Patient Confidentiality

Patient confidentiality is a fundamental part of psychotherapy and counselling

When you go to psychotherapy or counselling you need to have the peace of mind that what you say in your sessions remains private.  What you say here stays here, patient confidentiality is a part of the duty of care.

Your psychotherapy is the one relationship in which you should be able to feel confident that you can speak freely about the things that are on your mind, the things that have brought you to counselling in the first place.

Patient confidentiality is part of the framework of the counselling, though you may need time to feel that it is safe for you to speak openly, possibly a lot of time.  You cannot force yourself to speak, you may need patience to develop confidence in the process and in your counsellor or psychotherapist.

At the beginning of all psychotherapy work I explain that this conversation is confidential.

Counselling and psychotherapy are unlike any other relationship, it can take a bit of getting used to

  • You are meeting someone who is unknown to you in an unfamiliar place to have an unusual kind of conversation.  It is very unusual for you to have the chance to speak openly and frankly about yourself like this but this is all part of what ensures your patient confidentiality.
  • Often we spend so much time not saying what is on our mind that it feels strange to start to speak freely.

Sometimes people go to see a counsellor that they know, perhaps someone they have met through a friend.  This may seem a perfectly reasonable thing to do at the start but over time may limit the possibilities of what can be said.  Just knowing that your counsellor knows one of your friends or family may prove enough to hold you back and interfere with your patient confidentiality.

Developing confidence that you can take patient confidentiality for granted is part of the work.

Psychotherapy involves developing the freedom to think and say whatever comes to your mind

This is a very unusual thing.  No other relationship involves being able to say whatever comes to your mind.  But it is this freedom that paves the way for you to release yourself from the ordinary social conventions and rules that tend to limit freedom of expression.

As you allow yourself to explore your thoughts, memories, hopes and dreams you gradually find that you break free of the grip of censorship that blocks not only your free speech, but which interferes with your freedom to think.

  • What kinds of changes might you make if you did not have to avoid thinking or talking about certain subjects?
  • Imagine what you could do if you had the freedom to express yourself without any fear of your words being repeated elsewhere?


We tend to internalise aspects of the relationships and families that we grow up in

This usually means that we internalise particular social rules and family dynamics.  This happens in ways that we are not necessarily conscious of.  Identifying these social and moral obligations takes time.

Often you find that it is these internalised rules, rules that you unconsciously maintain that are the chief obstacle to the freedom you require to change the way you live, work and relate to other people.

For example, you may have grown up in a family in which trust could never be taken for granted, in which you always had to manage your way around your parents wish for control.  Some parents want to know too much about us.  They want to know everything we think, do and say.  This may start off from a wish to care for us, but its effect can be very limiting.  It can turn us into people who become very cautious about what we say, what we think.  From these positions our access to our creativity and spontaneity is limited.

In the film The Lives of Others (2006) a Stasi surveillance officer is assigned to monitor a playwright in East Germany.  The Stasi officer listens in on the playwright and his girlfriend’s private conversations.  As he listens, he starts to question his role in the Stasi and starts to feel for the people he is monitoring.

When we have patient confidentiality, when we have the chance to think and speak freely we sometimes identify things that we have not noticed, or have ignored about who we are, how we have become the person we are.

You might be thinking about going to psychotherapy to speak about a particular issue or symptom,

  • perhaps a problems with sleep, bad dreams or nightmares
  • problems with concentration
  • you may be suffering from stress, anxiety or depression
  • headaches, migraines

Sometimes these things are symptoms of more obscure underlying conditions.  The internal repressive rules that I am describing have consequences in terms of your health.  When you get the chance to speak freely, to get it off your chest then all kinds of health problems tend to improve.

Having the confidence that you can speak freely, that you are protected by patient confidentiality creates the opportunity to identify the things that are getting in the way of living a more satisfying life.

Changing your ways of thinking and relating to others enables significant reorganisation to occur.  The basis of this is linked to the fact that you know that you are protected by patient confidentiality.

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Psychotherapy provides patient confidentiality, an opportunity to explore the things that have happened to you, and to start to make constructive links with the different parts of your experience that continues to shape your life.

Psychotherapy could be the beginning of living a more open, constructive, creative and satisfying life.

Contact now for a free telephone consultation to discuss how my approach may be relevant to you.