Therapist's Breach Of Trust

[Sayre]

I've run into a situation with my T that I'm not sure how to handle. In the early stages of therapy a few years ago, my therapist agreed that she wouldn't consult with others regarding me or my case without my prior knowledge and approval. Not too much later, she did just that. I felt betrayed and we had numerous discussions regarding whether the T should be consulting with others in the field without my knowledge, approval or input. The upshot of those discussions was that she (the therapist) again agreed that she would not consult with others without informing me in advance and letting me know the topics of discussion. It took quite a while before the therapy relationship stabilized after that.

More recently, my T has been recommending adding group therapy and I had finally agreed to pursue it further. She gave me the group leaders' name, and I set up the evaluation appt for a Friday morning. This is a well-known, long established group in this area.

During my T session on the Wednesday evening before the appointment, I asked my T if she had spoken about me with the group leader and she said no. The night before the evaluation (Thursday), my T called me at 10 pm to tell me that she had forgotten to tell me that she had actually consulted with the group leader several times about me several months ago and had gone into a good bit of detail about the specifics of my case. Forgotten??!! With the evaluation appointment just a few hours away, I really didn't know what to say to her. I was furious and felt betrayed. I feel I was lied to. At one point during the conversation, my T made a joke about her dissociating and forgetting about the conversations with the group leader. Needless to say, I didn't find anything humorous about the situation.

The following morning I went to the evaluation, and was impressed with the group leader. In typical PTSD fashion, I went in and explained what had just occurred with my T. I should have waited to see how (or if) the GL approached it. But I didn't. Water under the bridge. The GL was unhappy to hear what had happened, and was forthcoming in discussing their conversations. She took the situation very seriously and referred to it as a breach of trust between a client and their therapist.

The rest of the meeting went well, and I asked a number of questions. The one question I didn't ask the GL (didn't think of it until later) was if she, the GL, had been aware that my T didn't have my permission to discuss my case at the time when they had talked, or if my T had misrepresented the situation to her. In retrospect, I really regret not asking this when I could have observed her reaction, because now I don't know whether to trust her, since I no longer trust my T. This whole situation has me feeling seriously conflicted about continuing my therapy in general and about starting the group therapy in particular. I'm also between a rock and a hard place because I have to be in individual therapy to be accepted to participate in the group therapy.

I'd really appreciate any feedback on the situation, possible options, and thoughts on different ways to proceed. Thanks in advance!

 

[ronin47]

It sounds to me like your T is not taking you seriously, which is definately a problem. If she really did so carelessly forget that she had betrayed your confidence, then she isn't giving you the consideration you need and deserve.

If you decide you want to seek a new T, I would handle it like changing jobs. Continue as best you can with the T you have while you search for a new one and don't stop until you have found a new one and can smoothly make the transition. That way you can remain in IT for the whole time and continue with the group. It sounds to me like the GL is empathetic with your concerns surrounding your T's inability to keep her mouth shut and would be a good person to continue communicating with. You've just met her, build up trust with her the same way you would build trust with any other person you've just become acquainted with.

It's hard when someone you were supposed to trust invariably so casually betrays that trust. However, if you shut yourself off from all therapy because of her or even because of a few professionals you may miss out on some tremendous opportunities for healing. I've had my confidence in mental health professionals violated on multiple occasions. So much so that I would seriously feel like I was going to vomit from sheer anxiety while sitting in the waiting room before an appointment. At one point I adamantly told myself that I was "done with therapy." But when I arrived at college and all the beginning of the year stresses began to pile up, I very tentatively decided give it another try with the counseling services at my school's Wellness Center. It was unequivically the best decision I ever made, it saved my life in every way you could possible interpret that phrase.

Keep working at it. Don't let some shallow blabbermouth female stand in the way of your healing.

 

[SimplyComplex]

I do totally get that it is a breech of trust and "forgetting" is a bit odd. I also totally get that you have asked her this and she seems to have made a promise, and that is a huge let down.

