Risk of talking to a pschologist

April 15, 2006 12:23 PM

Many years ago I did something that was bad and illegal. I've been plagued by guilt and I want to talk to a psychologist about it.

My problem is this. I know that doctors in many states by law are required to bring to the police any confessions that relate to illegal activity. Now I didn't kill anyone or anything like that... and its not part of a standing investigation. I just have grown to have a very "normal" and successful life and I don't want to risk that by sharing my thoughs. By the same token I fear that if I don't talk openly to someone about what happened 15+ years ago that I may harm myself or do something similarly stupid. What can I do? How much risk would I be taking by talking to a psychologist?

posted by anonymous to law & government (36 comments total)

Its hard, as you have been living with 15+ years of guilt. I wouldnt speak to a pschologist, because you could bring everything back up and risk getting taken to the police.

Have you spoken to your closest friend or family member. You have been living with this burden for such along time, and you just feel like to have to tell someone. Do it with someone you trust and see what they have to say.

You will feel much much better when telling someone you know that you have confidence in. If you have lived with the guilt you have already done your sentance, why risk going to jail.

Remember this, if your still doing what you have lived with for this time you should stop.
posted by spinko at 12:36 PM on April 15, 2006

is it so illegal you'd go to jail, or do you not want to pay the fine? i ask because confessing, paying the fine, and moving on - if it's an option - might be the best way to find closure. it's not really a psychologist's job to say "you have now paid your debt to society" (esecially when you apparently haven't - i'm not sure how getting away with it means "you have already done your sentence"), and they're not known for being cheap.

on the other hand, it may not be that easy to find anyone who cares enough to prosecute you, but i'd guess finding that out would also help.

otherwise this recent thread has some relevant comments about confidentiality.
posted by andrew cooke at 12:41 PM on April 15, 2006

Hmmmm. I am a doctor, not a lawyer, and as I understand it, my only obligation to report something told in confidence is if I can prevent harm from occuring. The situation you describe is different.

I might be wrong, so I'd be interested in what others have to say about it.
posted by Slarty Bartfast at 12:42 PM on April 15, 2006

What about a priest? I'm an atheist but priests are good listeners when you need to get something off your chest.
posted by puke & cry at 12:46 PM on April 15, 2006

I would recommend finding a GOOD Christian Counsellor. This way you are getting someone who will be non judgemental and also see things from an eternal perspective.

(I can only speak from personal experience and I found immense freedom through this route)
posted by pettins at 12:46 PM on April 15, 2006

From what I understand about doctor patient privilege you're mistaken about the nature of their legal requirements. My background is from Canada, but the common law is pretty much the same and I think this would apply in the US as well, but from what I understand Doctors and Psychologists and Psychiatrists are only required to report you if you tell them you PLAN to commit a crime. NOTE: Anything involving children is a whole different kettle of fish, as those reporting requirements are a LOT stricter.

But don't take my word for it: Your best bet for a simple and definative answer would be to call up your local College of X (where X is the health professional you wish to seek help from).

Psychologists: http://www.apa.org/
Psychiatrists (?):http://www.acpsych.org/

Call them up (from a pay phone if you'd like, but I doubt it's necessary) and ask to speak to someone regarding professional ethics and reporting requirements. Then ask your question.
posted by tiamat at 12:49 PM on April 15, 2006

I know that your anonymous, but could you give us a hint of what you have done? That way we would be able to understand more.
posted by spinko at 12:49 PM on April 15, 2006

Another idea: talk to a lawyer about a hypothetical situation. They wouldn't be required to say anything to anyone and they could give you advice about what the psychologist is required to do. The particulars of your situation are probably relevent, ie is there a statue of limitations that applies, is this something a reasonable person might think you could do again in the future, etc?

I'm glad to see you getting help and thinking through the proper way to do so. Good luck.
posted by Slarty Bartfast at 12:54 PM on April 15, 2006

I *think* that the statute of limitations on most non-capital crimes in the US is either seven or fourteen years. It might be a non-issue.
posted by stet at 12:57 PM on April 15, 2006

Talking to a lawyer first is a great idea. So long as you pay them for their time, the confidentiality is as watertight as you can get and they will probably be able to give you very helpful information about the crime itself and its possible consequences, as well as clearing up your concerns about talking to a medical professional.

