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Author: Michael Muldoon

  • Post #4

    Navigating the Field of Social Work with a Mental Illness

                   Many social workers and other helping professionals begin their career to help people with the life challenges that have afflicted people they know or themselves. It makes sense: people may want to give back or “pay it forward” as a way of expressing their appreciation for the support they have stumbled upon. Helping those who struggle with issues that you may have faced can also be empowering, in that you are not only managing your own mind and body, but you are proving to yourself that you are strong and resilient enough to help others. These are noble intentions. They are also often quite different and simpler than the realities of being a social worker or other helping professional.

                   Having experience with navigating mental illness and working in a position to help others do the same is a double-edged sword. On the one hand, knowing and having had the experience of mental health issues can help us relate to our clients or patients in an invaluable way. For example, consider the pertinent therapeutic task of rapport-building: to build trust with those we serve, it helps if they believe that we “walk the walk” also. However, when the worker has experienced similar realities to the client (or at least have this perception), there is a significant risk for countertransference and burnout, especially if firm, healthy boundaries are not maintained. This is a crucial point to consider, especially for new professionals entering the field.

    Social work is a field with a great variety of settings for employment, from the acuity of an inpatient psychiatric unit, to outpatient therapy, to ensuring the welfare of people across the developmental lifespan, from birth until death, and many more. There can be a high risk for countertransference and burnout in any of these positions. (I have experience though mostly in behavioral health treatment/therapy settings, where workers directly discuss sensitive mental health issues with clients/patients.) Social workers often enter into these complicated and stressful dynamics with upstanding moral intentions. in my experience, those who can endure are highly likely to have healthy boundaries in professional relationships, in that they maintain psychological and emotional distance from those they are serving, even in the context of vulnerable and serious work. I have also noticed that when a worker has rather porous boundaries, in that they may be reluctant to stand up for and protect themselves psychologically, there seems to be a higher risk of deterioration professional and/or personally. This perception/pattern is not usually evident from a small sample size of professional interactions, but rather may take place gradually, as the worker with porous boundaries invests so much of themselves in their work and patients, yet saves little time, energy, and compassion for themselves. You can consult the research and data for the more objective picture of burnout among healthcare professionals, and you will likely find ample evidence of the phenomenon of burnout in recent years.

    As someone who has struggled with symptoms of several mental health disorders, I also want to note that even if you maintain healthy boundaries, you may still be very susceptible to burnout due to mental illness traits. This connection (mental illness contributing to burnout) can look very different depending on the person, their demographic factors, where they have worked, and their particular diagnoses. A worker who has a depressive disorder and is employed in a setting with a high caseload of clients may burn out due to the sheer time and energy required by the job that saps the worker’s internal resources over time. A worker with an anxiety disorder may work diligently and seemingly without great difficulty on site. But outside of work, they worry excessively about their performance or perhaps “take work home with them” and spend too much time ruminating on particular clients (this countertransference can also be detected during work/sessions, and is pertinent to explore, ideally with a clinical supervisor). As a worker with mental illness, you have to be especially strategic and intentional about how to utilize your finite internal resources, for your clients’ sake and for yours. This care might look like having a firm boundary related to yours hours or caseload, or perhaps requesting to work with or not work with certain patient populations. This attention is especially crucial when you notice that your mental health and/or work performance is dipping even a small amount; then it is time to look at the big picture and be honest with yourself about what you can do differently in your personal and professional life to ensure long-term health and growth.

                   By no means am I trying to discourage those mental illness from entering a helping field like social work; we absolutely need this perspective in working with individuals, organizations, and society/policy to work with and on behalf of our clients. My aim with this post was to first validate the intentions of new social workers, and centrally to foster some reflection into what may lie ahead in your work journey, and what you ought to consider and possibly do to promote your professional and even personal sustainability. There is certainly a spectrum with how visible or open a worker is about their personal life and struggles, and it is okay to differ from colleagues on when and how much to disclose. And it can be especially difficult early in one’s career to assess how one’s mental health is being affected by professional life. But prioritizing one’s own health and honest consideration of one’s own trajectory with respect to mental health is a MUST for anyone in this field, in order to sustain yourself, the workforce, and those we serve.

  • Post #3

    Patience – What I’ve Learned (or am Trying to Learn!) from Burnout from Professional and Personal Life

    One hears many cliché mantras about the value of patience. And when we hear the same idea articulated over and over again, we may tend to tune out the subject subsequently. But this subject, being patient, is one that is worth your time, bandwidth, and energy to reconsider. I believe that impatience is one source to many of an individual and society’s problems, and that having the intention of patience (and walking the walk too!) can help unlock ample benefits and derive more satisfaction from life. In this piece, I examine patience as it relates to professional and personal life Burnout, in order to foster insight about the utility of living patiently, as well as to begin to offer reasons and strategies for prioritizing being patient.

