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Therapy & Confidentiality

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Bees Are Awesome

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Recently I was having conversation with a friend who is a therapist. Upon disclosing that I have PTSD she told me about one of her clients who has PTSD. She didn't use his name but I got enough information about him and his traumatic event that I could probably Google it (which I definitely won't) and find out who he is. I ended up changing the subject because I was uncomfortable. In hindsight I wish I had said something about keeping that information to herself.

So, of course, my effed up brain translated all of that to "I wonder if my therapist talks about my issues with other people." My brain can't stop there so of course I spiraled into a mess of emotions: anxiety, paranoia, fear, anger, sadness, mistrust, etc. What if she does talk to others about me? What if she laughs at me with other people? How do I really know I can trust her? You get the picture.

In my session yesterday I got up the courage to tell her about the situation with my friend and managed to ask her if all therapists were like that. I told her that I wasn't being accusatory and she said she understood. She said that the only person she talks to about her clients is her mentor in cases where she needs additional help or suggestions. She said that was in the information she gave me 3 years ago when I started therapy and that I had signed a release for him. I don't remember any of that but I believe her. She asked me why I don't just straight up ask her if she has talked about me to him but I couldn't. She later asked me how I felt about knowing that she talked to him about me before and if I was now mistrustful but I told her that I didn't know, that I would have to think about it and process it.

Now she's on vacation and I don't have another session for almost two weeks. Since therapy is part of my schedule and my schedule helps to make me feel safe I am a little rocked at the moment.

Has anyone else had to discuss anything like this with your therapist? Were you able to continue to trust him/her if you found out you were discussed with others? Has confidentiality been an issue with anyone before? I don't even really know what I'm trying to ask right now or what answers I am looking for. Thanks for reading.
 
I totally get what you're saying, but I also get the other side of it too, but before going on, it sounds like your friend was not using appropriate confidentiality skills. That being said, I have a friend who's a pastor who counsels, and I am a teacher so there are times i might discuss students with close friends, who are also teachers, but only to share ideas and thoughts! We almost never use names, and I can't even fathom that we would be laughing about our students in a mocking way!

I know that my T has talked about me to other T's and such, but I figure it's just like me talking with my friends. I hope most of us are not cruel and thoughtless and for the most part I think T's got in the business because they want to help people, not because they think we're all dopey! Does that make any sense?

We all need to share our struggles, concerns, and successes sometimes with someone else who understands because its too hard to see things clearly from only in our heads...at least it is for me ha! And that's what we do with our T's too :).

Maybe you might tell your friend who's a counselor that it makes you feel weird, and see what she/he has to say?
 
My T tells me if she talks to her therapist friend about me, she lets me know that she doesn't use names or identifying details. She also tells me why she does, because she isn't sure where to go next and is looking for input or a different angle. I'm ok with it because I trust my T, I also know that if she needs to use an example of clients to help me know I'm not alone in what I'm going through she is very vague, so much so that unless it was a friend who told me those things and said they were seeing my T, I wouldn't know who she was talking about.

So to answer your question, yes I've had similar discussions with me T. I am able to trust her with discussing me to others because I know how very careful she is with what she says. Confidentiality has not been an issue with this T (although it has with past T to very extreme cases).

If you are unsure about how to feel, try asking your T for an example of what they say when discussing you. It might help to know how descriptive/vague they are. I know it helped me, especially when my T uses her other clients as examples, hearing how careful she is to protect their identity and privacy helps me trust her judgment with my sensitive information.
 
I'd trust my therapist and ditch the friend. If the friend can't keep her trap shut when she's morally, ethically and legally bound to, then she has zero credibility in keeping things confident on a friend level. And I'd be tempted to report the friend to the proper governing authority because she's a bad therapist. I mean a primary responsibility is keeping her mouth shut and if she can't, she's in the wrong line of work. What she's doing amounts to gossiping. How professional.
 
I had an interesting thing happen to me the other day: I met a sweet awkward guy at the local bike shop (stay with me, there's more here). At the end of our chat he mumbled something about getting together to go riding, said he worked with local veterans and when he handed me his card it said he worked in behavioral health and early prevention. ( Never mind the shock and me thinking he had figured me out.) I told my therapist about it and said that there was no way I would get to know this guy since they both work in the same field and it is an INCREDIBLY small town, they likely know eachother. I joked that he would most likely tell this guy that I was a complete nut job. But my therapist kindly looked at me and said ' you understand that even if we knew one another and he knew I was councling you, I wouldn't discuss you with him, right?' The good ones aren't going to talk about you except to people they REALLY need to talk to about you. If they do, they shouldn't be doing this. My trust in my therapist is built on knowing that what is said is private.
I agree. Ditch the 'friend'
 
I agree with desiderata and I would tell the friend next time it made you uncomfortable and precisely why.

