What We Self-Disclose

Self-disclosure is a controversial topic among mental health professionals.  Many orthodox analysts frown on sharing ourselves and our life experiences with our patients and instead embrace the notion of the “blank screen”.  While total non-self disclosure – the blank screen – is not even possible, the theory behind the position is certainly valid and worthy of exploration.

As analysts, we to some degree self-disclose when we first make contact with a prospective patient to set up an appointment.  Even before meeting the patient we inevitably convey some of who we are with our telephone or email manner.  Whether we are a man or woman, warm or formal, brief or engaging – each will give a hint as to who we are and how we may be to work with.  Although our slightest comment or tone can elicit projection and have enormous significance, some impressions are likely to have truth to them.

We need to ask ourselves to what degree the prospective patient’s inquiry into the therapist’s personal life deserves a direct reply?  It is widely accepted when a woman seeking therapy wants to see a female therapist, when a gay person a gay therapist, or when a person wants to see a therapist of his/her own race or culture.  There is some validity to the patient’s need to work with a therapist who, the patient feels, shares in their experience.

But how do we consider other more specific or potentially indiscrete questions?  Because facts about the therapist may not be readily apparent or expressed (being a woman, being gay), questions about the therapist’s identity enters into the realm of self-disclosure.  What if a person wants to see a therapist who is a parent, or of a certain age, or married?  Such questions may be unanswered because they are deemed invalid requests.  Yet, why is wanting a female therapist or African-American therapist acceptable but not a therapist who is a parent or older or partnered?

Probing questions or attempts at elucidating details of the therapist’s personal life may become more frequent once treatment starts.  At that point, the questions have a different meaning; self-disclosure becomes delicate and the patient’s need for the information needs to be explored in treatment.  Furthermore, the therapist must examine him/herself to distinguish what is best for the patient and what may only satisfy the needs of the therapist.  As treatment continues, addressing the patient’s inquiries becomes a lot more complex.

Even if the analyst share very little, the person in therapy inevitably picks up many non-verbal cues as to the therapist’s identity.  How the analyst dresses, moves about, sits, greets, ends sessions, and decorates their offices all inevitably hint at his/her personal life and influence the therapeutic process and affect the people in our care.

Self-Disclosure

Because self-disclosure has always been easy for me, I’ve been an open book and share whatever people want to know about me.  However as a psychotherapist, I function quite differently and am very careful and deliberate with what I disclose to patients.  Learning to function differently as a therapist – finding my voice – has been a long and careful exploration of my role as an analyst, my social and political self, and my many years of theoretical learning.

At the beginning of my practice 16 years ago, I followed what I thought necessary at the time – the theoretical model of the blank screen.  I was silent most of the session and tried to let very little of my own personality into the room.  I thought that the best way for me to develop my technique was to pull all the way back from how I normally functioned in the world.

Initially, I shared nothing about myself or my background, believing that the most effective therapeutic stance was keeping who I am hidden so that the patient can project everything onto me, illuminating his/her psychic state.  Over many years and much careful exploration, I have moved away from the blank screen approach. This approach not only did not work for me as a therapist but I came to believe that the blank screen is not a possible stance for any analyst. Whoever I am comes into the room – either verbally or non-verbally – with the person I am working with.

The dyad of the patient and myself is unique and cannot possibly be repeated in same way with a different therapist.  I believe self-disclosure, carefully thought out, can at times be a very useful and vital  part of the treatment.

I will have much more to say on self-disclosure and the therapeutic stance in future posts.

The Yearning to Merge

In working with patients and in reflecting on the special relationship I had with my identical twin brother, I’ve thought a lot about how people yearn for symbiotic relationships.  Without realizing that total symbiotic relationships are a fantasy – whether with a romantic partner, a parent with a child, friendships or others – people enter relationships with the unconscious need to be completely known and understood.  When there is a break in the symbiotic fantasy – when one feels the other does not understand, expresses anger, criticizes or functions differently – the shock of separateness can cause a primal rupture that threatens the relationship and evokes feelings of insecurity and instability.

Symbiotic rupture is most frequent and most threatening between romantic partners and between parents and children.  The unconscious yearning to have partners and children be a reflection of ourselves is very powerful.  We fall in love, have children, and create close friendships with the desire that we will merge with the object of our affection and be safe from our innate aloneness.  When this merging is threatened, we feel rejected or confused and judged.  Instead of the beauty of the other’s differences, we feel the loss of the other’s sameness and protection from isolation.  Instead of celebrating and learning from the other, we experience the pain of separateness.   This pain threatens feelings of having found “our other half” or our children being a reflection of us.

