How is your mental health affected by the work you do as a mental health care professional?

This question has preoccupied me because there is no requirement for CBT therapists to undertake their own personal therapy.

This is not unusual.

All mental health professionals with a few honourable exceptions such as psychodynamic therapists do not have to look at their own mental health issue.

In the absence of this requirement it may be useful to think about how some of the ideas behind CBT, can be helpful both for individual mental health professionals and the systems they work in.

Thinking errors

The “Thinking Errors” sheet is a tool in CBT for depression.

It describes ways of thinking which do not reflect what might actually be happening in any given situation.

One error is “Fortune Telling”, where the person predicts that “everything” will be disastrous. Another is “Generalisation” when the person states that one specific situation reflects a general pattern.

For example if I “fail” to put up a shelf, then is evidence of my complete failure as a human being.  However, we, as Individual mental health professionals will make the same “thinking errors” in the line of our work. We will “fortune tell” believing that some clients will “never” get better.

We will “generalise” believing that a particular client’s one mistake is evidence of something integral to them.

Emotional labour

Mental health professionals can be understood through the idea of “Emotional Labour” from Arlie Hochschild .

Emotional labour is like physical labour.

Mental health work while not physically tiring is emotionally exhausting.

Working in a helping organisation

The cumulative effect of emotionally exhausting work can, in my experience “contaminate” the systems that mental health professionals work in.

The effects of this contamination can be understood if we use the Emotional Systems model in Compassionate Mind Therapy.  There are three systems. The Threat System is about perceptions of threat, emotions of anxiety and/or anger. The Drive system is about excitement. It is positive and is about working towards the achievement of goals.

If I help someone get better and feel pleased I am in my drive system.

The Compassion system is also positive and is about contentment and interconnectedness between ourselves, our colleagues and our clients.

The NHS feels under threat

At the moment the climate within the NHS can feel as if it is based on the Threat System.

This is understandable. There are cost pressures and the internal market in care focusses our minds on competing.

This focus exists even in the clinical area with the competition between different approaches to care such as the medical model and the recovery model.  

Although we can keep improving through working harder through our Drive System we can burn out, resulting in more thinking errors, and less empathy and connection with colleagues and clients.

Helping yourself as a helper  

One way of responding that has been used in our Trust in Derbyshire and in other organisations have been Schwarz rounds.  

These are structured meetings where all mental health workers can look at the emotional aspects of care. The evidence suggests that they help in enabling people to feel supported which then helps in coping with stress.

They help us ultimately get into the compassion system which then can help us and the people we work with.