What Does It Mean When A Psychotherapist Has Panic Attacks?

OCD and Anxiety Disorder Treatment and The Wounded Healer

by Daniel Frazer, LCSW

My entire life is quite literally all anxiety. I spend over 40 hours a week with the anxiety of my clients, those I supervise, on OCD and anxiety research, and the daily anxiety I also live with. Like a gardener who works with a fig tree, I work with my clients’ anxiety collaboratively — tending to it with care, but also with the willingness to help them feel, see, and weather the pain that growth requires. The goal is never topiary — it’s a wind-shaped cypress, with roots that grab earth by the throat.

My own anxiety: I’m more of a weekend warrior. Only on Sundays do I have a firm boundary to never work (but is it work? I love what I do, and I’m not claiming to be holier than thou, but it’s not clear to me when career and work meet—that’s another essay.) In my clinical practice, I am rather open that I’ve struggled with OCD and panic attacks. While I don’t go into the details of my own mental health history, I believe that OCD and panic attacks are the sort of conditions where we need to be willing to show our battle scars. Some Sundays I have panic attacks. Some Sundays I’m fine.

Jung coined the concept of the wounded healer: that in order to heal, one needs to confront their own suffering to gain the insight and empathy to treat others. Interestingly, nowhere more than in the modern treatment of OCD and anxiety disorders has this been more present: Joshua Fletcher, Glenn Murphy, and Paige Pradko, strong voices in the OCD and anxiety community, have all spoken openly and eloquently about their own struggles with OCD, agoraphobia and anxiety. These three were greatly preceded by Claire Weekes, MD — the brilliant and beloved Australian physician whose early works, still popular over 60 years later, were unique in their concept of running towards and allowing anxiety rather than perpetuating avoidance with psychoanalysis and other popular modalities at the time.

But what makes Claire Weekes, MD so unique for many was her willingness to share her own anxiety experiences — while I imagine early readers of her work could already ascertain Dr. Weekes “got it” in a way that others didn’t, in interviews in the late 70’s, Dr. Weekes shared her own instances of ‘nervous suffering’. In one interview, when she mentioned that she still occasionally experienced panic attacks, she famously told the reporter showing sympathy for her anxiety to ‘save his apologies for someone who needs them’. Dr. Weekes owned the realistic image of anxiety recovery and embodied the confidence one needs to work with people with OCD and anxiety disorders.

The realistic image of OCD and anxiety recovery is that it will never go away entirely. In multiple studies, while most will show significant improvement of symptoms with interventions such as ERP or CBT therapy, it’s rare to find good-quality research showing total, complete remission of OCD and anxiety symptoms. The goal, which Dr. Weekes understood in the nascent years of OCD and anxiety research, was to allow, to withstand and to willfully tolerate the symptoms of OCD and anxiety without avoidance.

So what does it mean when a psychotherapist has panic attacks? Recently, I met a fellow psychotherapist who expressed deep shame that they once had a panic attack while in session with a client. This provider, skilled and deeply feeling, seemed to forget that they had the rare privilege of ‘graduating’ this client out of therapy, that they continued working together until the client’s goals were met—a rare feat in the land of health insurance and finances. I believe that the display of this psychotherapist’s humanity either directly or indirectly was part of such good outcomes.

I won’t pretend to love my own issues with anxiety but I do know it makes me a better psychotherapist than if I had never had a panic attack. Sometimes, I meet clients who wish they’ve never had an issue with anxiety — I can understand this: Unless you’ve dealt with the disillusion of self that OCD brings or the chaos of panic attacks, it’s quite hard to understand them or to respect the sort of primal urgency they cause the individual. A single panic attack can have the power to trigger homebound disability for some individuals. OCD is listed as one of the top 10 most disabling illnesses by WHO among all illnesses, not just mental-health-related concerns. But when a client wishes they’ve never had anxiety, I push back on this because to wish to never have had anxiety, is itself avoidant. At its core, anxiety is hopeful — it is even helpful. Anxiety is an ancient and inherited enthusiasm for survival we must learn to collaborate with.

If you’d like to learn more about my practice, become a client (in NY, NJ or Maine) or would like to get in touch, please visit my website: Making Meaning Psychotherapy