Recently, a patient came to session struggling more than usual. Depression had settled in on top of her Obsessive-Compulsive Disorder (OCD), which is not at all uncommon. It just happened on the heels of the deaths by suicide of Kate Spade and Anthony Bourdain, and it sparked her to act.
“I can understand how someone could do it,” she told me. “I can understand what it’s like to have it seem like it just doesn’t matter if you are here anymore.”
She went on to talk about what she felt like at the present time, and then it happened. Maybe I nodded with too much agreement. Maybe I empathized in such a way that sparked the recognition.
“You, too?” she asked.
“I once spent two weeks in bed. Only got out to do the essentials.”
It just seemed to spill out of me, my admission that I, too, have struggled at times with major depression. I didn’t share it for her sympathy or to make me feel better. It just seemed like the right moment to say, “Hey, you’re not alone, and this beast can be bested.”
“I’m sorry,” she said.
“It was before I knew much about how to deal with depression. I’ve learned a lot since then.” And then we had an in depth conversation about how to deal with her depression.
Sharing Personal Information
There’s a bit of a rule in the world of mental health professionals that we don’t share much about ourselves. The treatment session is for our patients, not the place for us to get our needs met. We have therapy and our own relationships outside of the therapy room for that. I actually came from a training experience that encouraged us to be “blank slates” to our patients. We were to answer questions about ourselves with, “How will the answer to that help your situation?” or “What makes you ask that question now?” It always felt strange to me to answer that way, but I did it figuring that I’d get used to it. I didn’t.
When I began treating individuals with OCD, it was already out there in the world that I was a parent of a child with OCD. I’d written articles about it and I shared about it with most of my patients if it seemed appropriate. Working with other parents, it seemed to give credence to what I was asking them to do. To many, it made it seem that I understood, on a deep level, what they were going through. For me, it felt more genuine.
I don’t know if it was the right thing to do, letting my patient know I’d experienced depression myself. I’m not going to try to justify it, and I’m going to have to continue to look at why, when, and how I share personal information with my patients. I do know that being more real feels like a better approach than being a mystery or a “blank slate.” I do things in session like share about the panic attack I had at forty feet below the surface of the ocean while scuba diving. I share about the intense fear I had of public speaking when I was younger – so great that it nearly prevented me from pursuing a career as a psychologist (we had to take an oral exam). And I share how I learned not to have these things rule my experience.
On the day my patient came in struggling with depression, I took the session outside. It’s not something a lot of therapists do, but it’s not so unusual. I took it outside because we uncovered the fact that my patient had stopped her daily walking routine a few months ago, and because we talked about the importance of exercise as one component in dealing with depression. And so we walked. She in her athletic shoes and me in my dress sandals. Together we sought out slight inclines in the neighborhood and we climbed them. I got blisters…and a note from her the next morning showing the miles she’d walked and describing how the fog was beginning to lift.