Can a psychotherapist tell patients about himself?

It was last year. Alina, 36, recalled a recent incident when her therapist interrupted her story. “She told me, ‘This reminds me of my mother. I’m so sorry I didn’t talk to her enough while she was alive…” She interrupted me many times. At first she asked me questions, referring to her own experience, then we quietly moved on to more confidential confessions. It got to the point that she began to tell me her recurring dreams. At this point, I decided that I had had enough and stopped going to her. I needed a therapist, not a girlfriend.”

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Phillip, a 51-year-old publisher, also left his psychoanalyst extremely disappointed. At the end of the session, he, smiling, handed him the manuscript with a request to read it and say what he thinks about it, and see what “can be done from it.”

Did Philip and Alina do the right thing by parting with their therapists? Certainly! Why? Because psychotherapists began to use them. They betrayed the essence of their work in order to get closer to satisfying their own narcissistic needs. But apart from such obvious ethical errors, is it acceptable for a psychotherapist to talk about himself in the interests of his patient? Today, when many practicing therapists publish books that are essentially based on the facts of their lives, when humanistic psychotherapy based on the writings and therapeutic practice of Irvin Yalom is developing in the United States, this question preoccupies many professionals.

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Attempted distraction

In May 1889, during a hypnosis session, Emmy von N., a 40-year-old hysterical patient, rebuked Sigmund Freud for such an innocent thing as questioning during a session. “She told me in an extremely displeased tone that I should not constantly ask where this and that came from, but let her tell what she wants to tell me.” The presentation of her story, Freud stated, went to the benefit of Emmy von N., and he himself came to the conclusion that one must be able to be silent so as not to create obstacles for the patient’s work. Although the patient wants to know where his suffering comes from, he is also tempted to avoid confronting it by turning his questions to the therapist.

For many years, 70-year-old Alexander tried in every way to get rid of family secrets and tragedies: “I didn’t want to notice how much the experience in the concentration camps destroyed the life of my parents, and therefore mine and my sisters.” As a consequence, Alexander spent his time asking the opinions of psychotherapists – whom he always stopped visiting in the end, disappointed – about petty love and professional problems: “And you, doctor, what do you think? Have you already encountered such a situation? What would you do in my place?

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“When I am asked a direct question about me, I do not answer, but rather try to find out why this question arose,” explains psychoanalyst Patrick Miller. “This is not because I would like to hide anything, but because I do not want to deprive myself of the opportunity to access the work of the psyche of the patient, and this is much more important than sharing some part of my life.”

We are not in ordinary social relations, in other words, in a “classical” exchange, but “in an asymmetric connection, the purpose of which is to give access to knowledge about oneself so that the vague past ceases to press and becomes a tool for creating the future,” explains the psychiatrist. and psychoanalyst Francesca Biagi-Chai. – After all, when a patient comes to us, he, in essence, has only one desire: not to talk about what can hurt, and to find an accomplice in the person of a psychoanalyst. This is the whole paradox: he comes to investigate the causes, but he is afraid to reveal something that he does not know about himself. And then there is this temptation to get to know the person sitting opposite him better.

love trap

Freud called this phenomenon transference: we endow the psychoanalyst with all the virtues. We love it for two reasons. One has to do with his knowledge: we assume that he knows things about us that we do not. The second is with an “erotic” feeling: he represents for us and even begins to embody a father who became a hostage of a tragic family history, or an absent mother who did not lull us enough … Therefore, we are interested in his life, and we are thirsty for information.

The psychoanalyst, for his part, also experiences emotions, he is touched by what is happening in the session. Psychoanalyst and sex therapist Alain Héril, who directs the work and training of many therapists, often witnesses this: “Talking about yourself and giving details of your biography is sometimes risky. My job is to remind you that trust creates a relationship of intimacy and complicity that can develop into a transference of desire. It is very important for us to resist this, because symbolically we are in the position of a father in relation to a daughter. We can tell her, “You’re beautiful, you’re desirable, but I’m your father, so don’t look at me.” Any “incest” positions should be avoided.”

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Required words

It turns out that the answer to our questions should be the stubborn silence of the psychotherapist? For three years, 39-year-old Marina sat on the couch every week, “as white and cold as his owner, a handsome indifferent person. This repeatedly certified psychiatrist, when I burst into tears, did not even lift a finger to hand me a box of handkerchiefs, and when I asked him if his father beat him, he threw me: “I will not answer you. Go on.” I loved him very much. It’s stupid, right? I have rarely felt so alone in my life. But my masochism has a limit, and one day I found the strength to leave. When Marina informed him that she would not come again, her interlocutor finally expressed his protest, and then rudely scolded her in a text message. Unsuccessfully. The woman has since turned to a more human therapist.

Francesca Biaggi-Kai is convinced that in order to alleviate the pain of the patient and prevent him from feeling abandoned, “it is strongly recommended to tell about yourself, especially if the patient is on the verge of great despair. But one must try to bring the patient into one’s story, strive to let him speak out where the psychoanalyst refuses to act as a model. Radicalism and following standards can be dangerous. Because the more mysterious the psychoanalyst, the more the patient tends to idealize him. You can talk about yourself when it is necessary, and in the way that your own intuition tells you, but you cannot do this as the main method of your practice.

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Everyone has their own method. Gestalt therapists don’t hesitate to report the feelings their patients’ words evoke in them. Says practicing therapist Isabelle Temperville: “We involve patients in the field of therapy to help them reconnect with their feelings, become aware of their bodies. It happens to me during the session to say that I feel anger or sadness when they tell me about the tragic events in a funeral voice. Alain Eril follows the same trend, although he tries not to talk too much about his personal history: “To say “this reminds me of my mother” or “here I remember an incident from my childhood” does not make any sense. How will this help a person? Patrick Miller and Francesca Biaggi-Kai also do not provide details of their biography. Instead, they tell their patients if external events interfere with their practice.

However, do we really need to hear our therapist tell us about his personal life in order to guess about it? The newspapers in the waiting room, the books piled up in the closet, the paintings on the wall, the arrows he draws on large sheets with the tip of his gnawed pen, the hands he covers his face with when your choked voice sounds a terrible memory … In general, everything tells us about him, perhaps better than he himself could have said.

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Neutral benevolence

Psychoanalyst Bernard-Élie Torgemen reverses Freud’s term “benevolent neutrality” and suggests striving for “neutral benevolence”: “If the psychotherapist wants to remain unsullied and fenced off by silence, he forgets the healing aspect of therapy. There comes a point when you need to be able to let go of control, to accept tears, blood and excrement. Psychoanalysis is a living art, it must be based on life! Of course, I do not come to the session to talk about myself, but when I find myself face to face with very young patients, with sadness, with mass tragedies, I believe that refusing to answer questions about me will indicate a lack of support towards the person. in trouble. I explain that feeling pain is not a pathology, and that it has happened to me too, rather than leaving the patient to languish in his suffering. In the face of despair, I think we can talk, we can say that we sympathize, not leave the patient alone in an empty room alone with an echo.