Shirah Vollmer MD

The Musings of Dr. Vollmer

Archive for the ‘Confidentiality’ Category

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.

Posted in Confidentiality, Guilt, judgment, Psychoanalysis, Psychotherapy | 4 Comments »

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