Tuesday, July 15, 2014

Transparency in Therapy?!

I started going to therapy a few months ago, so my interest was piqued when I ran across an article about therapy patients being able to see their therapist's notes. My thought process went a little something like this:
Huh, that's interesting. But no!!!
I cannot express to you how much of a bad idea I think this is. Now, don't get me wrong, I don't have an education in psychology or anything even remotely related to psychology. I don't have any sort of professional ideas about why this is a bad plan. I just feel, to my core, that it's not a good idea. It's an instinctual idea that knowing what a therapist really thinks of me would make me feel worse about myself than I already do, which is counterproductive. For me, at least.

There are 700 patients at a medical group in Boston that're trying it out as a part of an experiment. Some psychologists there consider themselves medical trailblazers for making this sort of transparency a reality. They think it will foster an environment of trust between patients and doctors. That it will lessen patient anxiety about therapy and help them to understand their progress.

I get all that and think that would all be awesome, if I really thought it would work like that. It's my pretty heavy doubt that it would actually work that way that fuels my skepticism. This isn't the eye doctor, psychiatry can really harm a person if it's not done well. For me, it would cause more anxiety, not less. With all my worries and anxiety, it has never occurred to me to worry about what she's writing while I'm talking. That's not to say that others with anxiety might not, but I never have. Until now, and even now that it's occurred to me, I'm still not worried about it--which is a feat for me, because I worry about absolutely every. single. thing.

But more than that, these doctors should feel free to make notes without worrying about how their words/thoughts might be interpreted by sensitive patients (and every mental health patient is a little bit sensitive, right?). They should be free to write "What a colossal nutbag!!" if that's how they feel and it helps them do their job well. But with the knowledge that what they're writing will be visible to patients, they can't do that. It's not even a conscious thing, subconsciously they'll change or adjust their method to make it more digestible/desirable to patients. It will happen.

It's similar to what happens when I grade student papers. Maybe I want to stamp some of them with a big ol' "WTF," but do I do it? Of course not. It's not fair to my students, even when it's honest. Instead, I work my analysis in such a way that they will be constructively criticized while being simultaneously encouraged. I tailor my notes, carefully, so that my students won't feel put down. If I could keep their papers to myself, and write whatever I wanted, it might be different. Therapists will do the same knowing that patients will see their notes... even when they don't mean to.

When I mentioned this whole thing to my therapist, she didn't seem too keen on the idea either. As we discussed it, she said she would prefer I didn't see our session notes because she thought it would do more damage than good with my anxiety issues. I agree with her 1,000,000,000,000,000,000,000,000%. Way, way more damage than good. And, so far, I think therapy is helping me quite a lot. I just hope this thing doesn't become a thing, that it remains an experiment and then things go back to a sane place where therapists remember that they're dealing with people who're mentally and/or emotionally compromised. I mean, really, who wants to know exactly what their therapist thinks of them? No, thank you!