I’m hiding bipolar. Here’s why. By Anonymous

Photo of woman wearing smiling face mask

Editor’s note: I was confronted when we received this anonymous submission. It’s very common these days to see campaigns encouraging people to speak up about mental health issues. When you work in mental health or the media, you often have the privilege of being able to be open about your lived experience. We applaud celebrities and advocates who ‘share their journeys of recovery’. It’s too easy to forget that many, if not most, people live and work in environments where there is a risk attached to disclosing if you have mental health issues. Stigma is real, and this blog post is a reminder of how stigma makes living with mental illness harder than it should be. It’s also a reminder to be gentle with those around you – because you don’t always know their story.  Thank you, Anon, for sharing your story. — Sarah, Co-Editor, Our Mental Health Matters

When I was 12 I went on my first rollercoaster ride. I don’t remember it being a particularly pleasant experience, in fact I was terrified. Little did I know that was just the beginning, that my life was going to be one huge rollercoaster and it would take until I was over 40 to know what was causing it, and to find a way to get off.

As a child I was never encouraged to speak about feelings. My parents are not overly warm people and discussing emotions was never on the agenda. It is hard for people to understand how someone who had 4 younger sisters could have felt so lonely, but I did. I was an awkward girl, with low social skills and an incredible low opinion of myself. If there was ever a time that I did do well at something or felt any kind of jubilation, it was squashed very quickly. My family just had no time for encouragement or stroking of egos, and so I learnt very early in life to deal with things alone and not to seek out help. As a result the thoughts and voices in my head stayed there. I didn’t understand it at all and nobody ever spoke of mental illness. I knew that I was different but I just couldn’t talk to anyone about it, so it is of no surprise to me at all that now 35 years later, I still talk to only a very select few. I still feel lonely and I still hide my pain and pretend to be someone that does not have a mental illness.

I could write chapters and chapters about how the rollercoaster of my life has affected my youth, my young adult life and my marriages. How having a mental illness has been one of the most devastating and challenging things I have ever had to face, but the hardest most painful challenge of it all is the lie I live. The fact is to this day my parents still know nothing of my diagnosis, and will go to their graves never knowing. That I front up to work everyday and not one of my co-workers knows (or in my opinion would ever even think) that I am bipolar.

When I was first diagnosed I thought about being open and honest to everyone; that being bipolar was just another layer of who I was and that just having a name now to explain who I was wouldn’t change a thing. But only two days later when visiting friends, as one of my friends was talking about a person he knew, he spoke in such a belittling way about this person, describing erratic behavior and using words like crazy, off his head and mental, and then the kicker, ‘I think he must be bipolar’. My husband and I looked at each other and we knew at that moment that telling everyone was not going to be an option.

There are still so many people who are incapable of understanding mental health. A few weeks after my diagnosis I saw my parents. We are not close, and might see each other twice a year if that, yet I was still contemplating telling them. After all they are my mum and dad, above everyone else shouldn’t they understand? Apparently not. Over a cup of tea my mother bought up a conversation about someone we knew being depressed. My mother stated that she did not understand how this person could be depressed, she had a great life, lots of money and a wonderful husband. My mother stated that this lady was being self-indulgent and needed to get up and get on with life. Dad agreed, he claimed that every second person thinks they are depressed – wham, guess what?! I’m now not telling Mum or Dad either!

Perhaps I am selling my parents short; perhaps if I was to sit down with them they would understand, but I doubt it. I know enough of their beliefs and coping mechanisms to know that they would say I was being a drama queen, that I was always wanting attention and trying to make it all about me. I just cannot hear those words out loud again from them, I just cannot put myself through that, so I tell them nothing, I don’t lie, I just don’t talk about it.

I have a wonderful job. I am blessed with a boss who is kind and generous and gives me autonomy to run his very successful business for him. I handle millions of dollars each year for him, and he trusts me with all his finances, with major decisions and with his staff. There have been times that the stress has caused me to have small breakdowns or to spiral into deep, deep depression, however he doesn’t know that. When the episode occurred that finally saw me get a diagnosis, he never knew. I lied, I told him I had to have the week off because I was very ill with ear infections. He has never shown any sign of even remotely thinking I have any sort of depression or mental illness. I have never shown him a single sign of it. I have no idea how I can do that. How can I be so mentally strong when I am at work and walk out the door and fall to pieces? How when the black dog comes to visit I manage to get myself out of bed and go to work, and then come home and hide under the covers. I don’t understand it, but its what I do. Its almost like turning a switch and having my set of behaviors for work and my set of behaviors outside of work. I have heard my boss speak of people that have depression or anxiety. I know he doesn’t even pretend to understand it, that he jokes about mental illness rather than tries to be accepting of it. I know I can’t tell him, and I know that I wont.

