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April 10, 1996

The New Informants: The Betrayal of Confidentiality in Psychoanalysis and Psychotherapy

Author Affiliations

University of Nebraska College of Medicine Omaha

JAMA. 1996;275(14):1131-1132. doi:10.1001/jama.1996.03530380073038

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The New Informants by Bollas and Sundelson is a difficult book to review on several levels. There are some very strong criticisms made of the weakening of confidentiality by the courts, by some therapists themselves, and by third parties who may hold estate executor functions. These criticisms are easy to support. In the end the authors also provide a solution to the problem they define. As a biologically oriented psychiatrist who utilizes some psychotherapeutic techniques and has some involvement in managed care, I was challenged by this book to examine the issues involved.

On the other hand the authors' perspectives are so shaped by their adherence to an orthodox psychoanalysis that it is difficult to contemplate their thesis. Their expressed regret for the lost esteem and financial support of their clinical practice in contemporary therapy is so predominant that the message on confidentiality is blurred. The idea that psychoanalysis, a