In Therapy

A user's guide to psychotherapy

Is Your Therapist's Personal Life Confidential?

Mailbag: Finding out about your therapist

People change, hairstyles change, interest rates fluctuate
You readers are tough customers.

Here I am, dishing out riveting journalism on topics like Kleenex, Water Bottles and Letters of Recommendation and you keep reminding me that talking about transference and eye contact and confidentiality might be more useful. You've got a point. This is the User's Guide to Therapy, after all. I need to give the people what they want.

So today I pull a letter from the dusty mailbag with the hope of recalibrating my blog. My stockpile of relevant questions is finally being addressed.

C.Y.A. Note: I'm obscuring all identifying data in these mailbag letters. I'm using the story to launch into a broad discussion of issues, not to provide the world's most unconfidential psychotherapy. If you have a specific problem with your therapist I suggest you to bring it up with your therapist, a point I've made in every article I've ever written. Having said that...

Today we have a disguised and distorted letter from an unidentifiable and possibly fictional reader:

I have been seeing my therapist now for approximately two years, and I recently read an article on a local newspaper's website about a tragedy in his family. He's never mentioned this in therapy (I wouldn't expect him too), but now I'm not quite sure how to handle what I know about him -- do I mention to him that I read the article or should I just keep quiet, as it's part of his personal life?

...and here's the kicker...

I'm not sure I could still go to him for therapy knowing what I now know and not saying something about it.

Fictional Reader X is in a pickle. Therapists don't typically disclose much personal information for a variety of reasons. But FRX here has stumbled on some very personal details and must choose to either say something and breach the unspoken "know nothing about the therapist" rule, or keep it a secret which may be so unbearable as to draw therapy to a premature end. What should she do?

Let's back up. The roots of this problem lie in traditional beliefs regarding therapist non-disclosure. Why don't therapists talk about themselves? I can think of four reasons:

Blank Screen: For therapists of a psychoanalytic/dynamic/Freudian bent, the blank screen is crucial. Dynamic therapists get a glimpse of your unconscious through eliciting your projections. In non-jargon talk, that means we all have certain assumptions about people that say something unique and important about us. Maybe you assume everyone is going to reject you, including your new therapist. Dynamic therapists don't come out and say "Oh no, I'll never reject you!" because then we lose the ability to explore that assumption between us in session. The theory is, the less you know about the therapist, the more likely you are to experience these projections together, first hand. Hence, more self knowledge.

Not Inhibit: If I come out and tell you that I think boy bands caused the downfall of music and perhaps all art, you might be a little reluctant to talk to me about your wonderful time at the ‘N Sync concert. If I tell you about my retirement plan, my political views, my personal struggles and my favorite college football team you might think twice about sharing yours. Or maybe you'll share it, but with some filtering. Therapist non-disclosure sidesteps this by making the focus your background, beliefs and attitudes, and making the therapist responsible for keeping her bias in check.

Protection: Being a therapist is a safe, cushy job, right? Actually, this is pretty dangerous work. One psychologist in five has been physically attacked and some 80% report fearing a physical attack (more here). You never know. As the saying goes, hurt people hurt people. Some of what motivates therapist's blocked phone numbers and limited disclosure of family details is the need to protect our loved ones. No, not from you, our other clients.

Your Time: Some of this non-disclosure stuff is merely about customer service. You came to therapy to be heard, sort out your issues and get help for your problems, not to hear someone else gripe. Many people find this one-way street to be the most appealing part of therapy. Fifty minutes to focus completely on yourself without having to make time for the needs of the other. If a therapist starts taking time away from you by talking about her problems or seeking your guidance for her issues, it's a problem. It's your time, your dime. Therapists can address their junk in their spare time.

So therapists have a reason for keeping their personal lives personal. But there are certainly exceptions to the rule (check out this from Irvin Yalom for a thorough dismantling of the blank screen). Like when sharing some tidbit from the therapist's life would truly benefit the client. Or when the therapist's personal life becomes an issue or obstacle in the client's therapy.

Which brings us back to our letter. FRX could talk about the information she found with her therapist. Mentioning the article and the feelings it brought up is certainly fair game. Frankly, if it's in the news, he's expecting this talk with some clients. She mentions two years of a good relationship with him, so it's probably strong enough to handle one awkward conversation. But she should know that a discussion like this is going to look different in therapy than between friends. It's probably going to be 20% about the details of his situation and 80% about how she feels about it. That's what we therapists do, get you to talk about yourself.

But that's not all. If the therapist is having a personal crisis, it's also fair to ask if he has the emotional resources to provide the best care for her. It's up to the therapist to self-monitor this, but if there is a concern there's nothing wrong with asking. Again, your time, your dime. If he's in session but his mind and heart are elsewhere, that could be a problem.

Most of all, I wouldn't want this therapist non-disclosure thing to keep someone from getting the help they need. In many contexts it benefits both the client and therapist, but if it leads to a premature end to therapy no one benefits.

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You're welcome to send mailbag questions through facebook or my website. I'll get to them eventually!

 

Ryan Howes, Ph.D., is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California.

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