"The important issue for anyone training is that we have to be able to learn from the experience of others. If nobody ever related patients’ stories then this would be impossible"by Anna Blundy / March 26, 2015 / Leave a comment
Published in April 2015 issue of Prospect Magazine
I’m on a flight to Frankfurt sitting next to a Colombian woman who is married to an Englishman. She’s complaining about his lack of passion, his reserve, his failure to satisfy her physical needs. “I have a psychotherapy patient from Latin America. She has an English husband and says a lot of the same things as you,” I say. My patient is clear in my mind—her words and mannerisms are so familiar to me—and yet I feel I shouldn’t be talking about her to this stranger on a plane, even though I say no more than this and haven’t even identified her country of origin.
In the NHS, confidentiality means you can’t identify a patient such that someone else would recognise them. But what is in a way the most personal material—dreams, fears, the inner world—is discussed in well-attended seminars.
The trouble is, patients are part of the family—the mind’s family, at least. Therapists often see them in their own home. Mine—though as a trainee they are few—are always in my thoughts. I’ll read an essay by Sigmund Freud and apply it to them (as well as to myself). I mention them to my children, though I know I shouldn’t. “I had a patient this morning who has a recurring dream about turning up for her GCSEs naked,” I tell my son on the way to an exam. He laughs and I hope he feels better. I changed finals to GCSEs and there are no identifying features. But was the patient’s session fully confidential? Not really.
For, although this kind of confidentiality is crucial for the therapist/patient relationship, it’s breached all the time. In supervision groups we discuss our patients in minute detail for hours at a time—up to 15 people might think and comment,…
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