The struggle of feeling poorly when you're a mental health professional

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Hi, welcome along to the Aspiring Psychologist Podcast. I am Dr. Marianne Trent, a qualified clinical psychologist. Thank you so much for being part of my world and for listening to this episode, episode number 48, which is just wonderful. We are fast approaching a whole year together, which is ace.

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I sound a bit different today in my head, in my ears, in my throat because I haven't been very well. I've got tonsillitis. My tongue feels too thick. I don't feel like I can get my words out quite right. But people assure me I sound the same. But for me, all feels different. It all feels different.

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And this has inspired the topic of today's episode of the podcast, which will have some possible catchier title of working when we are poorly as aspiring psychologists and mental health professionals. Something along those lines. Yeah, I could do with help coming up with catchy podcast titles.

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And with that in mind, if you've got any ideas for things you'd like me to talk about on the podcast, please let me know honestly, please don't be shy. Otherwise you just get the random stuff that's going on in my life. And maybe you enjoy that. But I would also like some bottom up guidance as they say in the research world as well as top down. Oh, now I'm like, oh, they think I'm saying I'm the top of the tree. I'm not. It's just that, I'm creating it, so that would be top down.

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So yes, please don't be shy. Head along to my website, www.goodthinkingpsychology.co.uk/podcast, and let me know what podcast episodes would really light your fire.

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Okay. So I recall the first time that it cropped up for me as an issue when I was unwell because it directly impacted on the care of my clients. And that's when I was working for a university at undergraduate level. I was doing a job in my second and third year supporting disabled students to optimally engage in their studies. So it usually meant going along to lectures and/or exams with them if they had some kind of disability. And it could be a kind of longstanding disability or it could have been a temporary disability as well.

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So somebody once broke their right arm and they were right handed. And so, I really have awful handwriting, I was a very bad person for that job, but it was my job to scribe for them.

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So yeah, if you are at university and you are experiencing some kind of difficulty with accessing the level platform to engage in your studies, please remember that there are student support services there. And there will be likely some service to support you to more optimally engage so that it's fairer for you.

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And that might be, like I said, a long standing difficulty that you've got, such as what we discussed with Dr. Deborah Kingston when we were speaking about ADHD, and we're thinking about the Centre for Academic Writing. But also if you've got any kind of additional needs or mobility issues, then you can contact your student support centre and see in what way they might be able to help you. And then you might get someone ... Hopefully someone with slightly neater writing than me ... Runs in the family, my brother has got such awful writing, that the university had to pay to have his work transcribed so that they could score it. And he was doing pure maths. That's not easy stuff to transcribe. When I used to look at his work I couldn't even read it.

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So we've got very different brains. I'm into language and emotions, not at all arty, I don't think either of us are. Actually he used to be quite good at art. He used to be quite good at painting pictures of my rabbits and the cats and things. He often used to do that for his art homework. So I think he is artier than me. So yeah, he got the arty brain and the maths logic brain. And yeah, I got the other stuff. I got the other stuff. I don't know who's doing better but we're both doing all right. So there we go. Another aside into my life, which I know some of you enjoy.

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So as I was saying, the first time this cropped up for me as an issue was when I was in undergraduate study. And when I was then ill, I thought, oh no, it means so and so will have some sort of disruption to their lecture. They'll be unsettled. So I was working with some people that had autism as well and sometimes they just like to know that there was someone nearby in case anything went wrong that they could get help to problem solve. So if you are in this role yourself or looking to apply to this role, you'll be working with a variety of different presentations.

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So there's that sense that, am I ill enough to warrant wrecking two people's days? So I don't know about you, and I'm not advocating this, but certainly when it came to studying for final exams for myself, my lecture notes were usually in an assortment of mine and three of my closest friends' writing. So usually one of us of the four of us would've been to the lecture. And yeah, I'm going to name check them here because they're so lovely, Claire, Gemma and Katie. Usually between us, I'm sure they were dreading the day that it was my notes they had to read, but between us when we'd attended lectures or seminars, and the other person hadn't, we'd pass on our notes. So yeah, I did do my bit as well.

