This is the third in a series of blogs examining the stigma surrounding mental health clinicians who live with the same conditions they treat. A variety of viewpoints and experiences will be presented.
Sometimes, anticipating the stigma surrounding an identity or condition can be as bad as actually experiencing it. Predicted stigma comes with real costs and lost opportunities, especially for therapists who treat the mental health conditions they live with and the clients they could serve.
I have lived with bipolar disorder for over 25 years. I am a therapist in California (psychological associate working towards licensure under a clinical psychologist.) In the lifelong pursuit to “make my mess my message,” I organically found myself specializing in the diagnosis and treatment of bipolar disorder.
This move is not surprising: many therapists choose to apply their own experience to the betterment of their clients’ lives. In my opinion, this is a wonderful choice that allows therapists to leverage their hard-won wisdom and ultimately be more effective.
But it begs the tough question for the therapist: should I tell anyone about my own diagnosis or will I suffer stigma?
In my experience, most clinicians treating what they have do NOT disclose. I co-lead a peer support group for mental health clinicians living with mood disorders and we often discuss the choice of disclosure: who should know, what they should know, and when they should know. People in this group fear being stigmatized for their own iterations of the conditions they treat and therefore, by and large, stay silent about them.
Graduate schools and training programs add fuel to this unnecessary fire by advising fresh and frightened students to never disclose due to the inevitable consequences they will face. After all, what will your clients think? And what will your colleagues think?!
In reality, I haven’t faced any direct stigma regarding this dual role as a therapist with bipolar who treats bipolar. Perhaps I just haven’t noticed the stigma because I am public about my diagnosis and am unconcerned with what others think and say about me. But perhaps it is because others have less stigma than we might imagine in this circumstance. If I have proven myself to be a competent therapist, I’d like to think my bipolar takes a backseat in the minds of others.
What my clients actually seem to think:
There is a tacit understanding with my clients who have bipolar. They don’t have to be embarrassed. They don’t have to hedge. They know that I’ve been there (or somewhere nearby) and I truly sympathize with their pain and struggles. That feeling of being seen and not alone is transformational. If I weren’t public with my condition, this impact would be lost. Clients have directly told me what a relief it is to have someone who “gets it” and can offer guidance not only from textbooks but from their own battles. This is a benefit that I offer as a therapist to those living with bipolar that other therapists, however phenomenal, simply cannot. Perhaps this is a silver lining of the large cloud that is bipolar.
What my colleagues actually think:
If any of my colleagues have had stigmatizing thoughts or made negative remarks about my capacity to be a therapist while living with bipolar, they haven’t shared it with me or let it trickle down through the grapevine. From my supervisor, I have received only compassion and support as needed. Even from colleagues who I’ve witnessed perpetuating stigma about bipolar in general, they haven’t had negative judgments about me or have had the good sense to keep it to themselves.
With predicted stigma comes the cost of many missed benefits and opportunities. If I didn’t share my diagnosis, my clients wouldn’t enjoy that extra level of connection. I wouldn’t provide an additional data point for my colleagues about what bipolar disorder looks like outside of a textbook or case note. And I wouldn’t be an example for others with the condition trying to accomplish their own goals.
I encourage therapists living with the conditions they treat to move past this predicted stigma and relish their lived experience superpowers. It may feel like a leap of faith, but the change you can affect on the other side is exhilarating.
Andrea B. Vassilev is a fifth-year doctoral student earning her Psy.D. in clinical psychology. Her dissertation, titled “Overcoming Self-Stigma in Bipolar Disorder: An Intervention”, involved the creation of the first ever English language program to address and treat self-stigma in bipolar disorder. See www.ossibd.com for information. Ms. Vassilev works under her supervisor as a therapist for those with mood, anxiety, trauma, and personality disorders as well as with those seeking support and growth during life transitions or difficult times.
Personally, Ms. Vassilev dedicates herself to mental health outreach, awareness, and advocacy. Her primary passion is the fight to eradicate stigma regarding mental illness and heal self-stigma in those living with these conditions. To that end, she presents and writes on topics both academic and personal for outlets such as Slate Magazine, the International Bipolar Foundation, NAMI, and Behavioral Health News. These talks and articles cover a variety of topics both academic and personal. She hopes that telling her own story of life with bipolar disorder through the lenses of clinical causes, treatments, and outcomes will provide education, hope, and comfort to others. Click here to learn more.
Here are some specific examples of what partnership with us can look like. Every plan is customized — this is just a starting point.