                I am a Social Worker, more specifically a Licensed Clinical Social Worker. This degree and licensure allow me to work in many settings, performing multiple roles, for varying populations. What’s not to like, right? Shouldn’t I be set for the next few decades until I kick my feet up and retire? (Shockingly, no). I am also a dad, with a wife and two sons. While there is no degree or licensure needed to raise a family, it is a powerful thing not to be taken for granted. Both of these aspects, of my professional life and my personal life, while incredibly valuable and meaningful to me, come at costs. And from the title of this post, maybe you know in which direction I am moving – that these parts of my life have also contributed to the feeling of Burnout, and also that I am starting to realize the value of patience in preventing and recovering from this feeling of Burnout. In this post, I try to raise several perspectives and strategies to prevent burnout and remain patient, that can apply to multiple domains of life.

                Many people have biological and/or environmental (risk) factors that may predispose them to becoming burned out, in addition to the busy-ness of life and all of its stressors. Many people (but a different subset of the population) also have what is called protective factors, which help one overcome the difficulties of life; many of these are in one’s control, like the support network you develop or the coping skills you build, but some of these are outside of one’s control, like the neighborhood you grow up in or the medical conditions you have. I would consider myself to have many of both risk factors and protective factors to burnout. For example, biologically, I have/had several neurological/mental limitations, in a Brain tumor diagnosis at age 19, several mental illness diagnoses, some degree of perfectionism/OCD, and the psychological tendency to “spread myself thin” or “bite off more than I can chew”. However, I have many protective factors too, from ample support from family, friends, and professionals, to the skills and insight related to mental well-being that my career has helped me to gain. Essentially, it is worth considering these two sides ( risk and protective factors), in determining one’s likelihood to be knocked down and kept down by stressors.

                To connect the ideas of burnout and patience, I want to share an example of sources of burnout, and how cultivating an attitude of patience and developing this skill is relevant. Recently, after about 5 years of intense professional work in various settings for mental health treatment, like many others post-pandemic, my optimism and desire to help others has taken a hit, from which I may or may not recover. In this same time frame, I have also experienced the pleasurable and depleting source of parenting young children. My patience has, you could say, “been tested”, in that my willingness/ability to be caring and compassionate has honestly taken a hit, for both reasons somewhat outside of my control (biological/medical) and for reasons which are somewhat in my control to adjust (the psychological and social ones). More specifically, in caring for patients in crisis due to their suffering mental health, whether from building professional relationships and to some extent taking on the psychological weight of their burdens, and/or from the everyday challenge of giving part of myself to help them recover (both implicitly in simply attending to them or explicitly in teaching coping skills), I seem to have at least temporarily lost some passion for helping vulnerable populations. And many can relate to the stressor of raising young children (which I will not delve into here).

                So wait, how is patience related to the subject of Burnout? I believe there is a cyclical nature in this relationship, in that impatience can contribute to burnout, and also burnout can contribute to lack of patience. More specifically, if we are not patient enough to make sure we are “calibrated” or “filling our cup”, and instead rush forward with life because of internal and/or external pressure we face, we may be more susceptible to burnout. And when we are feeling burnt out, despite our efforts to engage in the present moment, our attention and compassion are more easily interrupted by fatigue and frustration. So, an important question is how/where to intervene to disrupt this vicious cycle. Below are several skills to develop or approaches to consider to facilitate patience and wellness, for which there is ample opportunity to explore further elsewhere.

    1. Practice mindfulness meditation
    2. Practice distress tolerance skills
    3. Practice psychological flexibility
    4. Slow down and consider the influence of societal values on your own “operating system”
    5. Compassion for self and others

    Patience is not just an idea; it is a skill, that many of us need to practice to improve. Doing so, and even incorporating it further into your mindset and life philosophy, has tremendous benefits for your quality of life (see the research!). Not doing so can have multi-dimensional, deleterious effects on your mental and physical health that can take a long, long time from which to recover. A good place to start to practicing patience is to consider your assumptions and beliefs related to professional attainment and identity. Figure out what your priorities are, and what allocation of your valuable internal resources will lead to the life you want. That can’t be too hard, right?..

  • Post #2

    My Struggle to be in the Present Moment

    The idea and skill of living in the present moment is popularly recognized as desirable in order to live an engaged, more wholesome life with less suffering. There is also ample research from multiple academic disciplines that demonstrates this reality. However, for many people, it is a deceptively difficult task whose value is often forgotten when life gets hectic. It is worth considering what barriers might exist to being present with oneself and the world. In this article, I will share some of my personal struggles along with seemingly prevalent barriers to remain in the here and now.

