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Therapist's Breach Of Trust
- Post starter Sayre
- Start date
- Status
Something occurred to me- I hope I can express this-
If I 'hear' you correctly it's the breech of trust regarding (her) explicit 'guarantee' as it were, to not speak to others without your consent.
I understand- am in Health Care as well.
And I understand, it's critical to have the anonymity or privacy, and trust, wherein to express freely what is in your mind and heart.
But here- on the forum- we frequently solicit others' 'take' (perspective) on issues.
I can only say for myself I doubt (myself), often; sometimes I go 'too easy' on others however I truly don't walk in their shoes.
I also have a virtual patholical-fear of trusting, and I miss the 'bigger picture' and I can throw the baby out with the bath water.
Someone said on the forum recently- (to get well) we have to seek out (or 'allow', more accurately) people to 'help us' (you know in Health Care those who won't are the most difficult to assist). But fundamentally, (to do so) is the opposite of ptsd.
The people she's consulted with- are they trustworthy and professional? Is it possible that she is not confident about accessing only her own abilities/ experience? Could she be consulting because she is afraid that without a different alternative she will have to recommend something more drastic?
How are you doing with her, do you feel better and are you progressing?
-These might be some of the questions that could be relevant, in deciding what you feel is best to do.
(Sorry if it is too much to say, I know you will know what's best).
((((Hugs))))
If I 'hear' you correctly it's the breech of trust regarding (her) explicit 'guarantee' as it were, to not speak to others without your consent.
I understand- am in Health Care as well.
And I understand, it's critical to have the anonymity or privacy, and trust, wherein to express freely what is in your mind and heart.
But here- on the forum- we frequently solicit others' 'take' (perspective) on issues.
I can only say for myself I doubt (myself), often; sometimes I go 'too easy' on others however I truly don't walk in their shoes.
I also have a virtual patholical-fear of trusting, and I miss the 'bigger picture' and I can throw the baby out with the bath water.
Someone said on the forum recently- (to get well) we have to seek out (or 'allow', more accurately) people to 'help us' (you know in Health Care those who won't are the most difficult to assist). But fundamentally, (to do so) is the opposite of ptsd.
The people she's consulted with- are they trustworthy and professional? Is it possible that she is not confident about accessing only her own abilities/ experience? Could she be consulting because she is afraid that without a different alternative she will have to recommend something more drastic?
How are you doing with her, do you feel better and are you progressing?
-These might be some of the questions that could be relevant, in deciding what you feel is best to do.
(Sorry if it is too much to say, I know you will know what's best).
((((Hugs))))
D
doglover
I'm in health care so I understand the extra need for privacy. I have this big fear that people will find out I'm getting treatment myself and decide I can't do my job...even though I do it as well as anyone else.
Consulting with someone you want to enlist to help your client is common for therapists, sometimes even a requirement of their job. What's less common is to be asked to clear it with the client but you have every right to make that request. Therapists will often try to keep the client in the loop but they sometimes make mistakes. Making a mistake about trust with someone who is working on trust is terrible.
I think the therapist's joke about dissociation means she felt terrible for forgetting the rules you had in place, so was trying to minimize it. Her human emotions getting in the way of the serious treatment you needed for the serious issue of breaking your trust. It would probably have helped you more if she had owned up to the mistake and apologized... and she didn't. I understand how you'd doubt the relationship in this situation. You deserved to have your current T take this seriously.
If you don't feel like she can help you, maybe find a new therapist? If I were in your shoes I'd have that feeling-level desire to wash my hands of the whole therapy world... but that's not going to help you recover either. If you can't trust her, begin looking for someone you feel you might be able to trust.
And you can also bring this problem to her in a session. With any hope, she will have put aside her human defenses and be willing to admit that her actions eroded your trust.
Consulting with someone you want to enlist to help your client is common for therapists, sometimes even a requirement of their job. What's less common is to be asked to clear it with the client but you have every right to make that request. Therapists will often try to keep the client in the loop but they sometimes make mistakes. Making a mistake about trust with someone who is working on trust is terrible.
