Therapist Grief and Functional Analytic Psychotherapy: Strategic Self-Disclosure of Personal Loss

Functional Analytic Psychotherapy (FAP), a behavioral approach that focuses on the development of genuine and meaningful therapeutic relationships including the strategic use of disclosure, provides a framework for therapist self-disclosure during times of personal loss. This article briefly outlines FAP and provides an example of FAP in practice following the death of the first author’s mother. Qualitative data from a client questionnaire on the impact of this disclosure are presented, which suggest that the disclosure was a positive experience for most but not all clients. The article concludes with clinical guidelines that can enhance therapeutic effectiveness whether or not therapists choose to disclose loss to their clients and general precautions for treading in this emotionally intense territory.     

Counselor Self-Disclosure

Self-disclosure in the counseling-therapy relationship has been an important area of research and study, with considerable emphasis placed on counselor self-disclosure. This study was initiated to explore further the phenomenon of counselor-therapist disclosure through direct assessment of potential clients' desires for disclosure and through development of a measure of counselor disclosure. Implications for counselor disclosure and for the counselor-client therapy relationship are discussed.     

Self-Disclosure and Vulnerability

Abstract

Based on the theoretical assumption and clinical observation that projective identification is a natural, constant element in human psychology, clinical material is used to illustrate how projective identification centered transference states create situations where acting out of the patient's phantasies and conflicts by both patient and therapist is both common and unavoidable. Because they are more obvious, some forms of projective identification encountered in clinical practice are easier for the analyst to notice and interpret. Other forms are more subtle and therefore difficult to figure out. Finally, some forms, whether subtle or obvious, seem to create a stronger pull on the analyst to blindly act out.

In some psychoanalytic treatments, one form of projective identification might embody the core transference. In other cases, the patient might shift or evolve from one level of this mechanism to another. Some patients attempt to permanently discharge their projective anxiety, phantasy, or conflict into the analyst. There is a patent resistance to re-own, examine, or recognize this projection. Some of these patients are narcissistic in functioning, others are borderline, and many attempt to find refuge behind a psychic barricade or retreat (Steiner 1993). In other forms of projective identification, the patient enlists the analyst to master their internal struggles for them. This occurs through the combination of interpersonal and intra-psychic object relational dynamics. This “do my dirty work for me” approach within the transference can evoke various degrees of counter-transference enactments and transference/counter-transference acting out.

Another form of projective identification, common in the clinical setting, is when a patient wants to expand the way of relating internally, but is convinced the analyst needs to validate or coach the patient along. This is why such a patient may stimulate transference/counter-transference tests and conduct practice runs of new object relational phantasies within the therapeutic relationship. Over and over, the patient may gently engage the analyst in a test, to see if it is ok to change their core view of reality. Depending on how the analyst reacts or interprets, the patient may feel encouraged to or discouraged from continuing the new method of relating to self and object. The patient's view of the analyst's reactions is, of course, distorted by transference phantasies, so the analyst must be careful to investigate the patient's reasoning and feelings about the so-called encouragement or discouragement. This does not negate the possible counter-transference by the analyst in which he or she may indeed be seduced into becoming a discouraging or encouraging parental figure who actually voices suggestions and judgment.

All these forms of projective identification surface with patients across the diagnostic spectrum, from higher functioning depressive persons to those who are more disturbed paranoid-schizoid cases. Whether immediately obvious or more submerged in the therapeutic relationship, projective identification almost always leads to some degree of acting out on the part of the analyst. Therefore, it is critical to monitor or use the analyst's counter-transference as a map towards understanding the patient's phantasies and conflicts that push them to engage in a particular form of projective identification.     

Intergroup Interaction and Self-Disclosure1

Two studies were designed to test hypotheses concerning self-disclosure during initial interactions with ingroup or outgroup strangers. Based on intergroup anxiety theory it was predicted that ingroup members would disclose less to outgroup strangers than to ingroup strangers. One study involved interaction with handicapped and nonhandicapped confederates and one involved interaction with Caucasian and Black confederates. It was found that on some dimensions there was less self-disclosure to outgroup than ingroup strangers during initial interactions. Additional data suggested that high levels of public self-awareness and perceived dissimilarity also reduced some aspects of self-disclosure.     

文化差异与性的自我表露

性的自我表露(sexual self-disclosure)是自我表露中最亲密的形式。它是一个亲密的二人关系中一方把他(她)的性事表露给伴侣的程度。出乎意料的是, 和对于大量关于其他方面的自我表露相比, 学界对这方面的研究很少。在这些为数不多的研究中, 一些研究发现：性的自我表露和人们的性满意度是相关的。因此研究性的自我表露或许有助于了解或增益人们的性生活。过去的研究从未调查过文化是否影响人们对性的自我表露。在不同的文化中, 人们性的自我表露的程度和内容都应该会有所差异。现有的关于人们自我表露中的文化差异的理论研究对未来研究性的自我表露受文化差异的影响提供了方向。     

Judicious Self-Disclosure by the Psychoanalyst

One of Sándor Ferenczi's greatest contributions to clinical theory and method is his pioneering concept of analyst self-disclosure. First introduced in his famous paper ?The elasticity of psycho-analytic technique? (1928), analyst self-disclosure changed the nature of clinical interaction between analyst and analysand, from the Freudian model of a surgeon to the responsiveness of an empathic mother. Ferenczi's clinical work with the so-called ?difficult cases? (narcissistic, borderline and psychotic disorders) moved him to discover the ethos of activity within an empathic method. Analyst self-disclosure is one of those responsive measures he developed to address the deficits in communication and interpersonal functioning in trauma survivors. An outline is presented of the ?Confusion of Tongues? which is the model from which self-disclosure is derived. A contemporary extension of this idea is offered in the clinical and theoretical distinction between judicious vs. conspicuous self-disclosure.     

