“Can I be a therapist if I have had my own personal history of mental health difficulties? Is it ok for a therapist to have had their own therapist? Can a mental health provider be effective while in recovery from their own lived experience with a mental health problem?”
Yes! Absolutely! Yes!
The Short Version
There are many complex questions I struggle to answer in career advising, but this topic is actually relatively easy, at least on the surface. Mental health professionals are humans. Therefore, just like anyone else, they are not exempt from having their own mental health difficulties. It is normal, common, and perhaps even desirable for a therapist to seek their own therapy. So, yes, it is totally acceptable for someone with their own personal history of mental health issues and/or treatment to pursue a career in the mental health helping professions. It is ok, really!
Lingo to Know
One relevant term to know here is “personal therapy,” which is the phrase often used to describe psychotherapy/counseling for therapists (i.e., it is therapy for their own personal wellbeing rather than for any other training purpose or another person). Another relevant term is “lived experience,” which is the phrase often used to describe mental health difficulties or stressors/traumas experienced by the therapist (i.e., issues they themselves have lived through rather than studied as an outsider). When reading in this area of the field, you will likely see both terms used frequently. And on this page, I am arguing wholeheartedly that it is alright for therapists to have both their own personal therapy and their own lived experience!
Analogies to Consider
There are some human services which simply cannot be provided to oneself without the risk of bias, blind spots, mistakes, or other practical problems in the care delivery. Many licensed professionals including physicians, lawyers, dentists, nurses, cosmetologists, and others need to go see a fellow provider in their field in order to receive relevant services. Mental health care is no different. Sure, being a therapist probably means that one knows more about the inner workings of the mind than the average person, and that could equip them to engage in more effective introspection, reflection, and self-care than the average person… but none of that means professional psychotherapy/counseling provided by another person is unnecessary. A therapist should be no more expected to treat their own mind than a surgeon should be expected to operate upon their own body.
More Details to Ponder
1) Can I Handle This?
To unpack all this a bit further, there are a few things worth mentioning. First, I am heartened when I hear questions like those above because I believe it means that the aspiring therapist is in touch with their inner experience and really cares about being able to conduct ethical and effective treatment. And in this way, it’s not so much about the optics of a therapist having their own therapist (which some might assume looks bad, but I beg to differ), rather, it’s a question of whether one can withstand the intense emotional work of therapy despite experiencing their own mental pains. In other words, if I have struggled with anxiety, depression, addiction, trauma, etc., will I be able to tolerate dealing with it so directly in others? This is where some nuance comes in, and the aspiring therapist needs to reflect upon their goals and experiences. Perhaps it will be important to avoid certain specialties or patient populations if they will rub too closely to one’s own mental wounds, or maybe it will work out just fine so long as the therapist seeks good consultation. It all depends. Know thyself!
2) What Does It All Mean?
Questions about the role of lived experience invoke a complex set of issues related to the meanings of such concepts as “mental health” and “therapy.” Concisely, if one believes that mental health is simply the absence of disorder, and that therapy is a didactic teaching endeavor aimed at alleviating disordered symptoms, then perhaps it would indeed be problematic for a therapist to need therapy because it would imply that they are not ‘well’ enough to work. In the same way, a sick physician should stay home until recovered so as to not risk infecting their patients. However, I would argue that these are flawed definitions and significant misunderstandings. Instead, I would assert a definition of mental health which is deeper and involves both symptoms and strengths, and I would encourage a definition of therapy which is relational and explorative. In that sense, all parties in the therapy have their own unique mental health status in the same way that they have bodies and minds. As psychologist Jonathan Shedler puts it in this article, psychotherapy for psychotherapists is “essential to deepen understanding of mental life and avoid playing out the therapist’s own emotional issues with patients.” Similarly, psychologist Nancy McWilliams has been transparent in her writing about the importance of therapists’ own personal therapy.