NB Since psychologists aren't medical doctors (unlike psychiatrists) there may be different standards of confidentiality: you need to watch out for that one.
posted by unSane at 1:03 PM on April 15, 2006

Depending on what you did, it might not matter that you did it anymore. If the statute of limitations for the crime is <1 5 years, then you might not need to worry about being hauled off for it. ten minutes with a lawyer will it up for certain and a quick google to find the statute for the crime in the state it was committed might give you peace of mind.br>
On preview, what slarty and stet said.
posted by jaysus chris at 1:04 PM on April 15, 2006

You must realize that even telling someone in confidence is not a guarantee of confidentiality. Also, telling someone won't change the past. Why not engage yourself in some activity, charity, or cause that will relieve suffering, and change the future?
posted by weapons-grade pandemonium at 1:08 PM on April 15, 2006

Spinko is right, a lot of pertinent information is missing that would perhaps enable us to offer more constructive advice.

This "bad and illegal" thing that you did - did it involve harming someone else? You say you didn't kill anyone, but obviously there are many ways of doing harm to someone, i.e. physically, financially, etc.
posted by invisible ink at 1:19 PM on April 15, 2006

Do you have a service like The Samaritans where you are? They should be able to help.
posted by ascullion at 1:55 PM on April 15, 2006

My shrink's agreement reads:

"disclosure is required by law where there is reasonable suspicion of child, dependent or elder abuse or neglect; where a client presents a danger to self, others, to property, or is gravely disabled."

It also says that if your place your mental status at issue in litigation initiated by yourself, the defendant may have the right to obtain the psychotherapy records and/ or testimony by the psychotherapist.
posted by forallmankind at 2:09 PM on April 15, 2006

I *think* that the statute of limitations on most non-capital crimes in the US is either seven or fourteen years. It might be a non-issue.

Might be, but this statement should not be relied on without further checking.
posted by grouse at 2:19 PM on April 15, 2006

It would be a good idea to consult with a criminal defense lawyer who would inform you of both (1) the relevant statute of limitations and (2) whether disclosure to a mental health professional would be privileged.

The majority rule in the states is Tarasoff, which holds that a psychologist has a duty to warn potential victims whom his patient identifies. I have not heard of any law requiring therapists to breach their duty of confidentiality to report past crimes when there is no future risk of harm. But because the public is hysterically protective against sex crimes and child abuse, you need to find a competent legal advisor to make sure your bases are covered. I hope you are willing to get through these hurdles and find a way to deal with your demons.
posted by Saucy Intruder at 3:28 PM on April 15, 2006

To the extent it informs other answers, I'm guessing that the crime at issue involved hurting another person. I don't think anyone would be guilt-stricken 15 years later for a property or financial crime. That the OP is worried about doing something similar again (so worried he/she might hurt themselves to avoid it), confirms that we're talking about something serious and something that caused harm to another individual. This is serious stuff, and probably not something you can tell your best friend about.

Maybe you have to avoid the whole confession idea and instead try to get treatment on a current basis, for your current state of mind. Go to the shrink, describe how you are feeling right now, and, for the moment, deny having ever done anything similar in the past. The shrink may be able to treat your issues without even knowing about the past event -- at least provide better treatment than you are gettting now (zero). Maybe if things go well with the shrink, you might develop a trusting relationship and confess down the road. By then, you can explore with the shrink the confidentiality issues with more confidence that the shrink isn't going to run to the police.
posted by Mid at 3:32 PM on April 15, 2006

IANAL but I just called a friend who is (and who has special expertise in legal ethics), Speak to an attorney, this will be absolutely confidential, and s/he can advise regarding the specific statute of limitations and whether it would be covered through privilege with licensed psychologists/social workers/psychiatrists,etc. Good luck and talk with some one
posted by rmhsinc at 3:39 PM on April 15, 2006

I would suggest the Lawyer route. First, he can not turn you in. Second, he may have some solid ideas on restitution or making amends of one kind or another. Third, going to a priest and/or therapist might help but there remains the possibility that what was done, taken, etc remains as a sore point and thus trying to make resitution might ease your way toward confession, opening up via priest/therapist.
posted by Postroad at 4:06 PM on April 15, 2006

Send a card to Post Secret.

