When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

If you are in emotional distress, you may have to face a dilemma: whether it is prudent to try to conceal your difficulties from people because you believe that some of them may judge you harshly and critically if they find out you are in therapy, or whether it is likely that they would understand, and perhaps even sympathize, if you were able to be open and had the courage and self-confidence to help educate others on a psychological level. Unfortunately, people in real emotional distress don't have the energy, the courage, or the self-confidence to fight social battles! It therefore usually seems to be a great deal easier to try to keep your own affairs private. But this is not always simple to do.

THE CONFIDENTIALITY OF PSYCHOTHERAPY

Confidentiality as it relates to counseling and psychotherapy is not a straightforward thing; much that has to do with confidentiality is still an unsettled and still debated issue. In reality, there are as yet few laws that fully and genuinely protect personal privacy.

There are two central questions relating to confidentiality that I want to raise here. The first is a question only you can answer. I will try to discuss some of the answers to the second.

HOW IMPORTANT IS CONFIDENTIALITY TO YOU?

Only you can answer this. It may be reassuring to know that, usually, the safeguards observed by therapists are sufficient to protect the personal affairs of clients. And it is unusual for any real or lasting harm come to a client if information about him or her is released.

Many individuals, when they are trapped in a prison of self-concern and self-involvement, are prone to exaggerate or magnify the ultimate significance of being "discovered" in therapy, believing that a release of information about them will be potentially explosive and damaging. Individuals who are emotionally very upset are inclined to focus on threatening aspects of therapy.

We have already looked at some of the ways that a heightened sensitivity to maintain secrecy about your problems can lead to self-imprisonment, to blocks that stand in the way of positive change (see Chapter 1). Most of the information you may want kept secret may not really be as damaging as you first were inclined to think. Much depends on how you respond to information that might be released about you. Let's look at an example.

A little more than a year ago, George Malcolm became seriously depressed. He was forced to resign from his job, and then he received disability income for ten months. During this time he entered therapy. His experience helped him to understand a number of important things about himself that he had ignored in the past. He discovered that he had felt very unsatisfied in his previous job; he had buried his frustrations and had suppressed the anger he felt at being trapped in a situation he disliked. It was a situation he felt he had no control over because of his concern for his and his family's financial security. He was also worried about his mother, who would probably have to be admitted to a nursing home in the near future. Her situation was an added reason for George's financial worry.