[mindmechanic]

The therapist and I would sometimes do video call on Skype, but two weeks ago, I decided to stop doing call with her. A few nights ago, I was cleaning up my phone, removing apps that I no longer use. When I opened the Skype app, the homescreen had a new feature showing "People You May Know." Aside from the therapist, I only have two other contacts on Skype. I figured that some of the names on the list could be the therapist's contact.

I brought it to her attention through email that evening. I wrote that this feature on Skype means that there is a breach in patients' privacy and confidentiality. I thought it's something she might want to know because she probably isn't aware of it. And indeed, she wasn't.

When we had our phone session, I jokingly said, "You're welcome" without her saying thank you. She said, "I don't need to say thank you to you until I hear back from the cyber security people at XYZ University-Hospital." I said, "What are you inquiring with them? It's a feature on Skype. Skype is a social platform like Facebook. That's why it had such a feature. After all, Skype is not for business or professional work and isn't HIPAA-compliant." She responded, "I don't need to tell you what I'm inquiring with them." I said, "Are you accusing me of something?" She said, "No, I'm not." I let it go at that moment.

But as I reflect on that session, I find something off about it. Although she did not outwardly accuse me of anything, the fact that she didn't show any appreciation and instead are bringing it to the cyber security folks at the hospital suggest that she doesn't have any basic trust in me. And that hurts. I was only a messenger. There is a phrase that goes, "Don't kill the messenger." I did the right and a good thing by bringing it to her attention. Not even a "thanks."

I sent her a text saying that hurts and if you do not have basic trust in me, then what basis is there for a relationship? I find myself in a Catch 22 situation. She said this is content for therapy. I said that I didn't want to come in and face you if you don't even have basic trust in me.

What does she think is going on? I hacked her account? If I did, why would I send her the screenshots of the feature on the homescreen of my Skype account? To shoot myself in the foot? What is there to inquire with the cyber security folks? It's like going to a nutritionist and why McDonalds serve junk food. Umm, because it's a fastfood place?? Her not appreciating my gesture weighs heavily on my heart. It shows that she doesn't have basic trust in me.

Is there another way to see this situation?

[HD7970GHZ]

I will reply to this later. Unfortunately I am in a rush right now. Try to be gentle with yourself while dealing with this situation.

Thanks,
HD7970ghz

[mindmechanic]

Thank you. Amid some other rocky things happening with the therapist, I didn't go to bed until 2am that night. But that's a different topic altogether. I'm finding that we may be fundamentally a bad fit... after three years of working together.

ETA: In my email to her, I did share that I looked up some of those names on the list. I said that it is a hypervigilant thing that I do. I had previously shared with the therapist that I do this in every aspect of my life: professors; supervisors; coworkers; and peers - basically anyone who comes in contact with me. Now, if I can see those names on my Skype account, chances are they can see me, too. So being hypervigilant and always covering my back, I looked them up.

The therapist said that what I did was wrong. She said that if I knew they were possibly her patients, friends, or family, I should not have looked their names up because that is "snooping."

I did feel guilty for what I did. But I wasn't sure if it was truly wrong. The therapist said it is wrong. I asked a clinical social worker and a friend and both said it wasn't wrong.

The therapist already knows that I have looked her family up in the past. One of her daughters work for a journal and the therapist knows that I have read her news articles. Back then, the therapist didn't say that what I did was wrong. In fact, she said, "What's public information is public."

But what I did in this instant is wrong? What's the difference? Or did she change??

[Out There]

Sorry you're in this situation and feeling like this. Everything runs on algorithm now and connects things that people don't always want connected , which then can be seen or construed as " something " Maybe your T isn't tech savvy , but it's left you feeling horrible when you did the right thing by bringing it to her attention. I hope you'll be able to work through this.

[mindmechanic]

Yeah. My friend said that perhaps she isn't tech savvy. But even if she isn't tech savvy and knowledgeable that this is how social platforms are these days, couldn't she have appreciated my bringing it to her attention? Even if you're not tech savvy and aren't sure how what is happening, is happening, why couldn't she say "thanks?" The fact that she didn't suggests a mistrust in me.

I've been nothing but transparent to her all this while. Hurts bad.

[Out There]

Sounds like she's got a bit paranoid and probably isn't sure what's happening to respond in a way that you would like or expect. Maybe she'll be different once it's explained. But it's hit a trust issue for you to explore , although I understand completely that you feel hurt.