I am exhausted, being two people is very tiring, but its how my life is and I am sure I am not alone. My hope is that one day people will try to understand, that there will be no need for lies or hiding of our true selves. I think we are a little way off that yet, and that’s a pity.

 

By Anonymous

“I am a 47 year old mother and grandmother, working full time and leading a very busy, fulfilling life.”

Photo by Geda Žyvatkauskaitė used under CC license.

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Growing as a Provisional Psychologist

I wrote a while ago about my journey towards provisional registration. I’m now nearly nine months into my 4+2. My 6 month report has been accepted, my caseload is full. I’ve done lots of professional development activities, lots of supervision, and have been reading voraciously. This time in my life is all about career, and about what I want in my career. I’m lucky to be in a position to focus!

A couple of weeks ago, I was at my supervision with Harriet.

We finished a long and productive session, and then Harriet said, ‘I’d like you to do some homework for me this week. I want you to reflect on your journey since provisional registration – not the skills or techniques you’ve learned, but on yourself as a Provisional Psychologist, where you’ve grown and where you’re perhaps ready to start growing more.’ I responded with a smile, ‘sure, Harriet. It’ll make a good blog entry.’

Here’s a bit more of what actually went through my mind:

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I’m pretty sure Harriet is onto me, and if she didn’t read my mind, at least had a pretty good idea of the sorts of things that would be on it.

You see, for a Provisional Psychologist, I am reasonably skilled, experienced and knowledgeable, and I have a history of doing all sorts of things in my work, from supervising mental health professionals, to program development, client-facing work across the lifespan, and all manner of other things. I’ve been working in psychology-related roles with complex clients for nearly a decade now so those are things I’ve been lucky enough to have experience in. Those are all about the work. The work is the easy part.

Thinking and talking about myself, as a Psychologist? This is the hard part.

You see, I have strong perfectionistic tendencies and can be a bit very obsessive at times, not exactly uncommon personality traits in Psychologists given the sheer level of obsession required to be willing to take the time and do the work to register. And despite my robustly good mental health, my resilience has been hard-won and it can be a knock-down mental battle to not say ‘sorry’ more than I need to, to withstand the inevitable judgement of others, or to admit (to myself, and to others) that I’m actually seriously, really truly pretty awesome. And this is after having identified and worked on these challenges from adolescence onward. No wonder I find myself easily relating to the struggles of many of my young clients. I may not have walked in their shoes, but my path has not been so different either, for all that my journey at this point has been 10-15 years longer.

But I digress. On to the task at hand. My development.

What’s changed for me since starting my 4+2? Professionally I’ve continued to build skills, much as I always have. I’ve always read voraciously. I’ve always attended as many PD days and sessions as I can. So my professional development has simply continued on it’s usual trajectory, perhaps a little accelerated as is inevitable given I’ve moved from adult mental health to youth mental health and have had a whole new language to learn, and the time and space to do a lot of learning at work.

But most of my development is about becoming. Becoming what? Why, myself of course.

Before I started my 4+2, I had some fears. I was worried that I could have a supervisor with a radically different view of what Psychology is to me. We’re a diverse profession after all. Given the availability of supervisors, it was entirely possible that I could have ended up with a supervisor with less experience in practice than I have, given my own career journey, or one whose underlying philosophies fundamentally clashed with my own, expressed in a way that didn’t challenge me to think, consider and grow, but rather served to constrain me, limit me, or invalidate me – exactly the things I try to avoid in my work with clients!

I’ve had experiences of not feeling that I can be myself in my work, of my skills and knowledge being dismissed, of feeling that I have had to be less than I am to fit in. And having had those experiences lead to a much greater sense of trepidation about the next step in my journey than I may have experienced otherwise. I did not know if I would be encouraged to be me. I was armed with my knowledge that my actual work role certainly allowed (and encouraged) me to be myself and use myself in my work, and that I have plenty of research to back up my orientation to practice. I knew that I could stay congruent to myself, but I also knew that the right supervisor could be an immense help in my journey. I feel very lucky to be supervised by Harriet!

