trpsyche

During a presentation on the topic of therapist disclosure at this year's SASH (Society for the advancement of sexual health) conference, a false dichotomy emerged on the question of whether to disclose personal information to a client during therapy sessions. Given what I have said and what I shall now write in this public forum, you may become aware of an overriding irony.

I'd set myself up to participate in this discussion by accepting a speaker's opening invitation for all members to come forward and sit closer to the front. It was the last day of a three day event. The likes of Patrick Carnes and Terence Real had made their keynote addresses and had moved on. Saturday afternoon: this was the final round of presentations, stuck at the back end like the final of mixed doubles at Wimbledon. No disrespect intended here; the topic and speaker were certainly worthy. Nonetheless, the stragglers who attended, like myself, were sparsely distributed throughout the hall giving the impression of underattendance. The speaker, nervous yet steely in his desire to elicit our help, moved the air with his hands and gathered people forward. I thought 'why not?' and stepped up to the very front row. The speaker nodded appreciatively in my direction, and began.

Multiple anecdotes later, mostly from the speaker but some pulled from the crowd, a discussion point was delivered: should a therapist, in the context of addictions work, share his or her story (presumably that of a recovering addict) with a client? The speaker offered a menu of considerations: the need to engage with difficult clients; the need to join, to relate; the need to provide space for the client's own story; the need for the therapist to 'check' his or her countertransference. With these softballs tossed onto our heads, a sprinkling of feedback began. The stories of how self-disclosure had 'worked' versus being a 'disaster' started pouring forth. An assistant with a wireless microphone ran around like a talk show host through the audience of roughly one hundred people. The success stories generally echoed the speaker's tendentious theme, that of "I'll show you mine if you show me yours". He nodded after each share, now in reinforcement of a winning idea.

One after another, audience members spoke of making clients feel comfortable, of providing a 'safe' place, through self disclosure. What most were conscious of was the wounded healer tradition of the 12-step community, wherein a therapeutic guide (professional or not) provides experience, strength, and hope (notably, that which has been derived from their own lives) as a means of modeling the possibilities for the so-called newcomer. Here the lines between therapist and, say, sponsor, blur somewhat, with therapists being the ones to introduce a note of caution into the argument. The counter goes something like this: if a therapist is taking too much space, or too much time with their own story, attention is drawn away from the client; furthermore, the therapist may be acting upon their own countertransference, which is a psychodynamic way of saying that a therapist is using their clients to work out their own material. These were the confounding arguments tempering the otherwise avalanche-like support of the baseline notion: you share your stuff with your clients. Though, to be fair, one person gave a different perspective, that of a non-recovering person working in the field: pointing out that she'd been subject to a counter-prejudice from those seeking reasons to discount therapeutic help, one woman spoke of the need to be general (and thus evasive?) in self-disclosure. BTW: the psychologist/researchers that were present (or else back in their hotel rooms preparing to check out) might have spoken up with their obligatory caveats: there's not a lot of data to support any of this!

Oh well, then. Opinions and anecdotes would prevail for now. I coughed, raised my hand, and prepared to issue my own caveat. The assistant with the mic shuffled over and the speaker smiled, eagerly awaiting my contribution. My first few sentences recapitulated the points of the speaker, and of most in the audience. Therapist self disclosure does indeed make the client feel comfortable; for some, the word 'safe' is not overstating the case. I further acknowledged that self disclosure had been a tool in my arsenal for fifteen years as a therapist. The speaker continued to nod, albeit wearily, perhaps thinking my comments were redundant. Then I shifted. "However, I'd like to stand up for the psychoanalytic tradition here, which isn't really being represented." As I was in front, I could not see the expressions of the one hundred people behind me; only the slight cloud of wariness that settled upon the speaker's face. I spoke next of splitting, that phenomenon wherein individuals (and societies) primitively, philosophically (dualism), and politically (us vs. them) divide the world, creating a mindset not so much for the communication of differences, but rather for the impossibility of that communication. That 'safe' place risks becoming fossilized as the only place where one can talk; that therapist, that sponsor, may become the only people that can be talked to. I put to the audience, and to you, the reader, that there is limited therapeutic value here. Presumptions of like-mindedness based upon supposedly shared life experience constitute another kind of prejudice, and are thus fallacies. Many of my clients (including the addicted) have hungered for the possibility of communicating with those presumably misunderstanding others, especially the misunderstanding loved ones. It's not my role, ultimately, to establish my office as the only place wherein my clients might talk.