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Clinical Meeting: The public, the personal and the professional

Art therapy in the UK originally emerged from, and is closely affiliated with, the psychodynamic tradition which often advises therapists to be “blank canvases”. However, discussing personal details with clients is a technique which has been used in various forms of therapy. In this month’s meeting we discussed the realities of managing our private identities in the client-therapist relationship by considering some recent literature about self-disclosure. We were also joined by Louis Whittal – a freelance IT consultant specialising in web design and online strategy – who came along to discuss specific issues about maintaining personal boundaries in a digital world.
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Image by Dave Rogers
Prior to the meeting, I had asked practitioners to google themselves and discuss any surprising or unwanted search results in the meeting. Alongside a wish to be open and transparent, concerns included therapists’ private details made public, links to unwanted websites and access on social networking sites. Louis, Our special “technical” guest, was able to answer specific questions and he talked to us about ways to maintain a private identity at a digital age. The art-making part of the meeting had the theme of “exposure” which led to interesting and thought-provoking images and discussion around clinicians’ personal experiences. I then talked about two recent articles on this fascinating subject:
Audet  & Everall (2010), writing in the British Journal of Guidance & Counselling, used qualitative methods to study the impact of therapist disclosure from the client’s perspective.  They locate the origin of self-disclosure in humanistic (e.g. Rogerian) approaches and argue that, even in psychodynamic therapy, the use of counter transference is in itself a form of disclosure of the therapist’s feelings and perceptions.  In their study, they found that clients tend to view self-disclosure more favourably than therapists do. Positive aspects of knowing more about the therapist included comfort, a sense of egalitarianism when struggles were shared, feeling understood and establishing a sense of trust and closeness to the therapist. Conversely, negative aspects included role confusion or even role reversal (e.g. when the client felt s/he needed to “look after” the therapist and consider the therapist’s feelings), a sense of the therapist as being too “fragile”, and inappropriate response – whereby the therapist assumed that simply going through similar experiences meant that s/he knew what the client was experiencing.
Janine Roberts (2012), a family therapist and professor and at the University of Massachusetts, writes about her own experiences of self-disclosure. She argues that, when done skilfully, clients repeatedly rate therapist disclosure as helpful. When working with stigmatised groups (for example, clients living with HIV/Aids) or oppressed communities it can break down the barriers of seeing the therapist as belonging to a dominant group. She argues that therapists already reveal so much about themselves nonverbally that self-disclosure becomes a question of how rather than if. She writes:
Much of what we reveal is inadvertent. The watches and jewellery we wear or don’t wear, how we dress, our hairstyles, how we talk, or how we decorate our offices all tell a story. Then there are unforeseen and undesired encounters outside of therapy, like the time in a grocery store when I was scolding my daughter and looked up to see a client watching me… As family therapist Charles Kramer noted, “It is impossible not to reveal ourselves. And when we try to be a blank screen, we reveal that we are concealing, which is a message in deception.” (p. 2/8)
While she believes that self-disclosure can be a useful technique in therapy, she stresses the importance of staying in emotional control over the content we choose to disclose and ensure we are not communicating a need for a particular reaction from our clients, consciously or unconsciously. For instance, while she has used her own personal experiences of having cancer and being in an abusive relationship to help her clients, she only disclosed these experiences many years after the event, when she had processed and come to terms with them. She advocates against disclosing such experiences when they are still happening or when they are not yet resolved, and stresses the importance of sharing personal struggles or challenges but allowing clients to arrive at their own solutions.
Bearing in mind Robert’s emphasis on having emotional control over disclosures, and Audet  & Everall’s list of possible negative outcomes when self-disclosure is not handled carefully, how can therapists manage their virtual identity? In a world where it is increasingly difficult to stop clients from seeing our personal pictures online, finding our home address on Google or seeing who our friends are on Facebook, disclosure is no longer fully within our control. We had an animated discussion about everyone’s engagement and avoidance with social media and Louis offered practical strategies for protecting ourselves online.
We also spoke about the various scenarios that had arisen in people’s practices eg. when a client had asked to befriend a therapist and how that was managed, or the idea of googling the client before the first session. It was suggested that knowing too much in advance about the client is like the reverse of a tainted blank canvas in that the therapist is in danger of losing objectivity and already, albeit unwittingly, sets up the transference dynamic. Another aspect, which is unique to art therapy, involves the sharing or showing of images; several London Art Therapy Centre practitioners recently displayed their own artwork in an exhibition at the Centre. This had the added dimension of clients seeing therapists’’ artwork, which may be deeply personal. (This is discussed further in a previous blog).
Ultimately, it appears, there seems to be no way to be 100% in control of the information available about us online. Our clients may look for us on the internet, and if they encounter information which changes or affects their perception of us we can only hope they will discuss it with us in the therapy sessions, and that it become useful material to work through within the therapeutic relationship. Perhaps the virtual trail we leave behind us as we browse, post pictures of our family or tweet about our favourite film is simply a modern-day manifestation of Robert’s assertion; we will always give away information about ourselves, with or without realising it, and by showing our humanity and flaws we hope our clients would be able to share their own.
More information:
For BAAT registered art thearpists: please note that BAAT has recently published its Social Media Guideline. To read them, log into the BAAT website’s members area and click on guidelines and Professional Advice.
  • A blog entry about a previous clinical meeting exploring the way clients and therapists communicate nonverbally by the way they dress, can be found here.

Audet & Everall (2010) Therapist self-disclosure and the therapeutic relationship: a phenomenological study from the client perspective
Roberts, J. (2012) Therapist self-disclosure


Posted by Nili Sigal, art therapist &
clinical meetings coordinator

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