...but I struggle to understand why you wouldn't want your t to consult her peers about your case? I really, really want mine to! The more people she can get to help her, the better it is for me. She and my husband's t talk about us often, I can tell. She has mentioned it. And I know there is part of my case that is complicated and outside of her normal client population and my greatest dream is that she will contact other ts that have more experience in it and get feed back on how to help me. I figure it is like asking your oncologist not to bounce your case off other people. And even more, Ts need to get support from their peers in order to be most productive and watch their own reactions. I actually worry my T is a little to sure of herself to get the outside input. And the last thing I want to know is the details of their conversations about me. I doubt they are sitting around laughing about me being an idiot. I trust her to be empathetic and advocate for me, and that is what matters most. But I am not there to do her job, so the details of my notes or of her conversations about me are for her to know.

So what are the fears about her talking about you?

 

[Sayre]

Thanks to both of you for your feedback. It isn't really a fear of my T talking about me as such, but several other issues at once. First and foremost, she broke a promise she had made to me. That is a major issue to me.

Secondly, I'm in the healthcare field myself, so I have the knowledge and background to specifically want to be involved in the ongoing development of her coordination of care plan for me, and she long ago agreed to include me. With her actions, she was excluding me from participation.

Additionally, it's because I am in the healthcare field that I need to have some idea what information about me is being communicated to which individuals and when. My name is well enough known in my area that it could potentially be an issue. I need to know who she wants to talk with in advance to avoid potential problems. It's not acceptable for me to simply find out months after the fact.

And finally, trust doesn't come easily to me, and I've been trying really hard to learn to trust people. This didn't help.

These are the reasons I'm so angered at her betrayal of my trust. Not only did she break the promise she had made to me regarding my therapy, she also tried to downplay what she had done. This makes me extremely wary of discussing much of significance with her in the future. What I'm really having trouble with is how to react appropriately and not lose my way in my healing process when my trust is betrayed.

 

[Tinyflame]

Like SimplyComplex said, all I know is I've often thought I wish somebody -anyone- could make sense of this, because I can't.
But yes, I can understand how you must feel awful. and the valid considerations you've expressed (we double posted).

 

[SimplyComplex]

I do see your frustration and I don't think you should stay with her if your gut says not to. I am not arguing with that. But you asked her to make promises that are binding her hands and keeping her from her normal ability to work with her peers. I won't make excuses for her if she promised and then broke it and lied. But it seems like an unusual request...even though you work in the health care field. No other ts can go around blabbing your info around town. But I think they often talk about their clients amongst themselves, I think they have supervisory therapists sometimes. Or get second thoughts from other doctors.

My husband is a physician. Twice a week he and his partners sit in a room and talk about their patients. I can't imagine him being asked not to. They are all bound by confidential measures, but he needs his peer's input and also a place to bounce ideas off and even vent to when things aren't going as planned. Would you ask your medical doctor not to talk to his peers if he has concerns? Also, hubby is a prominent physician and told his t she can talk to who ever she wants to about him.

I just think if you keep up that defensive stance, you are limiting how your ts can help you and setting them up for letting you down....although I could be wrong. Maybe ts dont work like that at all. Just my impression from the outside

 

[jimmy-joe]

The mental health field is a wee bit different and very much newer than the physical health field. The cases in question don't involve an infection eating at someone's pancreas, they involve often very intimate and private details of people's lives.

It's good to know which of your possibly secret things you told your therapist in confidence have been released to people whom you probably do not know and may not trust.
(My therapist asks me if he can talk about something with someone else, and he tells me who it is and why he wants to discuss it with them.)

 

[Jacquie]

Jugular! Had the same thing happen with the psychologist I saw. Had a BIG DISCUSSION regarding her saying it was confidential completely but then it wasnt. She came out on the attack and said I have trust issues. Me? Hello? CONFIDENTIAL and nothing we discuss will go outside the room. The big chat seemed to pull her back for a while, but then it happened again so I shackled her legally. Sent her (and everyone else) a document which restricted her from speaking to ANYONE else except the one person I had designated.

