Experts by experience

by Jenna Robinson

As part of my counselling course I am currently reading about the holistic approach to mental distress. The holistic approach focuses on the client as an individual who is influenced by a number of different dimensions (psychologically, emotionally, spiritually, socially, and physically) and therefore it is advised that all of these dimensions are accounted for when it comes to treatment.

One area that I thought was of interest when talking about the treatment of those with mental distress is the idea of ‘experts by experience’; which means those treating clients have experienced similar difficulties. These are still trained professionals but they have also been through mental distress. In the text I am reading a service user commented that the psychiatrics and the doctors were all very knowledgeable in what they did, what they had learnt in their own specialism’s; but none of them had been through a similar situation of distress that he was experiencing.

So what would it be like being treated by someone who has experienced distress, “the wounded healer” as it is commonly known. From the clients perspective they may feel more understood knowing that the person treating them would be able to empathise with their situation. However what about keeping the relationship professional, making sure boundaries are still in place, is there the danger of too much self-disclosure from the professional and the risk of old wounds opening up for them? Also if the client is aware that the person treating them has gone through the same thing will they be clinging to them for answers of how they tackled it, what they did, probing for advice rather than seeking their own path?

What do you think? If you were being treated by a psychologist would you want an expert by experience, someone who has been through a similar situation, has experienced mental distress and who has also been treated? Would you prefer someone who was a professional in their field, specialising in the treatment of mental health, someone who keeps to the professional boundaries, who you know nothing about and who is focused on treating your problem?

Comments

Totally would not want someone burdening me with their issues in a counselling session, that's my place. I'd go for proffessionalism over experience any day.

That's a very interesting one. When I was having therapy the first few therapists I saw did nothing for me, I couldn't respect them as they felt so 'schooled' i felt they knew nothing of MY pain or situation. I thought how can you understand mental illness from a book?

This said I have had two amazing therapists who (according to my knowledge) have not personally suffered, although I feel they had more 'experience' both in life and with a variety of clients. You can learn much from books and much from experience, I think it is vital that someone who gives advice does not do it purely on what worked for them, but has enough 'broad' knowledge and range of experience to be able to find the CLIENT's ideal solution.

When I gave up smoking a non-smoker said to me 'How hard can it be?' I did want to slap them! Because they had no experience of my situation, how could they dare tell me what I should feel! Experience is something that can not be taught and is a great asset, but should not be INSTEAD of education, but combined with education, to make the perfect counsellor (in my humble opinion :)

Charlotte

In my opinion there is a very fine line. I had counselling many years ago and felt that the 'text book' counselling left me cold. I think that things have improved since then and I would, personally, prefer to be counselled by someone who had had some personal experience of mental ill-health. It would be a fine line for the counsellor but one that, with the right level of professionalism, would be the perfect balance (for me anyway).

I agree with Liz, a balance, but I would certainly lot for someone with some experience

Fascinating question, Jenna. I think it depends on both the treatment and the illness/disorder/issue being addressed.

I had CBT with a counsellor after having my first child. It was very much focussed on motherhood and I found her references to her own experience helpful. Having DBT and psychotherapy for BPD, however, it was much more effective with someone that did not reference themselves at all, and kept professional boundaries at all times.

Sarah

Thank you for all your comments, it is interesting to hear other perspectives on this topic.
Experience always...
I think experience is important, as long as they keep it to themselves, boundaries are Si important, I'd hate to go to a psych and have them chip in with 'oh yes that happened to me'...
Brilliant question.... My ideas are these. If a therapist is making disclosures of unresolved problems to their client this is not good. They may have entered therapy to vicariously sort out their own problems. In my own limited experience, if someone says they want to work as a therapist I think 'what is this really all about?'. In DBT, a therapist would ideally be able to model the 'correct' behavioural response under the pressure of strong emotions like fear, guilt/shame, anger, (etc). It would be possible to understand intellectually this is so, but unless you have been in a situation where you have been exposed to strong emotion, you will never know whether you can do it in practice. If you are treating someone for PTSD caused by horror, if you dissociate as a therapist then I think that it is unlikely that you would be able to model the correct escape response for your client. The disclosures made by health staff say an awful lot and it is really good that you have brought this up.
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