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What to disclose to clients, and when, is a perilous question

Posted on 14 Jul | 2 comments
What to disclose to clients, and when, is a perilous question

Recently, Dr. Marsha Linehan stepped forward publically as being a survivor of terrible schizophrenic episodes.

The story of her decent into the lived experience of psychological, physical and spiritual pain, and her her life saving rise out of the darkness was featured in the June 23rd issue of the New York Times.

Why did she ultimately decide to tell her story even after decades of working to help others overcome their emotional pain? She felt she owed to them.

Disclosure is a touchy subject in therapeutic practice. Telling a client or patient that they share the same painful story may take away from the clients’ personal experience in sessions. Or it may cast a shadow of doubt in the therapeutic relationship that may lead one to believe that their therapist or doctor is not really capable of helping them since they were ‘broken’ at one point.

Dr. Linehan may have withheld for her own deeply personal reasons, and with much respect, it was the right thing to do in her case. But with her recent disclosure she has brought to light the fact that there are many people living their lives and contributing to society who have a personal history and current experience with mental illness.

This is to the benefit of the client and to society as a whole. There are many therapists who are called to the practice because of their own personal experience of mental illness. That information is rarely disclosed to the clients.

But knowing when to disclosure and if it would be beneficial is a challenge that many therapists face while working with their clients. Existential psychotherapist and author Irvin Yalom has an important guideline to adhere to in regards to self-disclosure:  it must be done to serve the client’s growth. In his book The Gift of Therapy Yalom offers this to new therapists:

“Endeavor to normalize the shady side in any way possible. We therapists should be open to all our own dark, ignoble parts, and there are times when sharing them will enable patients to stop flagellating themselves for their own real or imaginary transgressions”.

It’s a good rule.  Still, therapist disclosure is a risk, both professionally and personally.

In his book Existential Psychotherapy Yalom cautions therapists to be careful not to harm the client and to be aware of what they may or may not be ready to hear. Again, the intention in Existential Psychotherapy is to care for the client and foster their growth. Unloading on a client in an attempt to create a relationship based on a perceived shared experience is self-serving. Yalom suggests that therapists must be aware that their clients can discern whether or not a disclosure is authentic or self-serving. That means that they must be aware and present with their clients, truly with them along the journey of therapy.

The question that existential therapists must ask is, would it serve their clients growth to know that their therapist has overcome a similar struggle as well?

Dr. Linhen’s story has opened the door to a larger discussion about disclosure and mental illness. In life, many people hold back from revealing their mental illness for fear of judgment, and the potential of being denied access to basic rights and needs. Therapists also have to fear losing their profession as healers which would be a great loss. Sometimes having a self-knowing about what it means to be diagnosed and subsequently healthy can help to understand how to bring others to a place of health as well.

What if more therapists were to disclose? Would it help or hinder the field? Or more along the lines of existential psychotherapy, would it help or hinder the healing process of clients?

 

- Makenna Berry

Comments and Discussions

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Marks Web

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Daily Reference

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