Why Shrinks Have Problems

Suicide, stress, divorce -- psychologists and other mental health professionals may actually be more screwed up than the rest of us.

By Robert Epstein, Tim Bower, published on July 01, 1997 - last reviewed on September 29, 2009

In 1899 Sigmund Freud got a new telephone number: 14362. He was 43 at the time, and he was profoundly disturbed by the digits in the new number. He believed they signified that he would die at age 61 (note the one and six surrounding the 43) or, at best, at age 62 (the last two digits in the number). He clung, painfully, to this bizarre belief for many years. Presumably he was forced to revise his estimate on his 63rd birthday, but he was haunted by other superstitions until the day he died -- by assisted suicide, no less -- at the ripe old age of 83.

That's just for starters. Freud also had frequent blackouts. He refused to quit smoking even after 30 operations to correct the extensive damage he suffered from cancer of the jaw. He was a self-proclaimed neurotic. He suffered from a mild form of agoraphobia. And, for a time, he had a serious cocaine problem.

Neuroses? Superstitions? Substance abuse? Blackouts? And suicide? So much for the father of psychoanalysis. But are these problems typical for psychologists? How are Freud's successors doing? Or, to put the question another way: Are shrinks really "crazy"?

I myself have been a psychologist for nearly two decades, primarily teaching and conducting research. So the truth is that I had some preconceptions about this topic before I began to investigate it. When, years ago, my mom told me that her one and only session with a psychotherapist had been disappointing because "the guy was obviously much crazier than I was," I assumed, or at least hoped, that she was joking. Mental health professionals have access to special tools and techniques to help themselves through the perils of living, right?

Sure, Freud was peculiar, and, yes, I'd heard that Jung had had a nervous breakdown. But I'd always assumed that -- rumors to the contrary notwithstanding; -- mental health professionals were probably fairly healthy.

Turns out I was wrong.

Doctor, Are You Feeling Okay?

Mental health professionals are, in general, a fairly crazy lot -- at least as troubled as the general population. This may sound depressing, but, as you'll see, having crazy shrinks around is not in itself a serious problem. In fact, some experts believe that therapists who have suffered in certain ways may be the very best therapists we have.

The problem is that mental health professionals -- particularly psychologists -- do a poor job of monitoring their own mental health problems and those of their colleagues. In fact, the main responsibility for spotting an impaired therapist seems to fall on the patient, who presumably has his or her own problems to deal with. That's just nuts.

Therapists struggling with marital problems, alcoholism, substance abuse, depression, and so on don't function very well as therapists, so we can't just ignore their distress. And ironically, with just a few exceptions, mental health professionals have access to relatively few resources when they most need assistance. The questions, then, are these: How can clients be protected -- and how can troubled therapists be helped?

The Odd Treating the Id

Here's a theory that's not so crazy: Maybe people enter the mental health field because they have a history of psychological difficulties. Perhaps they're trying to understand or overcome their own problems, which would give us a pool of therapists who are a hit unusual to begin with. That alone could account for the image of the Crazy Shrink.

Of the many prominent psychotherapists I've interviewed in recent months, only one admitted that he had entered the profession because of personal problems. But most felt this was a common occurrence. In fact, the idea that therapy is a haven for the psychologically wounded is as old as the profession itself. Freud himself asserted that childhood loss was the underlying cause of an adult's desire to help others. And Freud's daughter, Anna, herself a prominent psychoanalyst, once said, "The most sophisticated defense mechanism I ever encountered was becoming a psychotherapist." So it's only appropriate that John Fromson, M.D., director of a Massachusetts program for impaired physicians, describes the mental health field as one in which "the odd care for the id." He chuckled as he said this, but, as Freud claimed, humor is often a mask for disturbing truths.

These impressions are confirmed by published research. An American Psychiatric Association study concluded that '"physicians with affective disorders tend to select psychiatry as a specialty." (Curiously, the authors presented this as their belief, "for a variety of reasons," without explanation.) In a 1993 study, James Guy, Ph.D., dean of the School of Psychology at Fuller Theological Seminary, compared the early childhood experiences of female psychotherapists to those of other professional women. The therapists reported higher rates of family dysfunction, parental alcoholism, sexual and physical abuse, and parental death or psychiatric hospitalization than did their professional counterparts. And a 1992 survey of male and female therapists found that more than two-thirds of the women and one-third of the men reported having experienced some form of sexual or physical abuse in early life. Freud seems to have been right about this one: The mental health professions attract people who have suffered.

Patients Can Really Ruin Your Day

So we're starting out, it seems, with a pool of well-meaning but slightly damaged practitioners. Now the real fun begins.