WHEN
PRIVATE PRACTICE TURNS PUBLIC
An Issue of Ego versus Ethics
By Shari Schreiber,
M.A.
www.GettinBetter.com
There's
an insidious problem in the psychotherapeutic world, and frankly,
I'm shocked and dismayed by it. Colleagues/friends are sharing the
identities of their clients or patients, and I literally wince
every time it happens. Bottom line, it's nobody else's
business whom a therapist is treating--and that goes for their colleagues,
their siblings, their best friends--or even, their spouse!
Many
years ago, a family member (by marriage) grandly announced that
his therapy client appeared on the cover of a high-profile magazine
that month. My gut twisted, allerting me this was
a serious breach of ethics. I had just returned to school in pursuit
of my psychology degrees--and my uneasiness about this issue, was
later ratified during that course work.
Protecting
the privacy and confidentiality of clients, is supposed
to be of the utmost importance. I've always placed a high premium
on my own privacy, so this issue struck a pretty sensitive
nerve with me, and I've taken a hard line in reference to it throughout
my entire career.
The
a very foundation of a meaningful, solid therapeutic relationship
is built on trust, confidentiality and empathy.
Let's just imagine, that the therapist is a public figure
who's in treatment; would he/she not be troubled to learn that their
clinician defiled their privacy and trust, by telling others about
it?
I've
assisted a few well known individuals, but my professional relationships
have remained just that. No boundaries crossed, no dual relationships--and
definitely no disregard for a client's anonymity. My piece
on Bipolar Disorder
discusses how difficult it is for someone of celebrity status to
seek help, due to fears surrounding loss of confidentiality,
and how shame sets the stage for suicidal deaths within
our film and music industries.
Some
therapists play it fast and loose with this issue, no matter how
many ethical or regulatory laws the BBS institutes to prevent
this kind of boundary violation. It seems they can't resist the
temptation to exalt their egos when a famous individual
has enlisted their care--but from where I'm sitting, it's just plain
wrong, and I'm disheartened by it. This sort of practice does not
raise my esteem for these clinicians, it lowers it--and it's stopped
me from referring-out to them. Is their narcissism showing, or just
their insecurity? Is there a difference??
Human
nature delights in its close encounters with fame--but
given this very common tendency, is it actually fair to reveal one's
secret client to a friend--but swear them to secrecy??
Isn't there something very wrong with
this picture? Oh, they've only told one person? I imagine it could
be surprising to discover how many people now know whom
they've been treating, and have spread the word. Shame on them,
and their naivety! I imagine that 'fame by association'
helps people feel more important/interesting, but when it comes
to ignoring every client's right to privacy, it stinks.
Don't
misunderstand. I've cared for these colleagues, and have also admired
them for years--but the instant they have shared a client's
identity (whether famous or not), my trust and respect for them
is tainted. They might balk at this, citing that "everyone
does it," but just because something has become standard practice,
this doesn't mean it's acceptable or right behavior.
We
have all engaged in collegial dialogues now and then, but I would
never share someone's identity (or even a first name),
with my dearest of friends. Strict adherence to ethical, sound and
safe practices is a natural outgrowth of emotional and moral development,
and integrity isn't bound by any rules or laws. Integrity
involves an intrinsic sense of right and wrong that's either instilled
in childhood--or acquired throughout an existence that's navigated
some twists and turns, but built character
along the way. How many march to the beat of that
drum?? Very few, I suspect.
So
whether it's De Niro, Oprah or the Prince of Pakistan who phones
for help, you'll never hear about it from me.
Revealing that somebody's in treatment is solely the right
of every client or patient. It's his/her exclusive prerogative
to tell others they've sought assistance--not
the practitioner's!
So,
I'm officially going on record here: To my friends/colleagues, please
stop rubbing my nose in your business.
If you've just gotta tell somebody, don't
let it be me. If you're needing kudos, or you're wanting to feel
better about yourself, try investing in some solid personal
inner work, to fortify your self-esteem. Perhaps then, you can
overcome your temptation to gloat, and quit dismissing the sacred
rights (and trust) of others. In short, first do no harm.
*The
BBS stands for The Board of Behavioral Sciences. If you are aware
of a licensed therapist who violates their clients' privacy, it's
perfectly acceptable to advise them that you're uncomfortable with
their behavior--and that if it continues, you may report this infraction
to their governing agency.