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I would say on balance I went to most lectures and probably all seminars because I think the seminars were compulsory, the lectures at that time were not. But yeah, not all of my original notes were in my own handwriting. So yeah, it was quite interesting to see just how many of those there were that I then had to read and understand and get into some ship shape order for my own exams and coursework.

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So yeah, it's probably all different now, you probably all take laptops or iPads and stuff. But at the time that was incredibly rare. So I started university in 1999. It was incredibly rare to have anybody tip tapping away. There might have been one person at the front and that was it. But I'm sure it's very different now.

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And even when I went to do some teaching at a DClinPsy course, they were all sat there with their laptops tip tapping what I said. And it was a very different experience. Whereas when I did teaching, we'd all sit in a ring shape with the presenter standing at the open end of the ring, the open end of the circle. And it was very collaborative. And you could get instant eye connection with people to get a sense that you were being understood.

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Whereas talking to the back of 15 laptops isn't quite the same. And it puts that distance between you and the people that you're speaking to. Which I didn't necessarily enjoy actually. I really thought there was something very special about being in the room with 15 people, with nothing on their laps, just bringing themselves with nothing getting in the way. That was something quite unique.

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So yeah, if you are going on to training, I would suggest sometimes that you just maybe suggest just being. How about we take pen and paper notes. Or one of us takes pen and paper notes, we take turns to scribe, so that the rest of you can take turns in really immersing yourself in the process. This is a total aside, this is nothing to do with being poorly. But just talking about technology and how that crops up at universities.

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But yes, so what I was saying was that if I was going to be sick, I had to work out whether I was sick enough to not go. And obviously if you had a vomit bug or something then you really can't go. The basic infection control principles are usually that you're not welcome back between 48 and 72 hours after you've last been sick. And so your hands are tied in that regard. And so you can't go. Certainly in the NHS, I think it's 48 hours after you've last been sick. It might have been 72, I can't quite recall.

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But in those positions you're going to have to not support your service user, which means you're going to need to phone in sick. And it's never an easy thing to do. Having to make that phone call to your supervisor, your manager or team lead or duty receptionist and say, I'm really sorry, I'm not coming in. And we can soften the blow these days by sending an early text to somebody and then saying, well, I'll call in when the lines are open at nine. But it's not easy.

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And so this cropped up for me this week because I've had tonsillitis. I've been really unwell. I first started feeling dodgy Friday, which was the day we got back from holiday. I felt dizzy, just completely exhausted, but like excessively exhausted. Because actually I hadn't had late nights, there was no reason I should be feeling that exhausted after a holiday. We'd done lots of walking. But usually I would feel uplifted and invigorated by that rather than completely drained. And the bed wasn't as comfortable as I would've wanted it to be, but it was not enough to warrant being that exhausted. So yeah, it's been rumbling. And then from Sunday I just didn't feel well at all.

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And then my tonsils were just awful, awful, awful, awful. To the extent that the doctor took pity on me on Monday and prescribed me some antibiotics. So thank you to her, she was lovely. And then I started to turn a corner. So I'm doing this on Wednesday afternoon and I started to turn a corner Tuesday evening I would say. I started to think, oh, I feel a bit more like myself.

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But I have been not role modelling terrifically well because on the Monday when I was feeling dreadful, I didn't want to let my membership down. So I still did my usual lunchtime live, which is if you're familiar with the compassionate Q&A, it's like that. But people ask me any questions once a week. So if you like the compassionate Q&As and you would like more of them, then you can get those within my memberships. That's worth bearing in mind as well.

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But then that evening I also had the second and final compassionate Q&A of this application stage. And because I'd been advertising it on the podcast and on socials, I didn't want to let people down. And because I knew that it is application season. And the applications in case you're not aware for DClinPsy, certainly for clearing house, they are due in before 1:00 PM on the 16th of November. In case that's not on your radar, it's coming up very soon.

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So my virtual assistant had said to me, why don't you just postpone it and do it later in the week when you are more well? And I entertained that idea for a couple of seconds and I just thought no, because I want to do it now. And of course it is a bit different because it meant that I was having to work for an hour and a half in my own house. It's not like I had to get a train, go out in the pouring rain, stand around for a while. It was more compartmentalised.

