“Terminal Uniqueness/Personal Exceptionalism is the false belief that the situation a person is facing is unlike anything anyone has ever faced before. …. It is called terminal because this delusional thinking that leads to a refusal to get help and the denial that consequences … apply to them, is ultimately self destructive and relationship destroying.”

– Bloomie, Out of the Fog

This is a concept often used in the context of substance use disorders, but I have observed well beyond addiction. I’ve seen this impact victims of sexual abuse, rape, domestic violence, other forms of violence, child abuse, mental health issues, suicidality, grief, health issues, and much more. It is common in people from all walks of life and in all situations.

Terminal uniqueness is a belief or feeling that your experiences are so unique that no one else can possibly understand what they were like or how you reacted. It’s a dangerous mentality. People who suffer from terminal uniqueness not only believe that they are alone in their experiences but also that no one else can understand or help them process the things that they have been through. They invalidate all suggestions and insights with, “You can’t speak to this if you haven’t been through it yourself.” While it is true that a person cannot 100% understand something that they haven’t lived, that’s not why people think this way. They think this way because their ego has come to rely on the belief that they are unique in their struggle. Their sense of terminal uniqueness often becomes a part of the way they identify and understand themselves. Letting it go means learning to view themselves differently.

This thought process leaves people feeling isolated and alone. It has also created a belief that mental health providers who haven’t experienced something (although this is an unfair assumption) can’t help. When no one can help, and no one understands, what is left in life?

This thought process can kill.

Think of it this way. The greatest cardiologist in the world cannot know what it feels like to have a heart attack if he hasn’t had one. He may understand the symptoms, but he doesn’t know how it feels. With that said, he doesn’t need to know exactly what it felt like; he is extensively trained to provide complete, competent care.  

Likewise, a heart attack survivor knows what it felt like to have a heart attack. But they “know” what their heart attack felt like. It doesn’t mean they know what anyone else’s was like.

Which person would you trust with your care? The cardiologist or the heart attack survivor?

The answer is both because both are important.

Peer Support and mental health treatment are not inherently at odds with each other. Getting good care will save your life. Being able to talk with people who have been through it will help you feel less alone. You can learn how others recovered and healed.

Let’s go back to this idea of terminal uniqueness. It becomes a part of a person’s self-perception. They invalidate all supports and push themselves to feel more and more alone. They sometimes engage in competitive trauma or hardship as well, which fuels these feelings more.

I speak about this mentality not only as a clinician that has worked with it for many years in many environments but also as someone who has overcome a sense of terminal uniqueness.

You could say I am both the cardiologist and the heart attack survivor.

With that said, I would like to point out that most cardiologists don’t tell their patients if they have had a heart attack or not, so it is dangerous to assume that they haven’t. In fact, most people in general don’t walk around announcing their life experiences so I think it’s unfair to assume anything at all.

I share this with you in the hope that my lived experience will assist you in breaking free from terminal uniqueness.

The first step is recognizing you have a problem.

Ask yourself:

1. Do I compare my hardships to other people?
2. Do I minimize their experiences?
3. Do I feel like I have had it harder than most other people?

The next step is figuring out how to address it (I’m making that sound way easier than it is).

1. Can I make a conscious effort to catch myself when I do this?
2. Who in my life can I talk to about this?
3. Will it help to talk to a therapist about it? (Hint: the answer is often Yes)

The last step is following through on whatever plan you have created. It may seem difficult but I know you can do it!

Be well. Be Brave.

Sarah