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) boastfully announced that
his therapy client appeared on the cover of a specific high-profile
magazine that month. My gut twisted, alerting me
this was a breach of ethics. I'd returned to academia in pursuit
of a psychology degree back then, but during the course of my schooling,
learned that my uneasiness about his having shared a client's identity
was fully justified. It was considered a serious, punishable offense.
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, even though I have not worked as a state licensed
professional. It always seemed to me, that if we were ethical beings
who innately sensed the difference between right and wrong, we would
comport ourselves according to this principle, and wouldn't need
all the rules and regulations imposed on us by a governing board.
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 feel 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
article 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 at the core of their pain sets the stage
for suicidal deaths within our film and music industries.
colleagues have played it fast and loose with this issue, no matter
how many ethical or regulatory laws the BBS imposes to
prevent these boundary violations. It appears that clinicians
cannot 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 disgusted and disheartened
by it. This sort of practice doesn't raise my esteem for these therapists,
it lowers it~ and has stopped me from referring-out to them. Is
this 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 even 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
would 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 admired
them for years, but the instant they've shared a client's
identity (whether famous or not), my trust and respect for them
is forever tainted. They might balk at this, while citing that "everyone
does it," but just because an action has become common or standard
practice, it doesn't mean it's acceptable or right behavior.
all engaged in collegial dialogues now and then, but I would never
share someone's identity (or even a first name), with my friends
or colleagues. Strict adherence to ethical, sound and safe practices
is a normal/natural outgrowth of emotional and moral development,
and personal integrity isn't confined by any rules or laws.
Integrity involves an intrinsic sense of right and wrong that's
either instilled in childhood or acquired throughout a lifetime
that's navigated some challenging twists and turns, but built character
along the way. Just 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 engaged your services, is solely
the right of the individual who's paying for them! It's his/her
exclusive prerogative to reveal to others they've sought
assistance~ not the practitioner's!
I'm officially going on record: To all my friends/colleagues, please
stop rubbing my nose in your business.
If you just can't resist telling someone who you're treating, do
not let it be me! If you're wanting kudos for somebody
famous eliciting your help, or you're needing to feel better
about yourself, invest 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.