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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 63. This is the beginning of the thread.
Posted by Dinah on February 22, 2004, at 9:17:34
I suppose it's no particular secret that I have had some concerns about the amount of therapist self disclosure that, judging from posts on this board at least, seems to be far more widespread than I had considered probable. And I have quite a few concerns about the impact of those disclosures on clients.
I should first say that I am a huge fan of client disclosure to therapists. I never ever think it's wrong to ask your therapist anything, and I never think it's wrong to want anything from your therapist, and I never think it's wrong to feel whatever you feel towards your therapist. I think it is a *good* thing for a client to disclose their feelings for a therapist, whatever they may be. Whether the client feels dependent or in love or sexually attracted or whatever the case may be. And I've been horrified in the past that therapists can't always seem to handle these disclosures with professionalism and empathy. Or that the therapists sometimes confuse the taboo of sexual relations with clients with thinking that a client shouldn't disclose sexual feelings for a therapist.
But lately my concern has been swinging in the opposite direction. That therapists have been disclosing everything from the fact that they masturbate to thoughts of attractive clients (in general, not client specific) to disclosing that they reciprocate the sexual attraction of a particular client (while acknowledging that the attraction can't be acted on).
In each case, the client can make a credible argument that the disclosure was good in their circumstances. That it increased their comfort with sexuality. That it increased their trust in their therapists by knowing that their therapists answered their questions with honesty. And in each given case, I might conceivably agree. But taken all together, I'm afraid that it conveys an idea that is dangerous. That therapist self disclosure of personal things is a *good* thing. Or that it can be a good thing, and of course we'd each like our own case to be one of those times it *is* a good thing.
First of all, I'm afraid that when therapists realize that they have crossed boundaries by disclosing too much, that the client inevitably pays the price. Either by the establishment of far stricter boundaries or even by the transferring out of the client.
Second, isn't it also trust inspiring to know that your therapist knows what is *his* and what is *yours* and honors both himself and you enough to maintain his privacy and dignity? I think there is something trustworthy about a therapist who can realize that there are things that we may want to know, but that might burden us if we knew. Even if it's not positive they'd burden us, even if we don't think they'd burden us, if it's possible they'd burden us, it's their job to have the strength to refuse to answer.
I'm sorry this is so long, and it really isn't even a question that pertains to me, as my therapist has excellent boundaries. It's just something that has concerned on a Babble wide basis.
So (finally), my question is what you think of therapist self disclosure. Do you think there circumstances when disclosure regarding the therapist's sexuality (especially regarding clients in general or a particular client) is useful or helpful to a client? If there are, is there any way to judge in a particular instance if the therapist self disclosure is harmful or helpful?
My therapist seems to think, though I disagree, that clients bear some responsibility in all of this. Would you agree? And if so, what is our responsibility?
And I suppose to properly evaluate your answer in context, we'd need to know your general orientation. Short term vs. long term therapy? Cognitive behavioral or more psychodynamic or interpersonal? Do you work with transference, or just try to minimize it?
Thank you for volunteering your time to Babble. It is very much appreciated.
Posted by noa on February 22, 2004, at 9:58:14
In reply to Erika Schmidt, LCSW - therapist self disclosure, posted by Dinah on February 22, 2004, at 9:17:34
Dinah,
That was a superbly written post with excellent questions! Thank you!
Posted by shortelise on February 22, 2004, at 12:38:56
In reply to Erika Schmidt, LCSW - therapist self disclosure, posted by Dinah on February 22, 2004, at 9:17:34
It would make me extremely uncomfortable if my psychiatrist were to disclose his sexual feelings. If he were to tell me who he thinks about when he masturbates - even in general terms - I don't know what I'd do! Even if it were somehow in context. Even if I asked him and was somehow convinced I needed an answer. I can't conceive of this, honestly.
The things I know about him are pretty innocuous, and are mostly things he has told me, always seeming to struggle with the non-disclosure thing if in answer to a direct question.
Dinah, I agree with what you have written. The relationship with one's therapist is complicated enough without throwing his or her caca into the mix. It's nice to know little things - that he's just had a baby, where he's from, that he likes yellow, or that he plays the guitar. But I depend on him to be clear of his own crap in helping me deal with mine, and if his crap is in the room, if he tells me things, then those things become part of my therapy.Could you please explain the use of "Erika Schmidt LCSW"?
