The Secret Life of a Family Therapist

Therapists are the keepers of secrets.

Within the process of therapy, clients often share knowledge that is very private and personal. They share their fears and anxieties, topics that are sometimes very hard to share openly with other people in our lives. The therapy room can be a safe place where people can take off the masks that they wear or to share thoughts and memories long kept hidden. A place where secrets can be shared and processed while still being kept safe.

Even before I began seeing clients, the significance of the secrets that people share in therapy was something that I was made keenly aware of throughout my education and training. Confidentiality is often a central theme in any therapy course, reinforcing the importance of protecting the private information shared with us by our clients. In addition there’s the importance of acknowledging the trust that clients are placing in us in sharing their stories as well as their courage in telling it. Even with all the checks and balances, sharing a story that has long been kept hidden can still be a significant challenge and as a therapist it’s always important to be reminded of this.

As therapists, not only are we responsible for honoring the secrets shared with us by our clients but in addition, we have the responsibility of guarding the secret of participating in therapy itself. The decision to attend therapy is often seen as very significant and often it’s a very private decision. In addition, there can be social stigma associated with attending therapy and sometimes the well meaning concern and curiosity of others in our lives can make it harder for clients to protect the content of their therapy work when their attendance is publicly known. This, I’ve discovered, is even more important in couple and family therapy work when different components of a family system can be involved in therapy at different times. Creating a safe and open space for dialogue is a central component of any therapy work and ensuring that clients are confident in the privacy of their work with you is of key importance to any therapist.

Therapists are by no means the only profession responsible for the keeping of secrets. Doctors, lawyers, priests, and accountants are some of the other professions in our society that we trust to keep our secrets safe. There is a significant difference however, which sets therapists apart. Not only are therapists the keeper of secrets, but also this task must itself be kept secret and thus we ourselves must sometimes remain a secret.

Let me explain what I mean with an example. You’re standing in line at the grocery store with a friend and your doctor walks up in the line behind you and says hello. While obviously, going into explicit detail of a recent procedure in public would be considered inappropriate, I’d say most people would not feel awkward acknowledging their professional relationship with their doctor publicly. If you replaced doctor with lawyer or accountant, you’d probably end up with a similar result. These relationships are publicly accepted and normalized so even though the content of those relationships must be kept secret, the relationships themselves don’t have to be.

Imagine now that instead of a doctor, it was a therapist. Now the chance meeting could result in discomfort for the client who would be forced to either acknowledge that they were in therapy to the person they’re with (who might be involved in the concern that brought them to therapy in the first place) or come up with some other reason for why you know this person standing in line behind you. Trying to ignore the situation can sometimes work but this could create added anxiety and stress that would be counter to the therapy work they were doing together.

Because of this, many therapists that I’ve spoken too have adopted the policy that they will not acknowledge their clients in public unless the client does so first and will mention this to their clients in advance so they don’t have to worry. In addition, many therapists will leave a store or department if they notice that one of their clients are nearby in order to avoid the situation entirely.

Before I began my career as a therapist I knew how important it would be to create a professional and confidential space at work to ensure that clients felt safe and comfortable working with me. What I hadn’t realized was how much the responsibility of respecting client’s privacy could influence the rest of my life. Being a therapist doesn’t end when the session is over or when you leave work for the day.

If you’re out with friends and reminiscing about some old memory, a client walking by might mistake the story about a friend as one about a client and may worry about the safety of their own story. The responsibility of keeping our clients’ secrets is something that has to always be on your mind and can change the way you interact with the world around you.

The trick I think will be to find a balance between being able to take care of myself and live my own life while still honouring my responsibility as a therapist.

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2 thoughts on “The Secret Life of a Family Therapist

  1. Great points. I’ve been in that situation several times (running into clients outside of therapy) and it’s always, while not exactly awkward, certainly a unique experience. If you’re lucky, you’ve brought up the possibility of that happening in advance and explained why it’s necessary that they be the ones to acknowledge or not acknowledge you as they see fit. Failing that, being able to bring up the situation in the next session is usually quite helpful.

    But when it happens with a former client, there is no such luxury. All you can do is hope that they understand that you’re not snubbing them, rather trying to protect their confidentiality. It’s hard, too, because you genuinely want to know how they are doing. I was thinking about writing about that, actually – the wondering about how clients are doing and not being able to know thing. Maybe sometime in the near future.

    • I hadn’t extended this idea to former clients when i was first thinking about this but that’s a really good point. wanting to check in and see how they’re doing since leaving therapy makes those boundaries in the community all the more difficult. Especially since, as you say, the contact would be out of genuine caring.

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