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"Porno-dependence gives us strong and uncomfortable emotions," posts the group's moderator Vincenzo Punzi, who's helped challenge the stigma of porno addiction by appearing widely in Italian media. "In order to get rid of those emotions, we need to find others." Today's online support groups, no longer chained to desktop computers and anonymous texting, can help create healthier emotions through stronger social bonds.
Should Therapists Self-Disclose?
In the psychoanalytic tradition, therapists were supposed to remain dispassionate, blank screens so that anything they "revealed" to clients resulted exclusively from the clients' projections and transference. But through the years, society's increasing informality and the expansion of the field to include social workers, counselors, somatic therapists, and clinicians practicing other approaches has resulted in a transformation of the classic therapeutic style. Now therapists and clients often use first names with each other and therapist self-disclosure—talking about their own past experiences or sharing their thoughts and feelings—once seen as "inappropriate," seems to be much commoner. Janine Roberts, creator of "Family Therapy Guidelines for Therapist Self-Disclosure" (Family Process, March 2005), who runs workshops for therapists internationally about the topic, says that, while there are no reliable statistics, almost every therapist she's spoken to on the subject admits to having done it. As often happens with changes in the profession, research and clinical guidelines on the topic have lagged behind. Now, in the February Clinical Psychology Review, University of Memphis psychotherapy process researchers Jennifer Henretty and Heidi Levitt have pulled together the research on the subject to propose some guidelines for when to self-disclose—and when not to.
The findings indicate that therapist self-disclosure can be effective but occasionally risky. Out of 30 studies, Henretty and Levitt found that 20 showed positive effects, 4 showed negative effects, and 6 had no clear effects or mixed results. The beneficial effects of self-disclosure include clients' experiencing greater warmth in their therapists and liking them more. According to their review of the theoretical literature on the subject, self-disclosure may repair ruptures to the therapist-client alliance, assist clients in identifying and labeling their own emotions, and provide clients with the experience and model of authentic communication. On the negative side, some studies have shown that clients who value separateness find self-disclosure to be intrusive or burdensome.
Henretty and Levitt conclude that self-disclosure should be used strategically and sparingly, and that it requires both forethought and afterthought. Before disclosing personal information, therapists should know the client well enough to have an accurate idea how the self-disclosure will be interpreted. After self-disclosing, therapists should check to see how the client responded, staying alert to the possibility that the intended effect of the self-disclosure may be different than the actual effect.
It's generally not advisable to self-disclose to clients with poor boundaries or who tend to focus more on the needs of others than on themselves. The former may interpret self-disclosure as a threat or a narcissistic injury, and the latter may feel obligated to reshape their own truths to match their therapist's view of life or to take care of the therapist. When therapists do share something of themselves, less is usually better than more, says Roberts. Telling clients, for example, that you were once in a similar situation can promote connection, but telling how you resolved it can rob them of their insights about the issue.
Are therapists better off avoiding these hassles and potential pitfalls and simply not self-disclosing? Given its effectiveness, Henretty and Levitt believe that therapists have an ethical obligation to consider incorporating self-disclosure in their therapeutic toolkit. "Although for decades therapists have sat quietly and comfortably behind a mask of anonymity," they write, "the theoretical and empirical research suggests that nondisclosure has risks and benefits that need to be weighed (as does disclosure)."
Virtual Reality: Virtually Better: www.virtuallybetter.com; Journal of Anxiety Disorders 22, no. 3 (April 2008): 561-569; Death Studies 32, no. 7 (August 2008): 674-92. Tears: Current Directions in Psychological Science 17, no. 6 (December 2008): 400-04. Hallucinations: Psychology and Psychotherapy: Theory, Research and Practice 82, no. 1 (March 2009): 1-17; Psychological Medicine 34. no. 8 (November 2004), 1571-1580. Teaching Therapists: Psychiatric Services 60, no. 5 (May 2009): 671-76. Porn: International Journal of Mental Health and Addiction 7, no. 2 (April 2009): 295-310; Cognitive Behaviour Therapy 38, no. 2 (June 2009): 66-82. Self-Disclosure: Clinical Psychology Review 30, no. 1 (February 2010): 63-77.