I find it interesting that my biggest fear in this journey isn’t about my practice, but about myself as a Provisional Psychologist. And what is more interesting is that my growth has mostly been in the intersection between the personal and the professional. I suspect some of that is because I’m really, fundamentally a bit of an existential humanist philosophically – for all that I can talk diagnosis, RCT’s and manualized treatments confidently enough, there’s always been a part of me that’s been more interested in the search for meaning and purpose in both myself and those around me.

Here are some of the key ways I have grown since starting:

  1. I am becoming a little more comfortable in being vulnerable. This is very difficult for me because like all of us, my experiences have helped to shape me. I learned as the bullied ‘fat kid’ in school in the 90’s that to be vulnerable was to be a victim. So I became very good at being guarded as a survival response. I learned to brush off negative comments, to intellectualize, to explain human behaviours in distant, scientific language, to escape into theory. This tendency is actually at times quite useful in Psychology. But not necessarily such a good thing for being an effective psychotherapist because without vulnerability, connection can be difficult. I really started work on this particular journey well before my 4+2, back when I did my grad dip in counselling, and even more so when I started to supervise staff in mental health. It was hard, but I wanted my staff in challenging roles to feel safe, even whilst I also had to sometimes change practice. Doing this required a complete shift in how I engaged at work. I had a gifted social worker as my supervisor when I was team leading, and we’ve stayed friends since – she told me it took ‘a long time’ for her to really get me. I’m more vulnerable/less guarded now in my career than I’ve ever been – it’s taken years for me to feel psychologically safe enough at work to start to do it, and it’s getting easier, with both a fantastic workplace and great supervision. But it’s still hard and it’s still ongoing.
  2. I’m really working to show my imperfections to clients, to really be myself in my work. I work with young people, in an outreach capacity. Part of my role can involve modelling how to build relationships, how to have conversations, share stories, and how to feel safe doing so. This means that for my clients, I need to be able to be less than perfect. I need to be able to show that we all have struggles, and that sometimes these struggles persist, and that it’s ok to have doubts and worries, because we can still thrive in all our imperfect glory. That’s particularly important for me as an ‘authority figure’. So I’ve found myself doing timelines of procrastination with clients struggling with doing assignments, giving examples from my own life (my procrastination/being ‘too busy’ to write up a literature review is coming in handy). Clients and I have practiced conversations using resources such as the Deep Speak cards as question prompts. I’ve modeled courage in revealing myself and my stories for young people who are learning to sit with their own imperfections and fears and engage with the world despite them. Interestingly, I’ve always found it much easier to be ‘imperfect’ around clients than my own supervisors and colleagues. I suspect it’s something about power dynamics.
  3. Before I started my 4+2, I felt a little bit like a psychology outsider. There I was, 9 years of mental health experience, eligible to join the APS, knew many Psychologists through my professional networks, but I never felt very connected to the profession/professionals in Psychology, despite feeling very connected to the discipline of Psychology. Much of that relates to seldom having psychologist colleagues during my career. There are a whole range of things that have made me feel more connected to the Psychology profession/networks. Firstly, of course, was supervision. Finally I had the chance to have the lengthy conversations about Psychology, myself as a Psychologist and my work through the lens of Psychology and not other disciplines (valuable as those perspectives are). Another was joining the APS, and finding myself on the branch committee and being able to get involved with planning events and training. I don’t think I’d have gotten nearly as much out of the APS if I’d not started rocking up to branch meetings and meeting with Psychologists through that. Attending residential college through the College of Professional Psychology has been a lovely way to meet with many other provisional psychologists in person. And finally, being part of groups such as the Australian Provisional and Early Career Psychologists, the Provisional Psychologists ForumWe All Wear It Differently, and EDPNA has been a fantastic introduction to many colleagues both in Tasmania and interstate. I now feel that I am part of Psychology. I’m in the building instead of looking through a window from outside. That helps me to feel more confident.

