Jumpstarting the Talking Cure

The “talking cure” originally referred to psychoanalysis, the brand of therapy made famous by Sigmund Freud and his followers. Today the phrase describes a very wide range of psychotherapeutic approaches, including psychoanalysis, that begin with clients, well, talking about themselves—their experiences, relationships, thoughts and feelings. Frank disclosure is considered the cornerstone of a trusting therapeutic alliance—and thus key to psychological healing and well-being.

But people don’t always want to disclose their inner lives, even when they seek help, and one of a therapist’s most difficult challenges is to nudge clients who are guarding their privacy. It’s often a painstaking process to build rapport and foster openness. Indeed, the pace is a luxury that many patients cannot afford in the era of managed care and short-term interventions.

Might there be a faster, more efficient way to encourage reluctant clients to reveal themselves? Arcadia University’s Steven Robbins and his colleagues decided to turn to psychological science for clinical insights that might be useful in the consulting room. Specifically, the researchers wanted to explore an area of cognitive psychology called priming, which has shown that words can—outside of awareness—activate certain thoughts and expectations, and thus shape behavior. Robbins wanted to see if this well studied laboratory procedure might be used to promote openness in the early stages of therapy.

The scientists recruited a group of young adults, predominantly white women, to study the idea. The volunteers believed that they were taking part in a study of what makes a good candidate for therapy. Under cover of this ruse, they completed a scrambled word test, which unbeknownst to them, contained several priming words. Half the volunteers were exposed to words related to openness—candid, communicate, free, and so forth—while the other half saw words suggesting wariness—concealed, quiet, shy, restricted. The idea was that those exposed to words related to openness would subsequently act more openly, revealing more of themselves.

They tested this by having all the (now primed) volunteers write two short essays. The instructions for the first were: “Describe the best thing that happened to you in the past 30 days and how it made you feel.” The second read: “Describe what you like best about yourself.” Robbins wanted to see which volunteers revealed more of themselves, their private thoughts and intimate feelings. He had independent judges read and code every essay, tabulating how many words each volunteer wrote, and how many phrases were related to feelings and self-image.

The results were unambiguous. As described in a forthcoming issue of the new journal Clinical Psychological Science, those volunteers who had been primed for openness were indeed more open and free. Not only did they write significantly more in general—nearly twice as many words as those primed for secrecy—they also wrote much more about their feelings. That is, the priming worked as hoped—nudging people to disclose more of themselves.

It’s not entirely clear from these preliminary findings whether general verbosity led the volunteers to reveal more personal feelings, or the other way around. But either way, the fact is that a simple priming exercise led these volunteers to express more of their feelings. This was the goal, and the laboratory evidence has therapeutic implications. Most obviously, therapists might be able to prompt greater openness simply through their word choice during the course of the initial therapy session—discussing the importance of openness and avoiding words suggesting guardedness and privacy. What’s more, therapists might want to be more mindful of the brochures and other written materials they leave lying around the waiting room. Materials that describe mental disorders and symptoms might have the unintended consequence of priming negativity and diminishing the therapeutic experience.

Excerpts from Wray Herbert’s two blogs—“Full Frontal Psychology” and “We’re Only Human”—appear regularly in The Huffington Post and Scientific American Mind.