Workshop Therapeutic Practice: Proximity Disclosure Ending and Appreciation
I have divided my original document into separate topic documents and will post each separately -so look out for Proximity, Ending, and Appreciation
Introduction
This workshop came out of requests to include various aspects of therapeutic practice, particularly disclosure. Allowing myself to freefall from these requests led to the arrival of four aspects of this workshop. I did not overly consider how they might interrelate, if at all, beyond being aspects of the therapy relationship. In the composition of these ‘emerging thoughts’ I was considering the habitual dimensions of my work.
The layout of my therapy room the proximity of the furnishings, the décor, the objects and soft furnishings, and so on, says a lot about me professionally and personally. So, I am disclosing to my client before a word is said. There is disclosure to the client in how you approach and welcome; in how you walk with or beside, in front or behind, as you walk to your room. Some form of disclosure is inevitable; something at last being allowable in psychoanalysis.
Disclosure
Disclosure is about what information you give of you to your client; and I am using disclosure as self-disclosure. Working from a relational perspective requires your input to the therapy of the impact of the client’s world on you. Some therapies would consider the relational approach does not invite, or prompt disclosure.
Although I consider myself to be a relational—and integrative— psychotherapist, I do not share the belief that this necessarily entails self-disclosure… like other powerful interventions - it carries serious risks. My experience has taught me, however, that self-involving communications tend to be broadly effective.
Ziv-Beiman 2013 p59
What is always present for the relational therapist is that
Although relational needs are present for both participants in every relationship, the therapeutic relationship is unique in that the needs of the therapist must be secondary to those of the client. The client’s relational needs are in the foreground; the therapist’s needs are in the background.
Erskine et al 1999 p122 / loc 2768)
And
Relational scholars emphasize that exposure to subjective otherness is essential for the foundation of the self (Aron, 1996; Benjamin, 1988) and view therapist self-disclosure as a form of intersubjective inquiry, which is part and parcel of every treatment
Ziv-Beiman 2013 p60
However
There is a common misperception that to work relationally means to self-disclose relentlessly
Wachtel, 2008, p. 245).
Coming from a Gestalt therapy background I am drawn to Gestalt literature and the senior practitioners in the world of Gestalt Psychotherapy. Robert Resnick (d.2014) is one such figure who trained for 5 years with Fritz Perls and was an internationally renowned trainer. In 1995 he was interviewed by another senior practitioners, Malcolm Parlett (and in this interview (Resnick 1995) says
… therapists discriminate and modulate their own self-disclosure in terms of what they believe will further (or truncate) the contact. They will take note of the strength and duration of the relationship and what it can bear as well as their judgment about the client's ability, fragility, resilience and strength. (p4)
The therapist's phenomenology is shared for three purposes: first, to enhance possible contact; second, so that clients have the possibility to hear and see an ‘other’ (provided they are not distracted from their own foreground which they may not be expressing); and third, as a modelling by the therapist who says what his or her experience actually is and also shows his or her way of sharing that experience. (p5)
In the second quotation, I want to draw attention to the particular point that phenomenology is purposeful.
In terms of working relationally and from a postmodern position by which I mean with an acceptance of each of our realities as truth there is literally no approach other than phenomenology that provides for encompassing each of our reality when there is a meeting, a contact, of persons. Resnick (1995) again
Only with the engagement of the 'two-ness' of phenomenologies, is true dialogue possible. 'Empathic attunement', without authentic phenomenological disclosure by the therapist, precludes any real dialogue. p50
What, though does this actually mean for the therapist sitting in front of the client? I ask this question because there needs to be some sense for the therapist as to what is this ‘self-disclosure’. I suspect the interest to discuss this is centred on things such as ‘how do I answer personal question like, ‘do you have children’, ‘did this happen to you’, ‘is that your car out front’, ‘where else do you work’, ‘how old are you’, …’ plenty of others. What questions are you comfortable with, which are you uncomfortable with?
Some question about your professional qualifications, training and duration are pertinent to be asked and can be expected.