Set up a disposable email account on a server in a country with good privacy laws and seek help in an appropriate mailing list.

Or use the account to email folk in this thread. Judicious use of CC: will make it possible to emulate a short-lived email list.
posted by five fresh fish at 4:13 PM on April 15, 2006

You must realize that even telling someone in confidence is not a guarantee of confidentiality.

If the person you tell is a lawyer (whom you have hired), then it is. Even if the lawyer were to break confidentiality , what you tell him/her cannot be used as evidence against you.

Hey, maybe if you find a lawyer who's a good listener, you won't even need the counsellor :-)
posted by winston at 7:13 PM on April 15, 2006

FWIW, I have a friend who once needed to talk to his therapist about such an event in his past. The doctor explained that she was not obliged to the law unless a crime was imminent.

Guilt is a horrible thing. Seek help.
posted by captainscared at 8:13 PM on April 15, 2006

I recommend the lawyer route, too, for the legal angle. There's a good chance the statute of limitations ran a long time ago, depending on the severity of the crime. The length of the statute often depends on the classification of the offense; the less severe the offense, the sooner it may run.

I think you should see a psychologist. Of course, the privilege that applies to psychologist-client relations varies from state to state, but I'd venture to say that you can trust ANY competent and reputable psychologist with your secret no matter what the privilege laws of your state may say. Psychologists hear dark, dark stuff without batting an eye---far darker and more heinous than the secret you're harboring, I suspect---they have no professional interest in ratting on you; and they would destroy their own careers by revealing a client confidence. Do not be afraid to confide in them.

Unless you are worried about the strictly legal ramifications of the matter, I would think you'd probably be better off seeing the psychologists. Lawyers are not trained to be moral and spiritual counselors, even though some may have those pretentions. If you're looking for more than advice on the statute of limitations, and you seek consolation and counseling, a lawyer is not the person to provide it.
posted by jayder at 8:34 PM on April 15, 2006

Psychiatrists are not required by law to report crimes (unless they are imminent, as captainscared said), but there is NO psychiatrist-patient privilege in court. So if by some other avenue, your crime was prosecuted, your psychiatrist could be called to testify and could not rely on a privilege to demure from providing information. In your case, that seems unlikely, but there is a small risk.
posted by Falconetti at 8:56 PM on April 15, 2006

I disagree on the lawyer suggestion, by the way, and IAAL. I don't think it would hurt to see a lawyer, but I think it's unrealisitic--what is the OP going to do, walk into a random criminal defense lawyer's office and just spill it? Seems to me unlikely. This is a psychological issue, primarily, not a legal one. A criminal defense lawyer can look up the statue of limitations for you, but that's about it--these guys aren't paid to do therapy. A shrink is the best bet.

I'll reiterate that I think the main priority is getting treatment, now. I think that talking about what happened in the past can be part of that treatment, down the road, but you don't have to confess on the first day (or the first month, or year) of treatment. Get yourself into treatment and talk to someone about this issue in the abstract--i.e., what you're feeling right now, why you are worried you might do something bad, etc. None of those feelings are crimes and they will be kept totally confidential. After you develop a trusting relationship with the psychologist/psychiatrist, maybe then talk about the past (after getting assurances on the confidentiality side of things.)
posted by Mid at 9:21 PM on April 15, 2006

Psychiatrists would be covered by whatever version of doctor-patient privilege exists in your state - discussions with a psychologist may not be. In any case, as others have said, unless you are talking about committing an imminent crime, or discuss something related to abuse of a minor, the psychologist has an ethical duty to keep your confession confidential.

However, if you want a truly rock-solid confidentiality, seek out either a) a lawyer or b) a priest.
posted by thewittyname at 9:27 PM on April 15, 2006

another thing to consider ... how specific do you have to be about the circumstances? ... if you say, "i did this in nameless town to nameless person" and keep it at that, your confession is not going to contain enough information to be useful for a police officer ... unless it's a really serious crime involving death, severe injury or a sex offence

first, though, you need to find out if the statute of limitations has passed on your offence
posted by pyramid termite at 7:30 AM on April 16, 2006

like Mid, IAAL and i don't see how the lawyer route will realistically help much beyond informing you on confidentiality laws or the statutes of limitations in your particular case. It certainly won't make you feel better or help you deal with the issue. If you think you need actual help dealing with it, I'd go to a psychiatrist or psychologist; if you just need to get it off of your chest, I'd go to a priest.
posted by ab3 at 8:41 AM on April 16, 2006

I know that doctors in many states by law are required to bring to the police any confessions that relate to illegal activity.

