Unwitting self-disclosures in psychodynamic psychotherapy: deciphering their meaning and accessing the pain within.
Unwitting self-disclosures (USDs), unconscious yet observable parts of personality, are often behavioral relics of past suffering and, as such, constitute valuable though frequently underutilized clinical information. While ego-syntonic aspects of personality can be commented on with impunity, dealing therapeutically with patients' USDs--manifestations of their blind spots--requires sensitivity, empathy, and timing. Providing many clinical examples of patient and therapist USDs from individual and group psychotherapy, this report discusses the origins, possible meanings, and the countertransference and empathic challenges encountered in the handling of these blind spots. The importance of establishing a narcissistic alliance and of employing the methods of the existential school of psychotherapy in processing USDs is described. Self-aware therapists can minimize the clinical impasse that may result when therapist-patient blind spots overlap.