Since I am returning to music therapy practice after two months of maternity leave, one clinical issue that I have thought about a lot recently is the issue of self-disclosure. I have had some major events happen in my personal life, and it is sometimes tricky to figure out how much of my personal life to share with clients. Depending on the client population, some sharing is appropriate and even beneficial for the therapeutic process. On the other hand, sharing too much may cause problems in the clinical setting.
Self-disclosure has some potential benefits. Sharing personal stories with clients can help to develop rapport and establish a genuine, authentic relationship by helping the music therapist and the client find similarities or identify differences. When the therapist shares her own story, it can take off the pressure from the client when their own sharing gets to be overwhelming. Sharing on the part of the music therapist can also shift the balance of power, allowing the therapist to show some vulnerability, some humanness, rather than having to maintain the all-knowing, totally-objective, unreachable role.
Of course, self-disclosure carries risks as well. Over-sharing can damage rapport, especially when it leads the client to feel misunderstood or minimized. Taking off the pressure can be counter-productive when it prevents the client from digging deeper into the therapeutic process. In fact, in this case the therapist might jump into self-disclosure because he/she is actually the one uncomfortable with silence. Over-sharing can also shift the focus of the session away from the clients and their needs to the therapist, skewing the balance of power further towards the therapist.
Obviously, the issue of self-disclosure on the part of the therapist is both very complicated and very important. How do we figure out how to negotiate this issue? Well, here are a few self-disclosure situations I have encountered in the past.
My first real-world experiences with negotiating self-disclosure were in my work on an inpatient psychiatric unit. In that kind of setting, boundaries have to be pretty firm and self-disclosure has to be considered carefully. One of my co-workers shared a story about a time shortly after the birth of his first child when he couldn’t help but show pictures of the new baby around the unit. One of the adolescent patients, apparently trying to get under my co-worker’s skin, yelled some verbal threats against the baby. My co-worker got angry, and the taunts from the patient ended in a restraint and seclusion situation, derailing the therapeutic process. In this case, my co-worker’s seemingly innocuous self-disclosure led to a negative outcome.
Since the psychiatric hospital was the place where I really learned about developing a therapeutic relationship, my tendency was to keep my personal life entirely out of my music therapy practice, with self-disclosure at a bare minimum. When I got engaged to be married, though, my shiny new ring made it difficult to keep this a secret. In fact, in the first session after I got engaged, the wife of one of my private elderly clients immediately noticed my ring. I shared a little about my fiance and that yes, we were getting married. The best part, though, was that this led my client’s wife to talk about their own courtship and wedding, and we discovered new songs that had been significant in their relationship so that my client, who was in the later stages of dementia, could connect with his wife through music. Because the husband’s dementia had caused strains in their relationship, finding ways for them to connect and enjoy each other through music was a primary goal of music therapy. My unintentional self-disclosure led to a positive therapeutic outcome.
Pregnancy is another aspect of one’s personal life that doesn’t stay hidden for long, and indeed, many clients commented on my changing appearance and seemed to delight in sharing stories about their own experiences with pregnancy and childbirth. I even found that my big ol’ baby bump could spark the interest of some folks who were more difficult to engage – once I had their attention, they were more easily drawn into our music-making. I didn’t make pregnancy or children a central part of any session – I didn’t want to draw too much attention to myself – and I kept an ear out for folks who might be saddened or confused by the topic, although I didn’t notice any negative responses. I tried to make this necessary self-disclosure an asset to the therapeutic process rather than a detriment.
So what am I doing now? Some of my clients don’t remember that I was having a baby, but others have been waiting to see baby pictures since the last session I had with them. (This doesn’t even include all of the staff people at various facilities who are also curious!) Again, I don’t want to make my life the center of attention in any session, but I know that many people love babies, and I do have some extraordinarily adorable pictures to share! I decided to begin each session by explaining why I haven’t been around for a while and passing around a small book of just a few 4×6 photos. This gave me some time to reconnect with group members individually while others were looking at the pictures. Once everyone saw the pictures, we moved on to non-baby-related music-making. As before, with my pregnancy, my clients had an opportunity to share their own experiences with babies and some folks were more engaged in the group process than they typically are. Several people have asked for me to bring the baby to visit, although I haven’t decided yet if I will do this or how I will handle it. And again, I’m keeping my ears open for unexpected responses – people who are saddened or confused by the baby pictures. I have one resident in mind who sometimes thinks that her young children are missing and she needs to go find them – she gets terribly upset that no one else seems worried or wants to help. I will be especially mindful with her when her group sees the baby pictures.
So, now that most of my clients are older adults in residential facilities, it seems that sharing more of myself and my personal life is beneficial. This would not have been the case if I were still working at a psychiatric hospital, however. Boundaries and self-disclosure considerations change depending on the population and the setting. How have you handled self-disclosure where you work? Have you experienced someone sharing too much? Please share your comments below!