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Traditionally the healthcare professions frown on self-disclosure. We are taught to be ‘professional’, to avoid getting emotionally involved, and to keep good boundaries. For good reasons! Sharing one’s own experiences can represent a failure of self-regulation and separateness.
First and foremost, we are there in the relationship with the patient to serve as a facilitator of healing. But, sometimes, sharing personal experience in the right ‘dose’ and at the right time can add immeasurably to this endeavour. In reality, the issue is not about sharing one’s own experience so much as being present as a warm human being. These are important issues when exploring stories.
It is a given that when listening for the feelings and meanings of a patient’s experience we are constantly drawing on our own personal experience and knowledge of the world to begin to understand and empathise with what is being revealed. More than that, the activity of exploring a story emphasises that the patient and the clinician are two persons together. One may be struggling to reveal and the other may be struggling to hear. It really does help patients to feel that the clinician is human. This is a very human and potentially vulnerable scene, especially for the patient. Disclosures need to be genuinely and carefully given and always in the interests of the patient, avoiding clinician self-indulgence.
In reality, the issue is not about sharing one’s own experience so much as being present as a warm human being.
Sometimes what are needed are examples of other people (appropriately made anonymous), showing how the connections of mind and body, story and illness are part of being human. Given the patient above, who developed hives when he was shifted without warning to another department in his company, disclosures and examples might simply be statements like: ‘I changed jobs once and it was not easy, and I suffered a period of headaches’ or ‘I once had a patient with hives that started when her husband shifted jobs’. It is much easier to share stories and to own them if we are not alone, and not feeling scrutinised by a cool, neutral, and somewhat distant professional.
Brian Broom
