Or someone who went through an intense trauma. Or someone who's done something terrible in a dissociative fugue. Or several different anxiety disorders/phobias. Or certain personality disorders come to think of it.
There's a lot of cases where certain information, if presented in the wrong way or at the wrong time, can be harmful to the patient, the relationship between patient and therapist, or both.
How does keeping secrets help any of those situations?
“I’m manipulating you for your own good!” sounds like you’re validating their delusions and fears. I’m just hearing the same excuse the government gives when they, eg, censor facts and promote misinformation for the “public good”.
Go ahead; explain to me specifically how it would help any of those cases — because this comes across as prioritizing the therapist’s convenience ahead of honesty with the patient.
Do you not see my point that engaging from a place of honesty and partnership rather than patronizing manipulation is superior, and that you’re causing harm with that mindset due to telling a lie that validates their fears, without actual benefit?
You don't have to lie to keep a secret. Not telling someone something is still keeping a secret, and is necessary in the scenario that you know something will trigger an episode in someone. There's also the factor of time. You may start talking about something previously left unsaid later on therapy, after you've established some trust.
It's really not any different than how people engage in normal relationships. How I talk to a stranger is different than how I talk to a colleague is different from how I talk to a friend. You need to first build a rapport before you can talk about certain things.
Sure — how does an institution keeping secrets from them help that situation?
From my perspective, you’re validating their delusion that institutional actors are trying to manipulate and control them; specifically how does keeping notes secret help that situation?
Go ahead, be explicit.
I think your failure to give an explicit answer even when asked points to this being a delusion on your part; so I’ll ask for you to give a specific example again.
I'm not the OP lol, I'm just telling you that some people are off the rails delusional and it's not about withholding information at that point. Do you think that little children should be told 100% factual medical information regardless of circumstances? Do you think an elderly patient with dementia should still be trusted with their own medical decisions?
There are not easy answers to these questions sure, and one might be philosophically opposed to the withholding information route, but as far as pure patient outcomes there are absolutely situations where a lie is helpful. The placebo effect is a big one btw. Pretty sure telling a patient with social anxiety that they suck at socializing is not the right play 100% of the time.
So… you don’t have a specific example of how it helps?
Yes, you should be honest with children about their medical condition. Similarly dementia patients. Why wouldn’t you?
Asking about “trusted with” is a non sequitur because we’re not talking about whether people should be dependents that require care — but whether doctors have a right to conceal information.
Again, why would you write “suck at socializing”? — but are you envisioning some situation where someone seeing a therapist for social anxiety would be harmed by “struggles with social skills” or “doesn’t have fully developed social skills” would be news to the patient? …c’mon. The patient already knows that; they’re there to get advice on how to address that. And a therapist telling such a transparent lie to someone with social anxiety seems likely to do more harm than good.
Again, go ahead and be explicit about how you think medical professionals concealing notes will help — I think it’s very strange you’re so adamant but can’t be explicit.
