Workshop on Confidentiality
February 7, 2004
Dale C. Godby, Ph.D., ABPP, CGP
Dallas Group Analytic Practice
Psychoanalytic Association Practice Bulletins
“the mere possibility of
disclosure may impede development of the confidential
relationship necessary for successful treatment” (Supreme Court,
1996). [Jaffe v. Redman] A thoughtful discussion on note taking
is found at the following site:
Bollas, C. and Sundelson (1995).
The new informants: The betrayal of confidentiality in
psychoanalysis and psychotherapy. Northvale, New Jersey: Jason
Our political passivity as
therapists has resulted in a loss of privacy that compromises
our work. They suggest we make an argument for absolute
confidentiality and try to get a privilege similar to
lawyer-client, journalist-source, or priest-penitent.
Caruth, E. G. (1986). Secret bearer
or secret barer?—Countertransference and the gossiping therapist.
Contemporary Psychoanalysis, 21, 548-561.
Quoting the Talmud says gossip is
like a three pronged tongue “…because it destroys three people:
the person who says it, the person who listens to it and the
person about whom it is said.” She says “The gossip can be
viewed now as d kind of metaphoric teddy bear, a transitional
phenomenon, which maintains the link with the absent patient
from whom the analyst cannot separate.
Lynn, D. J. and Vaillant, G. E.
(1998). Anonymity, neutrality, and confidentiality in the actual
methods of Sigmund Freud: A review of 43 cases, 1907-1939.
American Journal of Psychiatry, 155, 163-170.
Freud deviated from his own
recommendations regarding anonymity 100% of the time, neutrality
37%, and confidentiality 53% of the time.
Olinick, S. L. The gossiping
psychoanalyst. International Review of Psycho-Analysis 7,
Have all gossiped about a patient
at sometime? Gossip derives from “godsib”, or kinsman and speaks
to the need of close associates to tell tales. Olinick suggests
gossip develops out of envy, isolation, curiosity, and a subtle
sado-masochistic relationship that is organized around the
dominant one with a secret and the submissive one who wants to
know. He describes gossip as the forepleasure derived from
‘auditory scopophilia’ and from the bribed superego.
Rosen, J. (2000) The unwanted gaze:
The destruction of privacy in America. New York: Random House.
“Even the smallest intrusion into
private space by the unwanted gaze causes damage, because the
injury caused by seeing cannot be measured.”
“Hezzek Re’iyyah,” Encyclopedia Talmudit