[Salmon77]

It was good that you brought the issue to her attention and I think it would have been nice if she'd thanked you. I wonder if the lack of thanks might not be such a big deal if you didn't have other issues with her right now.

I probably would've googled the other people, too. I guess maybe it's snooping--like if she left an address book lying open where you could see it, you'd know it was probably not meant for you to see, so the "right thing" would be to ignore it. But I don't think you did anything terrible at all.

[ArtleyWilkins]

My guess is she replied to you the way she did because of how you sort of snarkily said "You're welcome." Yes, you say you said it jokingly, but your response to this minor omission of a "thank you" kind of supports that her perceiving your "You're welcome" as snarky and rather passive-aggressive is probably accurate. You bear some responsibility for her response to your comment.

She's checking with the tech people because that's what you do when you are working for a company and a technical issue comes up. It isn't a matter of not trusting your input about the Skype thing; it's probably normal protocol to take such matters to technology when they come up.

[nottrustin]

This is why Skype is not a recommended way of communication as it is not HIPAA compliant. There are some sights that are. Emdr uses one on occasion that is not only HIPAA compliant but free. I can understand why you looked the other people out of curiosity....was it the right thing to do? It is completely understandable though.

[RaineD]

Maybe she construed your email as an attack and became defensive.

[mindmechanic]

@Out There: I thought about that, too. I am actually learning that, when working with this therapist, whenever something major just came up and is raw, it's best not to show up for therapy. When she had a premature grandchild and had to move out of state, I vented in session and she lost her professional stance and gave responses that was personal rather than professional. And now this, too. You could be right. She was probably shocked and feeling so uncomfortable.

@Salmon77: But a therapist should be able to separate or categorize issues, right? Just because there may be tension in other areas doesn't mean you can't still have basic courtesy and say "thanks." There are definitely issues in our therapy work. But the session started out fine. No hostility until this point.

I can see how it could be protocol for her to report it to the cyber security folks at the hospital.

But, @ArtleyWilkins: I don't think it's a minor omission. I had said to her that stumbling upon this made me feel very, very uncomfortable, exposed, and naked and I wanted to hide and not come into therapy. Despite this feeling, I still shared this with her and showed up for therapy. When someone brings such a HIPAA violation to your attention, I think it's huge and basic courtesy would be good. I said, "You're welcome" to her to try and bring a close to that topic and move on to something else.

[Accesshoop]

Part of her response may be due to the fact that she knows she screwed up...big time. Sounds like she is using an app without required protections. I am guessing the cyber security folks are not going to be impressed with her disregard for security requirements. Snooping at a list of names on her desk would also be her problem. You have no legal obligation not to look; she has a legal obligation to keep patient information secure. In this case, a better analogy would be is that she (knowingly) mailed you a list of patients. She is the one in the wrong, not you. Although maybe her attempting to get some cover might be acceptable, trying to throw responsibility at you is completely inappropriate and unethical. I totally get that technology adds in whole new dimensions of complication, which just reinforces my belief that a person shouldn't be using what they are ill-equipped to manage responsibly. Perhaps she went to the security folks before she used this, but if not, in my opinion, she should be sanctioned/disciplined. I have fired employees for violating data privacy laws, regulations and policies. If a breach of your information has occurred, you have the right to know and to understand what she and the organization are going to do to rectify. In addition to HIPAA, if she treats children, she may also have violated COPPA. Clearly, this really ticks me off! Apologies if I offended.

[feileacan]

You know what your story reminds me of?

Few years ago I read an article my T had written in English and put on his professional web page. As English is not his native language, it had lots of grammatical errors in it. Honestly, I felt embarrassed that he put this piece up without letting someone edit it first.

I actually even considered editing it myself. I even started the work but I did not finish it because I imagined that if I would finish it and give him the edited version he would not appreciate what I had done and would not use it. Instead, he would inquire about why did I feel necessary to edit his paper and I honestly did not want to answer this question because the answer was plain obvious - because his writing in English was so bad.

Anyway, yeah, I figured that he would have been totally ungrateful. Neither did he thank me for saying that his wife's (who also an analyst in training) fb profile was totally open to public, although the wife's profile settings were changed after that. What a d...!

[mindmechanic]

We had a session yesterday. The therapist said that she felt like I was controlling her about what to say when I said, "You're welcome" to her. I feel like she was reading too much into it. For one, I said it in a humorous tone. And two, I said it to put a close to that topic and move on to something else. She did write me a note 10 minutes before session expressing this. In it, she also said that she appreciates my bringing it to her attention. She also wrote that while looking up names that I think may be her patients, friends, or family is wrong, it is understandable.

