Aaron Alan, MFT, CSAT Marnie Breecker, MFT, CSAT, CCPS Foundry Clinical Group aaron@foundryclinicalgroup.com 310.721.1894 Center for Relational Healing marniebreecker@gmail.com 310.860.9999 Facilitating a Formal Disclosure Aaron Alan, MFT, CSAT Marnie Breecker, MFT, CSAT, CCPS Foundry Clinical Group aaron@foundryclinicalgroup.com 310.721.1894 Center for Relational Healing marniebreecker@gmail.com 310.860.9999 Why a CEU on Disclosure? To give therapists a common frame Stress importance of working systemically Purpose today is to give info on process rather than debate validity (that’s a whole other conversation!) Defining Terms Addict: person disclosing secrets/lies Partner: person receiving information Discovery: when partner first learns of sexual acting out Disclosure: the formal process of sharing information about secrets & lies related to sexual acting out What Is Disclosure? The transfer of information from one party to another NOT an amends, but is often considered a piece of the amends to a partner Disclosure is done only with primary relationship Is a part of healing relational trauma Is highly stressful for everyone Purpose of Disclosure To facilitate healing of the trauma created by the secrets & lies Rebuilding trust and intimacy in rx (Re)establish equality in the relational dynamic To give partners the truth about their relationship and the person with which they have chosen to share their life. Shame reduction for the addict, surrender secrets “We’re only as sick as our secrets” Not All Therapists Agree Some clinicians advocate against Disclosure Consider it harmful to rx Shaming for addict Traumatizing for partner Creates power differential Differ in methodology/protocol Differ in content Voluntary Both clients must agree to participate Either one can choose not to participate Therapists should tread lightly in advocating for disclosure Outcome cannot be guaranteed The Frame Is Key Structure/boundaries Carefully planned Therapist guided Done in session not “over kitchen table” Staggered Disclosure When pieces of information come out at different times (“drips & drabs”) Partners often wonder when “other shoe will drop” Message is “there’s always more” Perpetuates trauma for partner Similar to compulsively picking a wound “But S/he Knows Everything” Formal Disclosures are completed even when a partner has been “told everything” because information previously revealed can often be incomplete; however well intended Don’t know what they don’t know Healing/catharsis in process When Is Disclosure Done? As soon as reasonably possible Addict is stabilized and is “sexually sober” After partner has begun therapy and is stabilized Contraindications When divorce is imminent or relationship is ending* Either person is not emotionally stable Unaddressed psychiatric issues Unaddressed CD/substance abuse One of the treating therapists is NOT on board Partner has no therapist and/or deficit of support Partner is in acute state of trauma Addict is continuing to act out / not in recovery Preparation Pre-Disclosure Informed consent (potential pros and cons) Disclosure worksheets Informing of Disclosure timeline Cessation of “detective work” and disclosurerelated questions No sexual contact From time Disclosure is scheduled through PostDisclosure follow-up session Safety planning for day of Disclosure Informed Consent Potential benefits Rebuilding trust, intimacy End of denial Validation that partner is not crazy Partner receiving the information to make decisions about future Establishing equality Shame reduction for addict Informed Consent Potential drawbacks Increased conflict in relationship Intrusive thoughts for partner & other trauma sx /retraumatization Anger/rage from partner Misuse of disclosure in a legal proceeding Destructive compensatory bx (addictions, compulsions) Emotional dysregulation for both people Immediately Disclosed Info Imminent risk of harm or actual harm e.g., safety, legal problems Sexually transmitted infections and other related health issues Imminent risk to reputation and/or social status Imminent risk or actual harm to household/family Imminent financial impact on household/family Consultation Confer with all members of treatment team Therapist for partner/addict Couples therapist (if applicable) Psychiatrist (if applicable) Group therapist (if applicable) Partner’s Preparation Managing of expectations Setting realistic expectations Psychoeducation about sex addiction Disclosure is voluntary Informed Consent given Exploration of information already known Exploration what information partner wishes to receive and NOT receive Partner’s Preparation (cont’d) Boundary setting (no detective work, no questions, stopping sexual contact with addict, etc.) Self-care planning for before, during & after Partners can request certain items/information