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THE RELUCTANCE TO SELF DISCLOSE | View Full Calendar
Presented by ALAN S. SUGARMAN, PH.D.
Alan Sugarman, Ph.D. is a Child, Adolescent, and Adult Training and Supervising Psychoanalyst at the San Diego Psychoanalytic Society and Institute. He is also a Clinical Professor of Psychiatry at the University of California, San Diego and maintains a private practice in La Jolla, CA. Dr. Sugarman received his doctorate from the University of Tennessee and then did a two year postdoctoral fellowship at the Menninger Foundation in Topeka, KS. After that he joined the faculty of the Yale University Department of Psychiatry where he was the Chief Psychologist at the Yale Psychiatric Institute, a long term inpatient facility for adolescents and young adults. He is the author of over 70 journal articles and book chapters, most of them involving applying psychoanalytic developmental concepts to diagnosis and treatment. Most recently he has emphasized the importance of mentalization its contribution to therapeutic action. He is on the editorial boards of Psychoanalytic Quarterly and Psychoanalytic Psychology and has served on and chaired a number of committees of the American Psychoanalytic Association.
Discussions by seasoned psychoanalysts of multiple theoretical persuasions, in a recent COPE study group at the American Psychoanalytic Association meetings, suggest that analytic anonymity is honored more in its breach than is commonly recognized. Despite the value of anonymity at certain moments in an analytically oriented treatment, self disclosures of all sorts to the patient, for a multitude of reasons, seem to occur with regularity, and with the same clinical utility as anonymity. Furthermore, the importance of viewing both anonymity and self-disclosure as potentially valuable has been emphasized in the analytic literature for well over twenty years. Nonetheless, many analysts remain either unwilling to self-disclose or unwilling to admit that they do so. This presentation will examine a number of the reasons for this continued reluctance. A major reason appears to be the theory wars that have characterized the not so distant history of our field. Many current day analysts continue to view self-disclosure as a relationally based technique and inappropriate for a contemporary Freudian approach. This belief will be shown to be incorrect and based on the failure to realize that Freud's original cautions against self-disclosure arose from his topographic model of mutative action. A contemporary structural perspective does not have to rule out self-disclosure. Other reason for this continued reluctance have to do with the discipline's collective concern about not using suggestion to promote internal change, the fear of challenging one's local institute's technical shibboleths, and the conflicts over aggression and other personality dynamics that characterize many psychoanalysts. These points will be discussed in further detail with clinical examples offered to support the value of judicious self-disclosure.
1. To articulate the reasons that psychoanalytically oriented clinicians are
reluctant to self disclose to their patients.
2. To use judicious self disclosure to facilitate insightfulness.
3. To describe the clinical rationale that Freud used to discourage self