I don't get how my looking up the names on the Skype list is different from how I looked her up early in our work and found a wealth of information about her and her family because of her ex-husband's public status. I even once asked if she had a twin sister, and she responded saying no. She also knew that I was reading some articles that her daughter wrote for a news journal. Back then, she said that what is public, is public. She didn't say that what I did was wrong. She affirmed it and said what is public, is public. But now, what I did with the Skype list is wrong and considered "snooping?"

If I kill someone out of self-defense, is isn't actually wrong is it? My intention wasn't to snoop.

[feileacan]

So, what is your main complaint about her about this issue right now?

[mindmechanic]

Why she thinks that looking up the names - people who I think could be her patient, friends, or family - on Skype wrong? But other times when I look her up on Google and her family and read her daughter's article, it's not wrong? She said the former is snooping and wrong. But she said the latter is public information, so what is public, is public.

[Lemoncake]

I don't think it's exactly the same thing. She's potentially exposing her other clients.

Edit: I mainly see R online on skype and emailed him about this too now.

[mindmechanic]

Yeah. And she said that she had transitioned all her patients to Zoom - it's HIPAA compliant. But she was still using Skype with me because that was what we had been using all this while before she transitioned her patients to Zoom. But guess what? She had a patient scheduled right after me yesterday. And the patient called her in from Skype. I recognized the Skype ringing sound.

She also said that she is very strict about HIPAA stuff. If you're so strict about it, then why were you still using Skype with me? There's nothing to take up to cyber security. It's about doing away with Skype completely and using something HIPAA compliant like Zoom.

And she said that my looking the names up on Skype knowing they could be her patients, family, or friends is wrong. But when I looked her up on Google and Google search led me to her ex-spouse and family and I looked them up further, back then, she didn't say it was wrong or snooping. In fact, back then, she said that what is public, is public. I don't see the difference in this sense.

Originally Posted by mindmechanic

We had a session yesterday. The therapist said that she felt like I was controlling her about what to say when I said, "You're welcome" to her. I feel like she was reading too much into it. For one, I said it in a humorous tone. And two, I said it to put a close to that topic and move on to something else. She did write me a note 10 minutes before session expressing this. In it, she also said that she appreciates my bringing it to her attention. She also wrote that while looking up names that I think may be her patients, friends, or family is wrong, it is understandable.

I don't get how my looking up the names on the Skype list is different from how I looked her up early in our work and found a wealth of information about her and her family because of her ex-husband's public status. I even once asked if she had a twin sister, and she responded saying no. She also knew that I was reading some articles that her daughter wrote for a news journal. Back then, she said that what is public, is public. She didn't say that what I did was wrong. She affirmed it and said what is public, is public. But now, what I did with the Skype list is wrong and considered "snooping?"

If I kill someone out of self-defense, is isn't actually wrong is it? My intention wasn't to snoop.

I'm very surprised at her response, as I thought Accesshoop's theory seemed right on.

I can see how the "your welcome" might feel controlling-but that is her countertransference. If she works with the transference, her feeling could be used to explore your 'out of control' feelings. My T sometimes does this since projective identification goes on a lot in analytic therapy....

However, in this case, I think your concern should have been taken seriously when you first brought it up rather than analyzed. It is concerning that her clients can be exposed by the automation of social media and a very valid concern. Your reaction to her not thanking you, it seems to me, is related to your concern about her lack of concern.

There was no need to make it about her feelings and even though you said "your welcome", her defensiveness is hers alone, not your responsibility to prevent or manage.

[mindmechanic]

@octoberful: That's why I think that countertransference can be dangerous. Sometimes the therapist's countertransference may not be an accurate feeling of what is actually taking place. But therapists follow their countertransference and use it to understand what is happening in therapy. And her defensiveness bothers me because if she doesn't even have the basic courtesy to say thank you when someone brings something major to her attention, I can't have any respect for her as a person or a therapist. And it jeopardizes our work.

I think that's crazy and stressful how a harmless and humorously said "you're welcome" can be perceived and misconstrued as a way to control her. I was merely trying to put an end to that topic so we can move on to something else.
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ETA: I was rereading Accesshoop's response and had a funny thought came to my mind. I'm not going to do anything with the names on the list. But imagine if the therapist has a totally out-of-control patient who starts harassing or stalking other patients - assuming that the names on the list really are indeed patients' names. There goes her career. Seriously. Her license would be revoked. And she is someone who has written papers on ethics...... Just saying.

