Self Disclosure in Politically Crazy Times

When it makes sense to be anxious about the news.

Posted Dec 06, 2018

Deborah Cabaniss
Source: Deborah Cabaniss

The other day, I listened to a patient in my office. She was upset—at the verge of tears. And it wasn’t about her mood, her marriage, or her mother. It was about the government. “I can’t believe what’s going on in our country,” she said, “What’s happening to us? The loss of checks and balances, the Supreme Court, immigration. It’s awful.” She paused, and then asked, “Are you feeling this way too?”

Patients frequently ask me questions about myself, such as “Are you married?” “Do you have children?” “Did something like this ever happen to you?” I was trained not to answer these questions for two reasons: 1) knowing too much about a therapist can impede development of the transference and 2) it’s a burden for patients to have too much information about us. So, generally, I try to say something like, “You know, I could answer, but we’ll learn more about you if you tell me why it feels so important to know.” Over the years, though, I’ve learned that, sometimes, answering is the right thing to do, particularly if it helps someone trust that I can help them or connect to their own, split-off feelings.

But the questions I’ve been getting in the last couple of years feel categorically different. First of all, they are predominantly about the news. In 25 years of practice, I’ve found that people rarely talk about the news—even during momentous events like the Persian Gulf War, Obama’s election, or the Columbine shooting. If they do, it’s ephemeral—in the air for a day or two and then gone, buried in a sea of pressing personal issues.

The exception was 9-11. I practice in Manhattan, and when the World Trade Center was attacked, everyone I saw either knew someone who had been killed or knew someone who knew someone. The smell of smoke snaked its way to my Upper East Side office. The streets were empty. People universally greeted one another with the question, “Is everyone in your family OK?” So of course, my patients asked me, too. And I answered. How could I not?

A few days after the attack, however, I was at a professional meeting and this issue came up. I was astonished to hear someone say that, for the sake of therapeutic neutrality, they were not answering.  Hearing that made me feel physically ill. Could it be that, in the midst of this incredible tragedy, therapists were falling back on “technique” rather than talking to their patients like fellow human beings? After discussing this with colleagues, we decided to investigate how people were handling these questions.  This study, which we ultimately published in the Journal of the American Psychoanalytic Association, asked 254 psychoanalysts various questions about what had happened in their offices in the days following the attack. Of the 141 who responded, the majority reported that they had answered questions about how their families were and how they were feeling. In short, during a period of acute, shared trauma, most had self-disclosed.

But that was a horrible tragedy in which thousands of people died. Although there isn’t much literature about this, there is some evidence that analysts behaved similarly after the death of King George V in England and after the Kennedy assassination. Again, the deaths of beloved leaders can easily be understood as shared traumas. So I ask myself—is what we are going through now similar? From the spate of “Is Trump Crazy?” Op-Ed pieces and books on this topic by therapists, I know that some of my colleagues are upset and anxious about the current state of the government. If we are feeling this along with our patients, are we perhaps in the same kind of situation that led us to self-disclose after 9-11? And if we don’t talk about it, will our patients think that we are as crazy as they would have had we not told them that our family members were OK after the Twin Towers collapsed?

I think they will. I’m not planning on sharing my ballot with my patients, nor bringing up these topics myself. But when asked, I think that I need to say more than, “Go on…” I can’t predict the denouement of the Mueller investigation any more than the next guy, but simply saying “I’m scared too” can help patients understand that there’s nothing crazy about being anxious in politically crazy times.

References

Cabaniss, DL, Forand, N, Roose, S;  Conducting Analysis After September Implications for Psychoanalytic Technique. Journal of the American Psychoanalytic Association 2004;  52 (2):  449-450.

Fairbairn, W.R.D. (1936). The effect of a king’s death upon patients undergoing analysis. In An Object-Relations Theory of the Personality. New York: Basic Books, 1954, pp. 223–229.

Wolfenstein, M., & Kliman, G., EDS. (1965). Children and the Death of a President. New York: Doubleday