Voicelessness and Emotional Survival > Voicelessness and Emotional Survival Message Board
Should therapists self-disclose?
BonesMS:
--- Quote from: Dr. Richard Grossman on July 10, 2011, 03:31:28 PM ---Hops,
You have seen all types (in terms of therapist self-disclosure and boundaries), and I appreciated your perspective and where you have ended up. You’re right. In and of itself, self-disclosure does not make for great therapy—the text and subtext of that self-disclosure are critical. But I think, as you do, that “feet of clay” are usually damaging.
CB,
Personality disorders including Borderline Personality Disorder present a whole different challenge for a therapist. My “kind of therapy”, I found, largely failed with patients with BPD. DBT (a mixture of cognitive therapy and mindfulness training) is not relationship based, but largely technique based. (Couple’s therapy, too, is largely advice-based, and not relationship based—so I’m not surprised self-disclosure didn’t help.) So, I’m not sure that Marsha Linehan’s acknowledgement would have helped her patients had she offered it in real time. Still, like you, I admire her admission—and I believe her having had the disorder was crucial to her finding something that worked for others.
Ales2,
I think your therapist telling you that his children were in therapy, in order to reduce your stigma/guilt was a fine thing to do…
Boat that Rocks
Here’s some evidence of the value of therapist self-disclosure:
Therapists Redraw Line on Self-Disclosure
By ERICA GOODE
Published: January 01, 2002
http://www.nytimes.com/2002/01/01/health/therapists-redraw-line-on-self-disclosure.html
PR,
“I find the idea that a therapist is an all-knowing, all-powerful Oz who has all the answers and the magic ability to "fix" me... well, it's off-putting. Yet, I think we all start the process with that stereotype in our minds.”
I agree. In the psychoanalytic heyday at the major teaching hospitals and institutes, this is what, in my experience, therapists wanted people to believe. Many people were either not helped or damaged as a result.
“Personally, I don't think a T's personal history is relevant to being able to guide a client through the process of learning a new balance within themselves. You reach out, steady them, help them find their balance... then slowly, give them the room to realize they can move around just fine, without wobbling and falling again. That doesn't require the T to have experienced vertigo, you know?”
In my experience, both as a patient and supervising other therapists, those who had experienced “vertigo” (metaphorically speaking) or some other disorder that allowed them to know something of what it was like from more than an intellectual perspective, were much better at helping those with the disorder. But there are many variables here, including whether the treatment was technique based (e.g. cognitive therapy), how severe the problem was, how broad or narrow the problem was, etc.
Bones,
If the therapist is narcissistic, self-disclosure is of no use at all…
Guest,
Yes, it definitely helps to know something about the therapist’s specialties before you start. The internet has been a wonderful help in that regard.
TT,
“It's kind of like a piano tuner knows how to tune a piano, but not necessarily know how to play a piano in the strict sense (if that makes any sense).”
For some problems, technique based solutions work fine. But for other’s, IMO, a relationship is required—and the better the relationship, the better the outcome.
Bones,
“On the other hand, I had the unfortunate experience of a therapist abandoning her patients in group therapy because an issue that came up with us triggered her PTSD. NOT fun!”
That’s a very sad situation.
Thanks to all for your responses,
Richard
--- End quote ---
You're welcome, Dr. G., and thanks!
Regarding therapies that are "technique based", one thing that bothers me with that approach is the "one-size-fits-all" mode of thinking. When I worked for three months, at a prison facility, they had recently changed from a client-centered approach to one of the technique-based approaches....cognitive behavioral therapy...and was attempting to force ALL the prison residents there to "fit the mold" so to speak. I was NOT comfortable using that technique-based approach, (plus I had NO prior training in that method) and I was seeing too many instances where CBT was just simply NOT appropriate! It made it difficult, if not impossible, to design an Individualized Treatment Plan while being pressured to write that plan from a "cookie cutter" standpoint. If a client could NOT "fit the mold", (e.g. suffering from schizophrenia and taking psychotropic medications), he was shipped to a different prison and he basically got NO help at all in spite of the fact that he was CLEARLY DUALLY-DIAGNOSED! In the end, I just could NOT condone that and stay there. (The powers that be were also violating several state regulations which also compelled me to quit after such a short time of employment.) The experience left me in a lose-lose situation....quit and be unable to become certified, stay and attempt to work while vehemently disagreeing with the way the clients were being treated....wait for the ax to fall on me as the now-identified "whistle blower" because I contacted the state to question what I was seeing and the state authorities used my name when they contacted my then-supervisor. I felt I had no choice but to leave considering the circumstances. That one experience left me with the impression that the powers that were in control was simply looking at the money going into their pockets and didn't care about the front-line staff nor the clients that they were supposed to be helping. They seemed to have forgotten WHY the clients needed help in the first place! I find it so sad when someone in a therapeutic professional position looks at a human being and sees ONLY DOLLARS, CENTS, AND PROFIT. Am I making sense?
Bones
lighter:
I agree that T's that share their own experiences, and struggles, helps me bond and feel safer.
I also feel that the trust goes both ways, and that's truly a gift, IME.
Lighter
Dr. Richard Grossman:
I didn’t publicly answer Hops’ question about my wife’s health. Hildy recently got the results of her latest CT scan, and all is well. As many of you know, she was diagnosed with lung cancer 4 ½ years ago. The non-profit she founded three years ago, Upstage Lung Cancer (http://www.upstagelungcancer.org/), is about to make a $100,000 donation (in conjunction with Lungevity-- http://events.lungevity.org/site/PageServer) to support research in early detection of lung cancer. Hildy is the most determined person I know. She, too, tries to turn bad “stuff” into good “stuff”...
Richard
Dr. Richard Grossman:
Hi Bones,
"They seemed to have forgotten WHY the clients needed help in the first place! I find it so sad when someone in a therapeutic professional position looks at a human being and sees ONLY DOLLARS, CENTS, AND PROFIT. Am I making sense?"
Perfect sense...and, unfortunately, things are only getting worse because of the financial crunch.
Richard
BonesMS:
--- Quote from: Dr. Richard Grossman on July 11, 2011, 10:35:51 PM ---Hi Bones,
"They seemed to have forgotten WHY the clients needed help in the first place! I find it so sad when someone in a therapeutic professional position looks at a human being and sees ONLY DOLLARS, CENTS, AND PROFIT. Am I making sense?"
Perfect sense...and, unfortunately, things are only getting worse because of the financial crunch.
Richard
--- End quote ---
Thanks, Richard! I wish I had the power to change things for the better.
Bones
Navigation
[0] Message Index
[#] Next page
[*] Previous page
Go to full version