    The biopsychosocial (BPS) model, considering biological/medical factors, psychological ones, and social/environmental ones, is a useful orientation from which to consider this topic. For some people, the way their brain is “wired” and can make it easier or more difficult to live in present moment. That is, some people have medical or mental illness barriers to remaining in the present moment. For example, I have Tourette’s disorder and OCD. Essentially, these ways of being tend to distract me from being connected with the present moment, due to compulsions which are somewhat involuntary. It can become a vicious loop in trying to ignore the compulsion, because although doing so may seem like it could help one attend more easily to the present moment, my brain/system seem to value compulsory movements and ensuring my thoughts are “in order” over the diverse, valuable external and internal experiences that come with being mindful.

    The third part of the BPS model in relation to this subject is fairly straight-forward; we all have stressors and difficult situations that deter us from living in the present moment, given the varying necessities to address the situation. For example, I have two young sons, ages 6 and 3; I think I have conveyed now enough about the situation that you may understand after these few words (haha!). But whatever external stressful situations are threatening to affect your well-being, they can inherently make it difficult to live in the present moment, given that stress, fear, anxiety, and other uncomfortable emotions can make it challenging to stay in the present moment.

    In this article, though, I want to focus on the second part of the BPS model, the psychological, and how our patterns of cognition, whether conscious or less so, can make it difficult to be present. There are a plethora of psychological themes that can interfere with our being present with our minds and world, and I will try to describe a few of them on a more personal level in order to give a concrete, more tangible sense of potential barriers. One overarching barrier that interferes with living in the present has to do with the narrative we tell ourselves, about ourselves. That is, some of us, myself included, consciously or subconsciously are often communicating to ourselves that we “should be” otherwise, whether more energetic or enthusiastic. We may hold unachievable high standards for ourselves in a perfectionist way, for sometimes difficult to ascertain reasons. For some it may be a result of internalization of values and beliefs of those we grew up with, often referred to as core beliefs, which are what we come to believe about ourselves and the world, formed by what happens to us in childhood, that come to significantly affect our perspective and thinking patterns. For others, the influences may be on a more macro scale, in identifying with Western cultural values that prioritize productivity and constant progress, which can also negatively affect our willingness and ability to accept the reality of and be with the present moment, accepting it regardless of the story we are telling ourselves. For example, I grew up playing organized sports, which had many physical and mental benefits in both the short and long term. However, whether I have distorted the values conferred to me through this involvement or whether they are more objectively out of sync with the priority of living in the present moment, I came to believe (at least in part) that in many situations I needed to be in a certain “zone”. That is, I thought that in order to achieve success in sports or life, it was not enough to be who I was in that moment, but that I needed to be more energetic and enthusiastic in order to be accepted. This mode was reinforced over the years with explicit and implicit feedback that suggested that this way of being was the best way to be. While there is certainly value in being enthusiastic or energetic or positive, being otherwise, or even on the other end of the spectrum, might not always be less than. It has been this misconception that has contributed to my difficulty in acknowledging and processing those less comfortable emotions. (I acknowledge here also that OCD tendencies do influence my desire/compulsion to comply with norms and perceived expectations). In a shorter way of expressing, my participation in athletics, along with the myriad benefits, may have, in combination with my psychopathology, have made it difficult to be accepting of myself and situation in the present.

    In this brief article, I have highlighted a few of the many potential barriers to engaging in the present moment, which of course are important to consider because they detract from the numerous mental and physical benefits of living in the now. One of the purposes of highlighting these themes is to encourage readers to question the extent to which they are living in the present moment, and to examine what might be in the way of doing so. For many of us, this effort is ongoing, and may continue to consume a fair amount of our internal resources, until ideally living in the present moment becomes more of a pattern and requires less effort to be this way. I hope that these few examples and points can incorporate even a few more people and ideas into this important discussion. In one sense, in a world where so much is outside of our control and influence, one area we can try to exert more influence over is how we show up to the present moment, regardless of your past or what lies ahead. It takes courage to embrace this philosophy, and to loosen the grip on our worries about the future or regrets from the past, but my experience from when I can be this way, is that it results in a better life with more well-being and less suffering.

  • Post

    Barriers to Employment for Young Adults with Mental Illness

                Statistics about rates of employment can be misleading. A simple google search would probably yield an “unemployment rate” for young adults in the U.S. to be 9 or 10%; this figure is a good bit higher than the rate for all Americans of around 4%. However, it is important to remember that this figure only include those people who are “actively seeking work”. The “economically inactive” rate, measuring the percentage of people not actively seeking work, for Americans was about 30% in 2024. And this rate for Americans with disabilities? Around 75%. Of course, many of those encompassed in this rate are in the geriatric population, but it is estimated that approximately one quarter of this population is under age 35. Another way to look at this issue is that young adults (ages 16-34) with disabilities are almost 5 times more likely than their peers to be economically inactive. So, clearly there are significant disparities, but what factors and considerations are behind these numbers? In this post, we take a deeper dive into the barriers for young adults with disabilities, particularly due to mental illness, to gain and maintain employment.

