A psychologist’s primer on self-disclosure

therapy session with client crying on couch

Most people assume the client is the one on the couch.

Psychologists’ guidelines on self-disclosure with clients are clear: DON’T DO IT! Okay, maybe that’s a bit strong. Psychologists can share information about themselves very occasionally so long as the sharing is to help the client and not for their own gratification. Many clients I’ve seen have described prior experiences with therapists who’ve spent the hour talking about themselves, sharing more than they want to know. Despite the other cardinal rule not to malign another therapist, I doubt I do a good job of hiding my inner disapproval.

As a new graduate, I followed these self-disclosure guidelines, but I’ve admittedly become more “flexible” over the years. I hope I don’t share too much with clients, but I certainly share more than I used to. If a client asks a direct question about my life, assuming it is not inappropriate, I am more likely to answer than not.  Working with children and teenagers necessitates that. Teenagers need honesty to open up, and younger kids don’t know better than to ask. Sure, sometimes we’ll discuss why they ask, but often I’ll just answer and move on.

All those disclosure rules went to pot a few years ago when I got very sick, was hospitalized indefinitely, and did not know when or even if I’d be able to return to work. Initially, I was well enough to cancel scheduled clients from my hospital room, but I had to tell them something. As I got sicker, I could not even make those calls. (It’s hard to talk with a respirator.) For the first time, a voice other than mine was on my voicemail and responding to my messages.

Now that I had leukemia, would I share news of my illness with my clients? If I did, how would I help them process what I’d shared?  The last thing I wanted to do was to raise any client’s anxiety. And if I couldn’t work, how could I facilitate transfer to another therapist without some explanation? They don’t teach this stuff in graduate school. Initially I’m sure I mishandled some of these calls since I was so overwhelmed by the cancer diagnosis myself. Even once my health stabilized, I doubt I convinced clients who called that I’d be around for a while. I know from my own shock at getting cancer and from watching others’ reactions to the news that people often assume cancer is an imminent death sentence; they may not realize how many people around them are living with the disease.

With these thoughts in mind, I initiated this blog with great caution. I realize I am sharing in the public domain and that clients could easily come across what I have written. I’d hope that a client who discovered the blog would not be distressed by what he or she read, since my focus is on living well with illness. But in keeping with those long-forgotten guidelines, I haven’t directed any clients to my blog and I don’t plan to. Doing so would be clearly for my own gratification, don’t you think? And, as J. sometimes reminds me, it can’t be all about me all the time.

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