Privacy and disclosure in psychoanalysis

The tension between privacy and disclosure in psychoanalysis operates in various ways in analyst, supervisee, and supervisor. Analysts need to maintain the privacy of their patients by keeping their material confidential; they also need to know and share their own internal conscious conflicts to be able to discover unconscious conflicts and their characterological ramifications. Clinical writing is one vehicle for the exploration, discovery, and communication of transference-countertransference issues and other conflicts stimulated by clinical work, but it does not provide the perspective that comes from sharing with another person. Telling a trusted colleague what we think and feel in relation to our patients and ourselves enables us to see our blind spots, as well as providing perspective and affect containment in our work. Mutuality in peer supervision tends to reduce the transference. The special problems of privacy and disclosure in psychoanalytic training are addressed, as are the ways the analyst's belief in maintaining privacy may affect the analytic process and therapeutic relationship.