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Therapists' Self-Disclosure

Compiled by Ofer Zur, Ph.D.     2004
 

For an online course on Self-Disclosure for CE Credit, based partly on this web page, Click Here.

 

Following is a compilation of short quotes and full references from different sources regarding psychotherapists' self-disclosure. Additionally, a few important resources are provided at the end.

 

For 7 of the 83 items, at least 90% of the respondents indicated that they engaged in the behavior, at least on rare occasions. . . Two of these almost universal behaviors involved self-disclosure to the clients: "using self-disclosure as a therapy technique" and "telling a client that you are angry at him or her." Thus, it appears that the more extreme versions of the therapist as "blank screen" are exceedingly rare among psychologists. Similarly, the models of the therapist as a distant, almost standoffish authority figure-which, like the "blank screen" approach, are derived from the classical psychoanalytic tradition-are infrequently practiced. (Pope, Keith-Spiegel, & Tabachnick, 1986).

A large majority (93.3%) use self-disclosure. More specifically, over half tell clients that they are angry with them (89.7%), cry in the presence of a client (56.5%), and tell clients that they are disappointed in them (5 1.9%). The most questioned of these was telling clients of disappointment: 56.8% viewed it as unethical or unethical under most circumstances

From: Ethics of Practice: The Beliefs and Behaviors of Psychologists as Therapists. By Kenneth S. Pope, Barbara G. Tabachnick and Patricia Keith-Spiegel. It appeared in American Psychologist, 42 (11) 993-1006. The American Psychological Association holds the copyright to the above article. Available online: http://kspope.com/ethics/research4.php.
 


 

Through my self-disclosure, I let other know my soul. They can know it, really know it, only as I make it known. In fact, I am beginning to suspect that I can't even know my own soul except as I disclose it. I suspect that I will know myself "for real" at the exact moment that I have succeeded in making it known through my disclosure to another person.

From:The Many Me's of the Self-Monitor, by Sidney Jourard. Available online at: http://wl.middlebury.edu/aosterman/stories/storyReader $20
 


 

Long-term therapy of some depth inevitably involves times of warm communion and times of great stress--for both participants. Living through these together has a true bonding effect which is not always recognized by those who teach or practice more objective modes. Nevertheless, therapist and patient often have what can only be called a love relationship, which is by no means simply a product of transference and countertransference. Patient and therapist are two human beings, partners in a difficult, hazardous, and rewarding enterprise; it is unreal to expect otherwise. (P. 258).

Humanistic practitioners might argue that for the therapist to be self-disclosive makes the patient feel more equal to, rather than inferior to, the therapist. It allows the patient to see that all people have failures and other unresolved matters in their lives, and that there is no essential difference, in fact, between those people who are psychotherapists and those people who are patients. In discussing self-disclosure with patients, Bugental advocates, "First and foremost: strict honesty is required" (1987, p. 143.)

From: Bugental, J.F. (1987). The art of the psychotherapist. New York: Norton.
 


 

Group psychotherapists may--just like other members in the group--openly share their thoughts and feelings in a judicious and responsible manner, respond to others authentically, and acknowledge or refute motives and feelings attributed to them. In other words, therapists, too, can reveal their feelings, the reasons for some of their behaviors, acknowledge the blind spots, and demonstrate respect for the feedback group members offer them. (p. 198)

From: Vinogradov, S. & Yalom, I. D. (1990). Self-disclosure in group psychotherapy, In G. Stricker & M. Fisher (Eds.), Self-disclosure in the therapeutic relationship, New York: Plenum, pp. 191-204.
 


 

Powerful authentic sharing occurs when one person discloses themselves in a way that allows the other to feel free to do the same.

Self-disclosure can be an important means of growing as a person. Self-disclosure is on a continuum, and the healthy personality has the ability to discern what is appropriate and what is not.

The therapist's use of self-disclosure demystifies both the therapist and the client. It allows more of the client's essence to come out and allows the interaction to become more of a dialogue.

Humanistic psychology is defined in part by an effort of self disclosure that creates conscious awareness by helping ourselves and others come to an understanding of what is going on inside and possibly the forces that cause that.

