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Editor's Correspondence
January 14, 2008

New Support for Long-standing Cautions About Self-disclosure

Arch Intern Med. 2008;168(1):110-111. doi:10.1001/archinternmed.2007.49

The recent exploration of self-disclosure by McDaniel et al1 is a cautionary tale for physicians who struggle to achieve a balance between building rapport and addressing a patient's concerns and medical needs. One may think of self-disclosure as an ingredient in the physician-patient relationship, and the data suggest that it has, so to speak, adverse effects (ie, diverting the therapeutic process). Therefore, it is better to apply the following dictum usually invoked in medicating older people: “start low, go slow.” It is a lot easier to increase self-disclosure later than to back off once you have started down that road.