It’s much easier to think of where I’ve grown then where I haven’t. That’s probably because we don’t know what we don’t know. But here are some directions in which I’d like to grow more:

  • I’d like to become more compassionate towards myself and let my perfectionism become a bit quieter. I’ve managed it in some areas, but not so much in others – usually by challenging myself to think about what I’d think about clients, or what I’d think about people I love. And I think it’s my own perfectionism that is driving some of my desire to be more compassionate, because I know that it what I need to continue to grow in my career. As perfectionism and self-compassion are more or less opposite in nature, I think there’s a tension between the two that I need to resolve.
  • I’d like to continue to build ways of better ‘switching off’ after work. I’m very good about keep my work phone off and not checking emails after I’m finished work or on weekends. I’ve long accepted that my work is a big part of who I am, that I’m someone who likes to spend a lot of time thinking about work, and that I would need to be a robot to never be impacted by the lives of the vulnerable people I work with. At the same time, lots of people I know from different contexts ask me how I fit everything in and whether I actually sleep, and doing my 4+2 does mean additional work and professional development time for me. Food for thought. And there are no easy answers to this one I think. I’ve never met anyone who cares who doesn’t experience challenges.

But what about you, reader? Where have you grown? Where would you like to grow next?

Risk assessment in mental health: So much more than you might think

If you work in mental health, what’s the first thing you think about when the word ‘risk’ is stated? For many of us, the first thing that springs to mind is risk of harm to self. I know that when I have interviewed new graduates for mental health positions, a common area they struggle in seems to be considering risk holistically. We are all trained in suicide risk assessment and management, but not always so much the many other types of risk that we may encounter.

The things that cause people living with mental illness to often have shorter lives than others include so much more than suicide.

For much of my career, I have worked with complexity and risk. I’ve worked with the consequences of when workplace safety systems and risk management fails as a Rehabilitation Counselor, and in my work in mental health programs, I’ve had to consider a whole range of risks in outreach-based sub-acute mental health care, not only to service users, but risks that may be presented to staff.

I take risk management very seriously. I make a habit of reading Coroner’s findings in mental health and any health legal reports I can. When I read Coroner’s findings, I learn about the worst case scenarios that I need to be prepared for in my work. I am a fan of the concept of root cause analysis as a means of better understanding risk.

So, when I think of risks related to clients, I don’t just think about suicide. And whilst I place client need first and foremost, I also consider risks to myself as a practitioner. I currently work entirely with clients with complex and substantial needs, and so risk assessment and management planning in my work role is accordingly quite robust with information from multiple sources and detailed and individualised plans.

These are just some of the things I routinely consider about risk:

  • Suicide risk assessment and management. There are many guidelines that I draw on in my work, bearing in mind that risk assessment is not easy and that suicide risk assessment and management of people from different age groups can have specific challenges. 
  • Risk of non-suicidal self injury. I’m careful to distinguish this from suicide risk and consider appropriate strategies. 
  • Risk of violence / harm to others. We may from time to time work with clients who may become violent. Violence is not limited to forensic work. If you don’t assess this, you won’t know if you need to consider potentially issuing a Tarasoff Warning, consistent with the APS Code of Ethics A.5.2.
  • Risk of harm to self or others because of psychosis. Some symptoms can lead to behaviours with tragic consequences.
  • Risk of harm caused by others. People living with severe mental illness are at much, much higher risk of being victims of violent crime than other members of the population. Anyone can be impacted by domestic violence. What vulnerabilities may the person be living with?
  • Risks related to medical conditions. The gap in life expectancy of people living with severe mental illness is something I find appalling, particularly because at least some of it is attributed to members of the medical profession assuming that the medical concerns of their patients who also happen to have mental illness are all in their heads.

A basic risk management plan for one of my clients will be a great deal longer than this blog entry, and will consider more factors as well. But I hope this summary provides a starting point of things to think about other than suicide risk!

If you ever get the chance, it’s well worth doing training or seeking supervision. In psychology, forensic psychologists frequently have extensive training and expertise in risk assessment and management given the unique nature of their work, but there are professionals with extensive skill and experience in risk assessment and management in a broad range of settings. Some of the most risk-aware professionals I’ve worked in have spent extensive time in public mental health and outreach settings, particularly when they must take ‘all comers’ to their services.

