John Schmid

Milwaukee Journal Sentinel

Editor's note: If you or someone you know is dealing with suicidal thoughts, call the National Suicide Prevention Lifeline at (800) 273-8255 or text "Hopeline" to the National Crisis Text Line at 741-741.

From China to Europe, from India to South America, average suicide rates around the world have fallen 33 percent since 1990.

Not in the United States. American suicide rates are at their highest levels since World War II, making suicide the second leading cause of death between ages 10-34, government data show.

The increase in suicides, combined with record levels of drug overdoses and alcohol-related fatalities, are so extreme that they're lowering the life expectancy of the average American. Mental health problems disable more American workers than any other affliction — suburban, rural or urban — and caregiver burnout and compassion fatigue are epidemic.

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Not for generations, if ever, has a wounded nation needed its elite corps of “wounded healers" as much as now.

They are the counselors, social workers and psychologists often best suited to accompany others on the path to recovery because they’ve already walked that path themselves.

They possess some of the most indispensable and in-demand therapeutic skills in the country, and by all accounts, they exist in sizable numbers. In a nation swimming against the global tide of improving mental health, these healers ought to be the heroes.

But few advertise what might be their strongest credential.

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Instead, many appear to do their best work with quiet professional anonymity — except in moments of confidentially when their private story might help a struggling client.

“There are many like us,” said Bart Andrews, a suicide attempt survivor who's a practicing psychologist and senior administrator at St. Louis-based Behavioral Health Response.

“We’re really afraid to tell our stories because we’re afraid we’re going to lose our jobs,” Andrews told a suicide survivor site called Live Through This, in a 2015 interview shortly after his first public disclosure. “People are going to take our degrees away. They’re going to take our licenses away. They’re going to think I’m not a good therapist.”

The mental health field professes to want to de-stigmatize the shame and stereotypes that isolate many who struggle, he said, and yet the same taboos reach far into the corridors of institutional providers.

Surprisingly few "come out," said Stacey Freedenthal, a Colorado psychotherapist and associate professor at the University of Denver Graduate School of Social Work.

“Some people cannot take the risk of revealing their mental illness, suicidality, or other vulnerabilities. They might be fired, or discriminated against, or hurt in other ways,” said Freedenthal, also a suicide attempt survivor.

Knowledge beyond a diploma

Unsung and unheralded, their occupation seems like a contradiction — mental health professionals who lived through mental illness, drug and alcohol counselors who lived through dependency, suicide intervention therapists who survived their own attempts.

“Theories and interpretations are not much help in the terrifying depths of the psyche,” Kathryn Larisey, a psychotherapist in Atlanta, wrote in her 2012 article "The Wounded Healer."

Swiss psychiatrist Carl Jung, a pioneer in modern psychology, coined the term “wounded healer” more than a century ago. He meant it as a badge of honor, a tribute. It remains in use: “My name is Dr. Paul Epstein and I’m a wounded healer," begins one therapist's blog post.

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But some balk at the title. To them, the word "wounded" smacks of impairment or deficiency. “I hate the ‘wounded provider’ metaphor and cringe when I hear folks use it,” Andrews said in an interview.

Whatever they're called, their numbers spill out beyond psychiatric hospitals and clinics. Within non-profits and social agencies, many prefer to be called "peer specialist" or "recovery coach." In the 12-step recovery programs of Alcoholics Anonymous and Narcotics Anonymous, they’re "sponsors." For those who served in war zones, they're fellow vets.

The most accepted term is a practitioner "with lived experience.”

Camilo Delgado, a Florida-based psychotherapist and international mental health consultant, prefers the term "alchemist" — someone who can transform pain into purpose.

“It is psychotherapy at its best," Delgado wrote in an email.

'Post-traumatic growth'

To be sure, just because people have crash-and-burn stories of their own hardly qualifies them as competent healers. Therapists preoccupied with their own traumas aren't much help to others.

But those who have mastered their own experience can make a uniquely convincing case that people do recover..

“Someone doesn’t have to have been suicidal to help suicidal people, but there can be gifts in the experience,” Freedenthal said.

At Rogers Behavioral Health in metro Milwaukee, psychologist Sarah Reed prefers to speak of “post-traumatic growth” — not the more common diagnosis of Post-Traumatic Stress Disorder.

In videos and workshops, Reed has disclosed her own history of an eating disorder, depression and anxiety. “It often gives me more clout than my degree and education,” said Reed, who holds a doctorate in community psychology.

