These Troubling Times: Self-Disclosure in Clinical Practice

These Troubling Times: Self-Disclosure in Clinical Practice

by Lisa Mortimore, PhD, RCC and Stacy Jensen, M. Ed., RCC

 

In the changing landscape of our global world, some authors (see Gibson, 2013; Tosone et al., 2011) have suggested that shared traumas or shared traumatic reality may continue to shift the edges of what is considered appropriate in terms of self-disclosure in the therapeutic relationship. We would go beyond appropriate and suggest therapeutic – when clients bring their shock, anguish and despair at the world gone wrong to the clinical space, an authentic yet regulated response is at times being asked for and needed.

Over the past several years an upsurge of news events have made their way into our practices – not in a passing way but with a need to be met, witnessed and processed. Over the past year or so therapeutic conversations about: the rampant rape culture in our nation and across borders; mass shootings; the death of icons; and of course the fear and threat felt with the election of Donald Trump in the USA have been potent. The common thread of these events is that they are part of our social reality and have shaken the bedrock of our security.

Karen Maroda’s (2009) wisdom that the “therapist’s expression of emotion toward the client served to complete the cycle of affective communication that was insufficiently developed in childhood. In expressing emotion at the appropriate times, the therapist provides an emotional reeducation and remediates a developmental void” (p. 20). Client led co-grieving in the session can be an extension of that re-education, and perhaps more significantly, a source of much needed human connection and comfort in times of heightened societal insecurity, social isolation and social dislocation (researchers indicate that social isolation is a leading issue for people in Greater Vancouver, The Vancouver Foundation, 2012).

As therapists, the question becomes how do we meet people in their shock, fear, and anguish while we are swimming in similar waters?

We’re suggesting that when clients bring forth their anguish or horror at what has happened, what is happening, or what they fear will happen in our world, that the required therapeutic response may go beyond holding space, witnessing and processing and move into a moment of shared grief and conscious disclosure of our authentic response. We know that right brain to right brain communication between client and therapist reveal our genuine response and our felt sense, words and actions need to be congruent otherwise confusion ensues: if incongruent, our “posture, facial expressions, gestures, and voice level convey reactions dissonant with their verbal communication” (Greene, 2005, p. 197).

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For Lisa, the Orlando nightclub shooting brought a moment of client disclosure which aroused her own deep sadness – they sat for many moments, both with water on their faces and deeply connected, and Lisa regulated (meaning present, attuned, embodied and internally organised) which in this way was an antidote to the senseless violence and disconnection of this crime. This illustration of self-disclosure was non-verbal but potent: self-disclosure “can provide a deepened sense of connection between patient and therapist….increasing the transformational power of positive affect for self-regulation and reconfiguring of the internal world” (Quillman, 2012, p. 2).

The election of Donald Trump has brought similar energies and calls into our practices. We have both offered genuine responses to his words and actions, alleged or otherwise, both verbally and nonverbally, depending on the therapeutic value in the moment. Again we heed the words of Maroda (2010), “The overriding principle that guides my choice of interventions is emotional honesty” (p. 3-4). Responding in this way is complicated and not without hazard, and needs to be timely, specific, developmentally appropriate and used with restraint, reflection and meta processing. Further, we need to be cognisant that our unresolved or partially processed material is being consciously invited into the therapeutic relationship (as opposed to our unconscious material entering in through enactments).

A further question remains, how do we stay regulated and offer an authentic connection while maintaining our role as ‘regulated anchor’?

As somatic therapists and educators we think a lot about embodiment and regulation of the autonomic nervous system (ANS) and how our reliance on a regulated nervous system allows for travel into unknown terrain with others while remaining in the here and now so that they can touch into the terror of what was previously unbearable – in this way, we provide the anchor to the present where healing can occur. Staying embodied and regulated is easy to suggest but the road to a deeply regulated ANS can be a long and arduous one as dysregulated traumatic material from early relational experience and challenges throughout the lifespan needs to be processed and reorganised internally – neurobiologically.

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The capacity to regulate these shared traumatic realities requires therapists to have regulated autonomic nervous systems and strong social connections to keep their ventral vagal systems deeply engaged and be connected to a world beyond themselves including: the web of life, the sentient world, spiritual or faith based understandings and practices, and nature to suggest a few. It is through these connections that therapists can feel steadied and supported and can reliably access the regulating influence beyond the world of social turmoil we face. As therapists, this expanded orientation offers added stability in the often rough seas of dysregulated affective material inherent in the therapeutic process and living in these troubled times.

 

REFERENCES

Gibson, M. F. (2012). Opening up: Therapist self-disclosure in theory, research, and practice. Clinical Social Work Journal, 40 (3), p. 287 – 296.

Greene, A. (2005). Listening to the body for the sake of the soul. Spring 72, p. 189 – 204.

Maroda, K. J. (2010). Psychodynamic techniques: Working with emotion in the therapeutic relationship. New York: Guildford Press.

Maroda, K. (2009). Less is more: An argument for the judicious use of self-disclosure. In Bloomgarden, A. and Mennuti, R. B., (Eds.) Psychotherapist Revealed: Therapists Speak About Self-Disclosure in Psychotherapy. New York: Routledge, p. 17 – 30.

Quillman, T. (2012). Neuroscience and therapist self-disclosure: Deepening right brain to right brain communication between therapist and patient. Clinical Social Work Journal. 40, p. 1 – 9.

Tosone, C., McTight, J. P., Bauwens, J. & Naturale, A. (2011). Shared traumatic stress and the long-term impact of 9/11 on Manhattan clinicians. Journal of Traumatic Stress, 24(5). p. 546 – 552.

Vancouver Foundation. (2012). Connections and engagement: A survey of metro Vancouver. Retrieved http://vancouverfoundation.ca/documents/VanFdn-SurveyResults-Report.pdf March 17, 2013.

 

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Lisa Mortimore, PhD is a psychotherapist and educator on Coast Salish land in Victoria, BC. In her Bringing the Body into Practice trainings and workshops, Lisa weaves somatic psychotherapy, embodied relational and attachment oriented practice, and connection to the sentient, archetypal world. www.lisamortimore.com

Stacy Adam Jensen, M.Ed. works from an affect regulation, somatic and attachment orientation in his clinical and teaching practice. He lives, works and plays on Coast Salish land in Victoria, BC. www.stacyadamjensen.com