Cardiac Self‐Disclosure: Clinical and Theoretical Reflections

Abstract

This article explores four primary themes while describing the author's process of advising patients of an imminent open‐heart surgery: the lingering controversies surrounding self‐disclosure, the artistry involved in sharing the information, the management of specific patient reactions, and how the dance between static and dynamic theory application in psychoanalytic psychotherapy unfolds. The author tailored his description of the medical crisis to the distinctiveness of each psychotherapeutic dyad—using a basically scripted but short description of the situation—and he improvised subsequent clinical discussions accordingly. Several patients reacted in surprising ways. Three clinical examples vividly illustrate the above‐noted themes, particularly the uniqueness of each dyad, the need for improvisation, and the application of a cross‐theoretical model (Karbelnig, 2022).