Therapeutic storytelling can be transformative for those who open up and for those who hear the stories, according to a consensus of recovered healers.

Reed conducts workshops to help young adults safely write their own narratives, using guidelines written by recovered healers. Young people sort the costs and benefits of sharing their stories, weighing how much to share and with whom — and only in situations that will be helpful.

Scripting a new narrative is a common strategy to build resilience. The objective is to map out a future that moves beyond the memories of the past. Those who move to the next step and tell their story publicly often become mental health advocates.

“People with lived experience are absolutely necessary and undervalued,” Reed said.

Out of the 'closet'

It took Freedenthal 22 years to break her silence. Her own suicide attempt took place in her first year of graduate school. “Professionally, it seemed too much of a liability for people to know,” Freedenthal wrote on her webpage.

In 2017, she published a short memoir in the New York Times (“A Suicide Therapist’s Secret Past”). She followed up with a "coming out" essay on her website (“The longer I hid that I myself had been intensely suicidal, the more hypocritical I felt.”)

As the feedback poured in, she discovered how many others like her anonymously populate clinics and psychiatric hospitals. Scores wrote to her — some in training to start their careers, some in mid-career, and many who kept their recovery stories secret all the way to retirement.

The statistics bear out what she found:

• A 2009 survey found that 87 percent of psychology graduate students reported experiencing anxiety; 68 percent reported symptoms of depression; 19 percent reported suicidal thoughts, according to the American Psychological Association.

• A survey conducted at a U.S. workshop for clinical psychology trainees found that 59 percent had experienced suicidal ideation and 5 percent at one point actually had a plan to carry it out, according to the New School Psychology Bulletin in 2015.

• An anonymous web survey of 678 British clinical psychologists found that two‐thirds “had experienced mental health problems themselves.” The same survey found that many didn’t want to disclose due to shame and career consequences, reported the Journal of Clinical Psychology in 2018.

The impact of economic disruption

Serious mental health challenges continue to rise in the U.S.

In 2017, deaths from alcohol, drugs and suicide hit their highest levels in both Wisconsin and nationally since federal data collection began in 1999. The increases in Wisconsin are slightly higher than the national average, according to a Journal Sentinel analysis of data from the U.S. Centers for Disease Control and Prevention.

The epidemic of mental and behavioral health afflictions defies simple explanations. But studies are consistent on one point: Exposure to traumatic assault, abuse and abandonment increase amid economic disruption. That leads to an increase in post-traumatic disorders including mental afflictions, addictions, aggression, homelessness and suicide.

However many recovered healers already exist, there aren’t enough.

Acute shortages of social workers and counselors are well documented, particularly in rural regions. Of Wisconsin’s 72 counties, 48 lack even one practicing child psychiatrist, according to the American Academy of Child & Adolescent Psychiatry.

"More of these healers and mental health professionals would greatly improve our mental health situation in the U.S," Delgado said.

A healer is born

Larisey, the psychotherapist in Atlanta, described her own crippling bouts of panic disorder and the horror of hitting bottom. In her article, she found herself in an emergency room in a full-blown anxiety attack:

"Heart pounding, head down, hands clutched before me ... What? Me? I have a disorder? This can’t be happening. I am a mother and a wife."

A hospital chaplain, apparently an alchemist himself, sat down with her. After a long silence, he told her:

“It is moments such as this one wherein healers are born.”

John Schmid reports on how Wisconsin’s people and communities are confronting the impact of globalization and economic disruption for the Journal Sentinel's Ideas Lab. Over the past three years, John has documented an epidemic of neurological civilian trauma and mental health afflictions, which drive downward economic spirals in rural and urban Wisconsin. Beginning with a 2017 series called, A Time to Heal, and then with multiple follow-up stories, he interviewed scores of social service and mental health practitioners. Email: john.schmid@jrn.com. Twitter: @GlobalMilwaukee'

'Hoan Alone:' Meet the Milwaukee man behind a remarkable film

“All I had was a ‘hello.’ It worked,” recalls a Milwaukee fire department deputy in “Hoan Alone,” an animated documentary about suicide prevention.

This 2018 short film by Milwaukee filmmaker Aaron Johnson touched an emotional nerve: It’s been shown at nearly 40 film festivals, won 14 awards and been lauded by mental health advocacy groups.

Join the Ideas Lab and co-sponsors WUWM (89.7-FM) and Marquette University for a special screening and discussion of the film at 7 p.m. April 4 at the Lubar Center at Marquette University Law School.

The event is free but you need a ticket.