Let's Just Be Real. Let's Be Ourselves

Click here to watch the TEDTalk that inspired this post.

I have been told that I "keep my cards close to my chest", which I assume means that I don't reveal a lot about myself - I withhold myself or parts of myself. Given this trait (that I don't dispute), my somewhat introverted nature and, my interest in other people, what you get is a person who listens more than talks.

Ash Beckham's TEDTalk "We're All Hiding Something. Let's Find The Courage To Open Up". Made me think. What do I reveal and conceal about my true self? When and why do I do that?

Maybe it's because I'm a "private person." Maybe it's because I prefer to think rather than to speak. Maybe it's because I'm afraid that I'll say the "wrong thing."

Or, more likely, it's my training and 30 years as a psychiatric mental health nurse.

Talking about myself was "taught out of me."

In my professional circles of mental health nurses, therapists, counselors, and psychologists, there is a concept called "self-disclosure". And self-disclosure is bad. This idea comes from training and tradition. I remember my professor in my undergraduate psychiatric mental health nursing class almost 30 years ago, emphasizing how important it was to know the difference between a "social relationship" and a "therapeutic relationship." Relationships were either one or the other; they could not be both.

To be sure, peer counselors are helpful because of their unique perspectives but they are also helpful because they, in my experience, are truly authentic. -- Mona Shattell

Fast-forward to the present and this is still in textbooks and is engrained in practitioners' minds. Today, if you are a health care provider and a client's friend, these so called "boundary" violations are called "dual relationships," and are not tolerated at worse, and seriously frowned upon at best.

Persons who seek therapy want their therapists and nurses to understand them. I conducted a study a few years ago where I asked persons with mental illness what helped them to feel understood. What I found was exactly the opposite of what is done in practice - persons with mental illness wanted someone who shared with them their similar experiences. They felt more understood when their health care providers shared some "authentic" aspect of themselves.

I agree that as a therapist, there are good reasons for some separation. I agree that the focus of therapy sessions should remain with the person seeking help (the client) and that self-disclosure can create a big shift of attention - to where the client spends the whole time helping the therapist. This is not what I advocate.

However, do we need to take it as far as we have, and continue to? Can we be more authentic, as Ash Beckham encourages us to be? Can't health care providers and therapists be more themselves?

It's no surprise then, to know that persons with mental illness really like talking to individuals with lived experience of mental illness, persons who have personal experience with the mental health care system, and who are recovering from their illness or substance use issues. These health care workers that persons benefit from talking to are called peer support specialists or peer counselors. At least 36 states have peer specialist training and certification programs. In Illinois, the credential is "certified recovery support specialist" (CRSS). And research supports their work.

Perhaps mental health nurses, therapists, counselors, and psychologists can learn something here. To be sure, peer counselors are helpful because of their unique perspectives but they are also helpful because they, in my experience, are truly authentic. They "self-disclose."

To take it back to a reference from Ash Beckham's TEDTalk, I sometimes would like to toss a grenade into the professional self-disclosure closet. Let's just be real. Let's be ourselves.

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