ShortE
Posted by shortelise on February 22, 2004, at 12:48:36
In reply to Re: Erika Schmidt, LCSW - therapist self disclosure, posted by shortelise on February 22, 2004, at 12:38:56
Oh, ok, now I get the Schmidt part.
S
Posted by terrics on February 22, 2004, at 14:43:46
In reply to Erika Schmidt, LCSW - therapist self disclosure, posted by Dinah on February 22, 2004, at 9:17:34
Excellent and detailed post Diana.
I believe my T. has made me ill with self disclosure. I do not think a patient needs to know that her T. was a drug addict and goes to NARANON espec when the pt. is not and never has been an addict. The pt. also doesn't need to know that Ts son is mentally ill and on many meds, that her daughter is getting divorced. That T. nearly threw her baby out the window. Pt. doesn't need to know Ts friends names, where they go together and what they do together. Also, pt. should not be driving her to car dealer to pick up her car. Are these boundry violations or am I too sensitive. terrics
Posted by Dinah on February 22, 2004, at 14:52:30
In reply to Re: Erika Schmidt, LCSW - therapist self disclosure » Dinah, posted by terrics on February 22, 2004, at 14:43:46
Posted by Dinah on February 22, 2004, at 14:56:29
In reply to Re: Erika Schmidt, LCSW - therapist self disclosure, posted by shortelise on February 22, 2004, at 12:38:56
He might share stories of childhood with me, or something like that. But nothing that has any sort of energy to it.
I think he did overdisclose once about his feelings about dependent women, but I think we both realized it was an overdisclosure. On the other hand, the overdisclosure had both a positive and a negative influence on our therapy. I think it could have been more negative if it hadn't been just that one session where he was overwhelmed and slipped. He never brought it up again, and if I do he neither denies it nor expounds upon it.
Posted by Karen_kay on February 22, 2004, at 15:23:15
In reply to Re: That's about all I know of mine, too » shortelise, posted by Dinah on February 22, 2004, at 14:56:29
I know too much entirely. I know that his dad died in a way similar to mine. I know his age. I know his usual sleep schedule. I know he thinks of clients at times when he masturbates. I know he thinks I'm beautiful. I know much more, but I won't say it as it would jsut be a waste of time...
But, I have mixed emotions on this issue. He's trying to help me form an emotional attachment to him. And it's working. And it's not sexual or "fatherly" in any way. It's helpful to me to know that I would be hurt if he went away. That we are similar in some ways. That he trusts me enough to tell me these things. Maybe he talks too much. Maybe he knows what he's doing. But, he's helped me quite a bit. And if he's making a mistake, I'll forgive him for it as he's really helped me. So, I guess it depends on the desired result from self disclosure. If it's to fill a need that the therapist has, it's wrong and unethical IMO. If it's to help the client trust and form an attachment, it's working. Maybe it's a boundary violation, but it's working... I'm trying not to be one-sided in this matter, but why do I feel everyone's picking on my therapist. His approach is working for me. And it's not causing too many problems in my life, other than me worrying about him. So, why not self disclose for the SOLE purpose of helping the client. We'll never really know the motivations behind it. So, if it's working, why not? If it's harmful, no way!
Posted by fallsfall on February 22, 2004, at 15:37:04
In reply to Re: Erika Schmidt, LCSW - therapist self disclosure » Dinah, posted by terrics on February 22, 2004, at 14:43:46
Posted by Dinah on February 22, 2004, at 16:00:12
In reply to Re: That's about all I know of mine, too » Dinah, posted by Karen_kay on February 22, 2004, at 15:23:15
Awww, sweetie. I don't mean to pick on your therapist. He certainly isn't the only one doing it. I'm just trying to figure out how to tell if they are making a well reasoned decision that has a good probability of being in our long term best interests. Because I'm sure everyone thinks their own therapist is doing that, and just as obviously not all therapists are doing that. So there really should be some guidelines that we, as informed consumers, can use.
And I'm not sure how we feel about it is a good guide. I'll bet any one of the people here who have been hurt by therapist overdisclosure thought that it felt like a good idea at the time.
