To Disclose or Not to Disclose
Should I be more explicit in divulging the details of my mental illness?
Posted November 8, 2021 | Reviewed by Gary Drevitch
Technically, I’ve already disclosed by virtue of publishing my story here and in other venues. I guess I’m wondering what to do when one of my clients says to me, “I’ve checked you out.” What exactly does that mean? Can I take that to mean they’ve Googled me? OK, then they know I have a mental illness.
After they say “I’ve checked you out,” they don’t say what they’ve found, so I’m left wondering whether I should acknowledge, “Yes, I have a mental illness,” or follow their lead with the conversation which invariably turns to another topic.
One study shows that there is a benefit to disclosing. One pro is instilling hope: When a psychiatrist discloses that he or she has dealt with a similar problem as a patient, this may increase the patient’s hope that, like the psychiatrist, he or she can overcome the problem successfully. That study also suggests that a downside to self-disclosure by the psychiatrist is that a patient may think the psychiatrist is too impaired to help him or her. A patient may also construe the information shared by the psychiatrist as negative, which may, in and of itself, eliminate the psychiatrist’s capacity to be effective with the patient.
I tend to lean toward the “pro” in disclosing, although done judiciously and with regard to the history of each client and where they currently are in treatment—that is, if they indicate to me that they want to know more. The old adage, “Meet the client where they are,” comes to mind. If they just say “I checked you out,” and do not pursue anything more specific, even though it’s clearly public domain, are they ready to hear details of my mental illness?
My inclination has always been not to initiate the subject, but not to deny it if the client brings it up. This has proven to be somewhat of a grey area. I hesitate because I don’t want the focus of the session to turn to me; it’s the client’s hour and it’s supposed to be about them. I envision one question about my history leading to another and then, all of a sudden, a good part of the hour has flown by.
The same study cited above cautions that the psychiatrist may be perceived as not wanting to listen to the patient. A disclosure may then be harmful because it interrupts the patient from talking about his or her own problems. The patient may wait impatiently for the psychiatrist to stop talking about him or herself, and may experience this interruption as intrusive and annoying.
The most important thing for me to remember going forward is to ask, if I choose to be more explicit in my self-disclosure, will it benefit my client? Am I speaking about myself for her sake and not my own? Because what I disclose may be one of the comments that sticks with the client from all their therapy sessions.