Scars on Healing Hands: The Role of Lived Experience in Social Work

by Jennifer Gerlach, MSW

     Why do you want to be a social worker?” That was one of the first questions I was asked by a staff member at the state hospital that had taken me on as a practicum student. The person asking was a security guard. I reached into my naïve, likely still developing brain and found an answer: “I want to help people.” His response sounded more practiced. “You’re going to find out that a lot of people don’t want help.” I smiled politely and left the conversation at that. 

    What I didn’t say was that I knew this defiance very well, and that I also knew it to be partially false. Before going to college, I had already had interactions with more helping professionals than I could count. I spent a good deal of time dodging their questions, their advice, their “recommendations,” and above all, them. I saw them as agents of society, or agents of my parents. I didn’t think they could help me. I didn’t trust them to help me. Still, on my own I was hurting. I desperately wanted help. There were people whose kindness eventually reached me. I realized the power of that kind of help, and it is what I have made my mission to give back. I am in recovery from a mental health condition. That is my reason for wanting to help. 

    My story is unique to me. However, the tradition of the once injured moving forward to give back is not. The prodigious psychiatrist Carl Jung reflected this in his archetype of the “Wounded Physician” (Jung, 1951) or Healer, which was described as an individual who has struggled—particularly in health—who has returned to help those still hurting (Benziman, Kanni, & Ahmad, 2012). He wrote of these healers as learning from their own experiences to relate to the suffering of a fellow human being and to guide a partnership in treatment (Jung, 1951). In ways, Jung himself could be called a wounded healer. He sometimes spoke of visions and may very well have walked through some of his own challenges (Dunne, 2000). With this intimate knowledge of the mind, he was able to contribute an abundance of health-giving perspectives. 

    Mental health surveillance research suggests that as many as 25% of Americans may live with some kind of mental health condition (Reeves et al., 2011). By these statistics alone, it can be estimated that among those represented include a number of individuals in the helping professions. Indeed, in a survey of personal statements by potential social work students, quite a number indicated a personal experience in their reasons for choosing social work as a profession (Regehr, Stalker, Jacobs, & Pelech, 2001). 

    Formal education, reading, and practice can grant insight into an array of elements related to mental health and the needs of individuals living with mental health conditions. Still, what cannot be taught by ordinary means are the intimate details of how it feels. Without having walked through extreme states of mind—such as psychosis, mania, and panic—social workers can at best learn from second-hand testimony of what these look like from the inside. Social workers and other “helpers” who have had experiences such as these have access to this less common understanding, and a number of these individuals have done fantastic work. Among those most notable helpers who have overcome overwhelming difficulties is Dr. Kay Redfield-Jamison (1997), a psychologist who has studied and written about Bipolar Disorder, and who also lives with the challenge herself.

    Beyond this, social workers who have had contact with systems of care hold a degree of knowledge of how it feels to seek out services. An understanding of what can make the mental health system easier to navigate, specifically for a person living with mental health symptoms, and what can contribute to a stigmatizing, comforting, depowering, or empowering treatment session, can be incredibly useful for service providers.

Scars Can Look Like Scarlet Letters

    Social workers wearing scars often feel driven to hide their scars, in fear of judgment and professional consequences. This fear is not unwarranted. Until recently, those living with mental health conditions were discouraged from entering any aspect of the mental health field, including social work. For many years, mental health conditions were viewed as chronic, incurable illnesses to which individuals were victim. With this in mind, social services would seem a dangerous career path for those who have been touched by mental illness, given the weak-minded nature of those affected, susceptibility to relapse under stress, and constant presence of symptoms. This stigma is well alive in the minds of society at large, as well as within the mental health profession (Nordt, Roosler, & Lauber, 2006).

    Today, more consumers and professionals alike are recognizing that it is possible for individuals to move beyond this impact and recover to lead meaningful lives. 

    With the advance of models that embrace reintegration of those living with mental health conditions and promote the concept of recovery, the voices of individuals with “lived experiences” have been given a growing role in all aspects of the mental health field. This has spread so far as for there to be an effort to seek out the skill of people with lived experiences in a peer-professional role as peer support specialists and recovery specialists (Davidson, Chinman, Sells, & Rowe, 2006).