From: Michael Lowman & Sidney Jourard: Sidney M. Jourard, Selected Writings. Marina Del Rey: Round Right Press, 1994. Summary of Central Ideas Prepared by Psychology 307 student discussion groups, Fall 2000. Available online at: http://www.sonoma.edu/users/d/daniels/jourardsummary.html
 


 

Self-Disclosure

  • Transparency - allowing the world to disclose itself freely, and disclosing oneself to others
  • Personal growth (change) is a direct result of openness
  • Self-disclosure increases
    • with intimacy
    • when rewarded
    • with the need to reduce uncertainty
    • when reciprocated
    • with woman more than men (this might be cultural)
  • Satisfaction in a relationship is highest when the level of self-disclosure is moderate
  • Women self-disclose more with people they like, men with people they trust
  • Wide differences in levels of self-disclosure between cultures

From: Sidney Jourard (pg. 260). This is a summary of the information in Littlejohn, Stephen. (1992). Theories of Human Communication (5th Ed.). California: Wadsworth Publishing. Appeared in a page title Inter-personal Communication Theories, copyrights by Brian Brown, 1998-1999. Online at: http://physinfo.ulb.ac.be/cit_courseware/research/theories1.htm#jourard
 


 

Results: Therapists' disclosures were twice as likely to be seen as helpful; conversely, non-disclosures were twice as likely to be seen as unhelpful. The greatest effects involved the alliance. Also, helpful disclosures fostered more egalitarian relationships, modeled skills, and normalized or validated clients' experiences. Unhelpful non-disclosures invalidated clients, inhibited their own disclosures, and set them up to manage the relationship by avoiding certain topics or issues. There were skills and skills deficits that were associated with both disclosures and non-disclosures.

Conclusions: Clients found self-disclosure to be a useful intervention, especially as a means of strengthening the alliance, and were more likely to find non-disclosure to be unhelpful. Disclosures and non-disclosures that were lacking in skill could have potentially serious negative consequences. However, when the alliance was already strong, even less skilled incidents could be integrated into the client's therapy experience. Therapists may find it useful to consider the skills needed and pitfalls involved when choosing to disclose or not to disclose to their clients.

From: Presentation titled, Should Your Lips Be Zipped? How Therapist Self-disclosure And Non-Disclosure Affects Clients, presented by Jean E. Hanson at the 10th Annual Counseling and Psychotherapy Research Conference. Abstract available online at: http://www.bacp.co.uk/research/conference2004/abstracts.html#28
 


 

Abstract: Working psychotherapeutically with patients who hold particular religious beliefs or report psychological experience m religious language poses certain technical questions for the psychotherapist. It has been recently recommended that therapists self-disclose personal religious beliefs to patients upon request. The American Psychological Association Code of Ethics was the basis for this technical recommendation. In the current paper, the author contests a stance of self-disclosure as an ethical imperative, and asserts that theory precedes and informs technique. Psychodynamic theory, in particular, informs the author's discussion of technique when working with religious themes in treatment. Theory, assessment, technique, transference, counter transference, and self-disclosure, frame the points of discussion.

From: Psychodynamic Psychotherapy, Religious Beliefs, and Self-disclosure by Jane G. Tillman, Ph.D., ABPP. Appeared in The American Journal of Psychotherapy, 52 (3) Summer 1998. The American Psychological Association holds the copyright to the above article. Abstract available online at: http://www.ajp.org/archives/52-03-1998.html
 


 

Abstract: This article is an effort to integrate contemporary psychoanalytic and existential perspectives on intentional therapist self-disclosure. It offers a two-stage decision-making model that considers self-disclosure from the vantage points of style and internalization. Clinical and research findings are presented to support the notion that the meanings a patient attributes to a particular self-disclosure, and its power to move him or her towards greater health, is the product of a fluctuating matrix of interpersonal and intrapsychic variables. Special consideration is given to the challenges that arise during the early and termination stages of treatment and to the psychotherapy of therapists.

From: Self-disclosure in psychoanalytic-existential therapy, by Jesse D. Geller, JD Published 2003 in Journal: J Clinical Psychology, May 2003. Abstract available online at: http://www.accelerated-learning-online.com/research/self-disclosure-psychoanalytic-existential-therapy.asp
 


 

Overview: The analyst as a specific human person with needs and individual characteristics was originally seen as potentially an interference. The issue of to what extent the analyst can or should remain relatively inexpressive and anonymous raises significant fears when extreme positions are taken. Careless self-disclosure poses the danger of flooding the session with the analyst's feelings, needs, and opinions, thus overwhelming or burdening the patient. On the other hand, any approach to the analyst's subjectivity that focuses on controlling or eliminating his or her personhood, runs the risk of reducing emotional availability, responsiveness, and spontaneity.