I think the therapist's joke about dissociation means she felt terrible for forgetting the rules you had in place, so was trying to minimize it. Her human emotions getting in the way of the serious treatment you needed for the serious issue of breaking your trust. It would probably have helped you more if she had owned up to the mistake and apologized... and she didn't. I understand how you'd doubt the relationship in this situation. You deserved to have your current T take this seriously.
If you don't feel like she can help you, maybe find a new therapist? If I were in your shoes I'd have that feeling-level desire to wash my hands of the whole therapy world... but that's not going to help you recover either. If you can't trust her, begin looking for someone you feel you might be able to trust.
And you can also bring this problem to her in a session. With any hope, she will have put aside her human defenses and be willing to admit that her actions eroded your trust.
Lucycat
Sponsor
SimplyComplex, I am with you on this one. I know and trust my T to share information about me when it is in my best interest. He has done so, and has told me so. I am so glad as it gave him an alternative route to take in therapy. One which proved very worthwhile.
When I first entered therapy I was paranoid about who would know and who he would talk to.He was very reassuring. Therapist are only human, they cannot know all the answers. We are a very difficult group of clients for them, even when they have a mountain of experience, every one of us goes into therapy with a different history, different problems and there is no 'one size fits all' remedy ( much as I would like there to be). I think it is important for therapists to share experiences and learn from one another. That is how the body of research is built up.
I do understand the OP feels like it was a breach of trust. IMHO the therapist should never have promised to carry the burden alone, but at the same time I don't think she should have been asked to.
There is no shame in the condition. But given that PTSD comes from situations and events, not from not washing your hands or eating improperly (unless you choked to death and had to be revived), the simple fact is you may not want someone other than your TRUSTED therapist knowing about the event itself.
You THINK they often talk about their clients amongst themselves. You obviously are not privy to their conversations. Have you forgotten that these are human beings? HOW DO YOU KNOW WHAT THEY TALK ABOUT? There is a difference between a therapist asking for your permission to get a second opinion on something, and them going into detail about YOUR LIFE with someone else without your knowledge(as good of knowledge you can get without being there).
That is why I say BE AWARE of what they tell other people. I don't say to tie their hands, I don't say to restrict their rights or techniques. It's called privacy and trust. I let my therapist talk to other peeps all the time. Sometimes I say, hold back that tidbit, or change it to this, and we find a similar situation so that someone I have NEVER met doesn't learn something deeply secret about me. You don't know if they are some power hungry freak who will use that shit against you.
It's probably not commonplace, but it is still very possible. (as someone good at pretending I like people I hate, I can guarantee you it is not that hard to pretend) At the same time I'm not saying all or even very many therapists are like this, most genuinely care, but we are all human beings.
I'm not saying be an information prude or to not let anyone help you. I'm saying to be aware. Don't blindly trust someone because of their job or school. ESPECIALLY NOT IN A FIELD AS NEW AS MENTAL HEALTH.
And when you discuss physical health, a good majority of the time you are talking about something that can be measured or seen. With mental health, ESPECIALLY PTSD, you can't run a bio scan for toxins or blah blah. There is a VAST difference.
And just fyi to yall who think the therapist shouldn't have to "carry the burden alone". They are taught to do that. It really is a rule not to breach confidentiality, so any therapist NOT on a team is breaching that when they tell something without your express permission.
Also, there is a time where they are REQUIRED to spill the beans, and that is if you are a danger to yourself or someone else.
LOL, and fyi, actually being involved in your treatment, instead of just spewing a bunch of stuff to someone with a degree and hoping they can tell you how to change, is a smart idea.
*she must not have gone to a "REAL" therapist's school :confused:*
P.S. SC, your question in chat worked :p
SimplyComplex
Gold Member
I am not blindly trusting anyone. I chose a t based on her education and experience and my comfort with her. And then I had to take a step back and allow her to do her job. Yes, this means putting myself out there for potential disappointment. And...trusting her. I have been let down. I dust myself off and move forward. I don't want to do it "her way" a good deal of the time. But I figure my way wasn't getting me healthier. So I am doing it her way, and so far, it is working.
