Therapeutic Responsibility in the Case of Anne Sexton

There is probably no more fundamental psychoanalytic issue than confidentiality, and it is difficult to conceive how psychodynamic psychiatry could exist without it.

Around 500 B.C., Hippocrates said, “Whatsoever things I shall see or hear concerning the life of men, in my attendance on the sick or even apart therefrom, which ought not to be noised abroad, I will keep silence thereon, counting such things to be as holy secrets” (Slovenko, 1980, p. 1988). We can see that healers were concerned with issues of confidentiality as long as 2500 years ago. Physicians were held to higher standards of discretion than were others, in that even information acquired apart from direct attendance on the sick was to be kept secret.

In modern times, confidentiality has been a cornerstone of medical ethics. As a resident, I was appalled when my Chief of Surgery entered an elevator in which I was describing a fracture to a friend and upbraided me loudly and publicly for gossiping indiscreetly. He was not placated when I explained that the fracture I had been discussing was my own, stating, quite properly, that it had not