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This book intrigues immediately because, even in its title, it provokes our curiosity: What are the many varieties of secrets? How do secrets originate? What are their function? And for this author, most crucially, what are the ethical determinants that guide us to know what to hold secret and what to make freely known?
Control over secrecy and openness confers secrets itself and is a critical factor in the identity of a self or a group. Bok observes that only when infants learn that things, even when hidden from view, continue to exist, can they develop secrets and control over secrecy and openness. What is kept secret and what is not at least partially defines who one is. The capacity to determine from an ethical base what to hold secret and what to reveal is an essential capacity of the healthy person. Also, the keeping of secrets requires empathy: one needs to appreciate just what the other is deprived of, as well as the effect of that deprivation.
For the psychoanalyst, an interesting and perhaps even a vital concern is professional confidentiality. According to Bok, there are four premises which underlie confidentiality: persons have a right to hold secrets, an expectation that confidences will be respected, a presumption that the principle of confidentiality has value beyond that of the shared secret itself, and a claim that additional weight to confidentiality obtains regarding an institution, such as psychoanalysis, which is serving a positive good for the society.
Nevertheless, states Bok, these arguments in favor of professional confidentiality are overridden when confided secrets include plans to injure others, as in the Tarasoff case. Also, confidentiality cannot be used as a shield against wrongdoing. From the ethicist's viewpoint, it is sufficient that one poses these questions concerning professional confidentiality; just how much weight each argument deserves depends on individual circumstances.
Also of interest to the psychoanalyst is the question of t