    In the same way, having a mental health challenge has become more accepted among those practicing in more traditional areas of social work. At least one agency providing substance use and mental health services has gone so far as to encourage potential applicants of this variety by adding statements such as, “Current or former consumers of mental health or co-occurring services are strongly encouraged to apply,” and “Welcomes applications from qualified applicants with Recovery experience.” (Chestnut Health Systems, 2014) to their job postings. This is a bold step toward encouraging the strengths and unique viewpoints these individuals can bring.

    Although sharing one’s story to ignite hope and to model appropriate coping strategies is key to the work of peer-staff, the place for self-disclosure is murkier for social workers in traditional roles. This kind of disclosure is sometimes discouraged or even forbidden in some capacities. Although service users might find it encouraging to know that a social worker has had experience with his or her own challenges, excessive or untimely disclosure has potential to take focus away from the client and to be detrimental to social work goals. If and how much a social worker chooses to share is a very individual decision. 

What Helps  

    Students and young social workers who have survived significant difficulties could be at greater risk for specific troubles, such as a triggering of traumatic memories (Zoskey, 2013) and over-identification with clients. Those involved in areas that correspond with our own personal experiences may be at especially high risk (Regehr, Stalker, Jacobs, & Pelech, 2001). For these reasons, supports and mentorship may be particularly significant for growing social workers with their own “scars.”

    Support can come from a recognized source, such as a counseling office or supervisor. However, it doesn’t have to. In a survey of social work students who self-identified as living with a mental health condition, many reported that they were more likely to seek out the support of a friend or family member than a professional (Reid & Poole, 2013). In an academic setting, opportunities for peer support and mentorship may allow a safe means for this needed support to take place.

    Reid and Poole (2013) also found that a number of the social work students they surveyed referred to their own coping strategies and self-care efforts, such as walking, as key supports for them in their work and studies. Social workers are known to be masters of compassion and giving care to the needs of others. We owe ourselves the best of our own abilities.

    A chief way in which social workers can support those with scars might simply be to acknowledge individuals living with mental health conditions as an oppressed group and extending the same anti-oppressive attitudes to them as they would to any other. The stigma that all individuals living with mental health challenges fight is ever-present. With an open door into the profession and recovery-oriented policies, wounded healers can flourish and lend a valuable perspective to the field. 

References

Benziman, G. Kanni, R. and Ahmad, A. (2012). The wounded healer as a cultural archetype. Comparative Literature and Culture, 14 (1), 

Chestnut Health Systems (2014). Southern Region Employment Opportunities. Available online at http://www.chestnut.org/Employment/SouthernMetroeastIllinoisArea 

Davidson, L., Chinman, M., Sells, D., & Rowe, M. (2006). Peer support among adults with serious mental illness: A report from the field. Schizophrenia Bulletin, 33, 443–450.

Dunne, C. (2000). Carl Jung: Wounded Healer of the Soul. Morning Light Press.

Jamison, K.R. (1997). An Unquiet Mind: Memoir of Moods and Madness. Vintage. 

Jung, C. (1951). Fundamental Questions of Psychotherapy. Princeton University Press. 

Nordt, C. Roosler, W. Lauber, C. (2006). Attitudes of mental health professionals toward people with Schizophrenia and Major Depression. Schizophrenia Bulletin, 32 (4), 709-714.

Reeves, W.C. Strine, T.W. Pratt, L.A. Thompson, W. Ahluwalia, I. Dhingra, S.S. Mcknight-Eily, L.R. Harrison, L. De’Agelo, D.V. Williams, L. Morrow, B. Gould, D. Safren, M.C. (2011). Mental illness surveillance among adults in the United States. Morbidity and Mortality Weekly Report, 60 (3), 1-32.

Regehr, C. Stalker, C.A. Jacobs, M. and Pelech, W. (2001). The gatekeeper and the wounded healer. The Clinical Supervisor, 20 (1), 127-143. 

Reid, J., & Poole, J. (2013). Mad students in the social work classroom? Journal of Progressive Human Services, 24, 209-222. 

Zoskey, D.L. (2013). Wounded healers: Graduate students with a history of trauma in a family violence course. Journal of Teaching in Social Work, 33 (3), 239-2o50.

Jennifer Gerlach received her MSW in 2015 from Southern Illinois University Edwardsville. She takes great joy in supporting individuals seeking recovery from mental health challenges, and does so often in her work as a crisis worker as well as in sharing her own story of recovery. She welcomes email at jgerlac@gmail.com