Comparative Confidentiality of Psychoanalysis

In 2003 the Institute undertook this project for the International Psychoanalytic Association. Its purpose is to examine the extent to which the confidentiality of patients undergoing psychotherapy treatment is protected by the rules and standards of professional bodies, by the law and practice of the courts, and how this varies from country to country.

The need for confidentiality of communications between psychotherapists and patients is universally recognized by practitioners. Confidentiality has a particular clinical importance in psychoanalysis, and in psychoanalytical psychotherapy, that goes beyond the normal considerations that protect confidentiality in a clinical setting. The nature of psychoanalysis is such that the patient is encouraged to reveal not only inner thoughts but also dreams and fantasies in order to make possible administration of the proper treatment. Confidentiality is needed due to the extremely personal nature of the material shared with the psychoanalyst. However, the extent to which confidentiality is protected varies from country to country.

As global communications develop, the need for the international psychoanalytic and legal communities to have a common understanding of these issues becomes more pressing. The disparities in the national laws and practices on psychoanalytic confidentiality currently present a confusing and fragmented picture worldwide.

The study examines the extent of the protection afforded by professional standards, and the circumstances in which they can be overridden, and by whom. In particular, the study is looking at disclosure to other health professionals, law enforcement agencies and courts. It will also examine the remedies used to protect confidentiality and the penalties imposed for breaches of confidentiality. In addition to examining the position in the countries under review, the study will attempt to identify common themes. The jurisdictions under scrutiny are Argentina, Brazil, Canada, Germany, Italy, the United Kingdom and the United States.

The project is being overseen by a supervising committee composed of Dr Mads Andenas, then Director of the Institute; Alexander Layton QC, 20 Essex Street; and four representatives of the International Psychoanalytic Association (Mrs Penelope Garvey (UK); Dr Robert Pyles (US); Dr Romulo Lander (Argentina); and Dr Andrea Marzi (Italy)). Hugo Warner undertook the research work at the Institute with the assistance of a number of correspondent psychoanalysts and lawyers from each country under review.

In 2004 the results of the Study were published by the Institute in Comparative Confidentiality in Psychoanalysis.