The Vicissitudes Of Privilege: A review of The New Informants: The Betrayal of Confidentiality in Psychoanalysis and Psychotherapy by Christopher Bollas and David Sundelson. Northvale, NJ: Jason Aronson, 1995. xiii + 204 pp.

THE ISSUE ADDRESSED in this well-written, intentionally provocative, and strongly opinionated book is one that psychoanalysts have been wrestling with for years: whether or not it is ever, under any circumstances, justifiable to breach the confidentiality of the patientanalyst relationship. Because the last few years have seen the increasing spread of mandated child-abuse reporting laws, the application of the duty-to-warn obligation contained in the Tarasoff decision, and most pertinently, the spread of managed care and its reporting requirements, the issue has newly urgent salience.

For this book, Christopher Bollas, a prominent, prolific, British-trained-and-based psychoanalyst, has joined David Sundelson, a California lawyer schooled in literature and psychoanalysis. Their central premise is that any intrusion into the essential confidentiality of the analytic relationship does it irreparable harm. The patient’s fundamental process of conveying everything that comes to mind is irrevocably compromised if the patient knows that somehow, someday, something revealed may have to be communicated to others, perhaps to the patient’s detriment. In a psychoanalytically highly sophisticated discussion, moreover, they