Let’s Start With the Basics

Psychotherapy is personal. Deeply personal. So it makes sense that anyone considering therapy needs assurance that whatever is said in therapy stays in therapy. That’s why, when I meet a client for the very first time, I spend the first few minutes carefully explaining the rules of confidentiality. 

Here’s how it goes. I do not disclose your information (i.e., what you tell me in session) to anyone or any organization, without your explicit written consent. That means that our sessions are a safe repository for the facts of your life, your hopes, dreams, fears, opinions, regrets, most awkward and painful moments, victories and successes, and anything else you might share with me. As I often tell my clients, it’s like the walls are 400 feet thick. You can talk about anything here. And in a lot of ways, that’s the whole point of therapy. 

There are of course limits to confidentiality. If a client presents an imminent risk of harm to self or others, I am obliged to take steps to ensure safety. If I learn of a vulnerable party at imminent risk of harm (e.g., child or elder abuse), I am obliged to report. Also, if a client is involved in litigation and a judge issues a court order requesting a copy of the clinical record, I am legally obligated to provide it – but I should add that this has yet to happen in my practice.  

Reading this, you might be thinking, yes well that’s all well and good, but there are some things that are too personal to share. Well, maybe. But in my experience, it’s the sharing of those things that one least wants anyone else to hear that turns what could be an ordinary conversation into a therapeutic conversation. That means helping you get out of your head and into some kind of dialogue. Which again, is what therapy is all about.

All of this is to say that confidentiality is the prerequisite, the very foundation of psychotherapy. However, there is a second requirement, and that has to do with how the therapist receives and reacts to that personal information. When sharing personal information, you might wonder – will the therapist will be understanding, or will he/she be judgemental, or shaming? The answer to that question is to say that not only are therapists trained to respond in helpful ways, the process of becoming a therapist involves exposure to so many versions of how a person can live a life, that as a profession, we tend to be open-minded and sympathetic in our view of others. 

So my hope is that you feel that you can invite me into your private world. It’s like taking me on a walking tour of your psyche and showing me around, with me going, wow, that’s cool, or I can see why that really hurt, or why you feel a certain way. Telling your stories to me (the therapist) helps you (the client) realize that all of the stuff you thought was just you is actually typical of the human experience, and it’s that realization that brings us out of isolation and into a more spacious and optimistic view of life. 

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