Writing and publishing have always confronted the clinician writer in the child and adolescent field with the dilemmas of confidentiality and consent. This is never more so than in our contemporary digital era, where access to publication of the intensely private can be just a tap of the finger away. This paper discusses the different kinds of clinical writing, and describes the author’s concepts of consent anxiety and writing through. The dynamics of reading or hearing others’ clinical work are described and discussed. The paper concludes that there are no simple guidelines; the clinical writer has to weigh up the risks versus the protective factors for each publication. The need to seek consent and show the patient the material may cast important light on the intersubjective nature of the therapeutic action in this new era of publication.