The Skeptical Sleuth

Applying a healthy dose of skepticism to new findings about health and psychology.

Marsha Linehan Reveals Her Borderline Personality Disorder: Must Our Healers Be Wounded?

By publicly disclosing her borderline personality disorder, Dr. Linehan was keeping with a well-established tradition in Western culture of the wounded healer. Read More

This is nutty.

About 99.9999999999999999999% of psychologists and psychiatrists never admit anything about themselves, especially having a mental illness. Why are you bothering to ask this question at all? Wait until you have slightly about .000000000000001% of the sample size doing what you are talking about before you start posing hypotheticals? God, that woman is probably one year away from retirement. That was an amazing article, so take it easy Big Guy.

Like wants like

Like wants like. One of the toughest things in therapy is to find a therapist who truly understands. Shared experience doesn't guarantee that kind of Weberian verstehen -- sympathetic understanding -- but it sure doesn't hurt.

Same reason African-Americans prefer African-American shrinks, Jews prefer to go to Jews, and Mormons prefer to go to Mormons.

It's not such a BFD.

Linehan's example is particularly notable for many reasons

Unlike the other examples used, Linehan's Dialectical Behaviour Therapy is hugely significant and successful in treating something previously untreatable, and she was silent for decades about her own horrific experiences.
She is an incredible person.

well in all honesty this myth

well in all honesty this myth is in all professions minus the healer part. Your boss has more experience then you do, when you start a new job and need a mentor your mentor knows the ropes.when we become new parents we often ask other parents for advice not non parents. So why is it so odd to think that a psychologist is any different? I had hard times growing up with abuse and such and believe it led me to psychology. Why not use my experience to help others that are having the same problems? I think the bigger problem is thinking psychologists have to be perfect and without problems or a past.

Dr. Coyne, What is your

Dr. Coyne,
What is your point?
My reaction to your article is that you enjoy making fun of these people. Is that your purpose?
If they were using these epiphany/ healer stories in order to advertise, sell, or otherwise promote their treatment models, by distracting from lack of any outcome data to support the models, then I would align myself with your apparent disgust at this behavior.

DBT, REBT, EMDR, and especially ACT show plenty of outcome data in support of utility of their models.

Your article feels to me to be diminishing to these people as people, and diminishing to those who also suffer both as clients and as those who have chosen to work in healing jobs.

It does nothing to examine the evidence that any of these models in fact help real people.

It ignores the benefits of these disclosures, in that many, many clients only trust those who demonstrate somehow that they have experienced similar suffering.

Given the choice...

Let's say I have weight issues, and want to seek psychotherapy to explore them. Given the choice between two equally competent therapists -- a normal weight therapist who has always been normal weight, and a normal weight therapist who was formerly grossly obese but took the psychological journey to thinness, which therapist do you think I would prefer?

Yup. Sorry, lifelong normal weight therapist. You might be great, but I'm going to try your colleague first.

The point of my blog article

I am not sure that my blog article can be reduced to a single point. But if I had to select one, it would be that the lure of this wounded healer myth is so strong that diverse healers find themselves compelled to conform to it because their intended audiences expect such a story.

I can't find evidence that "wounded healers" produce more effective therapies or self-help, but I think the need to have such a narrative is a distraction from attention to relevant evidence.

As for evidence of the effectiveness of ACT, I find that it has been overestimated, particularly in claims that ACT is more effective than other therapies. Such claims are damaging both to the credibility of ACT and to the larger field.

Much of the evidence for ACT comes from small, underpowered, methodologically flawed studies conducted or supervised by individuals who have financial stakes in ACT. I'm actually working on a meta-analysis now.

I really liked this

I really liked this article.

I have a chronic illness that has left me house-bound for 13 years. I am 24 at the time of writing.

In this time I have come across many, many "wounded healers" who claim that they can heal me because they have mostly or entirely healed themselves. I often think of what I have (Myalgic Encephalomyelitis, or ME) in comparison with being hit by a car: you will recover much faster and have much less damage if you were hit at 30 miles an hour compared to being hit at 60. So while I don't doubt that recovery is possible for some, others have a much harder time depending on the force they were "hit" (this comparison was inspired by researcher Dr. Hyde (http://www.nightingale.ca/) who said he doesn't consider his ME patients ill but injured).

Anyway, I suspect that many of these therapists are so invested in the idea of a wounded healer that they think they can cure everybody - even those who are more ill than they ever were or who have complications that they never had.

