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The authors present the reality that in the United States confidentiality in psychoanalysis and psychotherapy is a shambles and that the professions are in a life-threatening crisis. They try to reconstruct how the professions could have allowed this to happen and propose remedial interventions.
The book consists of five chapters. In the first, three California legal cases are reviewed to examine the history of the psychotherapist-patient privilege. In 1969 psychoanalyst Joseph E. Lifschutz went to jail for three days rather than testify about the treatment of a former patient (In re Lifschutz, 1970 2 Cal.3d 415, 467 p. 2d 557). With the advantage of a twenty-five-year retrospect, the authors criticize Lifschutz and his lawyer for not having argued convincingly enough the special need for confidentiality if psychotherapy is to work. In two 1990s cases, the California judges showed that psychotherapy and confidentiality merit judicial protection. Analysts and lawyers in 1970 were naive about the jurisprudential and legislative arenas regarding confidentiality. Lifschutz and his lawyer did what they could with the resources then available. At the time, Lifschutz was a hero for taking his stand and served as an inspiration for a generation of analysts who dedicated themselves to protecting confidentiality and treatment (Beigler 1972; Caesar v. Montanos 1976). It has taken twenty years of “working through,” intermediated by vigorous litigation, legislation, and publicity, to educate the public and the judiciary to modify the sanctity of the ruthless discovery of evidence.
In the book's second chapter, the rapid enactment of child-abuse reporting laws throughout the United States is lamented, and in the third chapter absolute confidentiality as a prerequisite to real psychoanalysis is discussed. A psychoanalytic pair that has to be on the alert for reportable