July 29th at 11:42am Pacific Time, a 5.4 magnitude earthquake hit Southern California. This being L.A., there were probably 1000+ people in therapy sessions who were shaken out of their chair. What thoughts raced through therapist's minds?
Safety was certainly the primary concern. Veterans of earthquake-prone regions know what temblors feel like and have their routines - quickly heading outdoors, seeking shelter in doorways or other havens safe from falling objects. Some just stay put and ride it out. Regardless of their behavior, therapists initially wanted to ensure physical wellbeing.
But that's not all. Their client's privacy was another major concern.
I work on the fourth floor of an eight-story office building holding nearly 100 therapists. It's therapy central. The elevators do all their work between 50-minutes past and the top of the hour. We should all chip in for bulk Kleenex.
When this old building started rocking at 11:42 and kept swaying for the next minute, people got out of their chairs and went to the hallway, down the stairs (no one trusts elevators in an earthquake) and out to the street. Picture it: clients and therapists scurrying together, equally anxious, hustling down the stairwell and outside to a busy sidewalk.
This is where things got a little awkward for everyone.
Confidentiality is essential for effective psychotherapy. It's necessary for building trust, which is crucial for allowing honesty, and without honesty we're wasting our time. Confidentiality is mostly about keeping information and details private; keeping what's said in therapy between client and therapist. But for many people, it extends beyond the secrets, stories, feelings and fantasies. A man might want the fact he is seeking psychotherapy to remain private. A woman might want the identity of her therapist to remain private. Some people don't want to be seen entering or leaving a therapist's office. Many of us have separate entrances and exits for this purpose.
So here it is, 11:44am on a Tuesday, clients and therapists hanging out together on Colorado Boulevard. Some therapists who know one another start chatting: "Any of your pictures fall down? Think that was a five-pointer?" Meanwhile, clients stand by, some continuing to talk with their therapists, some talking on cell phones, some just standing quietly. Before long the group splits up, some returning inside and others parting ways - session time is over. Mercifully, for many.
I doubt there were any ethical breeches here today. No therapist blurted: "Hey, I'd like you to meet my client John - he's got the most interesting fetish!" But there was a lot of discomfort. The safety of the therapy office had been intruded upon, the relationship temporarily left the four walls, and for a moment the hidden was exposed. I wonder who felt more awkward, therapists or clients. I hope they remember to talk about how it felt the next time they meet. The safety of the room and relationship needs to be rebuilt.
(Me? I had that hour free. I was going to use it to write my blog, but was procrastinating.)
