WHEN
PRIVATE PRACTICE TURNS PUBLIC
(Please Stop Rubbing My Nose in Your Business.)
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 siblings,
their colleagues, 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 that month's high-profile
magazine. My gut twisted, informing me this was
a serious breach of ethics. I had just returned to school in pursuit
of my psychology degrees--but my uneasiness about this issue was
validated throughout this 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 stuck an especially sensitive
chord with me--and I've taken a hard line during my career, in reference
to it.
My
sense is, there's a ridiculous irony about sharing a patient's identity,
for the very foundation of a meaningful/solid therapeutic relationship
is built on safety, confidentiality and empathy.
Let's just try to imagine here, that the therapist is a
public figure who's in treatment: Would he/she not be deeply troubled
to learn that their clinician revealed this to others?
I've
assisted some 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 privacy--and
how this 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 actually a difference?
Human
nature delights in its close encounters with fame--but
given this very common tendency, is it really 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 about whom they're
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 client privilege,
it stinks.
Don't
misunderstand. I care for these colleagues, and have greatly 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 diminished. They could balk at this, because "everyone does
it"--but just because something has become standard practice,
that doesn't mean it's acceptable or admirable behavior.
We
have all engaged in collegial dialogues now and then, but I would
never share someone's identity (or even their first name),
with my closest friends. Strict adherence to ethical, sound and
safe practices is a natural outgrowth of emotional and moral development,
and personal integrity is never bound by any rules or laws. It involves
an intrinsic sense of right and wrong that's either instilled in
childhood--or acquired during a lifetime that's navigated some twists
and turns, but built character along
the way. How many march to the beat of that drum? Few,
I suspect.
So
whether it's DeNiro, Oprah or the Prince of Pakistan who phones
for help, you'll never hear about it--at least, not from me.
This revelation concerning one's therapy belongs solely
to the client. It is his/her prerogative to share with anyone, that
they've sought assistance--not the practitioner's.
Okay,
I'm going on record: Dear friends and 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 wanting
kudos, or you're needing to feel better about yourself,
how about investing in some solid personal inner work,
to fortify your self-image? Perhaps then, you can overcome this
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.