Should a psychotherapist be completely transparent in patient interactions? More specifically, should they openly express or conceal their emotions and reactions to the patient?

The answer depends on the patient, her/his diagnosis, and the state of the relationship between us. No, in general, I am cautious about many of my thoughts and feelings as I treat them as speculative.

However, if what I am thinking or feeling is drawn into the interaction, especially if asked directly, then, yes I am transparent. I immediately pay close attention to how the patient reacts to this disclosure.

With some patients who grew up having to be exquisitely aware of a parent’s thoughts, feelings, and behavior to survive, I will be far more transparent than with other patients. Coming from a background where physical/psychological safety depended on the patient’s ability to know what’s going on, I have to be more active in helping that person tease out what they “know” and what is going on in me. I don’t want to do anything to increase the patient’s “paranoia” about me.

About left0089

Columnist at American News Report. Pain care activist. Poet, memoirist.
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