The ones I've met confidently peddle everything from light therapy (where little coloured lights are shone on accupuncture points on your body), affirmations, "quantum" techniques, and more. Some of the therapies are okay - like massage and meditation - but others are way out there.

The confidence these particular wounded healers have in their therapies can be, in my opinion, extremely damaging to vulnerable sick people.

I speak from experience here, which of course is exactly what all wounded healers claim to do. However, I think there are so many alternative therapists who razzle dazzle clients by using this archetype as street cred.

It works for the therapists, but can work against the patients.

I feel strongly about this, possibly because I was ill from childhood and my mother and I were so vulnerable to flim flam. I appreciate the article a lot.

Wounded healers aren't always more experienced - they could be simply more easily mislead.

now this part i dont agree

now this part i dont agree with.But this is where we must be smart consumers.A good tharapist will attempt to get to know you and may try different techniques. A not so good tharapist will say only their way works yada yada.Any therapy reguardless of who says what worked, one size does not fit all. And if something is not working then its not working and something else or a new tharapist should be tried.

therapeutic relationship

James Coyne, PhD, have you forgotten the most important element of any intervention in the therapeutic relationship itself? and what is that based on?
Empathy often, respect always.
We can harp on about evidence based practice, research the lot. But we are talking about working with human beings, not a set of chemicals. Some therapies will work for some people, some not. It's so subjective! I'm assuming your background is phychology which is mostly quantitative not qualitative research?
And the 'myth' of the wounded healer - what slosh. ALL human beings are healers and patients to a degree.

Linehan's credibility is a

Linehan's credibility is a joke! Her "DBT modules" have done more damage to the lives of clients than any other inept therapist out there (and they're are many). I've read her book on the cognitive treatments of such individuals who "suffer" from BPD and all Lineham did was mix Eastern Buddhism with Western psychology mumbo-jumbo to concoct a poison-coated pill that the psychological industry swallows without question.

The bottom line is BPD CANNOT be treated other than by palliative methods (what she calls DBT, which is a failure). Lineham knows this yet she has made a lot of money on selling her bullshit. Now she comes clean and claims she is BPD herself? Kind of the blind leading the blind, eh?

It's no surprise that too many therapist out there have severe mental illnesses themselves who cloak their disease behind their profession or try to live it out vicariously via their clients. Yet little has been done to correct this problem by the APA and I find that to be slightly disturbing. There is no "healing" in this profession - just egoism and an ever increasing cynicism - so drop the early 90's New Age psychology rhetoric please.

DBT

Rick, I'd be interested in reading some of the material you're basing your views of DBT on. Strong statements. And yes, it could be called a mixture of 2 cultures, but what's inherently wrong with that? Are we so ethnocentric that we think other cultures have *nothing* to offer us?

A glance at some public health figures can tell you we're worse off mentally and physically than a lot of other civilized countries. And I won't mention spirituality because I fear you would consider that "New Age mumbo jumbo." Just please be aware that if you are a practicing clinician, some of your clients care a lot more about their religion and spirituality, New Agey or otherwise, than they do about their 50 minutes with you. Best to keep an open mind so that we're tapping into our clients' strengths.

Well, okay Mr. or Miss

Well, okay Mr. or Miss Anonymous instead of me Googleing a bunch of statistics on why DBT is a failure it's better to look into the people who been through this latest psychological fad. There have been forums, websites done by those who have been through DBT and most will tell it was hardly beneficial whether or not their diagnosis was BPD. Many found it to be retraumatizing, too stringent and took away the humanity part of therapy instead replacing it with "diary cards" (whatever those are) not too mention being a big waste of money. I don't care for Lineham's research or her rhetoric on the subject. She looks at numbers, not human lives - especially the ones she has destroyed. (Personally, I'd love for her to actually respond to the people who have been through her DBT modules that claim to have been retramuatized by them - preferably with apologies.)

Not only that, most therapist only saw their clients who had BPD as being one dimensional through these diary cards or just another number DBT attendees in group therapy situations. How is THAT beneficial for someone suffering with BPD? Slowly, what Lineham did was to replace cognitive talk therapy with cheesy, unsubstantiated ideals such as "Wise Mind" and "Mindfulness." Both loosely based on Buddhist traditions.

And speaking of which Lineham did steal from Buddhist beliefs. Mindfulness for example, as it has become polluted and perverted by Western psychology is the Buddhist practice of Annica which roughly translates into "impermanence" - impermanence of thought(s)which I guess those who have BPD struggle with in that they allow for their thoughts to permanent into their behaviors thus being the root cause of their distress.