Also, it is not just the effect of the disclosure at the particular moment that should be considered. Perhaps, the most important effect of therapist self-disclosure or non-disclosure, is the effect it has on the analytic relationship over time. It is not the narrow issue of self-disclosure that is most important. I would like to propose that it is the emotional and relational availability of the analyst, and his willingness to accept that analysis is a mutually vulnerable experience that is a key factor in facilitating vulnerability and deepening the therapeutic process.

From:Overview of a paper Issues of Self-disclosure by Martin S. Livingston, Ph.D. (Discussant: Dorienne Sorter, Ph.D.) presented at the 2000 Self Psychology Conference. Overview available online at: http://www.selfpsychology.com/2000conf/abstracts/B02.livingston.htm
 


 

Abstract: Hugging, dining with, self-disclosing to, or making house calls to patients are among behaviors which have been termed "boundary violations" in psychotherapy. Although authors have asserted that boundary violations are both harmful and beneath the standard of care, some of the activities in question are consistent with the ethical practice of humanistic and behavioral psychotherapies, as well as with eclectic approaches deriving from those schools. Theoretical statements, survey research, and case examples are used to elucidate concerns about maintaining metaphorical boundaries in psychotherapy and to demonstrate that psychotherapy is diverse with respect to the behaviors at issue. It is concluded that even scrupulous humanistic, behavioral, and eclectic practitioners might appear to practice negligently by virtue of engaging in behaviors which some consider to be boundary violations and that innovative practice might be stifled by risk management concerns.

One matter that may be discussed at malpractice proceedings--before a civil court, licensing board or ethics committee--concerns the inappropriate crossing of boundaries by the psychotherapist. These "boundary violations" include, but are not limited to: hugging, dining with, self-disclosing personal information or feelings to, making house calls to, exchanging gifts with, engaging in non-sexual socializing with, or lending books to patients during treatment. The most egregious boundary violation is sexual intercourse during treatment--something that virtually all practitioners condemn. However, as discussed below, some contributors to the ethics literature assert that the occurrence of less severe boundary violations, like self-disclosure or gift-giving, lends validity to plaintiffs' contentions that sexual activity--denied by the therapist--must have actually occurred, and some contend that a series of minor boundary violations shows a pattern of negligence and justifies licensing sanctions or financial settlements even in the absence of sexual activity (p.239).

In discussing self-disclosure with patients, Bugental advocates, "First and foremost: strict honesty is required. (p. 245).

From: Williams Boundary Violations: Do Some Contended Standards of Care Fail to Encompass Commonplace Procedures of Humanistic, Behavioral and Eclectic Psychotherapies? by Martin H. Williams appeared in Psychotherapy, 34 (3), 239-249, (1997). Available online at: http://drmwilliams.com/SAdocs/bv.html
 


 

Further, I contend that for a genuine encounter to occur between patient and therapist, and for authentic growth in intimacy to emerge (which is at the heart of the need for therapy to begin with) a truly shared experience must take place. Again, the belief herein suggested is that the encounter between patient and therapist (like that between parent and child) should take place between (psychological) equals: between the co-participants of dyadic psychotherapy. Lastly, that the sharing of experiencing, which leads to intimacy, is achieved through the process of (mutual) self-disclosure.

From: Fisher, M. (1990). The shared experience and self-disclosure. In G. Stricker & M. Fisher (Eds.), Self-disclosure in the therapeutic relationship. New York: Plenum, pp. 3-15, p. 14
 


 

Let the patient know how you feel about what he or she is saying. This will make you appear more genuine and real (p. 514).

I told Ronda that I felt inadequate. I said I felt as if every sentence that came out of my mouth was wooden and useless to her. I said that although I usually felt I had something to offer, it didn't seem that way today. I told her I felt excluded and shut out, and that I felt angry with her. I said I wanted to give her something positive and I believed that the therapy could be successful, but I felt thwarted in my efforts (p. 521).

From: Burns, D.D. (1990). The feeling good handbook. New York: Plume.
 


