Therapists model good boundaries, but illness puts self-disclosure of highly private information on the table.

Clients talk about themselves; therapists don't, on the whole. That may change with illness.

Although confidentiality is a cornerstone of psychotherapy, it doesn't apply to the therapist.

A serious health diagnosis is one of those terrible therapeutic opportunities.

Co-authored by Martha Sweezy and Roberta Omin

Imagine you are a therapy client arriving for a session. You watch your therapist walk across the room with a limp. He seems to be in pain; he looks tired and preoccupied. Part of you feels concerned and wants to ask if he’s okay. Another part admonishes internally, “It’s none of your business! That’s how it goes in therapy.”

Now imagine being the therapist. Your limp is a big tell. You’re not sleeping well, you feel exhausted, and it's no wonder – you just got a troubling diagnosis. You are scared, and when you woke up this morning, you felt overwhelmed. You are aware of being deeply vulnerable. No part of you wants to share this information with clients. As you sit down, you hear some inner reassurance, “Don’t worry. We don’t have to talk about it.”

A Therapeutic Dilemma

Internal Family Systems therapy (IFS) maintains that the mind — the arena of subjective experience — is peopled with parts, or subjectively experienced individuals of all ages who live in an inner community but, just like people, are motivated by different perspectives and concerns. In IFS therapy, we get curious and question the parts who show up. Each one has a backstory. Take Sabra, the client in this example.

Her parts are in an uproar:

What if this is serious? What will I do if he’s really sick? And I........

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