deleted or withheld from the Disclosure, if they so choose Use worksheets Addict’s Preparation Education about denial and purpose of Disclosure Help in presenting information with ownership and responsibility-taking Understanding importance of empathy for partner Disclosure is voluntary Informed Consent given Addict’s Preparation (cont’d) Education and prep for Disclosure process, format and structure Boundary setting (no sex with partner, etc.) Incorporate partner’s personal parameters into Disclosure Self-care planning for before, during & after Disclosure vs. 9th Step “Made direct amends to such people wherever possible, except when to do so would injure them or others.” Disclosure is part of treatment Amends is part of recovery Treatment addresses the relationship/system Recovery addresses the individual Pain vs. Injury Pain is experienced when informed Injury occurred when acting out occurred Disclosure vs. 9th Step Like resetting a broken bone – yes, it’s painful! Disclosure = information transfer Accounting of the damage Necessary for a complete amends to be made Otherwise, partner cannot fully understand what apology is for Amends = repairing the damage Information vs. taking responsibility and accountability Content of Disclosure Sobriety Date List of general addictive behaviors List of specific addictive behaviors, including: Time frames of acting out (dates and/or events) Frequency/duration of acting out Places/locations of acting out that are relevant Money spent on acting out Behaviors that have involved another person/people Content of Disclosure (cont’d) Exact # of sexual partners (or best estimate if exact number is incalculable) Identity of any acting-out partner that your partner may personally know Identity of any friends/family members who may already be aware of this problem Content of Disclosure (cont’d) Information starting from start of relationship In some cases, partners may prefer to receive information spanning the addict’s adult life, which can be helpful to contextualize and depersonalize the addictive behaviors. In these cases, info preceding the relationship is general rather than specific. Any specific lies told in service of the addiction are clarified and the truth is given Structure of Disclosure Session Therapist Preamble What today looks like The purpose of Disclosure To have a clean slate To stop staggered Disclosure (drips & drabs) There may be info revealed that contradicts what addict previously swore was the truth Sometimes addicts hold on to info (not to be duplicitous), but after Discovery addicts gave answer that they feel locked into or truth was soft-pedaled This is opportunity to come clean about that Therapist Preamble (cont’d) It’s OK to have feelings about hearing contradictory information (normalize this!) Addict will read their Disclosure, giving info, no excuses, apology or rationale for behavior Recommend no physical contact OK to ask clarifying questions (timing, etc.) If question is more in-depth, we may ask that the question be parked so it can be discussed with therapist and asked later (post-Disclosure) Therapist Preamble (cont’d) Disclosure can be read twice Partner can take notes Partner leads the pacing “foot on gas and brake” OK to pause if partner needs to leave room Partner can end Disclosure at any point Are you both ready? Working Systemically & Advocating for the Partner Advocating for the Partner Advocating for your client with a therapist you don’t know and/or has differing opinions from you regarding Disclosure can be frustrating and extremely challenging It is important to focus only on doing what is in the best interest of your client and ensuring a thorough disclosure and safe experience for both partners Unfortunately, there isn’t one universal Disclosure process that is agreed upon and adopted – including within the community of sex addiction therapists Advocating for the Partner If the addict’s therapist is a colleague with whom you share similar views and approaches to Disclosure, your task will be much easier Being on the same page regarding the structure and content of the disclosure in very important When this doesn’t happen, each partner will receive conflicting information from his/her individual therapist, which can easily lead to more confusion and frustration for the couple Advocating for the Partner The time surrounding disclosure is typically overwhelming and emotionally excruciating and frequently causes further rupture to the relationship It is the therapists’ job to work together as a team to create the safety necessary for disclosure to occur Even the best intentioned therapists can succeed in splitting a couple when they engage in a power struggle over whose approach is best, as it leaves the couple arguing over whose therapist is “right” and “wrong” It is our responsibility