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When, why, and how clinicians decide to write about clients are ethical concerns. There are risks and potential clinical ramifications as well as responsibilities for how these decisions are made. On the basis of 141 interviews with psychoanalysts who have published in 3 major national and international psychoanalytic journals, the author explores decisions about whether to only disguise the client's material or whether, in addition, to ask consent outlines and some of the clinical consequences. The author concludes that clinicians need to Individualize their decision making based on the particular client and the nature of the therapeutic relationship and offers ways to go about making these judgments. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 (15) as regularly requested permission for the use of patients' material (8). 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. [ABSTRACT FROM AUTHOR]