Our mental health affects how we think, act and feel. Stress at work, problems with your relationships, or conditions like depression, anxiety or even eating disorders, can affect your mental health negatively.
According to a Singapore Mental Health Study in 2016, one in seven people in Singapore has experienced a mood, anxiety or alcohol use disorder in their lifetime.
And with Covid-19 upon us these past couple of years, even more people are seeking help for their mental health. A 2021 study by the Institute of Mental Health (IMH) showed that about 13 per cent of over 1,000 participants had reported symptoms of anxiety or depression during the pandemic. More than 80 per cent of these were willing to seek professional help for mental health issues relating to the virus.
While counselling and therapy can help patients work through many of these issues, what about the mental wellness of the person at the other side of the couch?
Therapists, counsellors, psychologists and other mental healthcare professionals are not immune to heavy emotions. In fact, psychologist Carl Jung once coined the term “wounded healer”, claiming how therapists’ ability to help others often comes from their own experience of woundedness and healing.
When it takes a toll
Working with people who are grieving, traumatised, in pain or feeling suicidal can take a toll and cause emotional fatigue in mental healthcare professionals.
Jung refers to what he calls “psychic poisoning” – where he recognises that psychologists and therapists are at higher risk of mental stress and fatigue, as they could be “infected” with their patient’s struggles.
Therapists and counsellors agree that the nature of the job is such that it can take a toll on their own mental health.
Ms Christabelle Ilankovan, a senior clinical executive at Silver Ribbon (Singapore), says that when she first started at her job, she found it difficult to draw the line and not take work home with her. “I ended up thinking about clients and being worried for them, even when I was at home.”
For Mr Shawn Lai, a senior counsellor at Samaritans of Singapore (SOS), the toughest part of his job is when he is supporting someone in an active crisis, “where my clients were either on the ledge, or had clearly expressed to me their desire to end their lives after our session”.
“Just being able to hold them emotionally and de-escalate the crisis takes a toll at times – both mentally and emotionally,” he says.
If the therapist does not have adequate support, there is the risk of emotional burnout. Mr Lai says, “I’ve met senior workers who don’t pay as much attention to their own care, and they either burn out or even start to inflict harm on their clients unknowingly due to their unresolved issues.”
On the other side of the couch
So, can therapists be patients themselves and how does being on the other side of the couch help them?
Mr Lai, for one, is a firm believer that every therapist needs a therapist. Only then can they continue working towards being the best version of themselves for the clients they serve. He says that seeing another therapist has enabled him to be more aware of his own pitfalls and struggles. “Going for sessions feels like I’m looking in a mirror, and it helps me see the not so good things that still need to be worked on.”
Other benefits that therapists can reap from seeking professional help themselves include:
1) Preventing burnout and fatigue
A 2016 study by Antioch University found that psychologists are prone to exhibiting burnout and compassion fatigue. This refers to the physical, emotional, and psychological impact of helping others – commonly found among professionals who work in a healing or helping capacity. If not handled appropriately, the high levels of distress could impair them from doing their jobs effectively. Ms Ilankovan says, “Not dealing with the stress and letting it snowball allows it to affect our ability to help others and make us feel unconfident in our work, which makes things worse.”
When it all gets too much, it helps to have a safe space to talk and share one’s feelings without being judged. By going for therapy, it also helps one realise that he is not alone. Says Ms Lucia Chow, a senior social worker with TOUCH Mental Wellness, “Our job is to understand and empathise with others. However, we are human, too. We must learn to seek help so that we are not alone in this journey – it is one of the ways we can regulate our emotions and maintain a positive state of wellbeing.”
2) Raising self-awareness
The Antioch University study also found that approximately 43 per cent of psychologists struggle to see any mental illness and psychological distress present within themselves. In doing therapy, one is often made to look at one’s own blind spots, which can be difficult. “Talking to a third party can help because it helps you to see things from a different point of view, especially for things we are unable to see ourselves. It helps us rationalise our emotions and keeps us grounded,” says Ms Ilankovan.
Mr Lai cites the example of himself seeing his own therapist, who brought up a pattern he noticed over time – that Mr Lai is someone who is easily discouraged by situations or circumstances beyond his control. “This brought about more awareness for myself when facing discouragement and helped me learn to react better in these situations,” he says.
3) Being able to emotionally distance oneself
Many counsellors and therapists find it hard not to take their work home – bringing the struggles of their clients with them, even after office hours. Mr Lai says that it’s important to reflect on the impact of client relationships on themselves as therapists. Sometimes clients can affect them more severely. “We may start to dread sessions with a particular client, or we may even develop physical symptoms such as heart palpitations when we notice the client is on our counselling list that day.” These, he says, are possible signs that the boundaries with clients are clearly drawn.
Mr Lai adds that in these cases, there may be issues in the lives of the therapists themselves that are left unresolved and the clients serve as a painful reminder. “It is thus essential that such issues be surfaced to our own clinical supervisor for processing, and to ensure that they can better support us as we work with these clients,” he says.
4) De-stigmatising therapy
While one in seven people in Singapore have experienced a mood, anxiety or alcohol use disorder, more than three-quarters do not seek any professional help. When patients learn that their own counsellors and therapists go for therapy too, it normalises it.
Care for the caregiver
It is important for therapists to find their own way to relieve stress or get rid of negativity. Besides therapy, this could also come in the form of self-care or a support system.
For instance, Mr Lai makes it a point to go out on dates with his wife or bring his children to the playground as a way to emotionally recharge. “I am blessed to have supportive family members, friends and colleagues that I can talk to whenever I need the space to vent, or am looking for emotional support,” he says. He also practises silence and solitude as a way to recharge.
Ms Chow, too, stresses the importance of self-care “by treating myself to a good meal”. She also speaks to her colleagues and supervisors who can help her process her emotions and thoughts.
Most mental healthcare organisations and counselling centres are equipped to support their employees and volunteers emotionally. TOUCH Mental Wellness provides free counselling for all its staff through its Employee Assistance Programme, and Silver Ribbon has weekly meetings to allow staff to check in on each other. Time-off is also encouraged if the staff needs to take a break for their mental wellness – and return only when they are in a good space.
SOS too, provides benefits and avenues for its employees and volunteers to be able to recharge. These include a therapy time off benefit to attend heavily-subsidised therapy sessions, and an internally run support group for clinical staff.
As Mr Lai puts it, “you are only able to give as much as you have received”.
“If we feel that we are running on empty, then there would be nothing left to give the clients that we serve,” he adds.