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Unwitting Exposure of the Therapist

Transferential and Countertransferential Dilemmas

Received April 11, 2000; revised August 1, 2000; accepted August 24, 2000. From the Department of Psychiatry, Harvard Medical School, and the Massachusetts General Hospital, Cambridge, Massachusetts. Address correspondence to Dr. Ulman, 17 Elm Street, Boxford, MA 01921.

The unwitting exposure of the therapist's private life creates an unexpected rupture in the frame and puts both the therapist and the patient off balance. The exposure introduces into the therapy a moment of human sharing of vulnerability that has the potential to enrich the treatment. Clinical vignettes are presented to help therapists anticipate possible exposures and their consequences. The discussion encourages therapists to predict their reactions, obtain needed professional support, and make the most of opportunities for full exploration of patients' material.

Key Words: Transference and Countertransference • Psychotherapy, Psychodynamic