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The Struggle with Self-Disclosure in Clinical Writing

There comes a time in the life of every clinician when writing about therapeutic work is a natural next step in professional development. Some people move easily into this life phase. Others hold back. They are unable to engage with the written word. They may have a strong sense of clinical competence–know how to be helpful to patients and use therapeutic process in complex creative ways–but to their surprise find that they are incapable of putting thoughts about their work into a cohesive theoretical framework and onto the printed page. They would like to see their clinical ideas in print. They long to write an article or a book, and think about doing so, but are unable to pick up a pen or log onto a computer and begin the task. These clinicians suffer from writing inhibition. The source of their resistance to writing often stems from unconscious conflict, wishes, and fears that stimulate a disabling writer anxiety. This is an anxiety that every clinical writer must, at some point in time, actively confront. This essay will use personal reflections to examine the psychodynamic meaning of writer anxiety, especially the form of anxious behavior that is rooted in a fear of self-disclosure. Writing is an act of self-disclosure. To write a clinical article easily and well, an author must be comfortable allowing the eyes of a discerning reader into the transitional space between patient and self (Winnicott, 1960). The printed page is a concrete form of that space, the place where