Several types of self-disclosure exist. These include deliberate, unavoidable, and accidental or inadvertent self-disclosure (Zur, 2009). Broad categorisation is immediate and non-immediate disclosure that may be intentional or unintentional.
Immediate Disclosure
Immediate disclosure is the in-the-moment disclosing of the therapist’s felt experience, their thinking and attitude regarding the therapeutic engagement. Generally, the humanistic therapy profession supports this disclosure.
Also in this category, would be questions of professional immediacy; being about such things as qualifications etc. I deliberately wanted to separate this aspect so as to maintain a focus to the personal disclosure. So, the personal disclosure of feeling disappointment, or joy, is your experience with the client relating an experience to you that is supported in the relational, phenomenological approach to therapy.
Unintentionally there is disclosure in a body movement. In the same way, as a holistic therapist, your observation of your client’s movements indicates something, so does yours and probably your client is interpreting this. So how still you be? Awareness of your body allows you to utilise movement as intervention. Leaning forward with interest; a raise of the eyebrow for curiosity, or for surprise. Shifting in your seat to register a change in interest and emotion. Hand gestures and expressions all have a story
Non-immediate disclosure
Non-immediate disclosure refers to information, thoughts, feelings, and opinions outside of the therapeutic engagement. Personal disclosure, for example, relating my experiences in teacher training is non-immediate self-disclosure. Did this disclosure [in the workshop] enhance my point; was it appropriate, or did you not read, or already have forgotten that part?
There is more controversy for the support of non-immediate disclosure (Ziv-Beiman 2013). More so when this disclosure is not initiated by the client. Consider, what reason would you have to reveal, voluntarily, something about yourself to your client
At times, I have found myself disclosing and immediately wondering, what did I say that for!!!! Well there is for consideration a transference and countertransference experience. There is your own confluence to share similar experience. There might a pull to be self-righteous in relating your more successful experience; or a pull to shame the client (rather than yourself).
However, in keeping with Resnick (1995) to further contact I do, with certain clients, engage in shared interests, or differences. I can bring to mind sessions where the work has been dominated by stories of experiences of us both. What would I do this for? To further contact of course; AND more. These ‘certain clients’ are those that I have determined, through our contact, and relational needs (Erskine 1999) require a relationship of shared experiences, mostly to enhance the ordinariness and contact the isolation of the client experience. Think of support groups managed and run by those of like experiences, dependencies such as alcohol and drugs. Individual will often seek for someone who ‘knows’ their experience. The actually for me is such a thing is not a necessity and may, indeed, point towards confluence and dependency rather than separation and inter-dependency; yet there is a contactfulness for what we have in common – a starting point..
Danger, danger ….
Self-disclosure is an intrusion; self-disclosure is an abuse. Quite possibility. Does your client want to know about you?
· Pro. Self-disclosure can help to reduce the power differential between you and the client.
· Con. The client may become too comfortable with you and begin to view you as a friend instead of a professional helper.
· Pro. Self-disclosure can increase trust in the counselling relationship.
· Con. poorly timed or executed self-disclosure can increase distrust. The client may question your motives, or see you as getting too involved.
· Pro. The client may feel less alone, knowing the helper has the same issue.
· Con. The client may feel that helper is impaired.
· Pro. The client may feel more understood, knowing the therapist has similar experience.
· Con. The client may feel that the therapist is not listening, that they are more focused on their own issues than those of the client.
(Barb 2012)
There is a vitally important relationship in which self-disclosure is to be guarded against and monitored in every moment; for making any actual disclosures and for being seduced to disclose. The therapeutic relationship with a client presenting with dependent and borderline presentations in particular. Your client may be drawn to looking after you and repeat their script for dependency and confluence. Buying into this is counterproductive and will not serve the interest of the client even though sometimes this will lead to a disgruntled, angry, disappointed client that might rage and leave therapy. Recently a colleague talked with me about their 18 months working with a client that was increasingly pushing for the therapist to take responsibility in caring for their behaviour, “you need to tell me to stop, you need to tell me what to do”. Resisting the pull to take charge and tell them what to do the responses were to affirm staying present and committed to supporting the client to own their behaviour and seek their own path for change. The client became angry and critical and scathing in an impulsive emailed termination of therapy.
