יום שני, 21 בנובמבר 2011

Online Therapy Privacy Concerns

Freud puts patient privacy and the development of the science in conflict. If a patient does not trust that his or her unprocessed thoughts and emotions are kept secret, the patient may censor them by what can harm his or her reputation. If abstract findings are not shared with a scientific community, the ability of a therapist to help a specific patient diminishes. 

1)  The patient needs the therapist to be the hub of many secrets, and the therapy to based on experience with other people's secrets. In this sense the patient agrees to a scientific study of the anonymous abstractions from the private therapy sessions of many patients. Then anonymity becomes the issue, not privacy.

2) People already share so much online, and right now they do it for facebook's advertisers to be able to deliver them with better ads. The same behavior that is encouraged by consumer culture can be used for good, with the patient's benefit in mind.

So, in my view:
1) Shared psychotherapy information should be anonymous. Not easy as it sounds.
2) Current technological standards should be adopted, as long as the ethical question is "how to help the patient?".

Bertha Pappenheim, was Breuer disguised as Anna O in his case study essay.


  1. Well... First, maybe I haven't understood what you're exactly talking about, but if we're talking about a one-on-one session by the internet - why is the anonymity the issue...?
    One problem with anonymity, if we take it to the extreme and talk about a session by computer which is only by text or with a mask (which increases anonymity ofcourse), can be the problem of building a true connection between to persons, which by many researches IS the major key for a good therapy.
    Second - how do you put what you've raised here in practice? Do you mean that while not in session, the psychotherapist can gain extra knowledge by data from the patient's computer? Didn't understand that also...

  2. Hello T,

    I feel technology is mature enough to do much more than one on one sessions over the internet. It allows us to be an online community. This may happen today or in 10 years, but it takes very little for it to happen.

    I am talking about sharing psychotherapy info online to allow data analysis and research. Gene research, it is common to make gene mapping of patients available anonymously online, and researchers from around the world access it and test their hypotheses on it, and develop new algorithms to predict gene adapted treatment. I wonder if the same could be done with, let's say, bio-metric readings, to develop new algorithms to predict treatment results and suggest optimal treatment.

    About the human connection between two people which explains the curative effect of psychotherapy, it should not be touched. I think that in addition to a therapist, people should also go to a consultant, similar to a life coach, that will profile your problem, recommend a treatment/intervention and monitor improvement.

    I hope this answers your questions :)