If you find yourself now feeling an immediate desire to learn more about risk and safety, Vicserv are providing outreach safety training for support staff facilitated by Holland Thomas & Associates in February in Melbourne. The training provides information about personal safety in outreach settings and is particularly useful if you are a sole worker. There are often other options that come up from time to time across Australia and many employers will also provide some training – I’ve completed training delivered by Holland Thomas and enjoyed it.

When you have any niggling concerns about risk, always remember there are supports available, such as community mental health teams and crisis lines that work with risk on a daily basis. If you realize there might be some risks in your work that you are unsure how to address, please seek supervision. You could also discuss the ethics of the situation with organizations such as The Ethics Centre. In the event of a crisis (or if in doubt), each state and territory provides crisis services.

The Mental Health Commission lists the following state mental health crisis numbers:

NSW – 1800 011 511- Mental Health Line

VIC – 1300 651 251 – Suicide Help Line

QLD – 13 43 25 84 – 13 HEALTH

TAS – 1800 332 388 – Mental Health Services Helpline

SA – 13 14 65 – Mental Health Assessment and Crisis Intervention Service

WA – 1800 676 822 – Mental Health Emergency Response Line

NT – 08 8999 4988 – Top End Mental Health Service

ACT – 1800 629 354 – Mental Health Triage Service

And in an emergency, dial 000 for police and/or ambulance.

 

By Ceara Rickard 

Ceara Rickard is a mental health professional with diverse professional interests, including adult and youth mental health, the consumer movement, career development and professional ethics. She has extensive experience in program development and management, mental health, and working with mandated clients. Ceara holds membership of the Australian Society of Rehabilitation Counsellors, Professional Membership of the Career Industry Council of Australia, Associate Membership of the Australian Psychological Society, and registration with the Australian Health Practitioner Regulation Agency as a Psychologist with Provisional Registration.

The power of peer self help support groups

Healing in the Everyday World: The benefits of peer self help support groups and their place in the therapeutic process towards recovery…

by Tabitha Dougall

Twenty years ago, as a new mum, I was struggling with (what felt like) atomic fallout left over from unresolved childhood abuse and complex family relationships that were collateral damage because, like most people, the perpetrator was known (from within my family) and there were mixed loyalties, ineffective coping mechanisms and no justice or resolve.

One Christmas time (when issues/feelings are often the worst), while driving I felt like crashing into a tree and ending it all, so instead I drove to my GP to get a referral to a psychiatrist. My  well-meaning GP asked why I was struggling, and told me “Christmas is a time for forgiving and forgetting” and I needed to move on.  I told her I’d spent 25 years trying to do that, and it didn’t work, and re-iterated my request for some professional support, now feeling further invalidated and unsupported by her dismissive response.

The psychiatrist was helpful with some other issues but didn’t seem to really know what to do about trauma so left that alone, and it festered.  (Many therapeutic professionals have actually had no trauma-informed training).  A few psychologists later (who were helpful to a point but traditional Cognitive Behaviour Therapy approaches don’t go deep enough or address the body, mind, emotional, soul, stigma and inner isolation issues) and I found myself borrowing everything I could find in the library about healing from trauma.  This ‘bibliotherapy’ was helpful and gave validation and a range of different approaches… and one book suggested that peer self help support groups could be helpful.

So began a journey that changed the course of my life.

Now, twenty years later, I work at a not for profit organisation part time overseeing recruiting, training and facilitation of volunteer support group facilitators and have my own private practice as a holistic counsellor. I’ve undergone a comprehensive cleansing and healing of my past with many resources suggested by support group peers.  Over the past few years I’ve been involved with training and supervising a few hundred potential self help facilitators and helping many different types of support groups start up. This all developed from a daring decision fifteen years ago to start up a support group for women survivors of child abuse, with no training or experience, just a passion and a need, and a little support from my counsellor at the time.

Why should people attend and/or run support groups? 