And I'm not trying to pick on Bubba. I actually don't think his disclosures have done you any real harm (unless they've played a role in the current situation). My therapist might argue that it's a diversion from the real work of therapy, but he and I differ on that concept a bit.
Posted by tabitha on February 22, 2004, at 16:26:44
In reply to Re: That's about all I know of mine, too » Dinah, posted by Karen_kay on February 22, 2004, at 15:23:15
Hi Karen. I hate to see you feeling picked on by this topic, even if that wasn't Dinah's intent. Let me try to be reassuring here... all therapists work differently from each other, and work differently with different clients. We can't really know your therapist's motivations for disclosing those things to you. Perhaps as you've suggested, he's doing it specifically as a way of working with your attachment issues. But ultimately you're the judge of whether he's working well with you or not, and it sounds like you are fine with the disclosures.
Hey, if you do have any doubts, how about asking him why he discloses so much? Maybe tell him some people have questioned whether it's good for therapists to disclose so much.. see what he says. It might be very reassuring.
Posted by Miss Honeychurch on February 22, 2004, at 16:36:46
In reply to Erika Schmidt, LCSW - therapist self disclosure, posted by Dinah on February 22, 2004, at 9:17:34
Dinah,
That was so well written. You have just stated what I have been feeling for the past few months here on babble about the alarming amount of self-disclosure about really inappropriate things. Having a therapist with REALLY strict boundaries has been so wonderful for me. To me, this proves that he really cares about me, that he wants to give me the best care possible and that he values himself as well.
A month or so ago My T and I were talking about how there are some therapists who never admit when they cannot help their patient or who want to keep their patients dependent on them for a few reasons (monetary, selfish, etc). He told me he would not hesitate to refer me on if he thought he wasn't helping me. He said this rather clinically and matter of factly which hurt my feelings, but the more I thought about it, the more I realized how much he was looking out for mine and all of his patients best interests. This made me love him even more.
I know by not self-disclosing some things that he is taking the proper and correct care of me. He is truly professional and I don't want any less for myself. If he were to disclose anything remotely inappropriate right now I would be so sad. I think in the beginning of our relationship I would have felt giddy, but now I know it would be pure sadness since I would know he didn't have my best interests at heart.
Posted by Dinah on February 22, 2004, at 16:44:56
In reply to Re: Erika Schmidt, LCSW - therapist self disclosure, posted by Miss Honeychurch on February 22, 2004, at 16:36:46
> A month or so ago My T and I were talking about how there are some therapists who never admit when they cannot help their patient or who want to keep their patients dependent on them for a few reasons (monetary, selfish, etc). He told me he would not hesitate to refer me on if he thought he wasn't helping me. He said this rather clinically and matter of factly which hurt my feelings, but the more I thought about it, the more I realized how much he was looking out for mine and all of his patients best interests. This made me love him even more.
>I continue to be so impressed by other posters! That would have started an orgy of abandonment concerns that would have consumed the next year of therapy. :) I think I have him convinced that even if he's not willing to offer forever therapy, that at least terminating me would be more trouble than it's worth. I'm not sure if that means he thinks terminating me would do more harm than good... I think I'll choose to think of it that way.
Thanks for your words of support. I really am glad to have the chance to have a guest expert speak to the subject, since it's been a source of concern to me too. I had been trying to figure out how to relay my therapist's comments on the subject without him actually catching sight of this site, which he's promised not to do.
Posted by Dinah on February 22, 2004, at 16:45:45
In reply to Re: Erika Schmidt, LCSW - therapist self disclosure, posted by Miss Honeychurch on February 22, 2004, at 16:36:46
Maybe that box being checked *should* be the default.
Posted by Pfinstegg on February 22, 2004, at 17:49:53
In reply to Drat, above for... » Miss Honeychurch, posted by Dinah on February 22, 2004, at 16:45:45
I think the main thing that happened with you and your therapist is that you got BETTER! Some of the disclosures by Bubba really did seem to be boundary violations, but there must have been so many other good things going on that helped you feel better and more reflective. The things that sounded so alarming here on PB apparently really were not damaging in the context of your total relationship- you grew, felt a lot better and really value the experience you had.