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I do think with the commonality we have of working from home these days, we are more likely to do some work on the days when we should be or indeed we are on sick leave. So yeah, probably if I was being entirely fair to myself, I would've got Hannah to contact the clients and to look up their numbers and cancel.

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Which is of course what we used to do in the good old days of the NHS before we had laptops, you didn't have any access to VPN connections to be able to securely access your client's contact details to cancel. And so then that would be done by the office from their desktops. They would look at information, call the patient and let them know that unfortunately the clinician isn't very well today. And they will make contact when they are well again.

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But I do think we are more likely to do some of it. And whether that's partly because we don't want to inconvenience anyone else because of course it's sometimes clinicians that have to do that and then telephone. Sometimes already overstretched admin staff having to make those phone calls. And so if we can do something to lessen the load of our ... minimise any disappointment or inconvenience, I think we are probably just by the very nature of our profession, we are more likely to want to do that.

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But do bear in mind that you don't have to. If you're not well enough to work, that you just need to report that you're not well enough for duty.

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And with that in mind, I think the most unwell I've ever felt was in 2016. And at that point I had a three month old baby and a three year old. And we were having an extension, we had no kitchen. And I had bronchitis and this was the weekend where the preschool had sent my little boy home with Wilf, the class bunny, to have a marvellous time at home. And my youngest, the baby, didn't sleep. He waked me several times a night. He was breast fed. And so when you are unwell and breast feeding, it's not the easiest. Although at least you can lay flat in bed. Hopefully the child might go to sleep and then you can put them back in their cot.

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But basically, I do recall at one stage Googling at that time, can you die of bronchitis? Because I felt so awful, so awful. And then having to somehow entertain this class bunny and pretend we're having a nice time when Mummy’s too ill to leave the house. And the house is in utter chaos because we had no kitchen, the living room had everything in it. My youngest didn't have a bedroom, so all his clothes were there, laundry was everywhere. It was an awful, awful time.

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And yeah, thankfully I came through it. But I was really so unwell. I definitely couldn't have gone to work. And yet still here I was having to look after two children. But yeah, my husband I do recall rallying around. He gets an awful pained expression on his face when I'm ill. He's so used to me just getting on with and doing things and sorting the kids' breakfasts. Because I'm an early bird so I'll often be up anyway. So if I'm sorting my own breakfast and drinks and things, I just do it for the kids as part of the things that I do.

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And I think when I'm not well enough to do them, suddenly he's like, I don't really like you being unwell, are you okay? Do you need anything? Whereas I'm a provider, I'm a nurturer, I'm used to being the one, do you want a cup of tea? Do you want anything?And I usually, probably four or five times a week, would cook tea. And then suddenly I can't do any of that. I'm laying flat. So yeah, it's tricky when we've got different roles. And then you're not well enough to do any of them. But yes.

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So my point with where I was going with that is we try and we do like this adjusting, don't we, where we think, well, I could be more unwell, maybe I'm not unwell enough. But we've got to be compassionate here and we've got to think, well, how much more unwell would you need to be to not go? Or should you be going? And well, if this got worse and you were admitted to hospital, then there'd be no question about it. You couldn't work from hospital.

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And so what we also know is if we give ourselves time to properly rest and recharge, so I spent all of Monday in bed apart from the one and a half hours I mentioned, and I spent all of Tuesday, every second of Tuesday, in bed until about 4:00 PM. When I thought I'd try and cook tea to see if I could manage it because I'd started to feel a bit better. So other than that, I was laying flat. I've watched some Netflix, I've read some book, I did check my emails and try to do a bit of my accounting software, but that's like non-work, it doesn't count as work for me because you're just literally locating receipts and attaching them and stuff.

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And also we've got to think, when we're employed, which I'm not, self-employed, a sick day when you're self-employed is a painful thing because you're not getting paid. But yeah, you've got to think about, sometimes when you are employed, about your sickness absence and how that's looked upon. And that can pressure you into work or pressure you to consider saying, can I work from home today because I'm not feeling that well? Or I don't want anybody else to get sick. But actually you're probably not really well enough to be there at all. If you're not well enough to be in a building, are you well enough to work? Full stop.

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So yeah, I'd love your thoughts on this, come along and discuss with me. But for now we've got a little break and I'll be back along very soon.

