Situation with therapist

[Lamename01234]

I have a t that I have a good relationship with and would say from all I have read on here she is a good t too. I saw her first 7 years ago when she was in practice by herself for about a year. Then there was a five year break. Then started to see her again Feb of last year. This time her office had moved and she was in practice with her sister and another therapist. I never thought anything of it. I assumed they talked to each other about their clients and just assumed it might be client x did so and so or friday at 1 client did so and so.
Also the second go around my trauma has surfaced. I struggle with dissociation, onset of tinnitus, body memories, flashbacks and all that good fun stuff....
Last week someone was in the waiting room with me and my t's sister comes out and gets her client and as they walk back towards the offices I SWEAR I hear her say to my t: Sarah is out there.
When I first heard it I thought weird she knows my name. Then brushed it off, got through the session. Then when I got home I thought about it some more and thought what else does she know about me. Which of secrets I confide in her sister with. I think, of course they talk about clients together. How could they not.
There was a two week break and I stewed on this. I thought about writing on here then also imagined everyone would reply: email her, or talk to her about it.
So I did today. About half way into the session. I asked her what does her sister know about me? She said: nothing. I said she knows my name, she said it last time I was here and I described what I heard. She said: nope, didn't happen.
She asked: if I could of heard it wrong? She said she would not of done that if she was with a client. But I swear I heard it.
She asked how I felt and I said that I felt maybe things I say in here are not confidential.
Now I just feel crazy because I know I heard it. I don't know who to believe me or her.

 

[Tinyflame]

I know I heard it. I don't know who to believe me or her.

If you know you heard it, I'd believe yourself.

I'm not sure if one's name insinuates confidentiality has been broken, but if I'm hearing you it's your T's response that adds to it. But, it is also possible to mis-hear, or for her to not have noticed, herself, and therefore not remember. With ourselves though, survival has often been linked to being aware, and things directly or indirectly related to safety, shame, etc, can have more salience.

I overheard a counsellor of sorts I had say, or say in response to someone's question, 'the (x, my profession) girl'. It is/ was enough to make me doubt, whether that be confidentiality, or being in the way, or who knows what?, as I have no relevance to anyone's conversation, and especially people I've shared zero with. But on top of it, I found out something was known about me too, that I did not reveal, and that I cannot shake and deeply hurts and disturbs me.

JMHO however. Hard call to make. Best wishes to you.

 

[kilted]

You are right to be wary.

The initial slip up could be put down to human error, but it's not cool for a therapist to refer to a client's name when there are clients present.

I think hearing your name triggered your subconscious (we are finely tuned to picking up our own name). Your subconscious has correctly sensed that what happened indicates that the practice is sloppy. However your your conscious brain doesn't believe it has enough information to be "sure" of this and this triggers a self-diminishing process with questions like "Did I hear correctly?", "Is it that important?"

You did exactly the right thing in checking it out with your therapist.... and in doing so your intuitive concern that your therapist and their practice is unprofessional was reinforced. So now your subconscious is going "Whoa problems here" while your conscious is still trying to work out what the evidence "means", possibly because there's an underlying issue with trusting your own judgement/intuition.

I'd say there are several things in play
1) The therapist made a slip in public, not an issue if acknowledged.
2) The therapist reacted badly to your concern by not acknowledging the slip and more significantly by saying that the other therapists "know nothing" about you, which your subconscious knows is scarcely credible. This defensive reaction by the therapist has escalated the conflict between your intuition and your rational side.
3) The slip probably means the therapists use names when talking together about clients. This is not professional. My experience with several therapists backs up what junebug says, therapists generally use appointment times and/or initials to denote clients.
4) Your therapist is in practice with a family member. This would raise a ethical flag in because the loyalty to the family member would over-ride loyalty to the client.

My view is that your intuition is correct..... the evidence indicates that the practice is sloppy, so instead of expending energy worrying about it, look at whether you can pursue this further with the therapist, in order to reassure yourself that the practice is well run, which may involve a whole session talking through how the practice handles confidentiality, who knows what, how therapists are supervised, how client notes and contact info are stored etc. Ask for the practice's written policy on client confidentiality.... if they don't have one.... it's not a good sign. While doing this acknowledge that you might have to move practice..... and maybe begin to look around.

These actions use the rational mind to acknowledge and act on your intuition using practical steps in the here and now. This means the conflict is defused and intuition and rationality act together mutually supporting each other.

 

[watundah]

I think kilted said it all. I wouldn't like what happened and I wouldn't like the fact that my T wouldn't even consider the possibility and blew me off. It is a big ding in the trust department.