But I've got to mention one thing: your therapy is being unilaterally ended by him, or much more likely, by his supervisor. He (she) must have felt concerned enough about some of the violations to recommend that. It's a shame this had to happen, as it sounded like you were an excellent "match" and that you gained a lot from your experience with him. I'm sure he'll go on to be a great therapist who keeps good boundaries, and that you, as and if needed, can find another therapist to have another very rewarding, growth-producing experience with. Still, it would have been good if you could have continued with him while you finish college..
Posted by Karen_kay on February 22, 2004, at 19:06:47
In reply to Re: Thoughts - Karen_Kay, posted by Pfinstegg on February 22, 2004, at 17:49:53
Oh, don't worry. If they tell me no more Bubba, I'll fight. But, the end outcome is one that I will accept. And I honesty don't think it has anything to do with the boundary violations, or I would be referred to a different therapist, not given the option of group with him.
I know I'm not "fixed" but I realize now I'm on my way to being a much happier person. I'd love nothing more than to continue to learn with the help and aid of Bubba. And if I'm told "No more Bubba" Oh, there'll be a war. But only because I feel it's in my best interest to continue therapy with him as the guide. But, if the end result is termination then I'll find a different therapist if I feel I need to. I'll take care of myself first and foremost if that time comes. But, if I can't contiune with him, he's taught me so much (and not just breathing exercises and thought challenging) how can I not go willingly and continue therapy on my own or with a different guide, which ever the case may be. I almost feel like I'm the girl in "Lost in Translation." I'm not scared anymore about the final outcome. I know I've learned so much and valued the time I had. I'm jsut grateful for the opportunity I had to learn.
Posted by Dr. Bob on February 23, 2004, at 8:47:54
In reply to Erika Schmidt, LCSW - therapist self disclosure, posted by Dinah on February 22, 2004, at 9:17:34
The thoughtful comments and questions about therapist self-disclosure, answering questions, and maintaining boundaries raise a number of important issues. Since there are no right or wrong answers regarding these matters, let me respond by offering some guidelines for thinking about the issues. First, therapists reveal much information about themselves in the way they do things, their style, the manner in which they respond and handle things, what they choose to say and not to say, even things like office decor. Much of this is done without deliberate intent, but does become a way through which people can learn much about their therapists.
Second, the primary guiding principle for whatever a therapist does, says, doesn't do, and doesn't say should be the creation of therapeutic environment for the client which promotes a feeling of safety for the kind of self-revelation by the client which makes therapy possible. What is done in the therapy should be in the service of the client's growth and development. This principle should guide the therapist's decisions about deliberate disclosure or response to questions as well.
Third, the rationale for not answering questions or for not providing certain kinds of information is to provide freedom for the client to express themselves openly without worrying about the therapist's feelings or investment in particular matters. If in doubt, less is probably more in these situations.
Fourth, answering questions or providing certain kinds of information, while it may appear to be a kind of honesty or openness, can be quite deceptive: it may avoid more difficult matters, it may close off certain avenues of conversation, it may distract both people from the work at hand, it may be an easy way out.
Fifth, there are certainly times when disclosure or answering questions is an effective way of handling things, and can further the therapeutic work. It depends, and can only make sense in the context of a particular therapist-client relationship.
Sixth, exploring the questions themselves, the reasons they arise, what they mean for the client, may be a more useful response than direct answers and can often lead to surprising learning. Whether the therapist offers information or doesn't, what is most important to understand is what the meaning is to the client. This kind of exploration of personal meaning is what therapy can really offer to someone.
There is much more that could be said on this topic, but this is a start.
Erika Schmidt, LCSW
Posted by Joslynn on February 23, 2004, at 9:11:07
In reply to from Ms. Schmidt: therapist self disclosure, posted by Dr. Bob on February 23, 2004, at 8:47:54
Thank you Ms. Schmidt.
I am still curious though, what would be your response to the specific questions Dinah asked about therapists revealing sexual attraction etc.?
I didn't pick that up in the post, can someone point that out to me if I missed that?
Thank you very much.