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Hello, my name is Avalon and I'm an undergraduate psychology student. I really enjoyed reading the Aspiring Psychologist Collective. And I really honestly just couldn't put it down. I found it really helpful because as I'm in my final year and starting to think about what I'd like to do after uni. And up until this point I've been very set on the idea of pursuing an AP role. And the Aspiring Psychologist Collective helped me to see that there are so many more options out there that may appeal to me. And I'm looking forward to exploring some of these and broadening out my options.

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And I also really appreciated that people were open about their lived experience and how they navigated this over their psychology journey. I had lived experience of an eating disorder, so it was really inspiring to hear about how people have brought that into their reflections and how it's shaped the clinicians that they are today.

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So we're thinking about ill health today. And of course there can be a number of causes of ill health. So far we've spoken about transient conditions such as bronchitis and colds and tonsillitis. And if you are battling any of those currently, I feel for you. I used to have tonsillitis all the time when I was an aspiring psychologist and I'd forgotten just how awful it is. So if you have that right now, if you've got a really horrid cold and you just want your bed, you just want a cuddle, please know that I'm sending you my solidarity.

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Came to 1:00 AM the other morning and I felt so wretched. Wretched is the word. And my husband was asleep. And I wanted to wake him up and say, I don't feel well, I just feel so awful. But I thought that probably wouldn't be fair. So I didn't. And then when he eventually woke up, he said, you were awful last night, you were just awful, awful to share a bed. I was like, I know, I felt so unwell. But to my mind, he was asleep all of the time. But clearly he wasn't. He was probably awake when I was asleep and making a lot of noise and being just very unwell.

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So if you are not feeling well, yeah, feel better soon. Try and look after yourself, try to eat if you can stomach it, try to keep your hydration up. See if you could ask other people to help you. Something we are not that good at all the time. Can you ask someone to look after you or to look after the people you would usually look after. They might be small people, they might be grown up people, they might be your siblings. Can you ask for more help so that you can focus on just some R&R, and maybe even a nap.I had a nap the other day, Monday afternoon. I thought, I can work from bed, but I really couldn't, I just wasn't well enough. So I had a nap and then thankfully felt a little bit better to be able to do my compassionate Q&A. But the next day my friend contacted me and she was like, Marianne, you look so unwell, you look so unwell when you were doing that. You sure you should have been doing that? I was like, I didn't want to let people down.

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So yes, if you are going through a sticky patch right now, please look after yourselves. And I hope it passes soon. But of course, transient ill health is not always the reason for sickness absence. Perhaps you live with chronic pain or you've got a physical health condition, maybe even if you've got asthma or allergies, that mean that you can't always get into work.

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And that obviously is impacted upon by any sickness absence policies as well because HR can get a bit twitchy in occupational health when you start having more days over a certain allocation in a time period. It's not easy stuff. And it does affect our decision of thinking about whether we are well enough to be at work or whether we are unwell enough to be at home and not working. So this is not easy stuff.

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But you can always talk to your supervisor, you can always talk to occupational health if you want to think about any changes to your working practises that might make it easier for you to work. And certainly occupational health are responsible for things like display equipment and the comfort of your chair. So if you've got any back problems, it's really important that you have a properly fitted desk chair workplace assessment. And sometimes they will leave that with your sticker on the back of the chair making sure that no one else touches it because it's set up for you.

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So yeah, don't struggle on in physical pain, make sure that work are looking after you, getting you any wrist guards or anything that you might need to protect your wrists and things like that. So yeah, contact your occupational health if you think there are adjustments that could be made to make your life at work, either at home working, or working in a workspace, work better for you.

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And again, regardless of what type of illness we're talking about, there's that sense of, are you really able to give your best self, to give your full attention to what your clients are saying, and to be sitting with the distress. If you are feeling in pain or really unwell, the answer is usually no. And so in doing yourself a service of staying home and not working, you are also likely doing your clients a service because then when they do see you again, you are firing on all cylinders. And therapy might then move more quickly as well. Or whatever you are doing will feel less of a struggle because you actually want to be there. Which is very different than when you are feeling like you're turning up because you have to be there.

