Many therapists have lamented about the lack of privacy the internet has created. More to the point in my view, the internet has taken away the veil of secrecy psychotherapy has frequently sought refuge behind. It used to be that the anonymity of large urban areas, or the possibility of a commute to the suburbs insulated therapists from their patients after the analytic hour came to a close. I friend of mine once went for years before discovering that Therapist A, who had referred him to Therapist B when treatment was stymied, was actually married to Therapist B. They did not share last names, but my friend in a moment of high curiosity and low impulse control drove over to Therapist A’s home address and discovered Therapist B’s name there as well. He terminated therapy thereafter.
For myself, I learned that privacy is to a large extent illusory, not from the internet, but from my first job. I worked in a community mental health center on a 13 mile long by 7 mile wide island which was 2 1/2 hours by boat from the mainland. You get used to a diminished sort of privacy on an island. I couldn’t avoid my patients if I wanted to, unless I wanted to avoid the library, most restaraunts, coffeeshops, the beach, or the one movie theater we had in the winter. Nor could I find privacy in limiting the type of work I did there. The Community Mental Health Center was the only one on the island. We were responsible for, and I did, school counseling, Psychiatric hospitalizations (which involved flying with often psychotic people in a Cesna six-seater airplane,) outpatient therapy, Alcohol counseling and DUI classes, drug testing, and court-ordered counseling for domestic violence perpetrators. I can still remember how when a colleague and I went out to dinner at a local pub one night one-third of the people at the bar left. It wasn’t just my privacy that was affected here.
You have a choice in situations like that. You can hide out in your house with a cat and television (which I did at first) or you can start living your life in the community and negotiate boundary crossings on a case by case basis (which I settled upon as my strategy.) I learned to cultivate a sense of never-too-uptight-never-too-relaxed when I was in public. It became second nature in many ways.
When I moved to Cambridge, MA, it felt very anonymous by comparison. But as many practitioners in “The most opinionated zipcode in the US” will tell you, Cambridge is really a village in many ways. I still ran into people, and by this time, technology was becoming more of a factor.
As Thomas Friedman has observed, “The World Is Flat” in the 21st century. Globalization and technology have removed many of the barriers to, and some would say protections from, knowing each other. Our patients can Google us, Yelp hangs up a business page of us whether we like it or not, and are often only one Facebook friend away from connecting with us.
Even if you want to make the poor business decision of staying off the internet in terms of a website, eventually your contributions to the Democratic Party, your address, and notes about you in your alumni magazine are still going to find their way out to the world. We’re all on an island today.
So what can you do? Well, my advice is to start blogging. I know sounds counterintuitive, but it makes sense on a number of levels:
1. Buddhism tells us to move into the places that scare you. We exert so much energy trying to avoid things, find a spot where we can stay safe and stop the awkward and uncomfortable learning process. And yet we ask our patients to do the exact opposite so often: to look underneath those rocks, descend into the depths of the psyche, face their fears. Our obsessive quest for privacy is perhaps not that different.
2. Make the internet work for you. One of the best ways to protect your privacy is to generate a lot of content that you consciously know is public-facing. Google “Mike Langlois, LICSW” for example. Go ahead, I’ll wait. What came up probably is pages of my website, professional picture, Youtube videos, and blog posts. Dig a little deeper and you’ll see me commenting on a few blogs. This is the practice of radical transparency. All of that content was written with all of you in mind, my patients, colleagues, friends, family members, potential coaching clients, high school classmates, potential employers, my future children and grandchildren and the FBI. The way Google and other search engines work, the more content I put out there that is public, the further back any unintentional pieces about me will be. By embracing that the world is flat I have learned to cultivate a style that I can negotiate in my work life while still feeling authentic. And it is great advertising, or fair warning, if you are considering working with me.
3. Radical transparency protects your patient’s privacy as well. Whether we like it or not, therapists are finding themselves on review sites like Yelp. Yes, anyone can post a review, and no, Yelp will not taking it down if you ask. More importantly, your patients might not understand the ramifications for their privacy or PHI if they post a review. Keeley Kolmes has great resources on this, and you are welcome to use my version of her version as well. Take a look:
Notice that half of my allotted space is not advertising, but a direct message to any potential commenters. Rather than hide out and try to get Yelp to take my name down, I have used it as a platform to market my business, model what I feel is ethical professional standards, and provide some information to patients in the spirit of informed consent. Do I want to get bad reviews? Of course not, who does? But that is not an excuse to hide my head in the cybersand.
4. Last, but not least, get over your bad self. Sometimes listening to our colleagues you would get the feeling that they are dealing with the paparazzi, not the public. Sure patients and others may be curious about your life, but really most people in the blogosphere just aren’t that interested. On a good day, my blog gets 200 views, on an amazing day last August I got 689 views. There are 7 billion people on the planet. Feel free to correct my math here but according to my calculations that means on a busy day 0.000009842857142857142% of the people on the planet are checking out my most visible presence on the internet.
Am I saying you should blog for the sake of blogging? No. I am saying that there is a Copernican revolution going on in the 21st century, and therapists need to join it. Rather than avoiding technology and the internet we need to start understanding it and harnessing it. You can be googled whether you like it or not. Yelp doesn’t care about contaminating your transference.
Being professional is about how we rise to the occasion of Web 2.0, not deciding to skip out on the party.