Friday, April 22, 2016

Should Therapists Write About Patients? - The New York Times

When it came time for the pre-publication legal review for my most recent book, I had an idea of what to expect, or so I thought. The book was highly critical of the American Psychiatric Association, a deep-pocketed, fiercely self-protective organization. I took particular aim at its most lucrative product, the Diagnostic and Statistical Manual of Mental Disorders. So I figured the review would rigorously investigate whether my account was fair and accurate enough to withstand any legal challenge.

I was right about one thing: The review was a veritable inquisition. But I was wrong about the subject of the lawyer's concern. It wasn't the A.P.A. Instead, she was worried, nearly obsessively, about my accounts of interactions with my therapy patients. 

I'd told such stories before. My previous book was full of descriptions of therapeutic encounters, and I'd taken the industry-standard precautions. For detailed case studies, I obtained written consent. In cases where that was not possible (for instance, if the therapy had taken place long ago and I'd lost touch with the patient), I changed all the identifying information; a woman became a man, a doctor became a truck driver and so on. And sometimes I would assemble composite characters, golem-like, out of many people I had seen — a physical characteristic here, a verbal tic there — in order to illustrate a clinical point with a brief anecdote.

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