| Privileged Information (1991) by Stephen White |
"It starts like this. . . " writes a patient in her journal.
And so begins a series of novels about the fictional Dr. Alan Gregory, a Boulder psychologist.
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| Privileged Information, by Stephen White |
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Stephen White opens his first novel, Privileged Information (1991), with every psychologist's two worst nightmares: the suicide of a patient and an accusation of sexual impropriety. White captures with stomach-churning accuracy what it must feel like to have one's whole world passing judgment and to be completely prevented by one's professional code of ethics from mounting any kind of public defense.
In Privileged Information, White introduces Boulder psychologist Alan Gregory. The general theme of the series is that in each novel, Dr. Gregory is confronted with a murder (or murders) he cannot easily solve without violating his professional ethics or Colorado state laws governing licensed practice.
The novel's title refers to laws protecting professional communications--in this case, between psychologists and their patients. Most jurisdictions grant, as does Georgia, the same level of privilege between psychologists and their patients as physicians and lawyers have. "Privilege" in this context means that what you say to me in the context of our professional relationship cannot become evidence in a court of law--unless a judge rules that the State has an overwhelming interest. Such an interest is presumed in cases of child abuse (as one example) in which we are expected to file a report. A client/patient waives privilege when she releases the information herself by, for example, making her mental state and her therapy an issue in a trial. Otherwise, "privileged" basically means "not discoverable". Opposing attorneys can't subpoena your chart (or me) and I can't volunteer the information.
With his title, White conflates privilege and "confidentiality", which is the ethical mandate to respect clients' privacy. Privacy and confidentiality are so important to us that they get a section of their own in the Ethical Principles of Psychologists and Code of Conduct, published by the American Psychological Association in 2002. (The Code is about 50 years old but gets updated periodically.) Protecting confidential information is one of our primary obligations as psychologists and the Code reminds us that we are released from this obligation only where the law makes an exception. So until Alan is actually under oath, the client (or legal representative) signs a release, or it becomes necessary to protect the patient or someone else from actual physical harm, he can say nothing.
In Gregory's fictional dilemma, this means that he cannot discuss his case with his colleagues, the press, or the police. He can discuss it with his licensing board and if he's sued or charged with a crime, he can discuss the case with his attorney and testify in his own defense, but only because the patient (or her legal representative) has now made the therapy a legal issue. But that's it: Other than the most general of statements ("I did nothing wrong") you can't even defend yourself to your own family, but must live with the misery of lovers, parents, children, siblings and best friends knowing about the case only what they read in the papers.
Gregory is generally a positive and accurate portrayal of real-life psychologists, but there are problems: I had more to say about that here when I first read the book.
Privileged Information is not a screamingly well-written book, but it's a good first effort and well worth the used-paperback price (you can buy it for a penny plus shipping on Amazon.com). Besides, White gets better with subsequent novels, and you'll want to read them in order.
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