Letter to the Psychology Today Editor

Yesterday, I received my usual copy of Psychology Today in the mail.

I’ll be honest, as a therapist of 15+ years with somewhat of a “situationship” with this magazine, some of the content can be a bit redundant and has at times been problematic, so I tend to skim. But I always read the editor's message. They tend to be the unsung heroes of the publishing world, and it feels a little like Cliff’s Notes.

This month’s Editor’s Note, titled The Therapist Ripple Effect, concerns the role of self-disclosure in the therapeutic professions, how it seems to be morphing with new generations of therapists, and the bidirectional effect on clients and clinicians.

Let me just say, I had some BIG feelings.

Unfortunately, Psychology Today does not publish comments or Letters to the Editor. I sent them one anyway, and I am posting it here on my professional blog and sharing it with my professional circles. There is a subtle bias in this particular Editor’s Note that needs to be addressed.  

It’s ever so subtle that I think most of us might actually miss it if we haven’t been keeping up with the literature. And I do say “we” with sincerity and earnestness, because without recently embarking on my own doctoral journey, I would probably not have been exposed to this literature or movement. It’s not quite mainstream yet, which begs some similar BIG questions about what we’re implying when we implicitly deride or discourage self-disclosure.

Here’s what I sent to Kaja Perina and the editing team at PT:

As a Licensed Marriage and Family Therapist, Kaja's insights on the generational changes taking place within the clinical professions when it comes to self-disclosure were interesting and valid, but I wanted to offer a different angle more aligned with third-order systemic change.

As one of the aforementioned therapists specializing in trauma who self-discloses my "in-group" status as a survivor to clients, I do this as a way of contextualizing narrative, establishing my credibility both as a clinical expert and from lived experience as a victim of sexual violence.

I was a volunteer victim advocate before I was a clinician, and the two pathways have evolved lockstep with one another ever since. They cross-pollinate one another with lessons learned and best practices in a way that helps both aspects flourish, all while being simultaneously shaped by my own first-person survivor lens.

Participatory action research and feedback-informed treatment models consistently empirically demonstrate that inclusivity of diverse lived experiences and client (i.e., mental healthcare consumer) voices should be at the forefront of our profession.

I choose to frame this issue not as some fraught disclosure parable plaguing our profession ("To disclose or not to disclose?!"), but instead that persons with incredible and informative experiences are choosing to come forward and join the same sacred calling to add their own unique lens of insight. Their contributions are what lends to the collective art and science of psychotherapy, not detract from its rigor.

A Call to Action

If this Letter to the Editor has sparked something in you, I encourage you to explore the following concepts:

• Third-Order Change: a framework for understanding organizational and professional transformation at the deepest level—examining not just what we do or how we do it, but the underlying assumptions and paradigms that shape our entire field; related concepts: cybernetics, first- and second- order change
• Participatory Action Research (PAR): collaborative research approach that involves the people being studied as active participants in the research process, emphasizing co-creation of knowledge rather than extracting information from passive subjects; related concepts: peer support specialist models, service user involvement (SUI), advocacy movements.
• Feedback-Informed Treatment (FIT): therapeutic approaches that systematically gather and incorporate client feedback throughout treatment, using their real-time perspectives to shape and adjust interventions; goes by many names in scholarly literature.
• Common Factors: therapeutic elements that contribute to positive outcomes across different therapy modalities—things like the therapeutic alliance, empathy, warmth, positive regard, client expectations, and hope. Research consistently shows these account for more outcome variance than specific techniques or theoretical orientations; related concepts: therapist credibility, therapeutic alliance, placebo/expectancy/allegiance effects.
• Cultural Humility (vs Cultural Competency or Responsiveness): rejects the idea that therapists can or should be neutral, value-free observers. It positions self-awareness and acknowledgment of one's positioning as ethical practice and supports diversity of lived experience as a professional asset.
• Reflexivity: an ongoing process of self-examination regarding how a therapist's background, assumptions, and positioning influence their work; related concepts: intersectionality.
• Wounded Healer Archetype: Jungian concept that therapists' own suffering can become a source of healing wisdom for others, though it requires careful integration and reflexivity.
• Democratization of Expertise: Tensions between maintaining professional standards and opening the field to diverse pathways and knowledge sources; related concepts: psychoeducation, power, gatekeeping.

I have also provided a reference list below. Generally speaking, I encourage self-sourcing, but if you experience significant difficulty locating the articles, please reach out to me via email or my contact page, and I will provide the article(s) directly.