Dale Larson Workshop 2 (Half-day)

Workshop Title
Secrets at the End of Life

Purpose/ Objective of Workshop
Participants will be able to

  • Understand the psychology of secrets and the effects of self-concealment on health and well-being before and after life-limiting illness strikes
  • Identify the most commonly reported secrets of patients and families in psychotherapy and end-of-life care
  • Identify strategies for facilitating safe discussions of secrets—whether shared or concealed--and the transformation of shame to pride
Learn strategies for managing the stress of working with trauma, loss, and shame
Secrets at the End of Life

Brief Description
Working with people facing grief, loss, and life-threatening illness ushers us into a world of secrets. Secrets that are most tightly held, such as sexual abuse, self-hatred, family secrets, extramarital affairs, disenfranchised grief, and serious medical conditions, including HIV-status, are painful and often stigmatized experiences. These secrets reflect the core of clients’ inner worlds--the places where they feel least loved and lovable, and most alone. Family secrets and cutoffs, often passed from generation to generation, can complicate mourning and produce the symptoms that bring families into our consulting rooms. We health professionals also have helper secrets--self-doubts that we are reluctant to share with colleagues, unresolved feelings about difficult clinical situations, or anger at patients and family members. Finally, when diagnoses and prognoses are not openly discussed, secrets grow and make the transition from curative to palliative care more difficult and hazardous. Navigating this world of secrets, and sensitively negotiating conflicts surrounding disclosure and the real-world constraints against it, are hallmarks of the effective counselor.

In this seminar we will look at secrets in everyday clinical practice and identify therapeutic techniques and relationship qualities that can bring the dialectic of concealment and disclosure, and the transformation of shame to pride, into the center of therapeutic action. We will draw upon recent work in several areas: self-concealment and health; trauma and trauma healing; emotion regulation; disclosure in therapy; social constraints, stigma, and disenfranchised loss; grief counseling theory and practice; family secrets; journaling and the writing cure; attachment styles; helper secrets; and end-of-life conversations as we explore secrets at the end of life.


Facilitator Bio

Dale G. Larson, Ph.D., is Professor of Counseling Psychology at Santa Clara University, where he directs graduate studies in health psychology, and is a Fulbright Scholar and a Fellow in the American Psychological Association. A national leader in end-of-life care and training in the US, he was Senior Editor and a contributing author for the Robert Wood Johnson-funded national newspaper series,  Finding Our Way: Living with Dying in America, which reached seven million Americans, and is the author of the award-winning book, The Helper's Journey: Working with People Facing Grief, Loss, and Life-Threatening Illness. His scholarly publications on stress management, grief counseling research and practice, self-concealment and health, and transdisciplinary team development are widely cited, both in the scientific literature and in the popular media. Dr. Larson was strongly influenced by his early work with Carl Rogers and Gene Gendlin. A popular national and international speaker, he recently authored a chapter on “A Person -Centred Approach to Grief Counselling” in the 2nd edition of The Handbook of Person-Centred Psychotherapy and Counselling (2013).