tag:blogger.com,1999:blog-26666124.post3421942811927498355..comments2024-03-18T03:28:36.581-04:00Comments on Shrink Rap: Writing about Patients -- or NotUnknownnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-26666124.post-65417253599216437892015-05-15T01:14:48.376-04:002015-05-15T01:14:48.376-04:00No one is, or ever was, a blank slate. Freud inve...No one is, or ever was, a blank slate. Freud invented therapeutic anonymity, yet saw patients in his home. They knew a lot about him, both professionally and personally. Nonetheless, when patients wondered about his life (or inner life) he used their uncertainty in the service of treatment, rather than immediately answering and relieving their anxiety. This approach can be used without being a complete cipher — indeed, in real life that's the only way it CAN be used.<br /><br />Nothing has changed in the age of internet exposure. There will always be questions and concerns in patients' minds, starting with what their therapists think of them. In dynamic work we may use this in the service of treatment, regardless of whether the patient has discovered the name of our dog, or what we paid for our house. (And it's fair game to be curious about the effort they expended to find out.)<br /><br />I admire Gornick's careful attention to confidentiality, her own conflicts of interest, and her effect on patients. She seems a bit purist or over-careful, but I can hardly fault her for that. The inevitability that patients will know things about us doesn't justify pro-actively filling them in. As she wrote, too much grist can clog the mill.Steven Reidbord MDhttp://blog.stevenreidbordmd.comnoreply@blogger.com