3) Empathy and Assumption
We should also consider the meaning of “empathy.” Some people (wrongly, I would argue) understand empathy to be a process by which the therapist has experienced a certain life event before, and therefore ‘knows’ how to advise a client in similar situations. In this framing, the therapist’s lived experience of any mental health difficulty comes with pros and cons. On the one hand, such experiences could hypothetically enable the therapist to more accurately envision the patient’s life and provide guidance; but on the other, the therapist’s mental health struggles mean that input could be coming from an unwell place and is thus problematic. In this framing, some have even argued that a therapist must (or must not) share certain characteristics with the client in order to be an effective provider (e.g., to treat veterans one must have also served in the military; to treat parents, one must have had their own children; to treat addiction, one must have had their own substance abuse history). I reject this understanding of empathy, and I believe most other seasoned therapists would agree with me. Instead, to empathize is to feel with the other person, to work toward a mutual understanding and shared conceptualization, and to communicate it together, all while acknowledging that it is an ongoing imperfect endeavor. To empathize is not to assume, but to explore. And in this way, a therapist’s own history of mental health difficulties is neither a distinct asset nor a definitive problem in the therapy, but rather an aspect of their humanity to be aware of alongside many other considerations. Indeed numerous studies on the topic of personal therapy (e.g., see here and here) have concluded that many mental health professionals seek their own treatment, they benefit personally from it, and they use those insights to perform better in their work with others.
4) Why Do This?
People are often drawn to careers in the mental health helping professions not despite their own mental health experiences, but because of them. We ourselves have suffered in various ways or yearned to understand ourselves more deeply, or we saw the challenges faced by our family and friends, and felt a calling to make a difference. When students are asked why they wish to pursue careers in therapy, many begin their response with a focus on the allure of helping, but further exploration can often unveil why it is so important for their psyche to pursue the role of helper. Perhaps it comes from family pressures to be the “fixer,” an altruistic desire to “give back” following one’s own need for treatment, or even a defensive tactic aimed at protecting one’s self-esteem. Exact causes for this vocational path vary of course, but most involve personal history. From this, we can conclude two key things: 1) It is perfectly normal for therapists to have lived experience, as it is probably why they became therapists in the first place. 2) It is important for professional helpers to engage in thorough self-examination and reflection to avoid projecting their issues and patterns onto those they serve, and personal therapy is well-suited to help mitigate that risk.
How to Proceed
If you are a therapist (or aspiring therapist) who is (or was previously) struggling with mental illness, addiction, stress, trauma, and any other mental health concern, it is important to know that you are not alone and that your input is important to this profession. Your struggles do not render you ineligible to pursue this career, however they should also be carefully considered to ensure you can do this work while getting well and remaining well. I would recommend being picky and shopping around thoroughly when it comes to both professional supervision as well as your own personal therapy. How to choose? I will cite Jonathan Shedler again, as he offers some recommendations here including that your therapist is focused on you (i.e., rather than your diagnosis), thinks with you about what is wrong collaboratively (i.e., rather than pushing their own formulation), and is relatively professionally humble (i.e., rather than claiming many diverse areas of expertise). If the first session ends with your feeling of connection and a mutually shared understanding of the purposes/processes of the therapy to be conducted, then perhaps you are off to a good start. And for those specifically with history of difficulties with substance use, they may benefit from exploring some additional materials organized in this blog post on resume-building while in recovery. For college students with mental health issues more broadly speaking, this webpage may offer some useful resources.
Note of Encouragement
I started this page with the proclamation that it is indeed ‘ok’ to be a therapist with a history of lived experience and personal therapy. We started simple, and then explored somewhat more complex considerations. Well, I would like to end this page on a note that is both returning to simplicity and offering some transparency and positivity. I am pleased to report that while writing this page, I myself am a psychologist who is actively seeing another psychologist for my own personal therapy. Now, and at multiple prior points in my life, I benefit from mental health care. And I am simultaneously an effective professional in my own practice serving others. Do not let your own difficulties and need for treatment deter you from pursuing the helping professions if this is where you see yourself engaging in meaningful work. We are all human and more alike than otherwise!
MI Mental Health Helping Professions 