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The betrayal of confidentiality in psychoanalysis and psychotherapy is the subject of this important book by Christopher Boilas and David Sundelson. Boilas, a Member of the British Psycho-Analytical Society, and an Honorary Member of the Institute for Psychoanalytic Training and Research in New York, and Sundelson, an appellate lawyer and university teacher of literature and psychoanalysis,
view managed care as the “single deadliest blow to confidentiality” (p, 130) among the many outlined here. This small volume was produced after years of conversations with psychoanalysts and therapists in the United States, Europe and South America. The authors found “a profound confusion among even well-qualified clinicians about confidentiality and about the analyst's obligation to preserve privilege” (p. xii). In addition, the “fear and despair” (p. xii) that grips North American clinicians was difficult to “adequately convey” (p. xii),
Bollas and Sundelson set out to answer three questions: How has the privilege between analyst or therapist and the patient been eroded in situations where it legally exists? How does the erosion of confidentiality impact on clinical practice? What can we do to reverse the trend?
The law recognizes several relationships as special and thus exempts them from the normal requirements of court testimony: those between attorney and client, priest and penitent, doctor and patient (first stated in the Hippocratic Oath), journalist and source, and husband and wife. The U.S. Constitution guarantees the right of privacy. The right to unbreached confidentiality has been established in some of these relationships by common law, i.e., by judges in the U.K. and the U.S. However, privilege between psychotherapist and patient, in the American states where it exists, has been established by statute (legislative decision). To date, 28 states have statutes covering social workers. The authors wonder how many therapists either know about or believe in privilege sinc