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Watson, A.S. (1972). Levels of Confidentiality in the Psychoanalytic Situation. J. Amer. Psychoanal. Assn., 20:156-176.

(1972). Journal of the American Psychoanalytic Association, 20:156-176

Levels of Confidentiality in the Psychoanalytic Situation

Andrew S. Watson, M.D.

David Beres opened the panel, commenting that although the title relates to the issue of confidentiality, it may be expected that our discussion will also consider issues of privilege and privacy as they relate to psychoanalysis.

He noted that the topics would fall into three general categories. First, the specific problems arising in the psychoanalytic situation: "Does the psychoanalytic situation present unique problems? What are the differences and similarities in the psychoanalytic vis-à-vis the psychotherapeutic situation? Are psychoanalytic records subject to subpoena? What problems arise when the psychoanalyst, who may be protected legally in some states, sends a report to a referring physician who does not have the right of privilege, as in a case in Connecticut? What about letters to draft boards, insurance companies, or other third party interests? What will happen if psychoanalysis is included in a possible national insurance bill? To what extent is confidentiality threatened in case discussions, published papers, and in tape recordings used for teaching or research? What are the problems in research situations involving a group of investigators? What are the special problems in analysis of children and adolescents?

"A most knotty problem arises in regard to the candidates in psychoanalysis. Do they as well as other patients retain privilege in communications to educational committees, the membership committee of the American, or other institute administrative bodies? What about confidentiality in the evaluation of persons considered for selection as training analysts?

"A second issue that we will be able to consider is what is now known as the Lifschutz Case." Beres noted that the presence of Dr. Lifschutz would turn the panel into something of a case seminar, inasmuch as his experiences were to be described.

"Third, there are general questions of the legal aspects vis-à-vis the ethical and professional aspects."

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