WHEN PRIVATE PRACTICE TURNS PUBLIC
An Issue of Ego vs Ethics
BY SHARI SCHREIBER, M.A.
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's business whom a therapist is treating - and that goes for their colleagues, their siblings, their best friends--or even, their spouse!
Many years ago, a family member (by marriage) boastfully announced that one of his clients appeared on the cover of a specific high-profile magazine that month. My gut twisted, alerting me something was very wrong with his revelation. It was a breach of ethics. I'd just recently returned to academia in pursuit of a psychology degree back then, and during the course of my schooling learned that my uneasiness about his having shared a client's identity was fully justified. It was considered in fact, a serious, punishable offense.
Protecting the privacy and confidentiality of clients no matter who they are, is 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.
The foundation of a meaningful, solid therapeutic relationship is built on confidentiality, empathy and trust. 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 they were treating them?
I've 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 privacy and confidentiality~ and how shame at the core of their pain sets the stage for suicidal deaths within our film and music industries.
Some colleagues have played it fast and loose with this ethical issue, no matter how many regulatory laws the BBS imposes on them 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 sit, 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 in fact, stopped me from referring-out to them. Is this inexcusable behavior 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 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? History has shown that gossip is almost irresistible to humans. 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 a client's right to privacy, it stinks.
Don't misunderstand. I've cared for these colleagues as friends, 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.
We've 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 defined 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.
So whether it's De Niro, Oprah or the Prince of Pakistan who phones me 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!
So, I'm officially going on record: To all my friends/colleagues, please stop rubbing my nose in your business! If you simply can't resist the temptation of revealing who you're providing help to, don't let it be me! If you're needing kudos or praise from colleagues for somebody famous eliciting your assistance, and you're looking to feel better about yourself, invest in some solid personal inner work to fortify your self-esteem. Perhaps within that process, you can develop enough to outgrow your need to gloat, and quit trampling on the sacred rights (and trust) of others. In short, first do no harm.
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*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.