The Therapeutic Potential of Self-Disclosure

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PORTRAIT OF A PSYCHIATRIST

Our own self-disclosure has had a long and complex history.

As psychoanalysis developed a century ago, Freud recommended being a “blank screen” to patients, including sitting behind them out of direct eye contact. Even if he didn’t always follow his own advice in providing psychotherapy, the theoretical rationale was that this therapeutic framework would allow patients to best focus on themselves.¹ It could also help to keep proper ethical boundaries between patient and therapist. Confidentiality became a primary ethical principle.

As time went on and psychotherapy developed, this stricture loosened with the realization that some carefully chosen personal self-disclosure could have therapeutic potential.² Nevertheless, this increasing self-disclosure with patients did not necessarily extend to colleagues, nor to acknowledgement of our own mental suffering and escalating rate of burnout. One reason is the perception that such self-disclosing can be harmful to one’s job, licensure, and career, which can lead to the avoidance of seeking needed treatment and help.³

No wonder that we don’t have enough research and knowledge about our own mental struggles, and that we seem to have such high rates of suicide and mental illness as well as a burnout epidemic. What could account for this conundrum? Why do we, the experts in understanding the mind, have so much difficulty in addressing and improving our own mental health? One explanation for this is the so-called boomerang effect.⁴ Because we have a need to preserve a positive self-image, we tend to avoid self-disclosure because of the assumed negative connotations.

If we feel our reluctance to self-disclose is necessary, how do we overcome that tendency? Perhaps one method is to publicly test the waters via the courageous sharing of brief self-portraits. Hence our call for self-portraits.

In response to our call for self-portraits, we received a goodly number of submissions that are turning out to be priceless. We trust that you will value them as the jewels that they are and share their worthiness accordingly. To date, they range the gamut of our experiences. The first in our series shows us how the childhood object of a psychiatrist has transitioned into a therapeutic tool.

We hope that that these self-portraits will contribute insight to our readers as we explore our authentic and healing selves in a meaningful new year.

References:

1. Freud S. The Interpretation of Dreams. New York: Random House; 1994.

2 Howe E. Should psychiatrists self-disclose? Innov Clin Neurosci. 2011;8:14-17.

3. Jamison KR. Night Falls Fast. New York: Vintage Books; 1999.

4. Levy A. The boomerang effect of psychological interventions. J Soc Infl. 2018;13:39-51.