Guess what? She recommended a different psychologist.

This said to me she never did have any intentions of 'confidential' and if she was made to DO what she SAID she didnt like it. One word. Tough.

IMO it would have been worse to stay in there (in denial) than push the envelope and see it for what it was.

If someone does NOT say to me confidential, then it isnt, thats one thing. But when they go out of their way to reassure you then breach that......I dont care if they're qualified....its a con. And when dealing with people and sensitive issues that is unpardonable. Its likely to drive them further into not trusting the right people and trusting the wrong people. Betrayal acceptance being taught as OK in T? Oh I dont think so.

 

[Srain]

To me it would make zero difference why you would not want her to confer with anyone about your case without your permission...it's ethics and trust period!! She knows that...you obviously know that, she broke that trust once and then did it AGAIN!!!

She has no business being in the field..none! She is morally incapable of following the basics.

Your group leader is upset because she should be! This is outrageous and completely unethical. I would write a grievance against her and see she was formally reprimanded. This is nothing about you having done a thing wrong and all about her failing miserably to build seriously important trust between the client and provider. It makes no difference the reason why you wanted her to not speak to anyone else.

I am sick this happened to you, I'm even sicker this happened twice. I think you need not have given her a second chance but you were more than gracious. I would not see her again and would demand some immediate action on your behalf. I am not sure if where you are at provides your tdocs, but I certainly would never see this person again, it would only be for her benefit and you've done that enough. It seems to me there should be someone more qualified and able to take over and begin to repair the damage this woman has caused on top of everything else.

I'm really very sorry this happened to you :( (((hugs))))

peace and healing,
Rain

 

[Zipperhead]

Are you scared to start group therapy? Are you not ready to make the step and grasping for the excuse? I have signed so many consent forms I really don't know who my Therapist is or isn't allowed to talk to about me anymore. And I don't care. I can talk to her, and that says it all. If your therapist is helping you, then suck back and reload. Don't throw it away. If she's not really helping you, find a new one. And if the Group Therapy is throwing you off, give it time, and do what feels right to you.

 

[Kb3]

I agree that if a therapist's lack of professionalism is interfering with your ability to feel safe and heal, then it is time to let them go. On an emotional level it is hard, because often we feel like we want to give other people second chances, but you have given her a second chance, and again she has let you down. Will it ever leave the back of your mind that she might break your trust again? I know that it would be hard for me to trust that she wouldn't, and that would definitely get in the way of my recovery. So my feeling is that on a strictly practical level, it might be wise to take your business elsewhere.

Ronin47 has a good point when they say not to let a bad experience put you off trying to get better. I have finally found someone who has been able to help me and they are therapist # 5. I'm glad I kept trying until I got it right.

 

[SimplyComplex]

The cases in question don't involve an infection eating at someone's pancreas, they involve often very intimate and private details of people's lives.

Guess I am going to have to disagree here, I don't see much difference. I can see if you have a lot of shame over your condition, then you might not want them to "talk about you". But if they are talking in professional ways and not gossiping, it is a medical conversation. When I first started with my T I knew I had some paranoia about her "talking about me". But I knew it was my issue, and something I needed to work on. She mentioned she talked about me. It drove me a bit nuts, but I had decided to stay out of her business and not tell her what to do so she can bring her best work to the table. I don't get why people would tie their therapist's hands.

As a side note, my t has told me things that aren't 100% truthful (random stuff like "I didn't read your journal this week" when she obviously did). First, I give her a bit of space on it because I trust she is making the best decisions she can to help me. And second, she is human and works in a profession where making mistakes is going to be part of the norm. I don't know where the OP's situation falls in the spectrum...but sometimes we need to step back and allow our therapits do the job we hired them to do.