Self help peer support groups are opportunities for small groups of people with a similar issue to voluntarily come together on an ongoing, regular basis for mutual support, empathy and encouragement.  They are generally peer-led, democratic, with open membership (people can come and go as they need) of between 2 and 20 attendees.  There is a strengths-based, normalising, de-stigmatising philosophy rather than a pathological, problem-patient vs expert-professional approach, and they are free or low cost as opposed to fee-for-service which makes them accessible to all.  Guilt, shame, confusion, alienation, fear and disempowerment can all be discussed, unpacked and worked through in the non-hierarchical group process and over time, replaced with empowerment, connection, normalcy, agency, self-responsibility, inner peace, self esteem, self respect, inner  strength and increased social skills. Members of the group are seen as equals and experts in our own recovery journey while a broader perspective of our issues can be gained from various viewpoints and experiences of other group members and modelling from others who are further along their recovery path.  Perhaps one of the most profound benefits is when we can adjust our self-view from one of victimhood, to one of ‘helper’ where our feelings, experiences, opinions, skills and qualities matter and can make a difference to someone else. Helping others helps us feel useful and valuable, like we have something to offer to the world, altruistically increasing our sense of purpose.

It has been said that there are two important qualities that foster great mental health – purpose and connection; both of which can be enhanced in the process of contributing in support groups.  We can feel less dependent and become more active in our own healing and in assisting others.  There can be a sense of hope and a new supportive community.  Support group attendance can be a stepping-stone and adjunct to professional help.

Group guidelines/norms provide a sense of trust, emotional, psychological and physical safety, usually involving respect, non-judgment, confidentiality and no advice-giving.  These can often model new and assertive ways of relating in the outside world as well.  Group members are encouraged to share experiences and feelings and talk through their thought processes, often challenging previous secrets and shame-based stuckness while being deeply heard, understood and validated.  Often this in itself is enormously healing.  Humour from within the peer setting can also bring a certain lightness that may not be available or accessed in a professional therapeutic relationship.  Other perspectives from within the peer setting can also be easier to hear than if coming from a condescending stance which can sometimes happen in therapy, or in families.

Yalom said: “we are separate, lonely, apart from but also a part of.  One of my members (of a group) put it elegantly when she described herself as a lonely ship in the dark.  Even though no physical mooring could be made, it was nonetheless enormously comforting to see lights of other ships sailing the same water.”

There is positive research on support groups’ efficacy and they are found worldwide. So why, then, if support groups can be so helpful, are they not on every corner? Why are they not included as an important part of professional therapeutic case-management? Why are support groups not recognised, acknowledged and referred to by GPs and mental/health practitioners at least?  Not known about? Not widely funded?

Some health professionals may be of the opinion that support groups are just ‘whinge-fests’ and there is no positive movement.  My experience has shown that sometimes progress is slow, and we need to check our own impatience with others who aren’t changing to our assumed goals and timelines, however many group members have experienced compounding rejection from families, friends, workplaces and therapists and the safety they find in support group settings is the first/only time where they can feel unconditionally accepted, and it is in this kind of environment where deep healing can occur.

People with lived experience as well as health professionals can all be trained to successfully run self help groups.  In the current climate of limited funding for mental/health, self help support groups can be a valuable budget-friendly addition to ANY service provision, offering ongoing support to a wide range and number of people, both in the bustling cities and in the resource-poor regional areas, and offering the opportunity to grow, develop and re-invent oneself.  Visit the Collective of Self Help Groups (COSGH) and/or visit the Centre of Excellence for Peer Support for more information.

About the author:

Tabitha Dougall is a Holistic Counsellor, Psychotherapist and Group Facilitator with lived experience. Based in Melbourne, Tabitha promotes healing & authenticity through creative expressive modalities alongside talking therapy. She draws from broad life experience & her own healing journey, over 20 years of personal and professional development, volunteering & coaching others, and 15 years group facilitation.

After Psych(Hons): Developing a career in mental health

By Ceara Rickard

It’s that time of year again where psychology students receive their end of year results and are forced to consider their professional futures in a far more immediate sense than they may have needed to during their first four years of psychology education. It can be a pretty difficult time, given that it’s not very easy to become a registered psychologist after completing 4th year, with two years to go in education or placement before one can register. The Psychology Board of Australia (PsyBA) specify three pathways towards gaining general registration as a psychologist, each involving at least two years of registration as a provisional psychologist.

None of the options are ‘easy’ and each bring their own specific challenges. The journey to psychologist registration can be a long and winding road. Perhaps learning about my journey may help you to consider yours. But my journey isn’t really about becoming a psychologist. It’s about developing a career doing what I love.

