This I believe:
I believe that people need real privacy to speak openly in therapy — and today there is no privacy.
Have we forgotten the type of shame-producing dilemmas people secretly live with? We know from the newspapers that people are sexually abused by priests, teachers, scout masters, step-fathers, and that a large percentage of girls have had an unwanted sexual experience by the time they’re 18… do we really think people can honestly tease apart their reaction to being seduced or molested when their managed care insurer requires contracting therapists to send reports on those discussions to the insurer — reports that become part of someone’s permanent medical record? That’s no privacy at all.
Have we forgotten that we human beings guard the complete truth about our private lives, our secrets, and especially those things we are ashamed of… that we’re unlikely to squarely face the traumas which may push us toward self-destructiveness, silent suffering, abuse of alcohol or drugs, or difficulty in our relationships?
When I was in doctoral training decades ago, we spent years learning to think rigorously about the subtle ways in which people indirectly communicate clues to conflicts in their lives – while recognizing that there are lots of topics a person might feel torn about divulging. For instance, that a person might hesitate to directly express their fury at a family member they also loved or depended on; or that someone who’d been sexually abused and betrayed might be “torn up” inside about it, especially if it was incest or homosexual in nature. I give these as examples of understandable dilemmas in people’s lives that they’d keep secret… unless they’re given strict privacy, time to develop trust and to slowly hint at the specific nature of their worries.
This I know: people have been divulging such secrets to me for decades. Guys who were raped by a neighbor as a child – and threatened with murder if they told anyone. Girls who mutilated their skin because a family member regularly snuck into their beds at night. People who absorbed a parent’s furious beatings as children. Children who were scapegoated because of their resemblance to a parent’s hated sibling. But people are less likely to face such excruciating personal secrets without privacy. Privacy has been lost today, with the ascendance of managed care, cutbacks at public clinics, employer access to insurance-usage information, and the overblown marketing of pharmaceuticals.
I believe that privacy allows people to hint at the central frightening questions which torment their lives.
So, together with some other psychologists in Connecticut I helped construct a charitable program that restores privacy.
Volunteers In Psychotherapy allows anyone to earn strictly private therapy – for no fee — by volunteering elsewhere, privately and independently, for the charity of their choice. So, in exchange for hours helping at a hospital, hospice, nursing home, volunteer fire department, reading to the blind or to children in a library – people earn therapy through VIP. No reports about people’s private discussions go to insurers or become part of their permanent medical record.
Through Volunteers In Psychotherapy a person can reveal their secrets, rethink them and hopefully resolve some of the understandable unhappiness and distress in their life — things which can only be relieved with real privacy. This I believe in – because I’ve seen it happen repeatedly. VIP is an inexpensive and practical charity that requires those who receive help to help others: everyone sacrifices a bit and contributes to the common good.
In Psychiatry “talk isn’t cheap” – but I believe, through innovative approaches like VIP, we can provide private settings for resolving the haunting secret difficulties which can otherwise ruin peoples’ lives.
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