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said, “...I’m sorry you had to go through that experience...” (p. 65); and “I’m so
sorry that you had that experience with the birth of your child [self- involving
response]. Hearing those words from the mouth of the doctor must have been
awful [advanced empathy]” (p. 62)- When you have made an error. “This makes me feel terrible. I thought I had
[scheduled that appointment for you, included that information in the letter I sent
you, etc.]. Please accept my apology” (Klinger et al. 2012 ).
11.2.2 Some Cautions About Using Self-Involving Responses
Self-involving responses can be risky because they require you to express your feel-
ings. You must be aware of what you are feeling and comfortable enough with your
reactions to discuss them with your patients. Patients may react negatively to your
feelings, or they may ignore them because they’re uncomfortable discussing emo-
tions. You may need to redirect patients to your self-involving statement if they
move on without commenting (e.g., “Can you tell me what you think about what I
just said?”). This will help to clarify confusion or concerns the patient may have
about what you expressed.
Moreover, when you are considering using self-involving responses in difficult
situations (e.g., a patient is angry with you), you need to first reflect on your reac-
tions including potential countertransference (see Chap. 12 ), such as taking the
anger personally (cf. Schema et al. 2015 ), before deciding whether sharing your
feelings is appropriate (Hill et al. 2014 , p. 313; Novotney 2008 ).
Remember also that some members of certain cultural groups (e.g., Chinese
patients) may be uncomfortable discussing feelings directly. In those situations, you
might try discussing feelings indirectly (e.g., “Some individuals might feel reluctant
talking to a genetic counselor because they would not trust her”).
11.2.3 Examples of Genetic Counselor Self-Involving Responses
Here are several examples of the types of self-involving responses genetic counsel-
ors have made during sessions:
- “I sense you’re angry at something. Is there anything I can do to help you?”
- “I get the feeling there’s something I’m not understanding. Can you tell me
what’s upsetting you?” - “I hope you’ve found this information helpful.”
- “I’m sorry that we can’t be more certain about your risk.”
- “I’m concerned about you.”
11 Counselor Self-Reference: Self-Disclosure andfiSelf-Involving Skills