Characteristics of Therapist Self-Disclosure in the Counseling Process

A survey was sent to practicing therapists to investigate their uses of self-disclosure in counseling and psychotherapy. A total of 46% returned surveys, and most indicated that they used at least some self-disclosure in their work with clients. Overall, respondents reported disclosing about professional qualifications and experience most often and indicated that they disclosed mainly to increase similarity between themselves and clients.     

Measuring Cohesion and Self-Disclosure in Psychotherapy Groups for Patients with Advanced Cancer: An Analysis of the Psychometric Properties of the Group Therapy Experience Scale

Objective: Understanding that the group process informs group interventions. However, there is little systematic research on group process variables in psychotherapy groups for patients with cancer. Method: We analyzed the psychometric properties of the Group Therapy Experience Scale (GTES) and evaluated its potential importance in advanced cancer therapy groups. Results: The GTES demonstrated good internal consistency (coefficient alpha = .84). An exploratory factor analysis with varimax rotation yielded four factors. Although all four models were explored, the 1- and 2-factor models appeared to provide the best fit for the data. The GTES total score was negatively correlated with group size and positively correlated with number of groups attended by participants. Further, the GTES total score was correlated with post-intervention spiritual well-being, benefit finding, post-traumatic growth, and quality of life.     

Public Self-Disclosure and Speaker Persuasiveness1

Two experiments were conducted to examine the conclusion of several rhetorical critics that intimate self-disclosure by high-ranking officials will be viewed by an audience as inappropriate and will result in lowered speaker persuasiveness. In Experiment 1 college students viewed a videotape of a speaker described as either a member of an oratory club, a candidate for Congress, or a congressman. Half of the subjects heard a speech in which the speaker revealed some intimate information about himself. Little disclosure was included in the other speech. It was found that the greater the prestige of the speaker, the more self-disclosure was seen as inappropriate. The audience was least likely to be persuaded by the speaker when he was perceived as a congressman who had disclosed personal information. This effect was replicated in Experiment 2, where individual differences in the audience members' l]evels of perceptiveness about disclosure appre priateness were examined. No significant effects for this individual difference variable were uncovered.     

Perceptions of Self-Disclosure in Initial Interaction A Japanese Sample

As an example of “culture-specific” communication research, the present study investigated “self-disclosure” during initial interaction within Japanese culture. Presented with a simulated conversation containing varying levels of self-disclosure, a total of 192 Japanese males and females filled out several scale items measuring episode perception, social attractiveness and communication competence of the discloser, and strength of logical force. While respondents generally rated a low level of self-disclosure positively, the results also indicated a significant dialogue-by-sex interaction effect on the episode and person perception variables. With regard to logical force, the results showed that the strength of prefigurative force varied little, except for cultural archetype-act linkage, whereas practical force differed as a function of self-disclosure level. Implications of these findings are further discussed within the context of Japanese culture.     

Look Who's Talking: Measuring Self-Disclosure in MFT

While self-disclosure plays a prominent role in the development and maintenance of the therapeutic relationship, most marriage and family therapy clinical research fails to include measures of self-disclosure. A factor analysis of Chelune's (1976) Self Disclosure Situations Survey (SDSS) reduces the number of items in this measure from 20 to six. Researchers are encouraged to consider conducting clinical research with specific attention to the construct of self-disclosure. The revised SDSS could easily be added as part of the self-report information collected in clinical studies.     

Self-Disclosure as an Approach to Teaching Ethical Decision-Making

This article presents arguments for and against weight loss counseling in feminist therapy. Conflicts between feminist therapy and weight loss counseling are explored and the implications of counseling and not counseling on women's empowerment are considered. Although each case requires an individual ethical decision, the author, a feminist therapist who has done weight loss counseling in the past, concludes that the answer to the title question should, in general, be "no."     

Reactions in Psychotherapy

The Pollyanna Principle states that people process pleasant information more accurately and efficiently than less pleasant information. This study examined whether different measures of Pollyanna tendencies are correlated with each other. Fourteen measures of Pollyannaism were derived for 133 students. The results showed that subjects who rated themselves as optimistic or happy also showed Pollyannaism on other measures of happiness, believed that the events in their lives were pleasant, gave themselves positive ratings on personality characteristics, recalled pleasant words more often than unpleasant words, supplied more free associations to pleasant stimuli than to unpleasant stimuli, listed pleasant items first, and judged that pleasant words were more frequent in the English language.