Oh you found my Instagram account? And how does that make you feel…?

Why your therapist may not share much about themselves, why some do, and why the whole thing makes me anxious.

This week, I shared something on my personal social media accounts that only my closest family and a couple of friends knew. In the past two years, my husband has been battling a serious alcohol use disorder, during which he spent significant time away from our family, in rehabilitation centers, detox facilities, hospitals, and sober living homes. He is currently strong in his recovery and our family finally feels as though we are returning to equilibrium. I will be writing and sharing more about my family’s process of treatment and recovery, on this account and hopefully elsewhere, but that is not what this article is about. In this piece, I want to discuss the impact of sharing our most vulnerable experiences with others and particularly, the considerations of doing this as a mental health professional.

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Have you ever asked your therapist a question about themselves, and had them respond with something like, “I wonder what that question means to you?” For as long as psychotherapy and the treatment of mental health conditions have been a thing, mental health practitioners were taught to be exceptionally careful about self-disclosure with their patients. This sensitivity was born in the tradition of psychoanalysis, the therapeutic paradigm that was created and popularized by Sigmund Freud. A central component of psychodynamic therapy involves the therapeutic use of the client’s projections of their internal experiences onto the therapist and the therapeutic relationship, a process known as transference. In order for the therapist to accurately work with the client’s transference, the therapist must come to the therapeutic interaction as a “blank slate.” You know the pictures you see of a person lying on a couch with the doctor sitting behind them? That’s psychoanalysis.

In 2024 however, most people in therapy are not engaged in psychoanalysis. Although there are still psychoanalysts in practice, and many training programs, most therapists are working with clients through different modalities. Some of our most enduring ways of understanding human behavior grew from psychoanalysis and psychodynamic theory, like Attachment theory. And some other concepts, for example, the importance of Freud’s “psychosexual” phases, have fallen out of favor due to lack of empirical support. So why has the ‘blank slate’ concept remained influential? If we are not intending to be a blank slate to capture and reflect our client’s unconscious thoughts and feelings, then why are therapists still so concerned about self-disclosure?

There are many legitimate reasons for therapists to be judicious about their self-disclosure. The therapeutic relationship is unique and powerful. A therapist and client spend a great number of hours together and discuss some of the most private and painful experiences of an individual’s life. It is not uncommon for a therapist to hear, “I’ve never told this to anyone before.” And despite what sometimes culminates to hundreds of hours over many years, the relationship is inherently one sided. My clients know that I am married and have two children and a number of pets. But they probably do not know how many siblings I have. They do not know if my parents divorced or what my religious affiliation is or the fact that I have asthma, etc. There are several reasons for this somewhat strange arrangement. Logistically, we usually only have an hour or less together each week and I do not want to use that time talking about myself. More importantly, we cannot predict how sharing any one detail of our lives might impact the client’s perception, reaction, and comfort with us.

Let’s pretend that a client asks me whether my parents are still alive. I respond, “My mother is alive, and she’s one of my best friends.” Innocent enough, right? Maybe. Or maybe not. Perhaps the client is also close with her mother and this similarity encourages feelings of connection with me. Or perhaps my client has a painful history with her mother, and this disclosure triggers feelings of envy or shame. Perhaps she lost her mother, or was adopted at birth, or is a new mother herself. This is not to say that excellent therapeutic work can not be done by working with the feelings that may come up between the therapist and the client in the moment or across the duration of the relationship; in fact, this is some of my favorite work to do. It can be brilliant and powerful when done intentionally and with informed consent. However, if the client in question was coming to therapy to work on, for example, developing strategies to manage ADHD in the workplace; my innocent self-disclosure may distract from what we are here to do, or worse, negatively impact the client’s ability to feel trust in the therapist. In fact, one of the number one complaints that new clients share with me about previous therapists is that the therapist talked too much about themselves, which was distracting and burdensome.

So I would argue, we don’t want to throw out the “blank slate” with the “oedipal complex.” And like most things, we must adapt to our current social landscape. Most therapists no longer aim to be a blank slate in therapy, but different individuals vary in their comfort with self-disclosure. For example, I have been privy to many supervisory conversations in which a therapist is anxious about showing up to their sessions with a new engagement ring. Will my clients notice? How will they respond? In a training I recently participated in, a young therapist shared that her training program encouraged her to wear a consistent and understated wardrobe to therapy sessions so as not to be distracting. The point is that people make assumptions about us based on our outward appearance, and a therapist should be mindful of that and how those perceptions may be showing up in the therapy room (or zoom). This sort of anxiety began to dissipate a bit for me after becoming pregnant with my first child. Although there was some trepidation about how to share and when, it was inevitable that I could not hide this life changing part of my identity and existence for very long (helped along by my unrelenting nausea and vomiting that lasted throughout pregnancy).

What Freud and his colleagues could not have foreseen was the dramatic ways in which our social landscape would change in only a century (lightspeed, in terms of human evolution). Therapists, like most humans, have social media and a digital footprint. Many therapists are using these platforms to provide valuable psychoeducation on mental wellness, along with normalization and destigmatization about mental illness and the hardships of being human. When I first began seeing therapists on social media, sharing tid-bits about their own lived experience with trauma, eating disorders, addiction, and more, I engaged in my own fair share pearl-clutching. Even something as seemingly innocent as a therapist showing themselves on a family vacation had me wondering (with some judgement, admittedly), “What about their clients?” Can you blame me? I spent a decade in school engaging in conversations about whether or not it was ethical to wear an engagement ring to a therapy session and now we are able to flaunt our lives on Instagram? I was genuinely concerned and confused.

