PRIVATE PRACTICE TURNS PUBLIC
An Issue of Ego versus Ethics
By Shari Schreiber,
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!
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.
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.
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 and angry to learn that
their clinician defiled their privacy, by telling others about them?
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.
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 own 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??
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 or interesting, but when it comes
to ignoring every client's right to privacy, it stinks.
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.
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 personal 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 had to navigate some challenging twists and turns, but built
character along the way. How
many march to the beat of that drum?? Very few, I suspect.
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
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 for someone famous seeing
you for help, 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 trampling on the sacred
rights (and trust) of others. In short, first do no harm.
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.