The Pearls and Perils of Self-Disclosure

*Names have been changed to protect privacy.*

To self-disclose is to reveal something private about yourself. Disclosing information can help individuals feel understood and accepted, but can also be hurtful if the person listening is critical, minimizes, or magnifies what is said or withdraws.

Individuals typically weigh the risks and benefits before sharing intimate details about themselves to others. What you choose to say will probably be based on how comfortable you are disclosing information, the person with whom you’re talking, and the immediate situation. Some people have nothing to share, although others may expect an outpouring of emotion or personal details. Tim Hayes said he didn’t avoid talking about his testicular cancer, but other than updates about doctor appointments or treatment, he didn’t have much to say. “I didn’t think it was very interesting when you got past the update. What else are you going to talk about?” He also didn’t talk about end-of-life issues. He believed he would survive.

The Risks of Self-Disclosure

Texas resident Michelle Rasmussen knows the risks of self-disclosure. Her father’s diagnosis of terminal liver cancer came out of nowhere during a difficult time in Michelle’s life.  Frequent battles with her soon-to-be ex-husband over money and property had drained her energy and time. She became the primary caregiver for her father and her mother, who had recently suffered numerous health issues and needed considerable care. Her friends said she had written a country and western song because of the many problems in her life, but they also said she was tough and would get through this difficult period. However, they didn’t see Michelle crying alone at night, pushing aside meal after meal, wondering when she was going to snap. When she asked her sister for help, her sister told her she had her hands full taking care of her children.

“I said to my mom, ‘I’m not Super Woman.” Michelle tried talking to her sister. “She made some catty comments. She didn’t understand how I felt. She didn’t know how to respond and react.” In the end, Michelle felt like she had no one to turn to for emotional support.

Lack of empathy, withdrawal, and rejection are just a few of the risks a person might encounter when self-disclosing. Being stigmatized is another concern for some cancer patients, who might also worry about losing their job or their independence, being a burden on others, or being blamed for their cancer.  Individuals may hold back from talking because they think they’ll cry or lose control. By keeping their fears to themselves, they may think they’re protecting their family members’ feelings.

That was the case with Katrine Bellamy and her husband after their nine-year-old son was diagnosed with brain cancer. A horrifying dream plagued her sleep. In the dream, all four members of the family traveled from their home in San Diego to Memphis, Tenn. for her son’s cancer treatment. Only three came back. “I couldn’t talk about it to anybody. It was too horrible.” Katrine found it difficult to talk to her husband about her fears. “You don’t want to share your worst thoughts because you don’t want to make their grief any worse. You want to protect each other.”

Even though Katrine and her husband might not share their worst fears with each other, they both knew exactly what a worst case scenario looked and felt like. Their four-year-old niece Kourtney had also been diagnosed with brain cancer. Katrine accompanied Kourtney and her mother on trips to the hospital and doctor. She helped care for her and supported the family through Kourtney’s cancer journey.

After her son’s diagnosis, Katrine became very involved with the pediatric brain cancer community. Over the years, she has seen several terminally-ill children carefully choose their words to avoid causing their parents pain.

The Benefits of Self-Disclosure

Despite the risks, multiple studies have shown that in intimate relationships, self-disclosure can be highly beneficial. For example, Michelle found the support she needed through a church counseling program and empathic coworkers.  “I was surprised at how flexible and lenient my boss was for me. She was very understanding. She understood the dynamics of family. Her parents lived far away in India.”

For some people, like Jeannette Patterson, self-disclosure is a tool to help educate the public and reduce the stigma associated with the disease. This was also the case with Tim, who was diagnosed with cancer in 1987. When Tim first mentioned he had cancer to people, he never said what kind. But it was the first question everyone asked. So, he began to disclose immediately that he had testicular cancer. Some of his friends asked why he would share that information.

“It’s funny and silly, but because it involves sex organs, people are more sensitive about disclosing it,” said Tim. “I discovered it’s not that big of a deal once you say it.”  He also came to the conclusion that being more upfront about the type of cancer he had, might help others. “If it makes it easier for other people to talk about their testicular cancer, then it’s a good thing.”

Self-disclosure can also build trust, help people feel less isolated, validate their fears and provide catharsis. After a cancer diagnosis, intimate couples might avoid talking about their feelings and instead focus on less emotionally-taxing conversations about physical symptoms and treatment. However, multiple studies have shown that couples tend to be happier, more supportive, and manage conflict better when they talk about their relationship and view cancer as a problem “we” are facing rather than as “my” or “her” illness.

To better assess how you and your significant other share information and feelings about cancer, answer the following questions:

• To what extent do you work together as a team to cope with cancer?
• Do you talk about how cancer has affected your relationship?
• How comfortable are you telling your partner what you need emotionally and practically to support you during the cancer experience?
• Have you talked about your future plans?
• How much do you share memories and experiences you’ve had as a couple?

This research project was funded by a grant from the National Cancer Institute (CA144235; Dr. Wayne Beach, San Diego State University, Principal Investigator). Co-investigators included Dr. David Dozier from San Diego State University, and Mary Buller, Dr. Valerie Myers, and Dr. David Buller from Klein Buendel, Inc.