Overview of Disclosure of Similarities
THEORETICAL PERSPECTIVES ON THERAPIST DISCLOSURE There has been a great deal of theoretical and empirical interest in therapist disclosure. Because this is the first chapter in which I discuss disclosures, I present here some of the theoretical perspectives on it.
Humanistic theorists (e.g., Bugental, 1965; Jourard, 1971; Robitschek & McCarthy, 1991; Rogers, 1957; Truax & Carkhuff, 1967) have long valued therapist disclosure. Because they value transparency, realness, and genuineness in the therapeutic relationship, they think that helper disclosure can have a positive effect on treatment. Humanists believe that a personal and transparent style of intervention benefits both the process and the outcome of therapy because it allows clients to see helpers as real people who also have problems, as fellow travelers in the journey of life. In addition, humanists believe that when helpers disclose, there is more of a balance of control in the relationship, in that clients are not the only ones who are vulnerable. Humanists also contend that disclosure enhances rapport because clients feel more friendly toward and trusting of helpers who disclose. Interestingly, humanists think that disclosure can help to correct transference misconceptions as they occur because helpers are direct and honest with disclosures and, hence, challenge distortions as they arise. Additional benefits claimed by humanists for disclosures are that helpers are able to be more spontaneous and authentic and can model appropriate disclosure. Moreover, helpers’ disclosures can facilitate client disclosure and repair ruptures in the therapeutic relationship. In effect, humanists believe that helpers’ disclosures encourage an atmosphere of honesty and understanding between helpers and clients that fosters stronger and more effective therapeutic relationships.
Similarly, cognitive–behavioral theorists advocate for the use of helper
disclosure. They believe that helper disclosure within sessions, when used with appropriate boundaries, can strengthen the therapeutic bond and facilitate client change (see Goldfried, Burckell, & Eubanks-Carter, 2003).
In contrast, traditional psychoanalytic theorists (e.g., Basescu, 1990; Greenson, 1967; Simon, 1988) view psychotherapy as focused on working through patients’ projections and transferences. They believe helpers should be neutral or blank screens so that clients can project onto them their feelings and reactions toward significant others. For example, a client’s childhood experiences might prompt the client to transfer onto the helper a fear that the helper is going to be punitive. An analytic helper might sit behind the client to enable the client to focus inwardly rather than watching the helper’s face for cues about his or her reactions. If a helper is in fact being neutral, she or he can assist the client in seeing that the belief that the helper will be punitive is a projection. If helpers deviate from neutrality, it is difficult to distinguish client projections from realistic reactions to what the helper is actually doing. For example, if a helper is consistently late, it would be difficult to determine whether the client’s anger was a distortion based on previous experiences or legitimate anger at the helper’s tardiness. Readers should not confuse neutrality with a lack of empathy, however, because competent analytic helpers are appropriately warm and empathic. It is not too surprising, given this emphasis on neutrality, that psychoanalytic helpers typically do not disclose.
In fact, psychoanalysts propose an inverse relationship between the client’s knowledge of the helper’s personal life, thoughts, and feelings and the client’s capacity to develop transference to the helper (Freud, 1912/1959). They believe that helper revelations contaminate the transference process and deleteriously demystify the therapy, thereby reducing the helper’s status (Andersen & Anderson, 1985). In addition, Cornett (1991) suggested that helper disclosure might represent unresolved countertransference difficulties on the part of the helper, which would seriously compromise the client’s ability to profit from treatment. Furthermore, psychoanalysts argue that helper disclosure can expose helper weaknesses and vulnerabilities, thereby undermining client trust in the helper and adversely influencing outcome (Curtis, 1981, 1982).
I should note, however, that some current psychoanalytic theorists advocate the use of disclosure (see Geller, 2003), especially related to the therapeutic relationship (see Chapter 14). In fact, many current psychoanalytic theorists would argue that there is no way not to disclose, in that even nondisclosure reveals a great deal about the therapist.
I agree more with the humanistic thinkers than with the traditional psychoanalytic thinkers about the value of helper disclosures. I have seen the power of disclosures in helping settings. But we should also heed the concerns the psychoanalytic thinkers have about disclosures and make sure that disclosures are used for the benefit of clients rather than for the needs of helpers.
In sum, helpers can disclose beneficially for clients if they do it for the appropriate intentions (not for their own needs) at the right moment. If helpers
disclose in a manner in which they maintain an objective stance (i.e., are not overinvested), focus on the client, and observe client reactions, disclosures can be helpful. In fact, sometimes disclosures can be more helpful than other skills because helpers are not “putting something on” clients but are respectfully offering different possibilities to help clients gain insight.
HOW TO DISCLOSE ABOUT SIMILARITIES A major caveat is for the helper to determine whether the disclosure is for her or his own needs or for the client’s needs. It is also critical to keep the disclosure short and turn the focus back to the client. The tone of the disclosure should be “We’re all human and imperfect” rather than “You think you have it bad, let me tell about my experience.” It is also important for the helper to disclose only problems that are relatively resolved rather than ones that they are currently troubled by (see also Hill & Knox, 2002). For example, when the client expresses feeling like she is the only one who has ever had a difficult time adjusting to college, the helper might say, “I had a difficult time too when I first came to the university. Tell me more about your experience.”