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And of course there's other types of sickness as well. This could be mental ill health or it could be complications and just normal run of the mill pregnancy can make you quite unwell as well. But also if people are trying to conceive with assisted fertilisation, that can be quite disruptive to your health and to the way that you feel.

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I was once doing a session with a young person in CAMHS when I was pregnant. And I think it was probably before I told certainly my clients I was pregnant. And I remember being sick in my mouth during a session and having to swallow it down. It's not nice. So I wasn't sick, sick and I wasn't contagious sick, but I wasn't living my best life then. I remember sitting in my office, I did have an office in that service, which was marvellous. It was a shared office, but it was still a lovely office, shared between me and one other person. But yeah, I remember sitting with my head on my desk, I was feeling so nauseous. So yeah, if I wasn't being sick, I was feeling nauseous. And it was very tricky to carry on.

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So again, if you are in that position, congratulations if you are feeling excited about it. But yeah, awful, awful pregnancy nausea, dreadful. Yeah, I preferred ... the days that I was actually sick, I felt better because then it's done. But if it's just that awful nausea that seemed to go on all day, there's nothing you can do. Nothing takes the edge off. So yeah, I've been there. It passes once you have the baby. But yeah, luckily both of my nauseous periods seem to stop into the middle trimester, the second trimester.

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But of course when you are pregnant, if you're expecting one or multiple babies, there can be complications to your health that means that you need to take some sickness absence as well. So I during my first pregnancy had to take probably about three-ish weeks off I'd say. And quite significant blood loss I was experiencing. And so I was made to stay home until they were confident that that was stopped. And that it wasn't a risk to me or to baby.

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Now of course, pregnancy sickness doesn't count as sickness in the same way. So if you are pregnant and you've told your occupational health, which people do encourage you to do, to tell your manager so that any accommodations can be made as well to make sure that you are not at risk and baby's not at risk in the settings that we work. So it is your choice, but it might be something that you would choose to do before your 12 week scan.

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It's not sharing on social, this is not sharing with the wider team, but this is sharing with somebody who has a managerial and a responsibility to keep you safe at work. So your choice of course, but it might be something that you want to consider.

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So yeah, pregnancy sickness doesn't count towards your usual sickness record because pregnancy is what's called a protected characteristic.

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So yes, I hope this has been useful because what I know is that we will have days where we feel physically unwell or when we feel mentally not well enough to be at work. And these are important considerations and they're conversations you might well have with your clients as well. If they're working, they'll be talking to you about working and how well they feel. And sometimes I'll say to a client, this is my professional advice here, I don't think you're well enough to be at work.

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And sometimes people can find that really validating because it gives you permission then to not work and to take the pressure off that guilt pedal. Well, Dr. Marianne also thinks I'm not well enough to work, so now I can relax into being unwell and really focus on getting better.

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And I certainly had that when my dad died. So I was on some sick leave after he died and the GP said, I don't think you are well enough to be at work at the moment. The job you do, with the level of trauma work you do, and the level of grief that you are regularly rubbing up against in your day to day work life, I don't think you're well enough to be there. And that was really, like I said, really validating to have someone else give you permission to have time off work.

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And of course that came in the form of a sick note, didn't it? But yeah, if you feel like you can't give yourself permission to be off work, then talk to someone else as well who can help you give permission to yourself to even get signed off work.

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All right, so I hope you found that useful. Come along to the Aspiring Psychologist Community Free Group to discuss how you're feeling. And if you are not feeling well, come and tell me about it. And I will go, oh, I'm sorry to hear that, look after yourself.

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So yeah, I'm going to go to bed. And I'm going to do the clinical notes from the client I saw this morning. And I'm going to edit this podcast episode. So I can manage that. My mother-in-law has been amazing, has been taking the children to and from school whilst I haven't been feeling very well. And she's picking them up for me today. And I'm hoping I will be feeling stronger and more able to resume normal service tomorrow. That's the plan anyway.

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So yeah, I hope you found this helpful. Hope you can forgive me looking ... You're probably like, she doesn't look any different. But I feel like I don't look like quite my usual self. Why are we so self deprecating? I don't know. That's a whole nother episode. But yeah, thank you for listening. I hope you found it useful. And I'm looking forward to catching up with you very soon. Take care.

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