No Boundary & I’m Spiraling - Struggling with therapist's unclear confidentiality policy

[Midnightmoon]

It's reassuring that other people find it difficult to. My T is almost implying that it's a normal policy and it's my trust issues that are the problem, rather than my take, which is I need really solid understanding of the policy to even think about trusting them with the more difficult stuff. When the confidentiality was broken last year I nearly walked, but I ended up talking myself round and that I was being unreasonable. I asked if we could find a middle ground, but it's been met with more of the same. I'm reluctantly concluding it might be time to find someone else.

 

[Charbella]

Just wondering but last year when you almost walked what was your Ts reasoning?

Did you keep seeing your T out of habit or was it understanding what they did was right, even if you didn’t like it?

Also I find it terrible they’re questioning your ability to trust, I mean shouldn’t they be helping you move the needle on that not using it against you?

 

[Midnightmoon]

They contacted my Dr for something minor, when I specifically told them I didn't consent. I didn't believe it was right at the time, but thought that maybe I was being too dramatic with my history of rubbish trust- I never had therapy before and had no one to ask, so guessed maybe it was just normal and I had to deal with it? Further along in the process I go the more and more of an issue it's becoming. I constantly censor myself, which is never going to end well.

 

[Movingforward10]

I'm in the UK, with a private T who is registered with a professional body. Hugely experienced and knowledgeable. First ever experience of therapy for CPTSD.

I just can't seem to move past the 'no set rule' to the point where I'm thinking I need to walk away. (I don't want to walk, I've done two years and my trust is still really poor, I can't help but panic at the thought of starting again... But maybe my trust is poor because I'm not feeling safe in the lack of boundary )

Every time we've spoken about it, it's like it's my fault for not trusting, but trust when I don't know what I'm trusting is proving virtually impossible

I'm in the UK with a private therapist. And I'm struggling with your T's 'no rile' thing. My T is very clear that she will only break confidentiality if she assesses me or someone else to be at risk of harm. And she takes things to supervision. But she's clear that what she takes is her feelings and very little about me and my story.
My T works by the usual ethics and standards.
So I'm failing to see your T's stance?
Who does she think she will say what to?
I don't even think I ever gave my T my GPs details. I have next of kin, but that's it.

 

[Midnightmoon]

TBH I've never come across a 'no rule' rule before. I've tried to read the professional standards of the body my T is registered with but it just says that Ts will set their own policies.

I'm more than ok with my stuff going to supervision and the like. It's putting stuff on my medical records (usual exemptions of threat to life etc excluded) I have huge difficulty with, which happened last year. Because my trauma has a base of medical issues, I wanted therapy and 'medical' to be very, very separate in my head, so I could hopefully learn to trust one person solidly who didn't represent 'medicine'. My T knows my GP details by accident, which I think is rubbing salt in the wound. I guess I could change GP and then not share it with them, so my fear is then resolved? They have a NOK anyway.

 

[whiteraven]

apperently it's not that. Everythings taken individually and assessed individually, which means I feel completely lost.

Yeah...no. I would NEVER see a therapist who did this.

My confidentiality has been breached before over something that it shouldn't have, which I guess makes me far more cautious of these sort of things.

I had the same issue with a specialist. They sent a two-page letter to a doctor I haven't seen in 10 years, outlining all of my issues (which they had explicitly told me would be kept private and not shared or put on the chart). I left them immediately. Pretty much don't trust any medical provider at this point.

but I would be absolutely OUT if there were no confidentiality policy at all.

Yep. Same here.

They contacted my Dr for something minor, when I specifically told them I didn't consent

It's understandable why you wouldn't trust, just based on your confidentiality being breached before. But even that aside, you are being asked to trust someone who is giving you no reason to. I couldn't talk to anyone who didn't assure me that what we discussed was private and confidential.

 

[Ice_Fire]

I'm finding my T's 'no set rule

Firstly, I’m in the UK too, also seeing a private therapist. Not having a policy is bizarre and I’m unsure where the T stands on the ethics code of BACAP with that in the first place. Which is a red flag because if they’re registered I’m pretty sure a policy of “there isn’t one” would be a no. Can you double check their registration?

1. If they’re private, and are under no obligation to report to anyone (Colleagues, Govt., NHS, insurance, employers, family, etc.) the ‘no set rule’ would seem to indicate that they tailor any info they share by client request? Like someone needs assistance with housing, or employment, or to attend a trauma center

This is where I was going to go with this initially. @friday’s point was something I wanted to echo as my T shared my CPTSD diagnosis to ensure I didn’t have to serve jury duty. But he had my consent for that. And the usual safeguarding stuff aside, he was clear that having no obligation to anyone meant that issues such as employer nosiness etc would actually be him able to protect me. But clearly that doesn’t Seem to be what’s happening here.

constantly censor myself

Bluntly? This is unproductive and regardless of how many conversations you have around it, the trust just isn’t there. I would switch therapists. It sucks to start over, it really does. But this is just a waste of time, effort and money. And I don’t like how he’s making you feel that it’s your fault. Even if unintentional he’s not really making any effort to change that perception. Nah, I’d be done at this point.

 

[Movingforward10]

Not having a policy is bizarre and I’m unsure where the T stands on the ethics code of BACAP with that in the first place. Which is a red flag because if they’re registered I’m pretty sure a policy of “there isn’t one” would be a no. Can you double check their registration?

i was just looking at the ethical code on BACP and it has all sorts of things there about confidentiality and privacy for clients.

So it seems that this T is acting outside of those professional standards?

 

[Friday]

I'm reluctantly concluding it might be time to find someone else.

It sounds like it.

As you’re seeing a private therapist, have you considered seeing someone anonymously?

That’s what I do, to neatly sidestep the entire issue. It doesn’t work if you’re using insurance, or paying by credit card; but as I pay cash (which comes with a massive fee reduction, with most of the people I’ve seen stateside), or use probono services? The only contact info is what I, myself, give them.

 

[Midnightmoon]

I've danced round the topic again today, it feels like the longer this sits the longer any progress is just on hold. I honestly can't believe that the policy is 'nothing is set'. I'm questioning myself if I'm just being silly and over sensitive but I think the comments on here suggest I'm not, then I start talking about it with T and I feel like I'm going mad all over again. They are 100% registered, I've double checked. I can't keep having the conversation with them, it's just constant groundhog day. We're never going to agree :(

 

[Ice_Fire]

From what you’re saying, the therapeutic relationship has broken down over this. Not your fault.

 

[Movingforward10]

I've danced round the topic again today, it feels like the longer this sits the longer any progress is just on hold. I honestly can't believe that the policy is 'nothing is set'. I'm questioning myself if I'm just being silly and over sensitive but I think the comments on here suggest I'm not, then I start talking about it with T and I feel like I'm going mad all over again. They are 100% registered, I've double checked. I can't keep having the conversation with them, it's just constant groundhog day. We're never going to agree :(

Have you told your T that this is a barrier for you to continue working with them? If they know this is preventing you from feeling safe and doing theraputic work, they should really talk to you about next steps.
I'm sorry you are in this position.