The “Healing Healer”? A Psychologist’s Personal Narrative of Psychosis and Early Intervention

It was only during a diagnostic interview¹ for a research study I was participating in that I realized the whole succession of psychotic symptoms I had. In hindsight, mine was a textbook manic episode, which together with my family history and subsequent episodes of depression assured a diagnosis of Bipolar Affective Disorder, Type I. Yet diagnostic checklists cannot fully explain the experience of developing, living and recovering from psychosis; nor how such experiences affect working as a clinician. I make no apologies for this richer and necessarily unsanitized account of accessing and working in Early Intervention in Psychosis (EIP) services. In this piece I will describe a little of my experiences of manic psychosis and my experience of accessing an EIP service. I will then reflect on my experience of working clinically in light of what I have experienced.

My shift from reality was nothing if not quick. What started with excitement, overwhelming chattiness and a feeling of “not being right” during the first few days quickly escalated from suspicion to paranoia and anguish. Objectively, I ticked all the boxes for a manic psychosis. Yet my experiences—of hearing music playing mockingly with harmful intent, feeling drawing pins thrust into my skin when I thought or heard the word “prick,” and believing my thoughts were being inspected to test my suitability for university—cannot be meaningfully reduced to mere hallucinations, delusions and thought broadcast.²

Above all, my experiences were completely terrifying. I had lost all control and the world had become impenetrably confusing. My delusions morphed in complexity in “lightbulb moments” where everything seemed to suddenly make sense but crumble again soon after. Once I had started treatment I gained flashes of insight when I first woke up in the morning; moments when I was totally desperate for the psychosis to cease, only to be propelled straight back to the horror.

That first episode feels merely like a horrific nightmare now, although I know I was awake. During this time the EIP service was a beacon of hope during incredibly dark months. I was seen at home rather than a psychiatric hospital. My EIP psychiatrist was more informal, telling me “I’m Dr. Smith, but you can call me Laura.” The team were compassionate and didn’t seem phased by any of my more bizarre symptoms, nor my distress. Most importantly, my care team believed in the certainty of my recovery in a period of life when I just wasn’t able to.

The fact that English EIP services now have targets to engage people with first episode psychosis in an evidence-based treatment³ within 2 weeks⁴ adds to my hope that others in a similar situation to me would also gain high-quality care and access to staff who believe in their recovery. I have since learnt that this positive culture is not just about the attitudes of individual staff members, but a team culture that places the service user at the centre of everything EIP services do.

I now know that my recovery was also relatively quick, although to me it felt tediously slow. My EIP care coordinator encouraged me to apply for a volunteering position in a charity shop, which helped build my confidence. I saw an excellent Clinical Psychologist who was skilled at helping make sense of what had happened and the impact this had on my identity. Crucially, she took time to get to know me so I can trust her with details of my life I hadn’t told anyone before. I was able to return to university and complete my degree, then my masters. Ten years after my first episode I will be starting training as a Clinical Psychologist. I’m not sure if this would have been possible without Early Intervention.

The Jungian archetype of the “wounded healer” is often used with reference to therapists with lived experience of mental health problems.⁵ However, I like to think that I am not wounded, nor even scarred by experiences. On balance, I see myself as a “healing healer”: someone who uses my own positive experience of seeking help for mental health problems as a starting point for a career as a clinician. I don’t believe that people with psychosis can remain unchanged by the experience, but with the right support they do not have to be continually wounded.

I feel that even now a decade later the healing process continues as I mature and learn more about the workings of my mind. Rather than a “wounded” healer, I feel I am a “healing” one: ever curious about my state of mind and the impact that might have on the clients in my therapy room. One autumnal day I was struggling with memories, and work was feeling too close to home. In supervision I was reluctant to share what was going on: I couldn’t separate my own experiences from work that day and wasn’t sure what was appropriate to share. My supervisor said to me: “we’re just people in a room, S. Talk to me about what’s going on.” Her compassion and humanity that day helped me integrate my experiences as a person and a professional.

I’m in no doubt that my experiences give greater insight and capacity to empathize the people I see. I understand how vulnerable it feels to be a patient sitting in the waiting room and answering questions about the most intimate parts of life. I know that it takes time to build up trust in a clinician. I feel strongly that fragmented services requiring repeat assessments, and waiting lists for support are actively unhelpful for the treatment process. I know firsthand how fragmented services and repeat assessments actively impede recovery.

I feel now that, on balance, that if I could take away my Bipolar Disorder I would consider not doing so. However, my psychotic experiences were so terrifying that I feel it would have been better not have experienced them. More than anything my experiences have helped me realize good health is a privilege not a right. Every day I am well I grab life with both hands and live it as positively as I can.

My recovery journey would undoubtedly have been more turbulent, traumatic and uncertain had I not been cared for by an EIP service. I believe that all mental health services should aspire to take such an inclusive, positive and flexible approach, which undoubtedly would enable more former service users to enter the mental health profession as “healing healers.”