You know, if she is talking about me as if I am a funny joke at dinner parties then it is on her. It has nothing to do with me. And if she comes in and does her job, she can laugh at me when I go. I want to get better, not make my therapist do back flips to prove their undying devotion...but I happen to trust that mine has my best interest in mind.
I think therapists are allowed to consult other doctors in confidential matters in order to get help with a case. (BTW, they may not give identifying info when they do so). I think the vast majority are staying within ethical bounds when they do so. And I think it is an essential part of the health of their own profession.
I am not saying it is easy to learn to trust your t. It takes a long time, it took forever with me it felt like. But it has to be said that this is important.
You know, if she is talking about me as if I am a funny joke at dinner parties then it is on her. It has nothing to do with me. And if she comes in and does her job, she can laugh at me when I go. I want to get better, not make my therapist do back flips to prove their undying devotion...but I happen to trust that mine has my best interest in mind.
I think therapists are allowed to consult other doctors in confidential matters in order to get help with a case. (BTW, they may not give identifying info when they do so). I think the vast majority are staying within ethical bounds when they do so. And I think it is an essential part of the health of their own profession.
I am not saying it is easy to learn to trust your t. It takes a long time, it took forever with me it felt like. But it has to be said that this is important.
SimplyComplex
Gold Member
what question?
You bring up good points, but how is wanting your therapist to get your permission to share intimate details of your life related at all to this concept?
(in this particular case it was someone specifically revealing their patients info, and I also get and definitely connect with the possibility she made the joke to cover up her own embarrasment)
Part of the trust comes from knowing that your info is in your control. YOU may feel fine with that info being out there, but your life isn't the same as someone else's.
And yes, my therapist has mentioned that sometimes he asks (he is in a partnership [business] with another therapist, who may be a doc, but idk) for second opinions about my stuff, but as you mentioned, takes away identifying factors. But the point is, he came out and asked me if I was ok with that at the beginning.
I'm saying, mostly from my own experience (for two years I was treated for bipolar, which I do NOT have, and actually don't show very many symptoms of, while having PTSD and parent-child relation issues and ODD on my axis 1, and BPT(kid version) on my axis 2, I was in 2 short-term units, and 3 long-term units, all with doctors, therapists, and MHWs discussing my case. Those many teams of Professionals never talked about the abuse, they never did more than ask whether I was having suicidal ideations, and how I was feeling, well one did, my favorite therapist, but that was ONE out of TEAMS) {I put this here to point out the fact that this is an uncertain field, they don't have nearly as much to base their ideas on as the physical field does} that just because they are professionals doesn't mean that they are going to have THE way to change. Especially if you are afraid to tell them something because you don't know how much info they divulge. (I can't speak for anyone else, but I know I have stuff I don't want anyone else knowing)
Which is why you need to be able to trust them. Which is why they need to respect the rules of confidentiality and YOUR trust, and ask for permission to share YOUR info. This truly is not unreasonable, especially if they keep notes, they can just write it down.
So while taking the somewhat hands-off approach feels safe for YOU, this does not mean it is necessarily safe or helpful for someone else. Especially if this is say, their first therapist, or the off chance they were the victim of one of those few bad therapists.
In hospitals, you sign release of information forms before they go to someone else. In mental health hospitals, before you go to the physical doctor, you sign a release. In finding a new psychiatrist, you sign a release. In transferring to a different mental health hospital, you sign a release. Or your guardian. This is STANDARD.
In Alaska, it is LAW. In Alaska, it is LAW that therapists do NOT release ANYTHING discussed in therapy, with the EXCEPTION of possible danger to you or others, and ONLY to the AUTHORITIES, without the patient's EXPRESS permission. It is LAW.
P.S. I mention Alaska law specifically because I have never lived/been treated out of state except for in San Antonio and Idaho Falls. (Had to sign releases there too)
It is a simple matter of asking for permission to share details of someone else's life.
