How fear of being un-masked dominates my thoughts: Hiding mental illness

I talked in the last post about impostor syndrome. I wanted to elaborate upon this a bit by showing how my thought process goes about participating in class discussions and how my fear of having my health health status discovered dominates my decision processes. This isn’t any one class but more an example of what my experiences in classes tend to be like.

Thought: I have to participate at least once each class. Ideally more, because participation is a large part of the grade.

[Professor asks question]

Thought: I have thought I would like to contribute to this, but the knowledge I have is based on readings I have investigated in depth in attempts to understand myself. Although I can respond to this question and keep the content intellectual and not personal, I worry that someone might wonder why I know so much about a niche area like this. I have to make sure the knowledge I convey all can plausibly be expected of me given my current training level. I know that for one question response it might not mean a lot but if they put together other pieces of information with my response they might start to suspect something. I’ll skip this one.

[Other student makes a comment]

Thought: I wish I could talk about the thing I am thinking of and add to the conversation, but it is not worth the risk.

[Professor discusses a diagnosis in the class which is one I have]

Though: Keep your face neutral, keep your face neutral. If a student says something stigmatizing and offensive keep your face neutral. If someone comments about frustrations relating to difficulty treating this population, keep your face neutral. Crap. I think I may have made a slight disgust face. Did anyone see? Does the professor suspect I have a personal relation with this subject matter?

[Professor asks a question related to a definition from the reading]

Thought: Good I can answer this! It falls into knowledge I am expected to know.

[I provide answer]

[I am asked to discuss my current research interests and directions]

Thought: I am doing me-search. I am very proud of the direction I am investigating, but is it too novel? Novel is good, but what if they wonder where did I get the inspiration for these novel ideas? I don’t have patients yet so I can’t claim it was inspired from working with them. What if people realize that the reason I am able to piece this research together in a unique way it is because I am using some of my experience (combined with extensive literature reviews) as a source of inspiration. I can down play the novel parts and make it look more iterative than it is but that hurts me by hiding something I can being successful at. But I need to blend in to avoid arousing suspicions.

[I discuss research]

Thought: Did I say too much? Are they getting suspicious? I should make sure I stop talking to avoid further damage.

[Class continues]

Thought: I need to watch my body language. Stop fidgeting. They’ll realize you’re anxious.


Logically I know that these worried fall under the Spotlight effect, but I consider being found out to be such a horrifically terrible event that even if it is low probability I need to do all I can to protect myself.

2 thoughts on “How fear of being un-masked dominates my thoughts: Hiding mental illness

  1. I just wanted to comment on how I felt much the same way in grad school (like an impostor in hiding) as I have at least one diagnosis myself. I ended up doing my dissertation on the topic of my own diagnosis. The truth is that I feel that the best therapists are often the people that have suffered too. It is really hard for me to be judgmental or critical of my patients when I am in touch with my own vulnerabilities and i think this makes it easier for me to truly understand the person sitting in the chair across from me.

    I stumbled onto your blog doing a little research on treatments for self-harm and really enjoyed reading about all the “bad therapists”. When i see something like that, I vacillate between thinking “Thank God, I’m nothing like those therapists” to “Maybe I’m one of those bad therapists, too!” I think the truth is that most of the time, I’m pretty good at what I do, but sometimes it just doesn’t work and that is okay because it doesn’t have to be somebody’s fault anymore. Anyway, thanks for sharing some of your journey with us and i wish you success in your doctoral program and your search for support.

    • Thanks for the kind comment. Always helpful to be reminded that others in this field have been through their own mental health struggles. I actually have been worrying a lot myself that I will be as bad as some of the people on my list. I am glad that I’ve written a lot of things out here because I think as I get more involved in the field it’s important for me not to forget the vulnerability I felt in a lot of these treatments.


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