My lips are sealed: Confidentiality and blogging

20170417_034323It’s been a while since I took to the keyboard but not for a lack of trying. On the contrary, ideas have been coming to me without having the courtesy to pause and take concrete form- writer’s block. But I’ve also been considering the ramifications of what I want to write. This blog is about my perspective but interactions with others are inevitable and necessary. Ultimately, writing about my experiences means writing about the experiences of others. But what right do I have to their stories?

Confidentiality is a fundamental and precarious pillar drilled into the head of every psychologist-to-be. I recall speaking to a psychotherapist about how strict the principles of confidentiality truly are. Can you reveal confidential information to the spouse? Nope. Can you approach the person if you meet in public? Not at all. Can you discuss the person with another colleague? Nada. Can you report them if they’ve committed a crime, such as theft or rape? No.

 “As long as they are not going to harm themselves or anyone else, now or in the near future, it stays confidential

The universal consensus is that, short of a subpoena, we keep our mouths shut. No one should be able to connect the privileged information to the identity of the person. So how can I share my accounts while keeping other’s under wraps when they are so blatantly fused together? How do I prevent breaching this defining aspect of being a psychologist? At first I decided to only blog about instances restricted to myself but that results in a paucity of posts and those that’d make the cut would be littered with holes. Even the choice to change names as I would with participants for a research project is not enough.

Funny thing about the world, it’s small. Fresh out of high school a psychologist granted me a monumental favour by taking me under her wing and letting me intern at her practice. One of my charges was a teenager and once or twice a week we’d work on tasks that would strengthen fine motor skills, such as stringing beads or sketching. Apart from that there was no other contact. One day a task required bringing in photographs and I happened to chance upon one of their family. In it was someone I knew from school and until then I’d never made the connection that they were related.

Lahore is the second largest city of Pakistan with a population of over 18.6 million, yet that number was dwarfed in the face of coincidence. To maintain professionalism I said nothing. Nevertheless, a few days later I was contacted by that same relative and asked to keep this new found knowledge to myself. How easily the line between professional and personal life can blur and even this vaguely described anecdote could easily be deciphered by that relative today. What are the odds that a person would find my blog, bother to read it, stumble upon the exact post that refers to someone they know and get past my oh so cryptic wording? Probably less than 1:18,600,000, but that 1 can still happen.

And it’s not just about me advertising the details of someone else’s lived experiences. It’s about the trust and respect this job commands for someone else’s life. I’ve signed no oath to maintain confidentiality but it’s a matter of practice I exercise in everyday life, to keep to myself what others may confide in me. It needs to become second nature. So, how to blog? The answer lay in the work of a clinical psychologist.

Professor Tanya Byron’s novel, The Skeleton Cupboard, relays the accounts of her clinical psychology training, which I will review as soon as I get my copy back- currently an ocean away. The subject matter meant it was about the stories of her and her patients and how she worked with them. Yet, so artful and cautious was her anecdotal evidence that she was able to relay the truth about working in the field without betraying confidence. The genius of it was that you never knew what was and wasn’t fiction but you still gleamed the essential truths of her experience as a trainee.

She had rules and I decided to follow suit:

  • I will not relay the experiences of those in my personal life. If they’re not someone I interacted with in a work space they are off limits.
  • I will not provide identifying information. Following Byron’s style I might even invent new information to conceal. My blog, my creative liberties.
  • I will not always reveal the organisation or institution I worked with.
  • I will focus on my experience, straying into someone else’s for only the essential details.
  • I may invent a fictional story, albeit rarely, inspired by real individuals if I feel it needs to be told. Another technique undertaken by Byron.

I want to keep this blog as close to my reality as possible but there may be times where anonymity can’t be compromised, thus the formality of such rules. Despite this, I know some self declared Sherlocks out there will piece the puzzle occasionally. To them I say, aren’t you a smart cookie but I still have plausible deniability.

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