(in this particular case it was someone specifically revealing their patients info, and I also get and definitely connect with the possibility she made the joke to cover up her own embarrasment)
Part of the trust comes from knowing that your info is in your control. YOU may feel fine with that info being out there, but your life isn't the same as someone else's.
And yes, my therapist has mentioned that sometimes he asks (he is in a partnership [business] with another therapist, who may be a doc, but idk) for second opinions about my stuff, but as you mentioned, takes away identifying factors. But the point is, he came out and asked me if I was ok with that at the beginning.
I'm saying, mostly from my own experience (for two years I was treated for bipolar, which I do NOT have, and actually don't show very many symptoms of, while having PTSD and parent-child relation issues and ODD on my axis 1, and BPT(kid version) on my axis 2, I was in 2 short-term units, and 3 long-term units, all with doctors, therapists, and MHWs discussing my case. Those many teams of Professionals never talked about the abuse, they never did more than ask whether I was having suicidal ideations, and how I was feeling, well one did, my favorite therapist, but that was ONE out of TEAMS) {I put this here to point out the fact that this is an uncertain field, they don't have nearly as much to base their ideas on as the physical field does} that just because they are professionals doesn't mean that they are going to have THE way to change. Especially if you are afraid to tell them something because you don't know how much info they divulge. (I can't speak for anyone else, but I know I have stuff I don't want anyone else knowing)
Which is why you need to be able to trust them. Which is why they need to respect the rules of confidentiality and YOUR trust, and ask for permission to share YOUR info. This truly is not unreasonable, especially if they keep notes, they can just write it down.
So while taking the somewhat hands-off approach feels safe for YOU, this does not mean it is necessarily safe or helpful for someone else. Especially if this is say, their first therapist, or the off chance they were the victim of one of those few bad therapists.
In hospitals, you sign release of information forms before they go to someone else. In mental health hospitals, before you go to the physical doctor, you sign a release. In finding a new psychiatrist, you sign a release. In transferring to a different mental health hospital, you sign a release. Or your guardian. This is STANDARD.
In Alaska, it is LAW. In Alaska, it is LAW that therapists do NOT release ANYTHING discussed in therapy, with the EXCEPTION of possible danger to you or others, and ONLY to the AUTHORITIES, without the patient's EXPRESS permission. It is LAW.
P.S. I mention Alaska law specifically because I have never lived/been treated out of state except for in San Antonio and Idaho Falls. (Had to sign releases there too)
Isn't this what happened??
I don't mean to sound snarky but this is a very important issue to me...and to many people I know. This IS the difference between trust in a relationship with a tdoc and just another example of a person letting someone reaching out for help getting let down.
Please don't take this personally.
SimplyComplex
Gold Member
From what I gathered from HIPAA (I couldn't sleep last night), it is acceptable for a t to consult with whom they choose about your case with or without permission, although the notes from sessions are private and can rarely be shared. I think asking your doctor to "not talk about you" is asking them not to do their job to the best of their ability. However, if they agree and don't follow through with that agreement, I think they are still not breaking any actual laws, but it could be causing some issues with trust. I think if you tell your t not to talk about you, its a pretty good bet you don't trust them anyways.
I don't...because I am not even sure of your point here. But wouldn't either way I guess :)
OP, sorry, its an interesting topic. Sorry it got sidelined a bit. But trust with your t is important and only you can decide if you will be able to accept this recent happening. Do you feel like she has your best interest in mind? Or do you think she is a gossip? Are there other times in your life where your trust was breached and you might be having a bit of transference with your t? Junebug had some good questions to ask yourself in order to make your decisions here. Good luck!
I don't...because I am not even sure of your point here. But wouldn't either way I guess :)
OP, sorry, its an interesting topic. Sorry it got sidelined a bit. But trust with your t is important and only you can decide if you will be able to accept this recent happening. Do you feel like she has your best interest in mind? Or do you think she is a gossip? Are there other times in your life where your trust was breached and you might be having a bit of transference with your t? Junebug had some good questions to ask yourself in order to make your decisions here. Good luck!
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