I think all professions draw upon experience and examples. But I've heard more than I should (due to my own profession) as regards Crisis Lines/ centers (and I personally knew many there or had contact professionally with them for training); as a result it would never be an option to call there and no resource. Not based on what I heard, saw and know. Perhaps had I heard the opposite (respect, professionalism, regard, sound emphasis on 'assistance' rather than disclosure or gossip) I would feel (conversely) inclined to contact them.

I suspect T's are like everywhere else- a few great, a few horrendous, many mediocre.

I think the key lies in the intent, the respect or lack thereof, and the legal grounds and parameters. Also transparency.
 
Editted to add: I would want to say that to the friend but knowing me I would probably simply avoid them and make sure I disclosed as little about myself as possible. The exception being if she was trying to help you, and knows you well enough to know you would not divulge it elsewhere.
 
I agree that what your friend did was totally unprofessional. Having done some counselling training myself I am very aware that this is not acceptable at all, as confidentiality really is of such massive importance.

My therapist I know has a supervisor, who she does talk to about her work with me, and this was agreed and she does tell me when she had talked with them, and why, though I would not expect her to always have to tell me, and have no problem with it at all. Supervision is obviously a very important part of counselling too, as therapists are obviously human, and knowing it is totally confidential, know it is a very good safety net, for both the counsellor and client.

I am glad you were able to talk to your therapist about it, and really hope you are able to find the right way forward with this friend too.

Helen
 
She said that the only person she talks to about her clients is her mentor in cases where she needs additional help or suggestions. She said that was in the information she gave me 3 years ago when I started therapy and that I had signed a release for him

Has anyone else had to discuss anything like this with your therapist? Were you able to continue to trust him/her if you found out you were discussed with others? Has confidentiality been an issue with anyone before?

I'm afraid I'm a bit lost about why you're concerned about confidentiality and trust with your therapist.

I do understand your feelings about your friend. At the same time, your own therapist seems to have behaved impeccably. I've got to say I don't think it would be fair to question trust with your therapist if the only thing she has done is in accordance with a release that you signed.

I might be sounding a bit harsh here, but my intention is to suggest that you look at the situation with your therapist as different from the situation with your friend - because from what you say, they're completely different.
 
Thank you all kindly for your responses. I am still in the process of learning how to talk about myself and what is going on with me. I don't do vulnerable well, even with something as anonymous as this forum.

@Hashi: Simply put, I have trust issues. Though my T has done nothing to make me mistrust her, and we have an excellent and healthy therapeutic relationship, hearing another therapist give out too much information made me think all those "what if" questions about mine. I brought it up at my last session and my T was straightforward with me. Since I have been with her for some time, I forgot about the release I signed years ago and have had no need until now to even remember it. I believe her when she said she doesn't discuss my business with anyone else but her mentor and will continue therapy as usual with her. You are right, the situation with my friend and with my therapist are completely separate. I have learned a lot from this experience.
 
@Unraveling1, I have huge trust issues and just knowing that would make me question my therapist. It is the age when the trauma happened and concrete thinking for me. If a therapist tells about someone, all therapists tell about their patients. Intellectually I know this isn't true, but emotionally I worried so much I told my therapist I didn't want to be dinner party fodder. He said he NEVER talked about me at dinner parties, but at the grocery store, it's a free for all. I actually got the joke and laughed. He also told me he was joking because he knew within a few days I would have known he was talking about me in the grocery store. It is hard. It's very hard.
 
I think this brings up even more boundary issues. Your "friend" is a "friend" and I think that she may be perhaps crossing a boundary by discussing therapy issues with you. Well, its been pointed out that she is violating the boundary of a current client, but what I mean is that she isn't keeping her professional and personal lives separate by keeping her friends as friends and not attempting to "therapize" them.

I have a so-called-friend who I have vented to in the past and since she's trained as a social worker, she thinks that she has a right to give me unsolicited therapeutic advice. I don't want it, and she should know not to dispense unwanted advice in the name of "being a good friend".

It's a big reason why I keep my distance from her and discuss my issues with other friends who listen and support me without psychoanalyzing me. I want a friend, dammit, not a therapist in a friend. It's really annoying to have someone lay on the psychobabble, IE you have transference issues, blah blah blah when all I want is someone to say something like "hey, it's ok" Lesson learned, I don't discuss my problems with her. (I think it's also the same reason why I get weirded out by those who come on here as professionals and try to support us...I don't need another professional, I need peers who understand. Professionals will never be my peers when they're dispensing advice in a therapeutic manner rather than as a sufferer or supporter.)
 
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