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Monday, February 28, 2011

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This is really interesting based on my experience-- that instinctively, I didn't talk about what went on in therapy outside the context of therapy. I don't think I felt a feeling of a need to protect intimacy-- and it may be because it didn't rise to that level of rationality.

I think instinctively I knew talking "out of school" would color my ability to be open in some way even if I was determined not to let it. It may be also as a lawyer dealing with confidences myself, picking up the other side of the transaction was natural. Are confidences inherently a two-way circuit?

Although I suspect there's probably an entirely different functioning of confidences for a lawyer and a therapist. I gave a CLE lecture once about how the ethical standards for lawyers and social workers functioned differently (to an audience of both, in a conference about elder law). I was really struck by how unstated differences of conception of duties were doomed to produce communication failures between the two-- e.g. social workers have duties to community and duties to disclose that can trump duties to a client in ways that are startling to a lawyer.

Inasmuch as I have not sought the help of Psychiatry/Psychoanalysis, I do not know about the professional/patient privilege involved. I can only relate it to attorney/client or physician/patient privilege, of which I am aware, and social worker obligations (which got some of them maimed or murdered) while I was involved(indirectly) with that public assistance profession.

I seem to recall the Hippocratic Oath saying something like, 'first, do no harm.'

What is my point? There is a question of balance somewhere in here. Recent tragedies have shown that the privacy of individuals does not trump public safety. "see something, say something" smacks of the big brother whip of totalitarianism? I agree. But how are we to protect the innocent when freedom is more sacred than responsibility?

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