Anne Buist is the Chair of Women’s Mental Health at the University of Melbourne. She has thirty years’ experience in perinatal psychiatry, and works with the legal system in cases of abuse, kidnapping, infanticide and murder. Her Natalie King: Forensic Psychologist series of thrillers is published by Text and her latest novel is called The Long Shadow.
Today, Anne is on the blog to tell us all about the new book and how it explores the world of therapy. Read on …
When my mother read Medea’s Curse, the opening volume of my crime-thriller trilogy, her first comment was, ‘If I needed to see a psychiatrist, I’d want one who was sane.’
Natalie King, the protagonist, is a forensic psychiatrist who has bipolar disorder. In my new novel, The Long Shadow, the main character, Issy Harris, is a psychologist with an anxiety disorder.
Given that one in five people will have a mental illness at some time in their life, it’s hardly surprising that there are teachers, lawyers, judges, pilots, doctors—including psychiatrists—and psychologists, who at times have mental illness. I know plenty of them, some socially, some because they’ve sought my help.
Does this make them better or worse at their jobs? In the grip of crisis or illness, people in any profession may not be able to manage their work, or at least not as well as usual. Maybe they will need to have time off, then a lighter load; or not manage certain tasks … for a while. But then?
If your therapist, like my fictional ones, does have bipolar or an anxiety disorder, can it make them a better therapist? Certainly psychotherapists are recommended to have therapy themselves, partly so they understand the process and partly to deal with issues of their own that may emerge when dealing with difficult therapy situations. Issy has a lot of anxiety around her baby’s safety. It’s not uncommon amongst new mothers (I couldn’t watch the road safety ad that was showing when my children were babies where a child runs out in front of traffic). In Issy’s case it’s gone beyond the ‘normal’ and caused panic attacks, as well as depression, now resolved. In the postnatal group she is leading, she’s dealing with women with anxiety … including fear for their children in the setting of a twenty-five-year unsolved baby murder in the town. Can Issy, with her own problem, still be a good therapist?
Simply, yes. Issy doesn’t always get it right but she doesn’t put her patients in harm’s way—she knows her limitations and uses her own experiences to help her patients. (And crucially, she has reflected on her illness, including its origins in the relationship with her own mother.) But the experience of being unwell—and getting treated—can make you more empathetic.
We train medical students by throwing them into hypothetical worst-case scenarios because most are in their early twenties—comparatively idealistic and without much life experience—and we know how this can impact on patients in the real world: as bigotry or arrogance or someone spouting medical gobbledygook they don’t understand.
Psychiatric patients who are admitted to an acute psychiatry unit are frequently terrified. They may be having hallucinations and delusions. Those with anxiety disorders sometimes need to self-medicate with drink or drugs to get the courage even to leave their home. Who better to understand this than someone who has been there and got through it?
As with any trade or profession, there are good and bad psychiatrists and psychologists. But their effectiveness will have less to do with their own mental-health history than with whether they are a good personal fit. There is a therapeutic component to the psychiatrist–patient relationship—even if therapy is not formally a part of the treatment—and the interaction needs to work. I’ve put up with a taciturn surgeon because I valued his expertise over his bedside manner; but a therapist’s bedside manner is part of the treatment. In psychotherapy I needed someone who I could trust, who would listen to me—and challenge me. When I was doing intense Gestalt group therapy on a Greek Island (this could almost be the subject of a book all on its own) I needed ultimately to be able to trust the whole group; you learn as much from other people as from your therapist in a group. For years I ran an attachment therapy group like Issy and, as with her group, the women I saw gained a lot from the support and experiences of the other women with anxiety and depression.
You might feel more comfortable with a therapist of your own age or gender, or with other affinities of life experience—or it might be those very differences that challenge you, if you are up to it, to bring about the change you want.
If you want psychotherapy, you should see a psychotherapist: not a psychiatrist who adheres to a biological model of mental illness and does fifteen-minute appointments, nor a psychologist who only offers cognitive behavioural therapy. You may need to shop around, and it isn’t easy.
But my guess is that finding the right person for you will have more to do with you—what you want and how hard you are prepared to work for it—than the therapist, and whether they have or have not had a brush with mental illness. For a mental health patient now or in the future, here is my advice: your therapist is an expert in their field but also human and vulnerable. Seeing them that way—understanding that no one is an AI robot, and nor should you want them to be— might just be part of what you need.
—The Long Shadow by Anne Buist (Text Publishing) is out now.
Until the 31st of May 2020, Text Publishing will donate $1 to the Royal Melbourne Hospital, one of five global WHO Collaborating Centres for Research on Influenza, for every one of their books sold – find out more here.

The Long Shadow
Write down something about yourself, as a mother, that worries you.
Psychologist Isabel Harris has come to the outback town of Riley because her husband Dean is assessing the hospital-the hub of the community-with a view to closing it down. Isabel, mostly occupied with her toddler, will run a mother-baby therapy group. But on the first day she gets an anonymous note from one of the mothers. The baby killer is going to strike again. Soon...
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