By Christopher Bollas
Confidentiality is likely one of the cornerstones of psychotherapy, and but this self assurance is betrayed with expanding regularity. this article makes an attempt to reply to 3 questions: how did this lack of privateness come about?; what does it suggest for scientific practice?; and what could be performed approximately it?
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Additional info for The New Informants: Betrayal of Confidentiality in Psychoanalysis and Psychotherapy
Why did the court miss Lifschutz's central point? Perhaps because he failed to support it. There is no rationale for the duty Lifschutz identi fied, no explanation for his claim (which is only implied) that the disclosure of one patient's confi dential communications causes damage to all of the therapist's other patients. The absence of such a rationale is fatal to the argument. Without it, the court simply abandons the idea of patients as a group. It rejects the notion of a right that exists independent of the patient-litigant who has waived his privacy by placing his mental condition at issue in a lawsuit: It is the depth a n d i n t i m a c y of the patients reve lations that give rise to the c o n c e r n over compelled disclosure; the psychotherapist, t h o u g h u n d o u b t edly deeply involved i n the c o m m u n i c a t i v e treat ment, does not exert a significant privacy interest separate f r o m his patient.
The legislative record re veals recurrent turf wars between different profes sional groups and agencies, all competing for the legislative dollar and the authority and prestige that go with it. In California, one of the casualties of these wars was the discretion originally granted to physicians when they encountered evidence of abuse. " A recurrent theme in the 1978 14 15 14. Another episode in this tale unfolded recently. S. 8 million child abuse grant because the state allegedly failed to meet federal requirements.
435). For Housek, this probably means that the actual content of his treatment, ten years before the law suit, would remain privileged, even though the opinion indicates that final determination would be made by the trial court. To protect the patient's privacy, the trial judge might make this determi nation after an in camera (in chambers) hearing, out of the presence of opposing counsel and of the jury. In that setting, the patient would have to re veal enough information to let the judge evaluate his claim of irrelevancy to the issues of the lawsuit.