Classroom wellbeing auditClassroom teachers assess their current wellbeing supports, identify specific strengths and gaps, and actively engage with research-based strategies to create an action plan for supporting student wellbeing in the classroom. This audit is more than a checklist—it’s a mirror that reflects how your everyday choices shape the mental health and wellbeing of everyone in your classroom. By pausing to rate, reflect, and plan, you will:
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Specialized mental health skill-building workshopsThis goes beyond basic literacy to provide staff with practical skills and techniques for managing specific situations and promoting positive mental health within the school. Examples
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Adult SEL developmentJust as students benefit from developing social-emotional skills, so do adults. Adult SEL focuses on educators understanding their own emotions, managing impulses, setting goals, showing empathy, building healthy relationships, and making responsible decisions. Examples
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Integration of mental health into curriculumEmbedding mental health education within the regular curriculum normalizes these topics, reduces stigma, and equips all students with foundational knowledge and skills related to their emotional well-being. Rogers’ understanding of key mental health concepts can inform curriculum development. Examples
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Mental health literacy trainingThis partnership focuses on equipping school staff with a foundational understanding of mental health concepts, common disorders in children and adolescents, and the importance of early identification and intervention. Examples
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Trauma-Informed practicesTrauma-informed practice recognizes the widespread impact of trauma and understands potential paths for recovery. In a school setting, this means understanding that students (and staff) may have experienced trauma and that these experiences can affect behavior, relationships, and learning. Training helps staff recognize the signs of trauma, respond in a way that avoids re-traumatization, and create a safe and supportive environment. It also includes understanding secondary trauma or compassion fatigue that educators may experience when working with individuals who have experienced trauma. Examples
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Mindfulness and stress reduction workshops for staffMindfulness involves paying attention to the present moment without judgment. Stress reduction techniques are practical strategies designed to lower physiological and psychological responses to stress. Training in these areas equips educators with tools to manage the inherent demands and pressures of their job, cultivate a sense of calm, and increase their capacity to be present and responsive. Examples
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Building resilience (CLE)Resilience is the ability to adapt well in the face of adversity, trauma, tragedy, threats, or significant sources of stress. Training in resilience helps educators identify their strengths, develop positive coping mechanisms, cultivate optimism, and build strong support networks. Examples
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Enhancing school climate – for the staffSchool climate refers to the quality and character of school life. A positive school climate for staff is characterized by trust, respect, collegiality, collaboration, and a sense of belonging. Consultation focuses on identifying areas for improvement and implementing strategies to foster a more supportive and positive environment. Examples
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Needs assessment and strategic planning (CLE)A systematic process of gathering information about the current state of staff wellbeing within the school, identifying key stressors, and understanding the needs and preferences of the staff. This data then informs the development of a targeted and effective plan for implementing wellbeing initiatives. Examples
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Developing supportive policies and practicesExamining existing school policies, procedures, and unwritten norms to identify those that may contribute to staff stress or hinder wellbeing. Consulting on modifications or new policies that actively promote a healthy work environment. Examples
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Consultation on school mental health systemsThis involves leveraging Rogers’ understanding of best practices in mental health care to advise schools on the development and implementation of comprehensive systems that support student and staff well-being. Examples
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Integrating wellbeing into existing structuresEmbedding wellbeing initiatives within the school’s existing operational framework rather than treating them as separate, add-on programs. This ensures long-term sustainability and demonstrates that wellbeing is a priority. Examples
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Leadership coachingCoaching specifically designed for school administrators and team leaders. This focuses on developing their leadership skills related to supporting staff wellbeing, creating a positive team culture, and effectively managing workplace dynamics that can impact stress levels. Examples
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Individual wellbeing coachingA confidential and supportive partnership between a trained coach and an individual staff member. The coach helps the staff member identify their wellbeing goals, explore challenges, develop strategies, and build self-awareness and resilience. This is particularly helpful for staff experiencing high levels of stress, burnout, or those seeking to proactively enhance their wellbeing. Examples
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Instructional coaching with a wellbeing lensIntegrating conversations and support around wellbeing into existing instructional coaching cycles. This recognizes that teacher wellbeing is intertwined with their classroom practice and provides a holistic approach to support. Examples
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Peer coaching programsTraining selected staff members to serve as peer coaches for their colleagues. This leverages internal expertise and fosters a culture of mutual support within the school. Peer coaches can provide a confidential and relatable source of support, sharing strategies and offering encouragement. Examples
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