                For those who struggle with mood disorders, like depression and anxiety, which are often cyclical in nature and not necessarily chronic, there are ample barriers to maintaining employment. Some hallmark symptoms of depression, like low level of mood or energy, feeling fairly hopeless, helpless, or worthless, and disruptions to physical health (sleep, diet, physical activity), can make it very difficult to consistently meet expectations at work, as well as limit an optimistic outlook that can help one to persist through challenges. Anxiety symptoms, whether cognitive ones (i.e. racing thoughts, ruminating, intrusive thoughts) or more physiological ones (i.e. heart racing, tightness in body parts, GI distress) also can significantly limit productivity and distort our interpretation of our own performance, often for the worse. In addition, those with mood disorders may spend much of their willpower, bandwidth, and internal resources managing their limitations, leaving less to give to professional life. In the short term, these trends may lead to missing deadlines or producing unsatisfactory results. In the long term, burnout and unemployment are prevalent. The logic of this paragraph has pertained to those already employed; for those not economically active, it is possible that many of these trends underlie the more apparent barriers that would be more evident in one’s lifestyle choices (level of activity and connection, maintaining of physical health, etc.).

                For those with more chronic conditions and/or neurodivergent ways of being, like ADHD or OCD, different factors are relevant to difficulty maintaining employment. In addition to difficulty maintaining concentration in ADHD, an important deficit lies in one’s executive functioning skills, which are critical in helping us stay organized, plan, control our emotions/states, and follow-through with tasks. Problems in these areas over time can interfere significantly in sustaining work. Persons with symptoms of OCD experience significant impairment in their functioning, regardless of how apparent their obsessions and compulsions are to others. The energy and time consumed by the irrational distractions characteristic of OCD are also significant impediments to maintaining employment. 

                Examining this trend from a cognitive-behavioral perspective is helpful to illuminate the cause-and-effect of various components of the difficult experience of staying employed. That is, our thoughts, feelings, and behaviors are connected, in response to events or situations. Something happens at work or in our life, and it affects our cognitive and emotional state, which then again can affect our actions. For example, we may receive some explicit feedback (being told that you are not meeting expectations) or implicit feedback (describing standards that others are meeting to a greater extent than you do). This would be likely to somewhat negatively impact our sense of competence; and for those who struggle with anxiety, depression, or other mental illness, we are more likely to distort the objective reality of one piece of feedback to hold greater significance, thinking that, for example, “I am a total failure”. This sort of irrational conclusion may lead to uncomfortable emotions, like sadness, worry, or shame, which could then be a further detriment to our likelihood to put forth a solid effort. In other words, because individuals with mental illness symptoms are more likely to struggle with rational thinking and may tend to distort reality, the deleterious effects of an unfortunate event can be amplified. And when this trend becomes a pattern and happens more regularly, it can exacerbate symptoms and result in an untenable employment status.

                To paint a more concrete picture of how the conglomeration of these factors can make maintaining work profoundly difficult, I will share a few of my challenges/barriers. Initially, I have a variety of symptoms of mental illness, including of depression, anxiety, and OCD. And depending on one’s level of stress, these symptoms can be exacerbated. In the recent past, my son experienced a medical problem, which resulted in a significant sleep deficit, exacerbating my already vulnerable system due to treatment in the past for a brain tumor. Another change occurred around this time, in my medications prescribed by my psychiatrist, which contributed to the storm of worsened symptoms. Outside of my mental health, for a variety of reasons, both external and internal, my employment at this time was becoming less of a source of fulfillment and contribution and more of a labor and stressor. MY performance was suffering, negatively impacting my confidence and self-esteem, as well as struggles with cognition for medical reasons, which likely all negatively impacted my work with clients. This cycle seemed to be a downward spiral, until I was no longer employed. You can see how a combination of biological, psychological, and social/environmental factors contributed to my decline. Millions of other young adults with mental illness struggle to enter or maintain employment due to a combination of predispositions/symptoms and stressors, like or unlike mine.

                So, given these considerations, where can you individually and we as a society, go from here? In my next post, I will explore strategies and solutions to address these barriers. It is also worth acknowledging that not all readers will share the same goal related to employment; for some, now might not be a realistic time to seek employment. But regardless of your situation, I believe it is worth more fully considering factors making it difficult to maintain employment, and then depending on your personal goals, exploring relevant strategies to help you reach your goals.

  • Hello World!

    For students or new professionals looking to enter helping professions, like Social Work and other professions that support and enhance the mental and physical health of others.