Therapist Self-Disclosure

In psychotherapy, the therapist him or herself is the tool that makes the change. Unlike a surgeon with a scalpel, a therapist takes his or her tool wherever he or she goes. Because it is investing themselves as persons that makes the difference, therapists learn to use themselves actively in the relationship. At times, this may mean the therapist tells the patient something about him or herself. The trick is figuring out what is shared and when.

While a psychotherapy relationship is mutual in many ways, it is not the same as a relationship with a peer. The therapist is there to facilitate a developmental kind of growth for the patient, and that task dictates how the therapy unfolds. Therapists do not share their own experience as a way of making the relationship mutual. They do not share themselves as a way of being understood exactly. Self-disclosure by the therapist is always in the interests of fostering the patient’s own growth.

Moreover, therapists do not share their experience as a kind of reality check for the patient. In other words, if the patient does something that makes the therapist angry, the therapist does not share that as a means of teaching the patient how other people react to him or her. This stance sets the therapist’s experience as a standard by which the patient’s experience is measured.

Therapists are people. They have unique histories and unique viewpoints. And, they are not infallible. What they can do is reliably focus on the interaction between the patient and themselves in such a way that something can be noticed and learned and patterns can be identified. However, this cognitive process and the increased understanding that results from it are not the healing factors. The healing factor is the therapist’s willingness to set aside his or her own needs and perspectives over and over again in order to be together with the patient in understanding whatever comes up. This commitment and care gradually becomes known by the patient in an experiential, comprehending way. And that structure then becomes a part of who the patient is.

In the interests of this process, the therapist shares his or her own experience, thoughts, and stories as a way of confirming the patient’s experience of the therapist. For example, if the patient perceives that the therapist is distracted on a particular day, the therapist may confirm that perception by telling the patient that she had a flat tire on the way to the office, and perhaps that is distracting her. If the therapist denies being distracted, the patient can only assume either that  his or her perceptions are inaccurate or that the therapist is not telling the truth, neither of which is helpful.

As much as they want to be genuine and genuinely engaged, therapists are together with the patient for the benefit of the patient. Ideally, that focus does not vary in a fundamental way, even when there are missteps, distractions, and misunderstandings. The ongoing experience of that focus becomes an inner certainty for the patient, and that certainty is what brings about change.

About norasblog

I am a psychotherapist with a private practice in downtown Chicago.
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