At the same time as therapists were getting comfy on social media, I was observing the rise of other powerful conversations and areas of research that were shaping my ideas around therapist self-disclosure. One was the research of Dr. Brené Brown on shame and vulnerability. Dr. Brown has argued passionately that the experience of shame corrodes our ability to show up authentically with ourselves and in relationships, leading to further disconnection and possibly some harmful strategies designed to manage the shame and isolation. Humans are relational creatures and we grow in connection with others; shame keeps us hiding, fearful, and feeling unworthy.  In her book Dare to Lead, Brown writes,

“If you put shame in a petri dish and cover it with judgment, silence, and secrecy, you’ve created the perfect environment for shame to grow until it makes its way into every corner and crevice of your life. If, on the other hand, you put shame in a petri dish and douse it with empathy, shame loses its power and begins to wither. Empathy creates a hostile environment for shame—an environment it can’t survive in, because shame needs you to believe you’re alone and it’s just you.”

When a mental health therapist shares that they too have lived through, let’s say, PTSD, is that not fighting against secrecy, silence, and judgment? My observation is that many clients appreciate knowing that their therapist is speaking from a place of personal experience. This may be particularly true with certain concerns, such as infertility or trauma related to oppression due to race, sexual orientation, or gender identity (just to name a few). When I was helping my husband navigate the treatment process for alcohol abuse, I was surprised to hear again and again that staff and therapists had their own history of addiction. During an intake meeting with a detox facility, my husband showed his own feelings of shame when he told the intake coordinator that “Everyone hates an addict.” She responded, “Well in that case I would have to hate myself, my partner, my parents, and a number of my friends.”

A second area of work that has shaped my attitude towards therapist authenticity has been research on self-compassion. Self-compassion refers to a process of acknowledging the pain that we all experience inherently as part of the human experience; and meeting that pain with compassion and without judgment. When we respond to our emotional pain, personal inadequacies, or failures with judgment and avoidance, it almost always exacerbates our suffering in the long term. Self-compassion offers a different way, intended to cultivate acceptance and feelings of worthiness, even in the face of imperfection. Psychologist and researcher Dr. Kristin Neff, a self-compassion expert, teaches that a core component of self-compassion is recognition of our “common humanity.” Individual human pain is part of the larger shared experience of being human. We know intuitively and through everyday experience that we benefit immensely from seeing that we are not the only one suffering. When we can say, with forethought, “I’ve felt this way too” we are given the opportunity to demonstrate common humanity and model a more compassionate way of responding to the most painful aspects of ourselves and our experiences.

This seems like a good time to note that a perhaps unintended consequence of withholding self-disclosure is that it further promotes a hierarchical relationship between the therapist and their client, with the therapist as the “expert.” Many of our current therapeutic paradigms promote a more balanced power dynamic. When clients see the therapist as the “expert,” i.e., the person who has it all figured out, it can contribute to a passive role in the therapy work. The client expects that the therapist will simply tell them what to do to fix the problem. This power imbalance can also discourage honesty and vulnerability, if the client feels the need to demonstrate mastery or they fear judgment of misunderstanding from the therapist. And even if what we initially want is to be given the answers, inevitably, most of us do not like to be told what to do and will not find the growth and change we are looking for via simply advice or education. Lastly, it can contribute to harm when the therapist is embodying knowledge and competence that they have not earned through lived experience.

This plays out with unacceptable frequency in the case of white therapists working with clients of the global majority (if you are not familiar with this term, I mean the non-white majority of individuals in the world who have often been referred to as racial minorities, at least in the United States). Fortunately, the field of psychology is slowly but increasingly more concerned with the impact of white supremacy and patriarchy on our conceptualization of human behavior and the process of psychotherapy. It has become apparent that our training has not only failed to prepare us to address the concerns of clients with marginalized identities, it has taught us to engage in harmful practice. While we were worried about whether or not to remove an engagement ring, we were failing to see the impact of showing up in the therapeutic space with our undeniable (often) whiteness. As much as we try to manage how we are perceived, we can never remove the metaphorical glasses that color our experience in the world as a person with certain privileges, which shapes how we understand a client’s presenting problems and blinds us to other explanations. I believe this is relevant to the conversation because psychologists and therapists concerned with decolonializing psychological practice are teaching us that not only is it helpful for a therapist to own their humanness, it is critical to the process of developing a safe and trusting therapeutic alliance, which is the foundation of all successful therapeutic growth.

When I see therapists sharing about their own mental health on public social media, there is still a quieter, internal grasping of pearls. That graduate school indoctrination was strong. Yet I know I have to get with the times. Undoubtedly, there is research happening as we speak on the impact of therapist self-disclosure via social media (if you are searching for a doctoral dissertation topic, you should look at this!). And, somewhat obviously, there is a distinction between what we share with a client in therapy and what we share with the world. As many therapists quip, “I am A therapist, not YOUR therapist.” And therefore, it seems unreasonable to expect us to manage the impact of our public disclosure on all potential clients; past, present and future, and not engage authentically in the public sphere.

I would love to have a conversation! Some thoughts to consider:

• What mental health practitioners are you enjoying on social media (or elsewhere, like memoir?)

• As a client, have you had positive experiences with therapist self-disclosure in your own therapy? What about negative experiences?

• If you are a therapist, have you shared my anxiety about sharing too candidly on personal or professional social media? How have you managed it?

• As a client, if your therapist wrote a memoir, would you read it? Why or why not? (Asking for a friend…)

• If you are a therapist in training, what guidance is your program providing on this topic?

For next week, I am thinking of sharing more specifically how I managed a vulnerable self-disclosure with my current therapy clients, about the loss of my father last Summer.

And perhaps a few more thoughts on grief.