 

[Lamename01234]

Thank you for the replies and your perspectives. Kilted you wrote out what I could not explain in my head thank you for breaking it all down, it has given me a lot to think about. I guess I was expecting a little more conversation from her and was thrown off by the "Nope didn't happen" off the bat. It surprised me because here is someone that has talked through so much out with me.
It is hard to think about going somewhere else but also hard to think about staying. IDK. Makes me sad.

 

[Tinyflame]

I agree with @kilted , though I thought of one thing before and one thing after reading the above:

In my case it does not involve the professional 'rigor' required within an office, and it's fair to expect it. For me, I was approached by a 3rd party, without witnesses, who was trying to make me feel badly. Whereas any sharing of info I'd rather not be the subject of I don't believe was with malice- indifference perhaps, but that is not malice or intimidation. But also, as Kilted said, my rational mind thinks perhaps I simply look sufficiently 'nuts' that the 3rd party guessed on their own? But tbh, I still find that intimidating because they dislike me so. :(

What I did think before however is that our First Responder Limbic system sees tigers everywhere, and though things may be bad or require remedy, they can take on a feeling of a bigger 'danger' than they are, out of proportion , or that others (especially without ptsd) don't understand why. I'm guarded against the loose term 'intuition' because of the way(s) my non-rational mind can interpret.

But then, trust being so crucial, and so difficult to overcome (or overlook) the possible or actual breaches, it causes cognitive disonance. There have been times I've tried to weigh evidence for or against, always we should include past history, as well as the present, but my stronger desire (which I need to choose to follow or choose to challenge and take on faith it's 'not so' or 'less so' ) is always the one that would be more safe. But it could also be related to what we are choosing to focus on- evidence of danger or evidence of safety, for example. (And too, that's not just interpersonal, but related to environment as well. ) For us it's not small it's big. JMHO.

I think it may also possibly be related to the reality many of us were taken unawares or blind-sided or deceived, during aspects of many of our trauma(s)? ETA, +/or not being believed, not having anyone to trust, witnessing or experiencing similar behaviours, etc etc.

I hate to say this as it's likely maladaptive and unhealthy and wrought with cognitive distortions but I just consider myself not important/ no value so it becomes easier to cut losses or avoid it altogether, or tolerate what people shouldn't. I don't think it's good for you @Lamename01234 to do that. Make the choice that's in your best interests to care for you. :hug:

 

[Sideways]

I think there's a lot of middle ground between it didn't happen and confidentiality is completely out the window.

For example - do they share a receptionist? If so, it's potentially really hard for them to not notice who is in reception. It's not uncommon for docs to keep an eye on the bookings and regularly check who is in reception and who isn't. Is there anyone that looks out of place, is here at the wrong time, or looks distressed, or...

Working in an office setting, particularly (but not exclusively) where secretaries are being shared, it's pretty standard to know the names on files. They're on the file, they're on faxes that come through, emails that come through, phone calls, print outs, receipts and invoices...

To me, in practicality, when I've been showing up for appointments at the same clinic regularly, I kind of assume that the staff in the office are eventually just going to put a face to the name. That doesn't mean that anything else is shared - it may just mean that the T is paying attention to what and who are going in and out of the office during the day...which makes sense given the how distressed and dysregulated a lot of their clients will be.

 

[Lamename01234]

Thank you for the replies. I have read then over trying to digest everything.

I agreed there is a middle ground and thought maybe because of what I am going to describe below a different conversation would of happen.

No, they don't share a receptionist. I have my t's personal phone number for emergencies or schedule changes.

In the office there is a common area where you wait, there is a door that leads to a small hallway. T will come out. Make eye contact and hold door open, you walk back to office and they follow.

There was an Informed Consent form I signed and went back and read. This part stood out in the confidentiality section:
I am involved in clinical consultation to further my knowledge and skills as a therapist. If I need to consult with other mental health professionals about your case, I will do my best to protect your identity. If we happen to see each other outside of therapy appointments, I will generally not acknowledge you unless you have acknowledged me. This allows you to have control over your confidentiality.

