Self-disclosure in psychotherapy.

This paper examines the ramifications of a psychotherapist's self-disclosure stimulated by the film Gloomy Sunday (Barkow, N., 1988, Universal Pictures, 1999). It describes the five-year psychoanalysis of a depressed surgeon who made serious medical errors while treating family members. Analysis provided considerable symptom relief, but decades later the patient again became depressed. His depression was precipitated by his having made a major medical error while treating a family member, his daughter, which had an almost fatal result. The surgeon then resumed psychotherapy two times a week for three years. Cultural and professional similarities between psychiatrist and patient cemented the therapeutic alliance, but the patient's medical errors when treating his family members persisted. The psychotherapist's self-disclosure stimulated by the viewing of the film became a fulcrum for renewed investigation of the patient's childhood unconscious contributions to his psychopathology. It also stimulated self-analysis regarding counter-transference issues in the therapist which was related to his own perceptions of Nazis. The resumed treatment ameliorated the patient's tendency to make medical errors. The description of both treatments is intended to deepen the understanding of a "boundary crossing" intervention that assisted psychotherapeutic progress, and to contribute to further consideration of its benefits and risks.