Examples of interventions for the above situation:
Will you stop this behaviour if I tell you to? How will me telling you to stop result in you stopping? Has anyone else previously told you to stop and what was the outcome? What is it about me that you will listen and stop? What authority are you giving over you with this request?
Conversely, and confusingly, there are times and situations in which ‘telling’ the client what to do is supportive, purposeful and appropriate. The backdrop to this is the therapist must hold onto the fact that it is all initiated through the client wanting to be ‘told’ – to be taken care of, to be absolved of (some) responsibility; to have the confusion of choice and decision making removed. This is where the work is and so initiating the ‘I am telling/ wanting you to do …’ is the catalyst for a focus on the client’s dependency; the client’s developmental unmet needs, etc..
Impact on Therapist
Sometimes, and in situations like this, our therapy work can evoke feelings of dismay and thoughts of incompetence along with ‘maybe I should have’. However, remaining truthful to your therapeutic approach both theoretically and clinically, will ensure you can reflect that you are working correctly, ethically and in the interest of the client; remembering we do not have the answer, the client does, and will, one day hopefully recognise this.
Social Media
Facebook, Web entries, LinkedIn, Organisational Pages, Archived Web, Twitter, and so on …
How secure and private is the information of you in this age of social media? Anything you have posted, or friends have posted through any social media outlet might well be considered available to your clients. That is until you have confidently secured this information. The bottom line, it seems to me, is that if you have said, done, photographed, liked, or commented keep in mind your client ‘knows’ this. What are the implications of this is for discussion….
References
Audet C. T., 2011 Client perspectives of therapist self-disclosure: Violating boundaries or removing barriers? Counselling Psychology Quarterly, Vol 24 No 2, 85-100
Barb 2012 Self-disclosure what you need to know. Accessed at www.mastersincounseling.org/author/barb Posted on November 1, 2012 www.mastersincounseling.org/self-disclosure-what-you-needto-know.html
Erskine, R.G., Moursund, J.P., Trautmann, R.L., (1999). Beyond Empathy: A therapy of Contact-in-Relationship, Brunner Routledge, London
Francesetti, G., Gecele M., Roubal, J. 2013 Gestalt Therapy in Clinical Practice: From Psychopathology to the Aesthetics of Contact (Gestalt Therapy Book Series 2) FrancoAngeli Milan. Kindle Edition
Hargaden H., 2010 When parting is not such sweet sorrow: “Mourning and melancholia,” projective identification, and script analysis. In Erskine R. (Ed), 2010 Life Scripts: A Transactional Analysis of Unconscious Relational Patterns. Chapter 3 Karnac, London
Little R., 2009 The Therapist’s Self-Disclosure: A Developing Tradition Some considerations and reflections. Enderby Associates. www.enderbyassociates.co.uk Accessed 3 March 2017 at www.relationalta.com/admin/docs/resources/the_therapist_self-disclosure.pdf
O’Brien M. and Houston G., 2000 Integrative Psychotherapy: A Practitioners Guide. Sage London
Perls F., Hefferline, R, Goodman P. (1951) Gestalt Therapy Excitement and Growth in the Human Personality, Souvenir Press, New York.
Resnick R., 1995 Gestalt Therapy: Principles, Prisms And Perspectives, Robert Resnick Interviewed by Malcolm Parlett. British Gestalt Journal Vol4 No1 p3-13
Resnick R., 1996 Differences That Separate, Differences That Connect: A Reply To Wheway And To Cantwell Robert W. Resnick. The British Gestalt Journal vol5, No.1 pp43-53
Ziv-Beiman S., 2013 Therapist Self-Disclosure As an Integrative Intervention. In Journal of Psychotherapy Integration Vol. 23, No. 1, 59–74. American Psychological Association