to do what we can do to help our clients heal, not exacerbate their problems Advocating for the Partner Having our own ideas and opinions and being reluctant to stray from that doesn’t take into account the individual needs of each client; such rigidity makes negotiation, compromise and resolution nearly impossible If two therapists working with a couple differ in their opinions, there must be room for negotiation Sometimes therapists get caught up in ego, pride and/or personality conflicts and can lose sight of the goal of Disclosure Advocating for the Partner All actions should be in service of relational healing Therapists working together on a disclosure must base their decisions and planning first on the partner’s needs, then on the addict’s needs It is important for therapists to manage expectations (both their own and those of their clients), as Disclosure does not necessarily mean that the couple will stay together or be successful in rebuilding intimacy and trust Advocating for the Partner When there are different opinions among the treating therapists, it may help to choose to work from a book such as “Disclosing Secrets”, which can ensure that both partners are being given the same information Timeline for Disclosure Once date is set, it’s imperative clts follow therapist recommendations (esp re boundaries) Safety planning (separate cars, 24 hrs apart, etc) If polygraph is incorporated, it’s usu done before Disclosure Allow 2 hrs for Disclosure session Partner usually has a support session immediately after Disclosure session Follow-up session is usually 3-7 days after Disclosure AKA “Boundaries & Consequences” session Couples therapy often recommended at this point Post-Disclosure Boundaries No contact for 24 hours after Disclosure Allows partner to absorb info Conversations only to “news, weather & sports” No physical contact initiated by addict No abuse (physical or verbal) Copy of disclosure is in partner’s therapist file for review in session Partner NEVER leaves with printed copy of Disclosure Use of Polygraph Controversial Can be effective as a therapeutic tool: level of ‘willingness’ to go to any lengths for repair of relationship Not “gotcha” experience (we want addict to pass) Is highly shaming for person taking polygraph Is highly anxiety-provoking for person waiting on results (partner) Protocol for Polygraph Use Addict’s therapist gives polygrapher 2-4 questions: “Is your disclosure complete and accurate to the best of your awareness/recollection?” “Have you acted out sexually since your stated sobriety date?” (1-2 questions generated from partner) Results delivered as follows: Polygrapher Addict’s therapist Partner’s therapist Addict’s therapist Partner’s therapist Partner Disclosure Follow-up Session Follow-up questions posed Boundaries & consequences delivered Partner uses a worksheet to assist in processing “What I need to feel safe in the relationship is…” “If you are unable to hold this boundary, I will take care of myself by…” Cause & effect rather than punative to addict Partner reads in session to the addict Addict SHOULD leave with a printed copy Mistakes Commonly Made Giving partner a print-out of the Disclosure Allowing content to include amends, excuses and rationale for behaviors/choices Disclosure written as a narrative rather than simply stating the facts Not editing out equivocations “probably”, “maybe”, “something like…” (sounds like guessing) Better to use “approximately” Mistakes Commonly Made Not editing out lascivious content Failing to interrupt the asking of lascivious and/or punitive questions Better to use clinical terminology “How large were her breasts?” “How could you do this if you loved me?” Including sexual template info in Disclosure This is a violation against the addict Mistakes Commonly Made Allowing “victim-stance” statements in Disclosure Not working systemically “I paid for sex because you rejected me that night” Trying to manage Disclosure by self Not requiring the partner work with a therapist through his process – even if it’s just temporary Being too rigid about the process Holding dates as more important than process / safety Resources Association of Partners of Sex Addicts Trauma Specialists (APSATS) Non-profit for training/certifying therapists Foundry Clinical Group www.foundryclinicalgroup.com The Center for Relational Healing www.lacrh.com “Disclosing Secrets” by Jennifer Schneider, MD Facilitating a Formal Disclosure Aaron Alan, MFT, CSAT Marnie Breecker, MFT, CSAT, CCPS Foundry Clinical Group aaron@foundryclinicalgroup.com 310.721.1894 Center for Relational Healing marniebreecker@gmail.com 310.860.9999 Aaron Alan, MFT, CSAT Marnie Breecker, MFT, CSAT, CCPS Foundry Clinical Group aaron@foundryclinicalgroup.com 310.721.1894 Center for Relational Healing marniebreecker@gmail.com 310.860.9999