Shirah Vollmer MD

The Musings of Dr. Vollmer

Privacy vs. Secrecy

Posted by Dr. Vollmer on August 16, 2012

Therapy is a play space, a circumscribed time, a specific place, where ideas can flow without consequences. It sounds like a dream come true for some, and an anxiety laden area for others. Within one person, there are times when both are true. Yet, people carry secrets in which the disclosure, even to a therapist, is filled with guilt and shame. Meredith, a devout Catholic, was having an affair with her male yoga teacher. Her shame and guilt around this activity made it intolerable for her to talk openly about it with me for many years, until ultimately, she wanted to “shine light” on this area of her life. Why did she decide to do it now, I always wonder. Is the “why now” issue a function of a deeper trust in our relationship, or is it that something happened in this affair that she felt like she needed to talk about it, or are both true? “This is a secret within a secret,” I say, highlighting that everything that happens in our relationship is private, or a secret, yet even without this private space, there are deeper private spaces that I am not privy to. This is always true, but in the case of Meredith, this deeper space was pressing on her consciousness causing her to feel bad about herself, yet happy and excited at the same time. The uncovering of these private spaces is the exploration of therapy. The timing and the content of these areas are what make psychotherapy a unique and ever fascinating process. Did I suspect that Meredith was having an affair? Yes and no. I detected a terrible sense of unease about her, such that there was a constant feeling which we discussed, that was pointed towards deep personal discomfort. Is there hope now that this secret has been exposed? Yes and no. Meredith worries that I judge her, even though, the problem is that she is judging herself. On the other hand, she feels relieved in the disclosure. Our work has deepened. We have had a before and after moment. She looks closely at me to detect my reaction. I look closely at her to see how she feels now that she has told me. There is intensity in the room. My job is not to look at the moral or ethical implications, but rather to help Meredith understand how she got here, to help her see how her brain leads her down a decision tree which ultimately has deep emotional consequences. Understanding is my job. Judging is her assumption. As we walk the narrow path between feeling understood versus feeling judged, Meredith might learn to heal herself from her bad feelings. She might begin to repair her relationships with those she deeply cares about. Maybe.

4 Responses to “Privacy vs. Secrecy”

  1. Jon said

    Now that you and Meredith have crossed the metaphorical Rubicon together, as Julius Caesar has said crossing the actual river, “the die is cast,” for there is much to be done in understanding Meredith’s intertwined decisions and emotions. Meredith’s guilt and shame are important feelings that need to be understood, as best they can be.

    Shirah, you and I have discussed the guilt before in this forum. I have stated that intellectually, guilt is a silly emotion. If one thinks about what one does and will do, and one will have guilt after doing it, then the situation is analytically simple. Just, don’t do what would make one feel guilty. However, as we have discussed, the intellect is far from the only motivator the controls peoples decisions and actions. As you have noted, Meredith, is in a “deeper space … pressing on her consciousness causing her to feel bad about herself, yet happy and excited at the same time.” Your and Meredith’s joint job of understanding can now begin, for without a true understanding, Meredith’s self judgment could not be just.

    • Thanks, Jon. As you have illustrated, thinking is not a linear process. There are a multitude of conscious and unconscious factors which contribute to decision-making. This variety of issues is what can lead to the guilt, in that at one moment, one has one set of priorities (eg immediate satisfaction) and then at another time, the priorities change (maintaining long-term relationships). As the sea changes, the waves of priorities shift, thereby causing a reflection which can cause some very complicated feelings of guilt, shame, and joy. Also, as I am sure you are aware, it is not that I think this “the secret” which is finally uncovered, but this is one of a series of shameful feelings that Meredith has kept private from me, and maybe from herself as well. The depth of these private experiences are endless, making my work continually fascinating. Thanks Again.

  2. Shelly said

    Why does Meredith feel that you judge her, if that is not your role as a therapist? I ask because you might want to explore that more with her. If she feels that you are judging her, then her not fully opening up to you can’t be a healthy patient-therapist relationship. It means that she doesn’t fully trust you and this does more harm than good. I’m sure you’ve explained that you don’t judge her ethics and morals, but something in your interactions has set off alarms in Meredith in which she feels that she must be guarded. That needs looking into.

    • Thanks, Shelly. Trust is not a binary issue. Trust deepens over time. It is not that Meredith, or any of my fictional patients, trust or do not trust me/ The issue is the level of trust. As we work together, and indeed in all relationships, the trust has a to and fro process, which hopefully leads, over time, to a greater level of sharing intimate thoughts, feelings and actions. In addition, there is an issue of trusting oneself. Meredith has to trust herself to handle shedding light on some secrets which she keeps to herself by not hearing herself talk about them with anyone. As she trusts herself more, she will begin to make peace with some of the inner workings of her mind. Meredith is worried about my judgment of her, and she is also worried about her judgment of herself. This judgment leads to inhibitions which need to be explored. So, it is not that the patient-therapist relationship is unhealthy, but rather, we are involved in the work of creating a “play space” which will help her feel more comfortable to allow her ideas and feelings to flow more freely. So, I respectfully disagree with the idea that our relationship is doing “more harm than good”. Our relationship is working towards unraveling some very delicate mental processes and this requires time, patience and commitment. Meredith and I are both engaged in the process, so as far as I can see, there is more good than harm. Having said that, as with all interventions, psychotherapy has the potential to harm people, so I appreciate you reminding me of that, so that I can monitor that more closely. It is a scary, yet realistic notion, that harm can come from good intentions, so being mindful of that, is helpful. In other words, thanks for your words of caution.

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