Healing Healers: Psychiatrists with Lived Experience of Mental Illness
Although most people may expect that psychiatrists must have perfect mental health in order to treat their patients, having a lived experience with mental illness may in fact be an asset. Psychiatrists who have struggled with their own mental health challenges or have faced significant personal adversity may have a deeper understanding of the patient experience, leading to greater insight, compassion, patience, and connection with patients. Lived experience can be seen as a gift which may positively impact the ability to treat patients, contributing to improved therapeutic outcomes.
Increased Compassion and Patience
Several studies have found that medical trainees experience declines in empathy as they progress through their education. This may especially be the case as the “us vs. them” mentality develops through training, when students are taught to practice defensive medicine, ie. protecting themselves against the risk of being sued or receiving a formal complaint, which can lead to compassionless choices. Furthermore, psychiatrists express explicitly negative attitudes toward people with mental illness, which contributes to reduced compassion and patience. Compassion fatigue is, in general, high within medicine.
Psychiatrists who have faced adversity or mental illness themselves may exhibit increased compassion. Rather than judging patients who are more challenging to treat, they understand that recovery is not a linear process and that setbacks are part of the journey. This perspective can help them provide ongoing support and encouragement to their patients, even during difficult times. They often exhibit greater patience and determination in treatment, exploring various recovery approaches, particularly influenced by their own experiences of impatient abandonment in care. This perseverance can foster a non-judgmental, supportive therapeutic environment, where patients feel safe to express themselves and work through their troubles without fear of criticism or rejection, enhancing therapeutic rapport and improving treatment outcomes even after setbacks.
Deeper Understanding of Mental Health Challenges
Patients sometimes seem to perceive that psychiatrists are wealthy, happy, and perfect, which can lead to envious resentment and a sense of, “You have no idea what it’s like to have a hard life.” Psychiatrists who have struggled with mental illness or personal adversities are able to overcome this barrier with empathetic self-disclosure when appropriate. Self-disclosure needs to be done carefully so that the patient does not feel that the psychiatrist is oversharing and reversing the roles. When done right, self-disclosure may enhance therapeutic rapport, leading to feelings of solidarity and acceptance, which in turn promotes open and honest communication, collaboration, and mutual respect. Patients who feel that their psychiatrist truly understands them from firsthand experience are more likely to trust their provider, engage in treatment, and follow recommendations such as proposed coping strategies. This shared experience can inspire hope, showcasing the possibility of recovery and resilience, with the psychiatrist serving as a role model for patients. Psychiatrists with lived experience may also be better equipped to recognize and intervene in subtle signs suggestive of suicide plans or illness relapse, and may have unique insights that enhance interpretation of “bad behaviour”, enabling them to address root causes rather than superficially treating symptoms.
Empathy and Connection with Patients
One of the most significant advantages psychiatrists who have experienced mental illness bring to their practice is a heightened ability to empathize and connect with their patients. Firsthand experience of the complexities of adversity enables psychiatrists to relate to patients on a personal level, understanding their emotional and psychological challenges, with associated barriers.
For example, the double empathy problem is a common difficulty faced by neurodivergent individuals, where they are repeatedly misunderstood by people who are neurotypical, and this can make the mental health system particularly frustrating. Psychiatrists who are themselves neurodivergent are therefore well prepared to treat these exceptionally marginalized patients, as such psychiatrists may be the only ones who can understand neurodivergent patients despite even the triple empathy problem that limits other treatment providers. A neurodiverse population requires a neurodiverse workforce.
People with a trauma history are particularly well-poised to become psychiatrists. Around 90% of patients with severe mental illness have a trauma history, so psychiatry ought to be a trauma-informed discipline. Unfortunately, a typical psychiatry resident is lucky to receive a handful of trauma-specific formal academic lectures by the end of a 5-year postgraduate training. The day-to-day clinical role modeling by typical psychiatrists is also not particularly empathetic, as many psychiatrists have explicitly negative attitudes toward people with mental illness. Decisions and offensive comments made by psychiatrists both toward patients and behind their backs can repeatedly fail to be trauma-sensitive, placing the patient’s wellbeing and outcomes at risk. Individuals with a trauma history are more attuned to insensitivities that others might overlook, such as the phrase “what you resist, persists,” which can seem innocuous to those without a trauma history. Many mental health professionals with personal trauma histories are drawn to specialize in trauma care, finding meaning in their own experiences through helping others.
Enhanced Advocacy and Reducing Stigma
Psychiatrists who have experienced mental illness may be more attuned to the stigma and societal barriers that their patients encounter. Their firsthand experiences with healthcare system-induced trauma can motivate them to advocate for their patients. They strive to dismantle misconceptions and combat stigmas, creating a more inclusive and supportive environment. Efforts by these psychiatrists not only improve patient care, but also influence broader healthcare policies, contributing to a more equitable mental health system.
Conclusion
Psychiatrists who have struggled with mental illness or faced personal adversity bring a unique set of skills and insights to their practice that can lead to better outcomes in treating patients. Their compassion, patience, empathy, deeper understanding of mental health issues, and advocacy efforts all contribute to their ability to provide comprehensive and effective care. Psychiatrists who have faced adversity can provide valuable strengths and perspectives that enhance their practice. As the field of psychiatry continues to evolve, recognizing and valuing these unique contributions can lead to improved patient care and a more compassionate and supportive mental health care system that honors the healing power of shared humanity.