 

Abstract: One of the critical aspects of Relational Therapy (RT) that distinguishes it from other treatments for eating disorders is the therapist's use of self-disclosure. Self-disclosure is one way the therapist authentically represents her- or himself in the therapeutic relationship to foster relational movement and growth. This article makes use of an initial clinical vignette to compare and contrast the use of therapist self-disclosure within an RT approach with views of therapist self-disclosure from other psychotherapy traditions. Advantages are discussed for using therapist disclosure with eating disordered patients. Criteria are outlined to help the RT therapist decide when to disclose. Additional clinical vignettes show different types of therapist self-disclosure, their therapeutic purposes, and their relational impact. The article ends with implications for future research, training, and practice related to the use of self-disclosure in the treatment of eating disordered patients.

From: Mary Tantillo, M. (2004) The Therapist's Use of Self-Disclosure in a Relational Therapy Approach for Eating Disorders. Eating Disorders, 12 (1), pp. 51-73. Abstract available online at: http://www.ingenta.com/isis/searching/Expand/ingenta?pub=infobike://brunner/uedi/2004/00000012/00000001/art00005
 


 

Self-revelation is not an option; it is inevitability.

From: Aron, L. (1991), The patient's experience of the analyst's subjectivity. Psychoanal. Dialogues, 1:29-51. P. 40.
 


 

Negative Approach to Self-Disclosure:
 

The slippery slope of boundary violations may be ventured upon first in the form of small, relatively inconsequential actions by the therapist such as scheduling a "favored" patient for the last appointment of the day, extending sessions with the patient beyond the scheduled time, having excessive telephone conversations with the patient, and becoming lax with fees. Violations can involve excessive self-disclosure by the therapist to the patient... Gifts may be exchanged. The therapist may begin to direct the patient's work and personal life choices... Meetings may be arranged outside the office for lunch or dinner.... Notice that in this scenario, the therapist has not touched the patient, nor has the therapist said or done anything that is overtly sexual. The treatment, however, has already become compromised, and the therapist may be found liable civilly. The therapist is also vulnerable to action by a licensing board, should the patient wish to make a complaint.

From: Strasburger, L.H., Jorgenson, L. & Sutherland, P. (1992). The prevention of psychotherapy sexual misconduct: avoiding the slippery slope. American Journal of Psychotherapy, 46, 544-555. p. 547.
 


 

Maintain therapist neutrality. Foster psychological separateness of the patient. Obtain informed consent for treatment and procedures. Interact only verbally with clients. Ensure no previous, current, or future personal relationships with patients. Minimize physical contact. Preserve relative anonymity of the therapist.

strong>From: Simon, R. I. (1994). Transference in therapist-patient sex: The illusion of patient improvement and consent part 1. Psychiatric Annals, 24, 509-515. p. 514.
 


 

Self-disclosure by psychiatrists and other therapists is a complex topic. . . Self-disclosures that demonstrate the practitioner's struggle with problems of living can be supportive to some patients. However, the patient may feel burdened by the therapist's self-disclosures of current conflicts or crises. Self-disclosures may also create role reversal in which the patient attempts to rescue the therapist. Sexual fantasies or dreams about the patient or others should not be shared with the patient under any circumstances. Self-disclosures by therapists have a high correlation with subsequent therapist-patient sex (14).

From: Simon R. I., M.D. and Williams, I.C. (1999). Maintaining Treatment Boundaries in Small Communities and Rural Areas Psychiatric Serv 50:1440-1446. Available online at: http://ps.psychiatryonline.org/cgi/content/full/50/11/1440#SEC5
 


 

Additional Important Resources:
 

Farber, B. (2006). Self-disclosure in psychotherapy. Guilford Press, New York.

Jourard, S.M. (1971). Self-disclosure: An Experimental Analysis of the Transparent Self.New York: Wiley-Interscience.

Stricker, G. & Fisherm M. (Eds.) (1990). Self-disclosure in the therapeutic relationship. New York: Plenum.

Williams, M. H. (1997). Boundary Violations: Do Some Contended Standards of Care Fail to Encompass Commonplace Procedures of Humanistic, Behavioral and Eclectic Psychotherapies? Psychotherapy, 34 (3), 239-249. Available online at: http://drmwilliams.com/SAdocs/bv.html

Zur, O. (2007). Self Disclosure. In O. Zur Boundaries in Psychotherapy: Ethical and Clinical Explorations. Chapter 7, pp 147-165. Washington, DC: American Psychological Association - APA Books

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Note: All highlighted texts (bold) were added by Dr. Zur and was not included in the original texts.

 
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