Being an identical twin gave me the primal experience of near complete symbiosis with another person.  Not only were we a merged unit from before birth – albeit also two separate individuals – we looked very much alive and sounded almost identical.  It seemed natural for me to go out into the world expecting the same symbiosis in my relationships with others.  It was with a lot of difficulty that I learned that the kind of relationship I had with my brother could not be repeated with others – whether partners, friends, or children.

This window into the special merging experienced in my twin relationship illuminates the yearning and desire of those I work with in my practice.  Through my own acceptance of the limitations of relationships other than the one I had with my brother, I help my patients work with the pain of not being able to fulfill the unattainable fantasy of total merging with others.

Intimacy between two people does not evolve from having the other be one’s own reflection.  Rather, intimacy grows because of the excitement and discovery of the other’s differences.  Working through differences that are both complimentary and challenging deepens the bond and the intimacy we crave with others.

Being an Identical Twin

Empathy and understanding are the cornerstones of the analytic process.

Being an identical twin has profoundly influenced my life and my perception of others.   From birth I had an intimate knowledge into how another person experiences and relates to the world, an experience that has left me deeply empathic.

My brother and I had an abbreviated language that conveyed what we were feeling and thinking; we understood each other thoroughly.  As I look back at our relationship, I realize that this intimacy has enhanced my ability to empathize with other people.  Because my brother and I were so alike, the empathy we shared taught me to have strong empathy with others – an enormous gift in my work as a psychotherapist.

Along with empathy, my brother and I shared a deep understanding of each other.  This has left me particularly sensitive to the feeling of being misunderstood by others.  With those I work with in my practice, this sensitivity sharpens my diligence such that I ensure others feel heard and understood.

Although not universal, the desire to be understood and to share a world view presents itself frequently in the course of an analysis.  As an analyst, my experience as an identical twin invaluably illuminates my work.

Being a Therapist and an Actor

I’ve been thinking more about Wallace Shawn’s comment to me that a psychotherapist and an actor are much the same thing. Aside from it being a funny comment, I find much truth to it.

Exploring background, motivation, and reaction with the characters I played or monologues I studied seems very analogous to my work as a psychotherapist. With the people I work with as an analyst as well as the roles I had played as an actor, I explore how they experience the world and function in it.  Both involve how I perceive others and how I function in relation to them.

The difference between the two professions are also intriguing.  As an actor, I attempted to merge myself with the character I was presenting which is part of the nature of acting.  As a psychotherapist, I have to be diligent that merging doesn’t happen.  If it does, I explore whether what is happening could be projective identification – feelings felt by the person I am working with that are intolerable and, hence, unconsciously projecting into me; or my own countertransference – feelings that come from my own emotional makeup.

Considering this analogy between the two disciplines, I can see why acting was always such an alluring profession for me.   Now that I am a psychotherapist, much of what drew me to acting is now expressed in my work with the people I treat.

After some thought, what initially seemed like a funny statement from Wally Shawn now seems quite insightful.

When I was Young

In my early adulthood I imagined myself being a therapist.  Although knowing nothing of what that entailed, I was always a people person and interested in who people were and how they got that way.  I remember when in my 20’s, new alternative therapies like Fritz Pearl’s  “Gestalt Therapy” and Arthur Janov’s “The Primal Scream” were very popular.  Living an alternative lifestyle myself, these new ideas were exciting and very interesting.  I particularly took to gestalt therapy.  With no training and only a BA in Sociology, I imagined being a good therapist if that is what I decided to study.   I also imagined that being a good therapist would be easy for me because of my curious and warm personality.

I never pursued therapy as a profession back then.  I had always loved acting and moved to New York in 1980 to pursued that profession.

As an aside, a couple of years ago, I was in a food market and somehow happened to talk to Wallace Shawn, the playwright and actor.  He asked me what I did for a living and I told him I was a psychoanalyst.  He also asked me what I used to do before that and I told him I had been an actor.  Upon hearing this, he stated that being a psychoanalyst and being an actor were very much the same.  I thought that was pretty funny.  Coming from Wally Shawn, who had appeared in numerous Woody Allen movies, that observation seemed like it belonged in one of those films.

When I eventually went back to school in my 40’s for my long training as a psychotherapist, I quickly learned how little I knew about theory and how it informed being a good and insightful therapist.  The more I learned the more I realized how little I knew.