Response to “Thinking About Our Work: When the Therapist Becomes Ill”

Abstract

Response to “Thinking About Our Work: When the Therapist Becomes Ill” Roberta Rachel Omin1 issn 0362-4021 © 2017 Eastern Group Psychotherapy Society group, Vol. 41, No. 4, Winter 2017 351 1 Private practice, Ossining and White Plains, NY. Correspondence should be addressed to Roberta Omin, LCSW, 151 Club Court, Ossining, NY 10562. E-mail: goodomin1@gmail.com. It is the rare person who gets off scot-free from an illness during his or her life. More likely, all of us will be confronted with a serious illness, medical crisis, or accident at some time. If the illness is terminal, everything becomes larger than life and imminent. Tending to our self-care, and all that it entails, necessitates that it becomes foreground. When we are therapists, more is added to our plates. What is our ethical and moral responsibility to those who come to us for their mental health care? When we are the medical patient, we become vulnerable and our lives become very complex. How do we muster the resources needed so we can cope personally and professionally? Alice Byrne’s memoir essay “When the Therapist Becomes Ill” is a brief glimpse into her world. I know this world, having been there myself—I have had two major illnesses and surgeries—and from interviews with more than 25 therapists. Ms. Byrne’s description, I believe, does not do justice to her actual experience. I would have valued hearing her fuller story, her personal crisis, with the emotional range of terror, vulnerability, extreme physical pain, helplessness, aloneness, and whatever else was embedded in that trauma for her. She found herself tossed and immersed into an existential here-and-now sudden crisis, while simultaneously trying to summon together immediate supports to reach her clients. And it certainly sounds like she did very well! When I lead workshops on this topic, “When the Therapist Becomes the Medical Patient,” I am very clear that we need to take care of ourselves first as human beings living with and through a medical crisis. And it is extremely difficult to be present 352 omin and available to our clients if we don’t have enough self-energy. As the airlines tell us, put the oxygen mask on ourselves first, and then on our children. I would have appreciated hearing more of Ms. Byrne’s professional crisis as well. As she stated, while there is value in the blank screen as a projection tool, when a therapist is ill, that may trump therapist nondisclosure. The issue of whether to tell our clients when we become ill needs to be thought through. Should we disclose when we are confronted with a medical issue? Or should we not? Going through this exercise in advance can be extremely helpful, even if what occurs down the road is not what we envisioned originally. Having an internal dialogue with ourselves, and thus having a framework and process that we may want to lean on should the unexpected or the expected occur, can be very centering. What are therapists’ attitudes and beliefs about this? When I lead workshops, we discuss what informs us about self-disclosure and not, and where those answers come from. Do they come from a protective, or private, or defensive, or worried part of ourselves that says what we believe is good for our clients and ourselves? What is really good for us and for our patients? Often participants come to some realization that disclosure in some form may be very beneficial. There is no one size fits all. The issue requires a differential approach based on our preparation or lack of preparation for our illness, surgery, accident, or fatal crisis, and, as significantly, what the illness or medical situation is. I believe that we need to be there for ourselves first, to put the life vest and oxygen on ourselves before we can do that for our clients. With that premise, we can then have a chance at bringing our more centered selves to our clients. In Ms. Byrne’s circumstances, this was not possible, and therefore an emergency backup team was required. More on that shortly. For those times when it is not an emergency, yet urgent...