Is what you say to a psychologist completely confidential?

Published Letter #597 - Posted in , .

Question:

I’ve had a rough life. I’m not gonna name the specifics because I can’t afford to break down. Anyways, all of my problems have caused me to cut myself, I used to do it for 8 months but I’ve been clean for 3.
I’m constantly thinking about cutting myself, because that was a release from my problems. But at the same time, I know that one cut will turn into twenty, like how it’s always been.
And it all comes back to one thing.
I need to cut myself, to feel a release.
And lately, I have been having panic attacks.
My parents don’t know any of this stuff.
I know I need help from a psychologist
My question is…. Is what you say to a psychologist completely confidential? Or is doctor patient confidentiality fake?

Irene

Submitted by

Answer:

Dear Irene,

It is clear from your letter even without details of your story that you are in a lot of pain and are suffering greatly from anxiety. But it is also clear that you are a strong person who is self-aware and wants to deal with your anxiety head-on in healthy ways. Three months clean from cutting is something to be proud of and requires a lot of strength. But it is not easy to be strong when you are suffering so much. Surrounding yourself with a support system and getting professional help is a positive thing to do.

You mention that you can’t afford to break down, that you have to hold your life together. You also mention that you understand the cycle that you are in, that cutting helps in the short run with a release from your anxiety, but that it leads to more and more cutting. It is a difficult cycle to break, especially when you need a release from anxiety so desperately because the feelings you experience are unbearable. Many people cut themselves to feel this momentary release. Many people use cutting as a release from tension, stress, anger (either at themselves or at others), and some feel that it gives them a bit of control in their lives where otherwise they would feel completely out of control. It’s important for you to know that cutting may help you to feel better briefly but the longer it goes on, the more dangerous it can become as it can cause permanent scars, infections and serious, and sometimes life threatening medical problems especially if you cut a major blood vessel.

You are taking a healthy step by reaching out to find help. There are many professionals who are qualified to help you deal with your anxiety, with cutting, and with the issues you are dealing with that cause such pain and anxiety. Psychologists are trained to help you and they will keep what you say to them in complete confidence. Patient/physician, patient/psychologist confidentiality is very real and it is there first and foremost to protect you.

There are a couple of things you can do. First of all you can call 1-800-DON’T-CUT where you can be referred to a therapist in your area. You can also go online to http://www.helpguide.org/mental/self_injury.htm where you can learn about cutting as well as additional things you can do when you have the urge to cut. And finally, when you have the urge to cut, you can always call the Trevor Lifeline at 1-866-4-U-TREVOR (1-866-488-7386) and talk with a Trevor lifeline counselor about what you’re feeling and experiencing as well as your urge to cut which can help to delay or stop the urge to cut. They can also work with you to find a therapist to help you.

Irene, you are indeed a strong person, but don’t feel that you have to be strong on your own all the time. We are always here for you, we want the best for you!