The issue of self disclosure in mental health setting is a controversial one and one to which I have given much thought. As I have blogged about previously I am a mental health professional who has lived experience of mental illness and the stigma which comes along with that.
It is only recently that I have been truly open with colleagues about my history of mental illness, I always waited until near the end of my placement and if it came up in conversation once I knew they had formed a positive opinion of my professional capabilities then I would share it. I now feel confident to share this at a far earlier stage and I think that comes from a confidence in my own abilities which has developed over the past three years.
I didn’t think I was anywhere near ready to share my experiences in a therapeutic way with service users though, that seemed like something which only really experienced practitioners could possibly do.
Last week during a 1:1 therapy session with a service user I was asked directly by her if I had ever experienced depression and it felt comfortable to answer to be honest. I could have deflected the question by saying ‘we are here to talk about you’ or some other evasive pleasantry but at that moment I felt that what this service user needed more than anything was hope. Depression is a thief, it steals so much from a person in its grips but worst of all it steals hope. Upon reflection I would do the same again in that situation, I felt that it gave her some comfort. I would have been unlikely to bring it up myself but given that I was asked outright I’m glad I chose not to lie or deflect. Maybe my disclosure allowed her to believe that recovery is a reality for her? or maybe not but it has that potential and that’s enough for me.
When I was in hospital in the midst of a severe depressive episode and without hope a nurse held my hand, looked me in the eye and assured me she ‘understood’, that moment was pivotal in my recovery as she was living proof that recovery exists, that the often talked about light at the end of the tunnel is definitely not a train.
Disclosure should of course, without exception, be to serve the needs of the service user and not the clinician. Of course it is important to retain professional boundaries and I would never put these in jeopardy as it is vital to ensure that the service user has their personal experience validated and does not end up feeling that they must provide care for the clinician, a wounded healer is not a good one if they allow their service user to feel this way.
I had a situation like this when I sought counselling outside the NHS to address my experiences of childhood trauma and the therapist openly cried as I described my experiences, after three weeks of caring for her I decided not to return to see her. Whilst I have no issue with professionals showing emotion it shows they are human after all this situation left me with the overbearing pressure of not being fully open for a long time for fear of causing distress even though my distress ought to have been where I concentrated my energies at that time. I would hope I would never leave someone I am supporting feeling that way. Obviously self disclosure requires careful timing and consideration of the situation and the individual.
So often silence around mental illness is related to stigma whether this is self imposed or indeed imposed by individuals or even society as a whole so by openly speaking about ones experiences that stigma is being challenged with each sentence uttered. I feel like I have developed that little bit more this week as a clinician using my lived experience as a therapeutic tool however as I explained earlier in this post I would only ever do this to serve the needs of the service user and not the clinician.
What do others think? Has a professional ever disclosed their own experiences of mental illness to you? or are you a mental health professional who uses self disclosure as a way to support others?