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The tension between privacy and disclosure in psychoanalysis operates in various ways in analyst, supervisee, and supervisor. Analysts need to maintain the privacy of their patients by keeping their material confidential; they also need to know and share their own internal conscious conflicts to be able to discover unconscious conflicts and their characterological ramifications. Clinical writing is one vehicle for the exploration, discovery, and communication of transference-countertransference issues and other conflicts stimulated by clinical work, but it does not provide the perspective that comes from sharing with another person. Telling a trusted colleague what we think and feel in relation to our patients and ourselves enables us to see our blind spots, as well as providing perspective and affect containment in our work. Mutuality in peer supervision tends to reduce the transference. The special problems of privacy and disclosure in psychoanalytic training are addressed, as are the ways the analyst's belief in maintaining privacy may affect the analytic process and therapeutic relationship.

When analysands read about themselves in reports, their reactions range from anger, disappointment, or condemnation to a sense of appreciation or even idealization of the analyst. The eleven interviews reported here reflect only conscious responses; the unconscious layers were not probed for. It should be kept in mind also that the analysts of these patients might report very different stories. Other limitations are the small sample size and the representation only of patients who volunteered. Nonetheless, the information they provide may help analysts consider how and when writing about patients may influence their representation of themselves, the analyst, and analysis itself.

The narratives of twenty analysts written about when they were patients are presented. Their stories provide suggestions about practices to avoid when writing clinical material, but no generalized prescriptions emerge. Individualization and sensitivity to the situation for each pair remain the best guide. The experiences these analysts recount run the gamut of emotions, from negative through neutral to positive. The neutral responses came mainly from twelve analysts who in the course of an interview about their own writing told of having been written about as patients. The other eight, volunteers who initiated contact for the sole purpose of reporting their experience of having been written about, appear on average to be motivated by stronger affective reactions. The era in which the analyst wrote also seems to have influenced the reactions; in earlier times, not asking permission was accepted professional practice. Today, however, it is increasingly common to ask permission when extended clinical examples are published. One problem specific to analyst-patients was concern about the loss of their role as patient when their analyst engaged them collaboratively in the writing.

Thirty American analysts who have published articles that include clinical material were interviewed about their methods for ensuring patient confidentiality. Eight of these analysts had patients who had read about themselves or heard their cases presented, though their analyst had not requested permission to use this material. Eighteen patients had been asked and gave their consent to have their material used. Twelve of these patients were shown the material written about them. The analysts' thoughts and reactions to their experiences of obtaining consent and having their patients read material about themselves, and of disguising material without asking consent and then having it inadvertently discovered and read by their patients, are discussed. Their views of the effect on their patients of reading written material about themselves are elaborated with case illustrations.

Thirty American psychoanalysts who have published articles using clinical material from their patients were interviewed about their method for ensuring confidentiality. Almost twice as many analysts chose to disguise material as regularly requested permission for the use of patients' material. The other analysts in the sample varied their approach, depending on circumstances, between using disguise alone and using disguise but also requesting consent. Methods of disguise, the timing of request for permission in relation to the phase of analysis, and changes in analysts' ideas about the benefits and detrimental effects of these choices are discussed and illustrated. Each decision is reconsidered in light of its potential effect on patients and their analysis. The dilemma posed by the importance of writing about patients for the health and growth of psychoanalysis as a field and the potential negative consequences for patients and their analyses is considered.

The triadic match is the author's term for the interaction among analytic candidate, supervisor, and patient. Overlapping or diverging characteristics of candidate and supervisor may influence the candidate's learning for good or ill depending on the way patient's and candidate's character and conflicts interact. Four candidates who had found their supervisors' character and supervisory styles particularly beneficial in relation to a particular patient volunteered to describe their experiences. Candidates and supervisors were interviewed. The aim of the paper is to illuminate factors in the match that enhanced or interfered with the candidates' learning. While the paper is presented from the perspective of the candidates' experiences, the balance between challenge and comfort in learning situations is also considered.