come up with their own answers. Just asking questions is often enough to help us see things from a different perspective, and to come to our own conclusions.
3. I’m Human. You Should Be, Too
There’s nothing worse than talking to a therapist who doesn’t seem to care: their answers are halfhearted; they seem disinterested; and half the time it feels like I should be giving them advice. Mental Health Workers May Not Recognize Their Own Burnout, by Zawn Villines, explores the emotional and mental exhaustion health workers face as a result of their jobs. I imagine it’s not easy listening to other people’s problems, which can weigh heavy on the heart and mind and can wear on a therapist or cause compassion fatigue.
You need to understand that no matter how hard you try to cover up your burnout, it carries over into your work. People see it during their therapy sessions, and it affects them. Therapists have important jobs, and I know from first-hand experience that they can change lives. You’re as human as I am, and despite the pride that may come with being a mental health worker, sometimes you may need to work on improving your own mental well-being, too.
4. I Want to Get to Know You
I’m not really sure what therapists are taught in school about maintaining distance between themselves and their clients, but I don’t want therapy to feel like a one-sided relationship. Sometimes I feel a little selfish talking about myself for 45 minutes straight, and it’d be great to hear a little about your life to break up the monotony of my own voice. It doesn’t have to be personal—just a little back and forth that feels like a real conversation. If I know you, I can more easily trust you, and trust is the foundation to successful therapy.
5. You’re the Expert, but I’m the One with First-Hand Experience
As discussed in Justin Lioi’s article, empowering people is important during therapy sessions. Because I’ve been through a lot—that’s why I’m seeing you—I want to feel like I can teach you something, and I want to get the impression that you’re eager to learn from and about me. Simple questions about how my experiences felt give me a sense of knowing something you don’t, and that helps me open up and also helps build our relationship.
6. This Stuff’s Embarrassing … and Kind of Funny
When I started going to therapy I was mortified to talk about the things I thought when I was depressed and the things I’d done when I was manic. After all, who wants to admit that they were once certain they were the Son of God, and also the devil, and also the reincarnation of Jim Morrison, and also a rat? Not me! The thing is, though, with a little perspective these things are actually kind of funny. If I genuinely laugh at them, don’t be scared to break a smile (but don’t ROFL!); that confirms that these memories are harmless and not really that serious in the long run.
7. We Can Get Through This
Over the years my therapists and I have been through a lot: depression, mania, anxiety, suicidal thoughts, confusion, anger, hopelessness, etc. While at times our sessions seemed like nothing more than spinning car wheels in mud, over time I learned the coping mechanisms needed to manage my mental illness, thanks to the help of my therapists. Once despondent, depressed, feeling hopeless after three manic episodes resulting in hospitalizations, and living at my parents’ house at the age of 30, I now own two businesses, manage over a dozen people, and have written numerous books. It may take time, but we can get through this.
GH Francis is the author of Icarus Redeemed: A Schizoaffective Story, a memoir about his experiences with schizoaffective disorder of the bipolar type. Diagnosed over 15 years ago, he has spent years learning to manage his mental health issues, and gladly shares those management skills with those who are also experiencing mental illness in some capacity.
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