Therapists are not immune to the complexities of grief, trauma, and healing. Many of us are drawn to this field because of our own lived experiences—particularly in perinatal mental health, where personal histories with infertility, pregnancy complications, birth trauma, or postpartum struggles often inform our work.
The show Shrinking offers a dramatized look at what happens when a therapist’s personal life starts to influence their clinical work in unexpected ways. Jason Segel’s character, Jimmy Laird, is a therapist grieving the loss of his wife, and instead of maintaining professional distance, he begins self-disclosing extensively, pushing ethical boundaries, and emotionally over-investing in his clients' lives. While exaggerated for entertainment, the show raises real ethical questions that therapists must navigate in their actual clinical work:
How do we balance authenticity and professionalism?
When is self-disclosure helpful, and when does it blur boundaries?
How does unprocessed countertransference affect our ability to hold space for clients?
These questions are especially relevant for perinatal therapists, many of whom enter the field because of personal experiences with fertility, birth, or postpartum struggles. Unlike in Shrinking, real-life therapists don’t have the luxury of disregarding ethical considerations. Instead, we must engage with our experiences thoughtfully—using them to strengthen, rather than complicate, our clinical work.
The Complex Role of Therapist Self-Disclosure
One of the biggest ethical dilemmas therapists face is: Should I share my own experience with a client?
In Shrinking, Jimmy often self-discloses impulsively, prioritizing his own need for connection over his clients’ needs. While this makes him relatable, it also creates role confusion. In reality, self-disclosure must be intentional, boundaried, and clinically relevant.
According to Touchstone instructor, Emily Spencer, MS, LPC/LCPC, PMH-C, BC-TMH, "When used thoughtfully and intentionally, [self disclosure] can benefit clients in a number of ways." Research suggests that thoughtful self-disclosure can strengthen the therapeutic alliance and normalize a client’s experience (Pinto-Coelho et al., 2018). However, it should never be used to fulfill the therapist’s own emotional needs.
For perinatal therapists, self-disclosure can feel particularly tempting. If a client shares an experience with birth trauma or NICU parenting that mirrors the therapist’s own, it may feel natural to say, “I’ve been there too.” But the question therapists must ask themselves is: Who benefits from this disclosure?
Before sharing, therapists should consider:
Is this disclosure in service of the client’s healing, or am I seeking connection for my own comfort?
Am I maintaining professional boundaries, or am I shifting the focus onto myself?
Is this disclosure necessary, or would it be more effective to hold space for the client’s unique experience?
Because self-disclosure is often viewed as taboo in some training models, many therapists hesitate to use it at all. However, as Emily points out, when done with intention and care, it can be a powerful tool for connection and validation. The challenge is knowing when it enhances therapy versus when it blurs the boundary between therapist and client.
Countertransference: When the Client’s Story Feels Too Personal
Countertransference occurs when a therapist’s personal experiences, emotions, or biases unconsciously shape their responses to a client. This is especially common in perinatal therapy, where many therapists enter the field after navigating their own fertility, pregnancy, or postpartum challenges.
Emily shares, "I was drawn to perinatal work after my own experience with severe preeclampsia requiring me to give birth to my son at 31 weeks gestation. While my son spent 6 weeks in the NICU, I vividly remember the emotional toll it took on me as a first-time parent AND counselor."
Likewise, many perinatal therapists find their work shaped by personal experience, which can enhance empathy but also increase the risk of over-identification. Without careful reflection, this can lead to boundary blurring and emotional exhaustion (Cruciani et al., 2024).
"I recognized a lack of training or fear around self-disclosure and believe it's important for therapists, especially perinatal therapists, to understand how their lived experiences can contribute to therapy outcomes when utilized thoughtfully and intentionally." — Emily Spencer, MS, LPC/LCPC, PMH-C, BC-TMH
Recognizing countertransference isn’t about eliminating it—it’s about engaging with it ethically and with self-awareness. By acknowledging and actively working with countertransference, therapists can turn their lived experiences into a strength rather than a potential pitfall.
Compassion Fatigue & Burnout: When Empathy Becomes Exhausting
Perinatal therapy is uniquely demanding. The work requires holding space for grief, loss, trauma, and anxiety—often on a daily basis. When therapists have their own histories of perinatal challenges, the emotional load can feel even heavier.
Without intentional self-care and professional boundaries, therapists are at risk of compassion fatigue and burnout—which can impact both their well-being and the quality of care they provide.
Hou & Skovholt (2020) found that highly resilient therapists engage in active self-care, maintain clear professional boundaries, and seek ongoing support through supervision and peer consultation. Without these strategies, therapists risk internalizing their clients’ pain, leading to diminished well-being and effectiveness.
Bringing It All Together: The Wounded Healer in Perinatal Therapy
Rather than ignoring or suppressing our own histories, we can engage with them intentionally—turning lived experience into a source of insight, connection, and clinical wisdom. But that process requires ongoing reflection, discussion, and training.
Emily believes that perinatal therapists "need to understand how our own lived experiences can enter the therapeutic space and affect our work."
The Perinatal Therapist & Wounded Healer: How Lived Experiences Shape Our Practices
🗓️ April 10, 2025
Learn how to thoughtfully turn lived experiences into strengths that enrich the therapeutic process in perinatal work.
This training will provide:
A structured framework for self-disclosure—so you can decide if, when, and how to share.
Guidance on recognizing and managing countertransference—so you can maintain professional neutrality.
Tools for preventing burnout and compassion fatigue—so you can continue doing this work sustainably.
If you’ve ever struggled with when to share your own story, felt emotionally activated by a client’s experience, or worried about the toll this work takes—this training is for you.
Unlike Jimmy in Shrinking, real therapists don’t have the luxury of throwing boundaries out the window. However, we do have the ability to reflect on our experiences, engage with them intentionally, and use them to strengthen—rather than complicate—our clinical work.
References
Cruciani, G., Liotti, M., & Lingiardi, V. (2024). Motivations to become psychotherapists: beyond the concept of the wounded healer. Research in Psychotherapy, 27(1). https://doi.org/10.4081/ripppo.2024.808
Hou, J.-M., & Skovholt, T. M. (2020). Characteristics of highly resilient therapists. Journal of Counseling Psychology, 67(3), 386–400. https://doi.org/10.1037/cou0000401
Pinto-Coelho, K. G., Hill, C. E., Kearney, M. S., Sarno, E. L., Sauber, E. S., Baker, S. M., Brady, J., Ireland, G. W., Hoffman, M. A., Spangler, P. T., & Thompson, B. J. (2018). When in doubt, sit quietly: A qualitative investigation of experienced therapists’ perceptions of self-disclosure. Journal of Counseling Psychology, 65(4), 440–452. https://doi.org/10.1037/cou0000288
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