A few things that have popped into my head is:
1. I am in the process of divorcing my wife. She is a therapist. One that was sloppy at home with confidentiality. We live a town of about 90,000 people not to big and not terribly small. When I first saw t I was single. Second go around I started back close to my wedding, for help with issues with soon to be wife. Trauma hit right around wedding when my abuser out of nowhere contacted me, unleashing floods of forgotten memories 20 years old. I left my wife 6 months later. She handled everything awfully. Stepping away was the best thing I did. Here is the back story...
When I went back to my t, my wife had just been invited to a support group she ran for therapists that treat a certain type of client. Upon seeing her we discussed in detail confidentiality, that she could never even acknowledge seeing me as a client and she would never discuss anything with her. As my personal relationship started to quickly deteriorate, my wife became jealous of my t. As I could open up to her but not to my wife.
About 4 months ago they both attended the same CE workshop. My wife gets angry when she sees her in public and calls me to yell at me about how my t won't talk to her. Crazy I know. Each time my t tells me she will/has handle(d) everything professionally and has as far as I can tell. There have been multiple times. So yes I trust her, we have navigated this tricky situation and confidentiality with my soon to be ex.
2. Her sister who I have never met is also the EMDRIA consultant for our town and my wife has seen her too for another peer consultation group. My head says, of course she talks to her sister. They have probably had to talk my ex and how to handle her.
3. When I asked t what does sister know about me I thought she would say something to the effect of issues with wife. My name would of come up there. This is where the Nope, never happened, threw me off. I then think is my t so split second sure she never ever said anything she can confidentially say no that fast. Thus leaving me questioning what I heard. When we did talk about it she said her sister would never say something like that with a client. Just would not happen.
4. I have always been concerned everyone in the office in the offices can hear me talk. Utter these incredibly painful words. Recently my t asked me to look around the room and name things. I looked at the wall and there are two panels basically canvas stretched over frames I asked her what they were as there no painting on them. She told me they are just that canvas stretched over framed but inside it is also lined with egg crated as a sound buffer. I have told her I feel everyone can her me. She tries to assure me they noise machines cancel out all noise and voices.
5. Sometimes I want to ask for a time slot when no one is at the office. I have a good feeling that is not possible as they are a 9-5 business. One of the other therapists are always there, rare times we have been alone and the office totally quiet.

I am so sure I heard it and was thrown off by how sure she was it did not happen.

 

[watundah]

Argh. That is sooooo messyl with all of the crossed lines.

First of all, I would run if I thought someone could hear me. The noise buffering efforts sound like there is a problem and I would feel the same way about wanting to be there when no one else is. You don't feel safe to share. Not good.

And all of the crossing lines between wife, sister and T!!! No way.

It is maybe not black and white and folks here are often quick to tell folks to drop their therapist, but you have a lot to think about here..trust, confidentiality, safety, faith in your T are pretty squishy.

 

[Lamename01234]

Thanks Watundah
After some contemplation two things came into play:
I think I was lumping my ex's behavior as a t with sloppy confidentiality onto my t.
I realized this as I ran into my t and her husband in the grocery store sunday night (after posting on here). I freaked, they were checking out as I was walking in. We saw each other. I saw husband. I walked 5 more step thinking of all of the times my ex and I laid in bed; listening to her talk about clients. Then I imagines my t and her husband laying in bed talking about me. I then turned around and quickly walked out. I am sure she saw. Then I got to car and realized I parked right in front of her car. I go so flustered. I drove home for sure I was ready to quit therapy.

Then I decided to phone a friend or two....
I talked to friend #1 who has also seen her. She is also a t and I asked her if she thought there was a chance anyone could hear in the other offices or hallway. She said no way. She also said t is super ethical and could not imagine she would talk about me to anyone.

Friend #2 who saw her at old office but knows her said no way that would happen. She said: "if the t said it didn't happen then it didn't happen." Friend #2 is also a mother of a special needs son. She reminded me when he was first diagnosed and she had to go to inpatient because it was so distressing. When she got home so many nights she said she thought she heard her son call for her and she would run across the hall open the door, only to find him asleep. Even tho she swore she heard him. Just like I swear I heard my name.

So I circle around to it is possible maybe I didn't hear it.
Maybe my t is right when she said c-PTSD causes all kinds of stuff like flashbacks and tinnitus and maybe we can add this one to my list.
She has always handles things professionally and I might need to trust that a itty bitty more.

Yes things are murky being in a small mountain town. I forget how small it is until I write this out. Or go to a real city, were downtown is more than 3 exits off the highway.

I feel pretty bad I accused her and her sister of breaking confidentiality.

 

[Friday]

So I circle around to it is possible maybe I didn't hear it.
Maybe my t is right when she said c-PTSD causes all kinds of stuff like flashbacks and tinnitus and maybe we can add this one to my list.
She has always handles things professionally and I might need to trust that a itty bitty more.

It's also possible you simply misheard, rather than are hearing things, if your name is Sarah.

I have 2 friends named Sarah/Sara. One is constantly jumping, turning, looking, half rising... In crowded places, cafeterias, waiting rooms, etc. The other you nearly have to be all "Yo! Sarah! That's right! You!" ... Because?

Sarah rhymes with "There's a" & half rhymes with "There".

If there's an "air" sound in any word? One of my Sarahs is turning her head to look and see if she caught part of her name. Lol. While the other is all lalalalalalalalala-can't-hear-you-lalalalalala.

"There's a," tilts head towards waiting room, indicating a client, "out there."

Would sound just like "Sarah's out there." If you only caught most of it, and your brain filled in the blanks.