Sep 08

Therapist Self-Disclosure: Appropriate, Powerful Uses

Several therapists have written and spoken publicly about the topic of therapist self-disclosure.

One prominent psychologist who’s done so is David Treadway, whose late-stage cancer became the subject of a memoir, Home Before Dark: A Family Portrait of Cancer and Healing (2009). It includes contributions from his wife Kate and his two young adult sons, Michael and Sam.

Treadway’s previous Dead Reckoning: A Therapist Confronts His Own Grief (1996) was similarly self-disclosing about the effects of his mother’s suicide. It included (Publishers Weekly) “parallels between what Treadway’s patients are experiencing and his own problems; revelations of his own therapy; excerpts from his family’s painful recollections; and incidents from his own ongoing life.”

Whether as a therapist or in his writing, Treadway views such openness as a carefully chosen act that can be helpful to others if used appropriately. In Andrea Bloomgarden and Rosemary B. Menutti‘s 2009 Psychotherapist Revealed: Therapists Speak About Self-Disclosure in Psychotherapy, you can find his chapter on what he calls “clinically constructive self-disclosure.”

Another psychologist, Ofer Zur, has said that “(T)he decision to self-disclose is based first and foremost on the welfare of the client.” He acknowledges four types of therapist self-disclosure (“Self-Disclosure and Transparency in Psychotherapy and Counseling“):

  1. Deliberate–such as having a family photo on display in the office or responding  with personal reactions to clients’ statements
  2. Unavoidable–when things about the therapist are observable, e.g., approximate age, ethnicity, gender
  3. Accidental–for example, a client and therapist run into each other at a community event
  4. Clients’ Deliberate Actions–when questions are asked or when info is tracked down, e.g., on the internet (very common these days)

The thoughtful therapist is aware of different ways in which personal info might be revealed and works on ways not to have self-disclosure interfere with a client’s work. Above all else, it should not be about the shrink trying to get his/her own needs met.

Possibly the only shrinks today who don’t sometimes use self-disclosure or at least deal with it to any significant degree are the traditional analysts, those who may still subscribe to the “Don’t just say something, sit there” strategy and who believe in a strict interpretation of the “blank screen” approach, i.e., “only if I am inscrutable to you can you do the important work of projecting your childhood stuff onto me.”

Psychoanalyst Linda B. Sherby addressed this in the process of writing Love and Loss in Life and in Treatment (2013), which is about the grief process related to the death of her husband George. Although she anticipated condemnation from other analysts regarding her self-disclosure she felt “it was important…to demonstrate how a therapist’s present life circumstances affects the therapeutic relationship because I do believe that particular aspect of the patient/therapist interaction has been largely ignored.”

States Janine Roberts, Ed.D., an author and scholar who’s studied therapist self-disclosure (Psychotherapy Networker):

Hundreds of therapists in workshops I’ve led in the United States, Europe, and Latin America have said they share personal information to strengthen the therapeutic alliance, demystify therapy, and reduce the power differential between themselves and their clients. Given that research has found that the quality and nature of the therapeutic relationship–not the specific model or method–account for up to 30 percent of the variability in therapy outcomes, they’d appear to be on to something.

Furthermore, Roberts cites research indicating “that clients working with therapists who don’t self-disclose often describe the experience as problematic.”

Increasingly, I think that clients expect or want from their shrinks more personhood and less unknowability. Very often they’re working themselves to be more open and better understood—so isn’t it useful for therapists to model this in appropriate ways?

Apr 23

Therapists Crying During Sessions: Some Research

Here’s a rarely studied issue: therapists crying. As reported in BPS Research Digest, researchers Amy C. Blume-Marcovici and colleagues surveyed 684 therapists in the U.S., a majority of whom were women, on this issue. Represented among the shrinks were varying theoretical orientations, e.g., CBT, psychodynamic,  eclectic, and more.

How many had ever cried during therapy? 72%—or most of them. And 30% of those who’d cried did so in the preceding four weeks.

Who were the most likely to cry? Older, more experienced therapists with a psychodynamic approach.

Did the women cry more than the men? Nope. Even though in their daily lives they did.

What were the stated reasons that the therapists cried in sessions? Mainly sadness and “feeling touched.” But also warmth, gratitude, and joy.

What kind of therapist personality cries the most? One who shows more openness, for starters. And to a little extent, more agreeableness and extraversion. But none of these findings were actually that significant, statistically speaking.

What effect does crying have on clients? As they weren’t the ones being surveyed, we don’t really know. But the therapists themselves mostly believed that it didn’t matter one way or the other or that it helped.

Did any of the shrinks think it was harmful? Just less than a percent.

From BPS Research Digest: “Referring to the literature on therapist self-disclosure, the researchers speculated that perhaps therapist crying has a positive impact when the therapist-client relationship is already strong, but can threaten that relationship when it is weak or negative.”

Does anyone reading this have any thoughts about this study about therapists crying? Clients out there? Therapists? Therapists who are also clients?