One of the challenges for me as a therapist is to decide how and what information about myself to disclose to a therapy client. I am not referring to information which the client should have, like training background, experience, therapeutic orientation, professional affiliations etc which may already be in the public domain. This kind of disclosure could and possibly should form part of the intake session. I am talking about more personal information which reveals something of who I am, and how I live my life away from the therapy setting.
Of course even writing here, as myself, asks of me to consider where I stand regarding this controversial and difficult issue in psychotherapy. After all, if a therapy client or potential therapy client should read what I write, they would come away with certain ideas about how I think and feel, and opinions I may have. We were trained that the rule of thumb is to not reveal anything: to literally present yourself as the blank canvas onto which the client/patient can project their fantasies and ideas, and to be ruthlessly vigilant in not letting them know anything about yourself at all. The idea behind that principle is that the person’s fantasies about what and who the therapist really is (an aspect of transference), becomes rich material to explore.
But as a highly intuitive therapy client recently pointed out the self evident truth to me: that in fact it is impossible to not communicate some information. Just my mere appearance, for instance, is already somewhat revealing of aspects of who I am. How I dress, the colour of lipstick I prefer, my accent… The way we decorate our consultation rooms(this is a photo essay of therapists rooms in New York) is another subtle but important aspect of information gathered by a patient which all form part of an idea of who the therapist may be in terms of tastes and style preferences and even socio-economical status: particularly when working from home. I currently work at a clinic where I share rooms with two other psychologists so that the space is less personal, but I may start seeing people from home eventually, and I intend to decorate the room according to my personal taste. A therapist friend of mine who is busy being trained as a Jungian analyst, spoke about displaying a statuette of Kali in her rooms, and we wondered how that would impact how patients will perceive this and respond.
It’s really impossible to control every little detail which may give something away about ourselves. And I believe that we need not be too frantic about that either. But it is important to be as conscious and as clear as possible about what, why, and when to reveal information about ourselves. Whatever we reveal, either consciously or unconsciously, has an impact on the therapeutic relationship.
My way of working is to disclose about myself mainly when asked: and then to answer any question about myself which a therapy client wants to know, honestly and directly, but to always explore and inquire what prompted the question, and discuss how the information given by me, has affected the patient. A female patient who is in a very unhappy and unfulfilled marriage a while ago noticed that I had a new ring on my left ring finger and asked me if I had gotten engaged. A simple “Yes” and holding out my hand for her to look at the ring more closely, thereby acknowledging her observational skills, and further “How is it for you to know that I recently got engaged?” lead to a very powerful and meaningful session where her fears and reasons for staying in a dissatisfying relationship, and her yearning for real connection and intimacy became conscious for her.
When I answer a question in this simple, direct way, I validate an observation or an intuition of a therapy client. Also, it is very human to be curious about you therapist’s life. I believe that is more important to answer honestly than to deflect the question as some strict psychoanalytical therapists may do.
Sometimes there are more personal and private issues which the therapist may not want to share with a patient. I have in the past, also said then: ” I would prefer to not bring that information into this space, if that is ok with you” and then proceed to inquire into what prompted the question. On reflection, that has not happened often. Of course, each therapist has to decide where they stand about which information they are willing to divulge. Some would be ok to state their religious beliefs and world views , some not. Some would be ok to reveal their sexual orientation, some not. I think that as Irvin Yalom so eloquently says in his book: “The Gift of Therapy”, most clients in fact do not want to know too much, and our fear as therapists that once we have shared something of ourselves, it would lead to continued demand for disclosure and violation of ethical boundaries are mostly unfounded.
In the age of social networking, sometimes our patients stumble across information about us, such as our Facebook account. Of course it is important to set the privacy setting to its most secure, but it has happened that a patient could see timeline pictures and events I had shared with my friends, because she had become a Facebook friend of a FB friend of mine through a completely different set of friends, and my settings allowed friends of friends to see my information. Luckily she brought it into the therapy session and I could change the relevant settings. This also lead to exploring what was evoked for her, suddenly having had a window into my private world.
I have had friend requests from patients, which I always discuss in the session, or if it is a former client, I would write a message explaining the professional considerations and the ethical principle of not having social relationships with patients or former patients. I do however honour the interest and the need of therapy clients to have a kind of a continued connection to someone who is or has been part of their own development and growth and healing. This prompted me to create a FB page as a professional entity, where I post this blog and also interesting articles and information about therapy and psychology, with no links to my personal timeline.
We show of ourselves all the time. We are fellow human beings , not aloof experts with all the answers and unaffected by life, despite out training. We suffer our own pain, we have our own joys. All of this informs who we are as therapists, and will seep into the way we relate to our patients. It cannot be avoided, but it needs simply to be noticed and consciously worked with(during supervision), particularly if it gets in the way of effective therapy. How and what and when to reveal should ultimately always be in the interest of the patient. Revealing too much can be inappropriate and burden the client with information they do not know what to do with, while revealing too little could affect how authentic and transparent the client perceives us to be, both potentially hampering and even harming the therapeutic process. It takes experience and practice and sensitivity to each individual therapy client to find this balance for oneself and then, however the patient responds or reacts, to use that to deepen an understanding and insight.
I know that this is an issue each therapist has to address sooner or later, so how do you feel about self disclosure as a therapist? And if you are a therapy client or patient, how do you experience this issue? What is it that you are most curious about your therapist’s life? And how do you feel about your therapist’s way of handling this?