Posted by pegasus on February 23, 2004, at 13:42:27
In reply to Re: from Ms. Schmidt: therapist self disclosure, posted by Joslynn on February 23, 2004, at 9:11:07
I thought I understood that Ms Schmidt was saying that if the disclosure about sexual attraction was designed to somehow foster an environment that was therapeutically beneficial to the client, then it would generally be seen as ok. But, of course, it's easy to imagine lots of situations where that type of disclosure wouldn't be about helping the client's therapy.
My old T once told me that he would tell me anything about himself, if it seemed like that would be helpful for my therapy. And, at a couple of points in my therapy he did tell me very personal things, which - in the context of what we'd been talking about - did make a difference in how I approached those issues. I think in one case it was a misjudgement, and made me hesitate to self-disclose on that particular topic in the future. In the another case, it was very helpful, and really opened up some areas that had been difficult in the past. I appreciated him taking those risks, and I trust that he was motivated by helping me - not by gratifying his own needs. So that seems ok to me.
- p
Posted by Dinah on February 23, 2004, at 14:05:18
In reply to from Ms. Schmidt: therapist self disclosure, posted by Dr. Bob on February 23, 2004, at 8:47:54
I guess I'll stop worrying about it then. Or at least stop saying I'm worried.
Posted by pegasus on February 23, 2004, at 14:48:03
In reply to Re: from Ms. Schmidt: therapist self disclosure, posted by Dinah on February 23, 2004, at 14:05:18
I appreciated your saying that you were worried. I think it's a worrisome thing, too.
I think a lot of self-disclosure doesn't follow the rule of "is this for the client's therapeutic benefit". And that even if it does, it can be damaging to therapy (as in the case of my T's misjudged disclosure, which caused a few problems even though motivated by wanting to help me). Personally, I think this is really tricky business, and T's need to be thinking about it pretty carefully when they disclose stuff.
And at the same time, I always enjoy it when my T discloses stuff. Even when it's bad for me. Which only makes the responsibility on the T that much more serious, IMHO.
So, thanks for bringing it up.
- p
Posted by tabitha on February 23, 2004, at 15:46:31
In reply to from Ms. Schmidt: therapist self disclosure, posted by Dr. Bob on February 23, 2004, at 8:47:54
I guess my therapist is from the same school (figuratively). When I ask questions I always get 'what would it mean to you if I were?' or something of that ilk.
Her office is so blah.. beigey and mild southwestern theme prints. Nothing has changed in ten years except a couple of plants. I swear it reveals nothing.
Posted by tabitha on February 23, 2004, at 15:47:48
In reply to Re: from Ms. Schmidt: therapist self disclosure, posted by Dinah on February 23, 2004, at 14:05:18
> I guess I'll stop worrying about it then. Or at least stop saying I'm worried.
Here's a therapist-like question for you: What does it mean to you when you hear others talk about their therapists revealing personal details?
Posted by Dinah on February 23, 2004, at 16:25:16
In reply to Re: from Ms. Schmidt: therapist self disclosure » Dinah, posted by tabitha on February 23, 2004, at 15:47:48
Do you mean do I want my therapist to disclose his sexuality or whether he finds me sexually attractive? No.
Do you mean that it bothers me to think of therapists as sexual beings who see their clients in a sexual way? Perhaps.
Do I worry that my therapist gets an erection in the office? Ick. Perhaps yes. Where is he sitting? He doesn't have a usual chair... Fortunately there's that whole eunuch thing.
Do I worry that he gets one with me? No, thank heavens. :)
Do I still have issues with the fact that my father made me stop sitting on my lap at puberty, which not only made me think of him as a man, but meant that he thought of me as a sexual being? Yes. Eueewwwww. Ick. Ick.
Mostly I was worried that the board in general was doing something that could prove to cause hurt to clients in the long run, and OCD me didn't want to be part of that. But if the practice is considered ok by Dr. Bob's guest expert, that lets me off the hook. I'm certainly no expert. I'm not sure I'll encourage it, but I won't worry about it any more. I could use a bit less worry in my life.
Posted by Crooked Heart on February 24, 2004, at 8:09:59
In reply to Re: Erika Schmidt, LCSW - therapist self disclosure » Dinah, posted by terrics on February 22, 2004, at 14:43:46
Just picking my lower jaw up from the floor, terrics. And she was being PAID for this!!?
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