Sounds like a solid idea, right? One problem with that is many therapist out there have no idea what they are doing with this shit - sorry, practice accepting it as blind faith because Lineham shows a bunch of numbers - done by her own research - that it calms those with BPD down. It's like giving a dentist a scalpel to do a root canal and a surgeon a dentist drill to perform an open heart. In other words, not too many therapist out there using DBT know anything about the Buddhist practice of Annica but instead use only instill parts of it (again, based on Lineham's crap) on their clients and in the end it's the client who suffers when it is not done right. That is what is inherently wrong with mixing two cultures without studying how one of them works.

This is not "therapy", it's stupidity. DBT is the Est rehash of the decade: overrated, misunderstood, no solid evidence that it actually helps and is used because therapist can make more money selling this nonsense to their clients than pharmaceuticals which also have been shown to have little benefit to those with BPD. Didn't stop Lineham from going to the bank though.

So...um...where is this "healing"? Oh, and I never criticized either a client's or therapist spiritual beliefs. I could care less.

Seeking Prometheus Unbound

The part where you find yourself in the care of someone who is getting a big rush of superiority while you sit and struggle is counterproductive.

I think you need to feel like you're in an egalitarian environment where there's no chance for exploitation or any other agenda aside from working on healing and recovery.

The part of Linehan's story that quotes one of her patients as saying, "You mean you're one of us. . .that gives me so much hope" really resonates with me. It's very inspiring to see someone who's walked that road of healing before you, someone who isn't going to judge out of a desperate need to avoid their own shortcomings by focusing on yours. ..that's powerful stuff.

This is my second year of dbt therapy and it's been a lot of hard work and backsliding, but thank god finally the suicidal hopelessness and urge to self-flagellate is subsiding. I actually see myself growing old as a productive member of society with something to offer in terms of being a healer myself. That's major progress. My family and friends thank you too, Doctor Linehan.

From the Viewpoint of a "Wounded Healer"

I've heard the phrase "wounded healer" before as a derogatory term used by a teacher towards one of my classmates who was struggling. Not only is it derogatory and condescending in nature, it is also nonsensical. If someone has a wound, it eventually heals, and we no longer call them wounded. The implication is that these individuals have healed, and brought the knowledge gained from that experience to others, so why continue to call them wounded? The last sentence of this article seems to me a bit unfair, or perhaps your meaning is veiled. I get the idea that you're perhaps jealous of success or insecure in your choice of field. The fact you've chosen to use the words "wounded healer" at all seem to imply that. Perhaps you've never felt as though you've undergone something incredibly transformative or difficult that involved your health.

I don't believe all healers must be "wounded", but it does come with an understanding of what it means to suffer. I imagine medical professionals who haven't experienced illness or suffering have to go out of their way to understand what that feels like until life hits them over the head with a frying pan. As a student of psychology, and as someone who is about to pursue graduate study in medicine, I was led to the field by my own experience with mental illness. I've experienced what it's like to have a difficult illness, and I think it's given me a much greater sense of compassion for others experiencing suffering.

The tone of your writing seems to suggest you believe these individuals are fraudulent. Does having a "wounded past" influence how well a therapist or given treatment will do? Probably not. Should we still look at statistics? Definitely. But when someone is struggling as I did and these fellow "wounded healers" had, the idea that I was undergoing something difficult to help others make transformations in their own lives helped me to heal.

While I don't agree with their self promotion in marketing their therapies, I applaud them for making a difficult journey to improve their health and their lives, and making the decision to use their well being to help others. I suggest you commend them for their bravery in "coming out" in the medical field, and giving hope to people who want to be more than just an illness.

I find your article very condescending

I find your article demeaning in spirit, and the extent of its sarcasm is hurting.

I suffer from chronic and severe mental illness and have been in treatment for a long time. That a health care professional reveals she or he has been on "this side" of the situation as well, has already a healing effect in itself for me. It gives me hope.

I also do not understand why you so much want to attack the very, very few health care professionals that dare to come out. Why, I ask myself? Much more times being in the consultation room gives me the feeling of a strict line between me, "the sick one" and the "healthy" professional, in contrast. Anything that softens this barrier helps a patient to feel hope and to feel he or she is also a person.

People suffering, or having a history of, mental illness (maybe health care professionals especially) face huge stigma. Your article makes it even more difficult for patients to rid themselves of stigma.

Your article impresses me as a form of shaming, and I find its tone hurting. I don't see why we need more of that in the world.

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Jim Coyne, Ph.D., is a clinical health psychologist and Professor in the Department of Psychiatry at the University of Pennsylvania. more...

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