What We Hold

I can keep a secret — a lot of secrets. I can, and do, and have, kept hundreds of thousands of secrets over the course of my career.

I have not told parents their teens are sexually active, or gay. Or that they’ve tried alcohol or marijuana. I have not told the single male 4:00 p.m. client the 5:00 p.m. female client his age is also single and shares his love of Country Music and Great Danes.

I have made sure that one Tempe Police officer doesn’t pass another in my waiting room by strategically not offering them adjacent appointments. I have not told the father of a 19 year-old that his son was no longer attending appointments, even after the father shared he had been giving his son money weekly to do so. I don’t leave voice mail messages on people’s phones or send mail to their homes without their permission.

I don’t use people’s names in the waiting room when others are there. I haven’t told a single soul about the celebrities to whom I have provided services. I don’t tell husbands and wives that their partners are contemplating divorce. I cannot share when I have a client who wins a sporting event or gets elected to office. I cannot tell my cousin that I’m seeing a client whose first name is my cousin’s father’s name and whose last name is my cousin’s mother’s name. I am seeing a client I am certain is the sister of another one of my clients although neither has mentioned it, so I believe they each picked me independently and don’t know the other one sees me and they may not have even told each other they’re seeing a therapist at all.

I don’t tell anyone you were raped several times as a teen when you were drunk at a party. I don’t tell anyone you went through the drive-through after dinner last night and ate a whole second dinner. I don’t tell anyone that you fantasize about your old girlfriend while you make love to your wife because your wife has gotten so overweight you no longer find her attractive, but you love her and would never leave her.

I hold this for you. I hold this so you can heal from your wounds and do the difficult work therapy requires without fearing for your privacy. Every therapist holds all of this for their clients. We are bound to confidentiality or we will lose our license to practice. We take the vow very seriously.

That said, I sometimes want to talk to someone about “my day.” It used to be the case I could come home and tell my husband when I had a rough day without violating anyone’s privacy. To simply tell him that I’d had a rough day doesn’t give him any client information.

I also became expert at telling him only the parts that mattered to me, without linking them in any recognizable way to a client. For example, I might tell him a client came in and told me that they had been contacted on Facebook by an old flame and the client didn’t tell their spouse and I am worried they might be thinking about cheating on their spouse. Without even stating the client’s gender or the gender of the old romance or the gender of the spouse, my husband would have no earthly clue to whom I might be referring, and he wouldn’t care.

We’d just be able to talk about the importance of not keeping secrets like that in marriages in general and in our marriage, specifically. However, now that my husband is my office manager, I can no longer say those sorts of things because even if he doesn’t try to guess, it’s not that hard to figure out which one of our clients I might be talking about if our day included two single women, a couple of teenagers, an elderly man who doesn’t even have a smartphone, and a sour-looking woman whose husband stopped attending sessions with her months ago.

I might have a client who is cruising along in therapy, working on routine issues, and they come in and tell me that their cousins were out hunting together and one of the cousins accidentally shot and killed their grandfather, and after a session like that, I am shocked and would really love to just tell him that something really major just went down, and even that much would be a violation of client privacy. So, what I do, what all ethical counselors do, is we keep your secrets, we manage our emotional reactions to the things we hold, and we engage in an extraordinary amount of self-care. We take time to rest, we journal to process our emotions and then shred them. We have our own therapists. We take vacations,  we cry, join causes, hug our children, spouses, and pets. We exercise, drink enough water, go to the movies with friends, go to bed at a reasonable hour, eat reasonable portions of nutritious foods, engage in spiritual practices, read, have creative hobbies, and express our feelings respectfully to appropriate audiences at well-chosen times.

You have a hard story to know. Each therapist has his or her own hard story to know as well as thousands of others. Self-Care is the key to staying in the field a long time in a healthy way that does service to the clients.

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