No, actually. My understanding is that I am required to break confidentiality only if I believe there is imminent danger of personal harm to the patient or to another person, which could only be remediated by breaking confidentiality.

Whatever this is, if it happened 15 years ago, it would be covered by confidentiality and doctor-patient privilege. I could not even be required to disclose it in court. (And, for what it's worth, I wouldn't. Nor would any decent practitioner.)

Psychologists are very used to dealing with these issues; it's quite normal for the first discussion you have with your psychologist to be about the borders and limits of confidentiality, in a way that can give you the confidence you need to discuss matters openly.

In short, don't hesitate to go talk about your troubles. You're protected by law.
posted by ikkyu2 at 11:48 AM on April 16, 2006

My advice about the lawyer was only to find out specifically what the psychologist is required to do. I do not think you need to "come clean" in a legal sense.

A health professional's number one, overwhelming obligation is to the person they are treating. I once saw a woman who had confessed she was involved in a murder many years before. There was a mention of some police activity at the time and the circumstances were such that It was clear she wasn't at risk of committing this crime again and therefore I didn't think even for a minute about going to the authorities. My only concern was for helping her deal with the emotional fall out of what had happened. I think this will be the natural inclination of any competent counselor or doctor you see.

Also, I checked with a lawyer friend of mine last night. In our state, it's true that the reporting requirements are focussed on preventing imminent harm or stopping ongoing harm such as child abuse.
posted by Slarty Bartfast at 12:37 PM on April 16, 2006

For those of you against discussing this with an attorney before meeting with a health professional please be aware that for some crimes there are no statute of limitations and some crimes--specifically sexual child abuse--the statute does not start running until the victim reached majority (and in those cases there continues a duty to report). I am extremely doubtful that any of these issues would arise. But in the absence of knowing the specifics I would still encourage this poster to first discuss the situation with reputable counsel who can give proper direction regarding confidentiality and prosection.
posted by rmhsinc at 1:01 PM on April 16, 2006

Just a note for you, from a person who works with insurance companies, many of the items which you sign at a provider's office do specifically allow them to release information to an insurance provider for the purpose of claim payment.

In a situation like this, the insurance provider would be covered under HIPAA regulations to require the records to be kept confidental as well, but it is easily possible that someone who is not as committed to your privacy in the same way as your physician/therapist. I would adivise that you get confirmation in writing from your provider that any discussion of this not be included in any medical records which are disclosed to your insurance provider.
posted by slavlin at 6:24 PM on April 16, 2006

sorry. Add "could wind up reviewing the records." to the end of the 2nd paragraph 1st sentence.
posted by slavlin at 6:26 PM on April 16, 2006

This is slightly tangential, but you describe your long-past transgression as both bad and illegal.

My recommendation would be that before you decide to talk to anyone about it, you look closely at what you mean by 'bad' and what you mean by 'illegal' and the degree to which those are dependent or independent. Not knowing what you did, I can't say much more, but it might be fruitful to dig deep into what those things mean to you, and how they've influenced and fostered the guilt you still feel these days.

For what it's worth.
posted by stavrosthewonderchicken at 7:01 PM on April 16, 2006

Slavlin: I don't work in insurance, but I gotta believe that when a psychiatrist fills out the form for an insurance claim, the form says something like "Treated Anxiety" rather than "Treated Anxiety Stemming From Totally Illegal Conduct." I mean, how could anyone tell a shrink about embarassing problems if this was a real concern? I'm sure the shrink writes down some basic description of the issue (i.e., depression, mood problem, etc.), but not a lot of detail about the underlying causes.

But again, this is something that could be covered in a discussion of confidentiality with the psychiatrist early on.
posted by Mid at 7:23 PM on April 16, 2006