Counselling, Confidentiality and Airbag Moments
There is a clear boundary around your right to confidentiality in counselling. This boundary line is very important! Understanding it gives you freedom in therapy and keeps you safe as you work through depression, mental health, or other life challenges.
It is important for two reasons.
Firstly, knowing and trusting how big the space is inside the boundary line is really important. A deep understanding of just how private and confidential working with a counsellor is, is also really important. It ensures that you feel safe to be open in your conversation and therapy. Losing control of your privacy or worrying that the counsellor might do something or tell someone you might not want them to is a huge barrier to healing in therapy.
Secondly, knowing where the other side of the safetyline is makes sure that you know objectively when you’re not ok and need more support than you’re currently getting.
I describe counselling confidentially as working like this. Drawing on the counselling as "going for a drive" metaphor I introduced in an earlier blog, most of the time I am the passenger in the car and you are driving the conversation. If, however, we are talking and what you tell me makes me think you are swerving off the road and crashing into a power pole, I become the airbag.
There is no airbag button on the dashboard of a car. When you are having an accident you don't analyse the situation and make the decision for yourself that you are turning the airbag on, nor do you decide, "It’s not that bad a crash. I don't need the air bag". There are sensors built in to the car that assess the impact and if their threshold is breached by an impact of enough danger, the airbag goes off, keeping the driver safe.
The important word here is safe. Not comfortable, unembarrassed or without cuts or bruises. Safe. If you have watched a car accident where the airbag goes off on a movie or a tv show, the airbag has ensured that the driver is alive. They are not having a good experience. It's an extreme situation.
If you are going to harm yourself in a very serious way, if someone else is going to harm you, or someone else is going to be harmed, I need to act as a counsellor to prevent that harm.
I make that decision one person's situation at a time. A lot of the time when I work with someone I never make the choice to act. Sometimes I do. By harm I mean that I am worried you or someone else might die or something almost that bad. Not "things that are harmful".
Also, I only act to prevent harm that could happen. Old danger is in the past and I can't prevent that. Only if it is it part of assessing current and immediate risk is it relevant.
When I am working with you and you have an airbag moment, it's highly likely it will be awkward, uncomfortable and difficult. But you will be alive. That is the choice a counsellor is making when they choose to disclose something you have told them to someone else.
Even if the airbag does go off, what it means is that I tell only the person or people that can keep you safe. Not anyone else. Even then, only what they need to know that's relevant to you staying safe is part of the disclosure.
As I said earlier every decision I make when working with people is driven by my agenda and values. I want them to be having the safe, healthy and awesome life they want. But I also know I am not there to tell them what their safe, healthy and awesome life should be like. They should be in charge of their life. I am not here to tell them what to do or make choices for them.
But "safe and well" is the main value. It overrules "in charge of your own life" if I think you’re hitting a power pole. If you are not here anymore, then being in charge of your life didn't really matter in that moment.
The thing to take out of this is that talking to a counsellor is extremely confidential. Also, preventing harm is the chief value we ascribe to as professionals following our code of ethics (in my case the New Zealand Association of Counsellors code of ethics). We are called to uphold this ethical standard balancing your autonomy against your safety. But the boundary line that causes us to act is a very high bar, and you have a huge amount you can discuss with us that can be harmful, risky or very private and it will stay that way.