A while back, Dr Boris Fedoric introduced me to the Chaos Theory of Careers and wrote about his fascinating journey. The theory is also illustrated very well by my own career journey.

We live in a fast-paced world, where change, chance and complexity are inevitable. Whilst it would be very pleasant for us to be able to accurately predict every step of our career journeys, the truth is that it is impossible to predict and control everything. So, for the last 15 or so years, I have wanted to become a psychologist.

When I was in high school and undergrad, I thought my career journey would look like this:

That is, of course, not what actually happened. I finished Honours in 2006. I am now, finally, registered as Psychologist with Provisional Registration, working through my 4+2. My career journey has not been the straightforward process I thought it would be at the age of 16.

Before writing this blog post, I thought about what stories to tell about my journey. My journey towards Psychology has not been a linear process so I can’t tell just one story about my career. So here are a few plot lines. There is the story about a third generation welfare recipient going to uni. There is a story about wanting to do a Masters degree for nearly a decade and not getting there. That one is more a comedy than anything, with a sub plot about being a hapless pet owner! There are the stories of my colleagues, managers and clients and how they have influenced me. There are also the stories about how my family, my relationships, and my friendships all influenced my career choices and options. There is even a story about the direct influence of government policy on my career. There is the story about a wonderful journey of self-discovery I have been on as a mental health professional. It’s also a story about values and choices. It is a story about how I learned to stop worrying and embrace change, uncertainty and unpredictability. Ok, that’s a lie. I’ve just learned to accept that worry is part of life and that it’s not really anything I need to, well, worry over.

This is a little of what my journey since completing Honours in 2006 actually looks like. Don’t panic. My story is a good one. Start at the top left and follow the lines. Don’t worry if it confuses you. Looking back, it confuses me a little too. But that’s a large part of what has made it useful.

Here are a very few of the things I have learned professionally in taking the path I have taken:

  • Relationships come first. How I engage as a professional is more important than what therapeutic modality I choose to use. This is not only something I’ve noticed from personal experience. It is also consistent with the literature. In my work, whilst I am ever mindful of appropriate professional boundaries, I have learned that I need to know myself, be myself, and use myself to be effective, and I bring my own personal style into any work that I do.
  • Psychology is one of many disciplines, all of which have different approaches and theoretical orientations, and all of which have unique strengths. Working with diverse clients in a multi-disciplinary environment has been one of the best career choices I have ever made.
  • Registering as a Psychologist is not nearly as important to my ability to have gainful employment as I believed when I was a new grad. I can have a career I love whether or not I were to ever gain general registration and there are a whole range of qualities that effective therapists have that should and do exist in Psychologists, but also often exist in many other mental health professionals.
  • Psychology was definitely the right choice for me professionally, and my Psych Hons degree has given me a wonderful foundation for other learning. The critical thinking, emphasis on evidence-based practice and diverse knowledge base of Psychology continue to appeal to me. That is why I’ve continued to move towards registration, despite my winding way of getting there.

What I have learned personally in taking a less straightforward path:

  • It might be a platitude, but I truly believe the journey is more important than the destination and now I know this from experience, and not just reading Robert Frost poetry.
  • I have learned how to (mostly) leave work at work and accept ‘imperfection’ in myself and in my clients.
  • I have learned that I will never know everything, I am not a perfect practitioner, and never will be. No one can be. And that this is ok. I am enough.
  • I have learned to embrace the fact that I am a massive nerd, and that I continue to read at about the same rate that I did when I was at university – not because I have to meet minimum PD requirements for some of my registrations, not because I have assignments to do or will be performance managed if I don’t, but because Psychology is much more than a career to me. Mental health is an enormous part of my identity.
  • I have learned more about my own values, and how these impact my choices, both professionally and personally.

The challenges in my career journey have had an enormous impact on my work, and a positive one. I would be a different person, professionally and personally, had I followed my original plan, but not necessarily a better one.

If you are not happy with your results, or miss out on that treasured next step in your career, whatever that may be – take heart. Your journey is not over.

 

About the author

Ceara Rickard is a mental health professional with diverse professional interests, including adult and youth mental health, the consumer movement, career development and professional ethics. She has extensive experience in program development and management, mental health, and working with mandated clients. Ceara holds membership of the Australian Society of Rehabilitation Counsellors, Professional Membership of the Career Industry Council of Australia, Associate Membership of the Australian Psychological Society, and registration with the Australian Health Practitioner Regulation Agency as a Psychologist with Provisional Registration.