A specific situation that requires a bit more attention is how to respond when a client asks the helper for a disclosure. For example, a client might ask where the helper went for vacation or whether the helper is married or has children. A general rule would be to briefly provide information (if it feels comfortable) but also to then be curious about what motivates the client’s desire for this personal information. Helpers might ask clients about their thoughts, fantasies, or concerns about them to learn more about what motivated clients to ask for information. In addition to providing the personal information, helpers can thus use the situation as an opportunity to investigate why clients want the information. Processing these issues in a gentle and supportive manner can provide the client with insight and strengthen the relationship.
A Comparison of Skills for Exploring Thoughts
Restatements help clients hear what they have been saying and enable them to clarify and expand. With restatements, clients often feel that helpers are listening to them and trying to understand them. In contrast, open questions and probes about thoughts directly ask the client to explore more, so they give guidance about what the helper wants the client to talk about at that given moment and therefore can be helpful when the client is not sure what to do or needs direction. Closed questions ask for specific information and are helpful if the helper plans on using the specific information in some way (e.g., developing a diagnosis, assigning homework), although such interventions rarely help clients explore. Disclosures of similarities can help clients feel that they are not the only ones who have ever faced difficulties and can be effective if the focus is quickly returned to the client. I recommend
using mostly restatements, with occasional sprinkles of open questions and probes, closed questions, and disclosures of similarities. One guideline is to use restatements when the client is exploring thoroughly and you want to help her or him keep going, whereas it is perhaps better to use open questions and probes about thoughts when the client seems to need more direction.
What Do You Think?
Debate the efficacy of restatements compared with responses that are more typically used in friendships, such as advice and disclosure. Compare and contrast restatements and open questions and probes about thoughts. In his early theorizing, Rogers (1942) promoted restatement at the most important skill, whereas later he focused more on other skills. What do you think about restatements? How do you respond when people use restatements or open questions and probes with you? What cultural considerations can you think of in using restatements or open questions and probes? Do you agree that helpers should not ask “why” questions in the exploration stage? Debate the merits of focusing on thoughts versus feelings.
R E S E A R C H S U MMA RY Self-Disclosures Citation: Knox, S., Hess, S. A., Petersen, D. A., & Hill, C. E. (1997). A qualitative investigation of client perceptions of the effects of helpful therapist self-disclosure in long- term therapy. Journal of Counseling Psychology, 44, 274–283. doi:10.1037/0022- 0188.8.131.524
Rationale: In the theoretical literature, the use of therapist self-disclosure is controversial, with psychoanalytic theorists cautioning against it and humanistic therapists advocating for it. Given that a previous study (Hill, Helms, Spiegel, & Tichenor, 1988) found that clients rated self-disclosure as the most helpful therapist intervention even though it was used infrequently, Knox et al. wondered how clients experienced therapist self-disclosures.
Method: Clients currently in long-term therapy were interviewed about their experiences of therapist self-disclosure (which was defined for the participants as “an interaction in which the therapist reveals personal information about him/herself, and/or reveals reactions and responses to the client as they arise in the session,” p. 275), both generally and in a specific example of a helpful disclosure. Transcribed interviews were analyzed using a qualitative methodology.
Interesting Findings: Clients typically believed that their therapists disclosed to normalize their experiences or to reassure them. Helpful therapist disclosures were primarily of facts (recall in the current book that there are also disclosures of feelings, insight, and action). The disclosures were mostly of events in the past, about family, leisure activities, or similar experiences. None of the disclosures were about the immediate therapy relationship (which is called immediacy in this book). Disclosures typically resulted in positive consequences. More specifically, clients said that they gained insight or a new perspective; viewed their therapists as more real and human, which improved their relationship; felt better because they felt normalized and reassured; and could use therapists as models. Although not typical, clients occasionally had negative or neutral reactions to therapist disclosures (they felt wary of the therapist or feared the resulting closeness).
Conclusions: Disclosures in which a helper reveals ways in which she or he is similar to a client to reassure the client of being normal can be helpful if used cautiously and in the right context. Importantly, these disclosures were of past events that had been resolved. There can be some negative effects, particularly of clients becoming nervous about therapists crossing boundaries and wanting to be too close.
Implications for Therapy: Used infrequently and at the right time (e.g., when clients are talking deeply about personally distressing thoughts), disclosures can help reassure clients that they are normal, help clients gain greater insight, make the therapeutic relationship stronger, and serve as a model for clients about the benefits of disclosure. Helpers need to be careful about not disclosing for their own needs.
Practice exercises, labs, and other resources for students and teachers are available on the companion website: http://pubs.apa.org/books/supp/hill4.
It seems to me that clients who have moved significantly in therapy live more intimately with their feelings of pain, but also more vividly with their feelings of ecstasy; that anger is more clearly felt, but so also is love; that fear is an experience they know more deeply, but so is courage.
Tyler, an aspiring actor, had been in an automobile accident that left him with a disability and made it unlikely he would ever be able to act again. Throughout the session, his helper used a number of reflections (e.g., “You feel angry because you can no longer do what you love to do,” “I wonder if you feel afraid that people will laugh at you,” “It sounds like you feel anxious about going out in public”) to help Tyler talk about his many feelings so he could identify and accept what was going on inside him. The helper also asked some open questions (e.g., “How do you really feel about that?”) that helped Tyler stop and think about what he was really feeling and then try to express his feelings. Once he was able to express his feelings, Tyler felt relieved.
In this chapter, I identify four skills that can be used to help clients explore feelings. Helpers can use reflections of feelings, disclosure of feelings, open questions and probes about feelings, or focusing.