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On Therapist Self-Disclosure

Article first published in Lapidus Magazine Issue 4


A self-disclosure: I’m not sure how to start this article. I’ve been procrastinating, badly. I’m writing now on the floor of my six-year-old’s bedroom. It’s late on a Saturday evening and she’s still awake. Every so often, I’m pelted with a soft toy lobbed from her bunk-bed.


At the risk of getting too meta, I wonder about the impact of this self-disclosure? What impressions and responses does it elicit? Does it make you more or less likely to read on?


As a clinical psychologist, I spend my days thinking and talking about emotional difficulties. I’m positioned as an expert on psychological frailty; the murky depths of the psyche are the waters in which I swim. And yet, I give little away of myself. My stance is one of boundaried professionalism. What little I do reveal is filtered through the checks and balances of the therapeutic frame.


This is, in many respects, as it should be. Our job as therapists is to attune to our clients; a task which requires us to shelve our own “stuff” for the duration of a session. The paradox, of course, is that we must also remain deeply and authentically present. The instruments of our work are our own selves; our capacity for empathy and compassion, our human feelings and reactions. Allowing ourselves to be genuinely affected by a client’s story and communicating something of our response is arguably the bedrock of therapy.


There’s a related issue here concerning what we as therapists choose to explicitly communicate to our clients about ourselves. When and how is it appropriate and helpful to do so? The ethics and utility of therapist self-disclosure continue to be hotly debated, and the research landscape is similarly conflicted (Henretty & Levitt, 2010). Conveying something of oneself as a therapist can help to build a therapeutic relationship. It models openness, and often elicits more self-disclosure from clients. It may help to normalize client experiences, provide reassurance, and flatten power.

On the other hand, there’s potential for self-disclosure to be experienced as a boundary violation, or to inadvertently fuel a felt sense of responsibility on the part of the client towards the therapist. Inevitably, context matters: what may be helpful for one client at one time may be unhelpful or even harmful for someone else, within a different therapeutic model, or at a different stage of therapy.


“Self-disclosure” is also a bit of an umbrella term, incorporating a range of communications. Personally, I’m more likely to share my emotional responses in a session than I am autobiographical information. Increasingly, I’m also prepared to reflect with a client on the identities, characteristics and lived experience we each bring to the space. Again though, formulae for success feel hard to come by, and undoubtedly there’ve been times I’ve wondered about the wisdom of things I’ve said.  

 

What emerges for me is the importance of a rationale for self-disclosure based on an understanding of the client, in the context of the evolving therapeutic relationship. This is easier said than done when you’re sat in a room with someone, responding to their suffering, thinking and feeling your way through a session. Inevitably, some degree of “intuition” comes into play. I like to think this is based on accumulated implicit knowledge but, as with any intervention, it’s always worth asking what one’s motives are (or were) for going down a particular route. In the case of self-disclosure, this perhaps becomes particularly important to help ensure we are not (consciously or unconsciously) allowing our own needs to steer the therapy.


There’s also another consideration here – one that is becoming increasingly relevant in our digital age – around what we disclose of ourselves outside of sessions. What might our clients learn about us from our social media accounts, articles, books, performances, activism? As a therapist, my primary agenda is the client and their wellbeing. As a poet, I’m writing in the service of the poem, the reader, and – undeniably – myself. What happens when these roles converge?


My poetry collection, The Sessions was an experiment in bringing together my different hats as poet and therapist. The book took shape over the space of a year or so, emerging from what I came to think of as my “sand tray” document – basically, pages and pages of notes, quotes, lines and drafts. Early poems focused on my experience as a therapist; later, I started writing about memories of being in therapy myself.


There are fifty poems in total – reflecting the traditional “fifty minute hour” of a therapy session – all sonnets (of sorts!). As I found my way into the writing, the sonnet became a kind of container, its formal constraints mirroring the boundaries of a session. Much like therapy though, sometimes the rhymes and revelations don’t follow the pattern. Sometimes the reality is messier than the model. Alongside poems that speak to the power and potential of therapy are poems that interrogate its limitations and contradictions – and mine. There was a particular kind of vulnerability in the writing of these poems. They occupy an uncertain and arguably quite “non-professional” territory; anxious, unruly, flawed.


Whilst caution around self-disclosure in therapy is necessary, I do think there can often be an element of reticence – stigma even – within professional contexts when it comes to talking about our vulnerabilities as therapists. Organisational pressures, performance-driven services and the influence of the medical model can, I think, drive a retreat into an “us-them” framework which makes certain things difficult to talk about. For me, poetry can be a space to move towards the unspoken, towards uncertainty and vulnerability, the elusive and unreliable poem as guide.


As I reflect now on the book, the relationship between personal and professional feels complex. It doesn’t feel right to think of my “real” self as temporarily parked behind a professional screen. In some ways, maybe, I am more myself as a therapist – or at least, practising therapy helps me connect with my better parts; it enlivens my capacity to listen, flexes the compassion muscle. Then again, there’s something very real and alive in the silliness of throwing a squishy toy around the room with a giggling daughter, and undoubtedly the capacity to play influences my professional practice. Whatever we choose to share in the room with a client, it’s important, I think, to be able to acknowledge and talk about our own feelings, contradictions, vulnerabilities and messiness. As for how a client might respond to the book – well, that remains to be seen. There was a conscious commitment to a level of honesty in the writing. Admittedly, this comes with some anxiety, but ultimately my hope is that the spirit of the poems aligns with that of therapy. Just like the therapeutic hour, I think of the sonnets as meeting points, little windows within which to listen, feel, connect.


Henretty, J. R., & Levitt, H. M. (2010). The role of therapist self-disclosure in psychotherapy: A qualitative review. Clinical psychology review, 30(1), 63-77.




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