Use of Self

I am kind of an over sharer. I have a tendency to spill out my life story when someone asks me a fairly benign question. For instance, a question about what brought me back to Philadelphia after going to school out of state sends me into a long, complicated tale with details about a protracted break up and a deep sense of homesickness (in case you were interested). I will tell almost anyone almost anything. My co-workers know far more details about my personal life than I think they want to, but that's just the way I am. 

 Photo by  Matteo Vistocco  on  Unsplash

With my patients though, I often wonder how much to divulge. I want to recognize and respect that I'm meeting people in their bedrooms, at their kitchen tables, in their intimate spaces, and asking them deeply personal questions. It's only natural that the boundaries between us are a little blurrier than they would be in an office setting. I don't mind answering a few personal questions: am I married, do I have children? I ask these of my patients; they're fairly benign. What gives me pause is when people hit a nerve they don't realize they're hitting. 

Now I have to give you a little more information--I'll try not to overdo it but it's important to this particular post. My mom died on hospice two years ago. She was comfortable and we had an enormous amount of support from the staff and from our friends and family. All that being said, I am still grieving and maybe will be for the rest of my life. 

I'm sure it's clear to you how this effects my clinical work, in this particular field. I frequently meet families that struggle with making end of life decisions. They hesitate to give medication or sign a do-not-resuscitate order or choose hospice at all. I have been asked sometimes, "What would you do, if it was your mom?" That's the nerve they (unknowingly) hit.

This is where I struggle with use of self. I have to ask myself, in the brief moment I can pause before it becomes too pregnant a pause, what am I willing to divulge? What will be therapeutic? What does this family need to hear? Sometimes I simply say, "If it was my mom, I would want her to be comfortable." Only recently have I been able to say, "I have been through this and I know it is incredibly difficult." And you know what? I don't know if that's the right thing to say. That's the thing about use of self, or about any part of therapy: one size does not fit all. There are so many variables.

This work has a science to it, of course. We use evidence-based theories to help people. But there is also a true use of instinct and intuition. We would not have become social workers if we weren't sensitive to other people's moods and body language. And so, when faced with this question that tugs at my heart in a very profound way, I must rely not only on my training about use of self and the therapeutic benefit, but also what my gut tells me. Sometimes it's wrong. Sometimes people's compassion for me derails the conversation and it's hard to get it back on track. But sometimes they are able to see the bridge I've laid out in front of them and thank me; they can trust what I'm telling them.

As always, I end this with no real answers. (Notice a theme here?) But I do believe it's an interesting question: how much do we divulge? How sharp should our boundaries be? What is self-serving and what is client-centered? Food for thought. Or, better yet, tell me your answers! I love to hear your feedback and look forward to it. Until next time, let's keep talking.