I have been assigned to see a 12-year-old girl whose father died a year ago, and her mom and teachers report she seems depressed. My mother died when I was 14, so I have a good idea of what she’s going through and think I’d be a good therapist for her. My supervisor said she’s concerned that this case could be too close to my own experience, but I think it’s good that I know what’s it’s like to lose a parent.
This situation illustrates how our personal history informs and affects our work with clients. We have similarities and differences with each client, but the balance between the two is different with each one. When you are working with someone who seems very much like you or with whom you are heavily identified, it is important to rebalance your attention by being aware of the ways in which your experiences diverge. Similarly, when you are struck with how different your life is or has been from your client’s, you need to look for commonality.
In this example, you and your client share the experience of losing a parent in your early adolescence. It is understandable that this common experience takes the foreground of your attention when you think about beginning to work with her. However, there are some important differences that are apparent even in the preliminary information you have: the death of a father compared to the death of a mother and being 12 or 14. Undoubtedly, there are other differences between you and your client in your specific family relationships, cultural background and identities, other developmental events, and personality characteristics. I’ll discuss three strategies to maintain your attention on your client’s needs while minimizing the potential interference of your experience of parental loss.
First, pay careful attention to your tendency to make assumptions in this case. It will be easy to believe that you understand your client’s thoughts and feelings without your usual level of curiosity and information gathering. Err on the side of caution by asking questions or being tentative in your reflections with statements like “are you saying you feel lost?” or “it sounds like you might be angry.” Remember that it is your job to help her on her own journey of grief and loss and that hers will inevitably differ from yours. She may feel sad in a situation in which you felt angry, or she may feel burdened rather than afraid.
Second, be especially careful when you think about self-disclosure. You will probably think of several examples from your own life and experience that are related to your client’s pain and grief. It may seem as though sharing your experiences will let your client know you understand her and will give her a sense of hope for her own healing. However, self-disclosure always has a risk of diverting the client’s attention from her own experience to yours, especially when she hasn’t asked about your life. In this case, it may be appropriate to share minimal information with your client if she asks. For example, if she asks whether anyone close to you has died, you could say “yes, that did happen when I was a teenager” and you might tell her that your mother died if she asks for any other details. Then I would turn attention back to her experience and how she feels knowing this about you.
Third, a case in which your personal history is similar to your client’s makes supervision extremely important. You may feel that your knowledge of your client’s experience means you don’t need as much guidance from your supervisor as with your other cases. However, as noted above, there is a potential for your clinical judgment to be clouded by this similarity, so discussing this client and her progress in treatment is essential. Your supervisor’s concern suggests that she is aware of this difficulty and will be able to support you in thinking through your emotional responses to the client. You may also find it helpful to talk with your personal therapist about the emotions and memories that arise for you in working with this young woman. You may find that your grief and loss emerge in a new way as you face the issues as a therapist.
I hope you find this helpful in managing the impact of your personal history in your clients’ treatment.