Festive Season Affective Disorder

by Daniel Reeders

I’d hold out against it as long as I could, but each year in early December, I froze, giving way to that familiar feeling of dread. Then a couple of years ago I began seeing a therapist, and that year I raised with her the plans I was making to get through the festive season: dinner with Mum and boyfrang at a Chinese restaurant on Christmas eve, talking pretty much exclusively about television to avoid the emotional history Mum loves to discuss; lunch on Christmas day with Dad and my sister and step-mother, hoping he wouldn’t drink too much, before going home to start drinking myself.

My therapist doesn’t shake her head, but she gently pointed out that going into ‘survival mode’ – priming your fight or flight response – pretty much guarantees misunderstanding and conflict. No matter how much you try and anticipate what your parent might do, she said, you can’t; they’re too good at it.

Christmas that year was a doozie.

I wound up in emotional deep-freeze afterwards. I finally cracked through the ice in March, with an email asking Mum “did you really mean to say that?” Afterwards, I felt so relieved, I thought I was having a manic episode, and I went and got myself assessed for bipolar. Turns out I don’t have it: just recurring episodes of major depression with relatively predictable triggers.

Christmas is the perfect storm: family, end-of-year exhaustion, and repetition.

Every school holiday after their divorce, my parents had the same fight: over the meaning of a single word in the access (custody) agreement. Mum argued Dad must take his children for an extra three days every school holiday; Dad pointed out it said that he may – and he chose not to. Apart from the message that your parents are fighting over not having you around, the difficult thing about this fight was the repetitiveness of it, its viciousness and the impossibility of averting or resolving it; if I intervened I became a target for Mum’s invective, so all I could ever do was freeze, go numb, play dead.

As anyone living with multi-episodic depression will know, there’s a certain ‘not again’ panic about the onset of an episode. One of the ways the past traps us in the present is through our re-enactment of strategies that worked for us as children in the face of challenges in adult life. Like putting on a mask and getting through Christmas. But as Brené Brown points out, you can’t selectively numb: it’s all or nothing. And when I go numb, I lose emotional perspective – feedback on whether my behaviour is consistent with my values – as well as motivation. In a word, depression. The coping strategy now sets up the problem.

My counsellor, Carol-Ann Allen, argues for an approach that recognises how the situation has changed since our childhood experiences (and the strategies we devised to cope with them). As children we were powerless: as adults we are not. She reminds me that I now have much wider scope for agency and my own skills for dealing with people being difficult.

One possible strategy, recommended by Carol-Ann, involves keeping your sense of humour in play – via the slight detachment of a conscious appreciation of how perfectly in-character the difficult people in our lives are being when they throw us a curve ball. When you see it coming, instead of freezing, you might think, ‘Damn, that remark is so perfectly you. Five stars!’

Helpful tip: don’t verbalise this thought.

Carol-Ann Allen will be giving a talk on ‘Making peace with your parents’ at Midsumma Festival in Melbourne (February 3) with a particular focus on queer and trans experiences of coming out. This article reflects what I’ve taken away from our sessions and any errors or omissions are mine alone.

About the author

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Daniel Reeders is a PhD candidate looking at stigma and public health. He blogs about these topics and many more at Bad Blood.

We’re launching a new blog on mental health in Australia. Here’s our manifesto.

We are excited to be launching Our Mental Health Matters, a group blog which aims to share analysis, opinion and discussion of mental health, mental health care and the mental health caring professions in Australia. It will contain writing by mental health practitioners, educators, researchers, advocates, carers and people living with mental illness.

You can read our manifesto here. We hope it inspires you to get involved as a writer and commenter. Over there you’ll also find some information about us, Ceara Rickard and Sarah Stokely. We’re both passionate about mental health and improving the practise of mental health in Australia, and we look forward to discussing and learning with you.

We are on the lookout for people to contribute to the blog so please share this post with anyone you think might be interested. Visit the manifesto to find out how to express your interest. Or simply leave a comment below.

If you’d like to be notified when the blog launches, please make sure you visit our home page and sign up to the email notifications.