That's why I find it odd that she claims herself to be very strict about HIPAA. But she still used Skype, did not transition me to Skype, and even after this feature was brought to her attention on Wednesday, her patient who was scheduled the same minute that my therapy session ends, called her on Skype. I could hear the ringing and recognized that it was Skype's video call ringtone.

[mindmechanic]

Do you guys think I should send a note to the therapist NOT to bring it up to the cyber security folks at the university-hospital if she wants to keep her job? It didn't occur to me until you guys said that the cyber security folks would not be impressed. What if they are somehow obligated to report such violations to the university-hospital??

[susannahsays]

By saying you were wrong to Google the names that came up on Skype, it seems to me like she was not taking full responsibility for using Skype and therefore not maintaining strict HIPAA compliance. While there could be arguments that looking up names that you knew might be other clients isn't quite right morally*, that is a completely separate issue from her transgression. She cannot expect you to diminish the effects of her actions. It was her responsibility as the provider to maintain HIPAA compliance. Skype is well known to not be HIPAA compliant. If she had done her due diligence - even a basic Google search on this - she would have known.

As for the whole feeling like she doesn't trust you thing, I admit from your exchange I don't really understand where you came up with that. This woman is clearly either not tech savvy at all and is completely reliant on an IT department or company to manage things for her, or she didn't know what else to say. I agree that it would have been good for her to express appreciation that you brought the issue to her attention in her initial response - and I think it was reasonable for you to have expected this. I do think your "you're welcome" comment could have easily been misinterpreted. If someone said that to me, I would not perceive it as them making a humorous comment to close the topic. I'm also wondering if it's easy to tell when you're making a lighthearted or humorous comment. I know you've mentioned before that you're schizoid, and people with that diagnosis can sometimes come across as humorless and flat emotionally. Obviously, people are different and that may not apply to you, but sometimes it's hard to tell when certain people are serious and when they are joking - and that actually applies to everybody, not just schizoid individuals. As for the controlling thing, I don't really know what she meant by that, unless she was referring to you feeling like she doesn't trust you just because she consults with professionals.

I don't know if I'd call what could be happening countertransference, as that would indicate she was bringing emotions that have nothing to do with you into her relationship with you. I do think that your tumultuous relationship with this therapist may have resulted in resentment on both sides. You clearly have some towards her, and while she is supposed to be able to manage her feelings, "supposed to" does not necessarily translate to "does."

*I think of it similarly to when celebrities have nude photos leaked online - like that whole iCloud thing. I think it is morally wrong to view such pictures, even if they are publicly accessible, because they were obtained without the permission of the subjects. The names on the Skype, if they were or even could be clients, were in breach of HIPAA and therefore represented an illegal disclosure of client information. You can't help that you saw the names, but you can avoid taking advantage of an illegal disclosure. Other names you might look up in association with your therapist are different because they are not subject to legal protections or privacy laws.

[mindmechanic]

@susannahsays: Thank you for your feedback. I wonder a lot, too, if she has some resentment towards me. When I ask her, she denies having any anger or negative feelings towards me.

Oh, she is not very tech savvy, but she is well aware that Skype is not HIPAA compliant. She just didn't expect it to have such a feature. lol

I don't think she or anyone else gets to decide whether what I did with the names is wrong or not. I didn't cause harm. I did it as a hypervigilant thing to protect myself. I Google professors, teachers, coworkers, supervisors, and peers. I do that to keep me safe. If I kill someone in self-defense, that killing is not morally wrong.

And question. Patients' names aside, the therapist also said that it was wrong for me to look up the names if I thought that they could be family or friends. But early and throughout her work, she was well aware that I knew stuff from Google about her and her family. But she affirmed that it wasn't wrong or snooping and instead said that what is public, is public. So it's okay to look her and her family up on Google; it's not wrong or snooping. But looking the Skype names up is wrong?? That's not very consistent.

Originally Posted by mindmechanic

@octoberful: That's why I think that countertransference can be dangerous. Sometimes the therapist's countertransference may not be an accurate feeling of what is actually taking place. But therapists follow their countertransference and use it to understand what is happening in therapy. And her defensiveness bothers me because if she doesn't even have the basic courtesy to say thank you when someone brings something major to her attention, I can't have any respect for her as a person or a therapist. And it jeopardizes our work.

I think that's crazy and stressful how a harmless and humorously said "you're welcome" can be perceived and misconstrued as a way to control her. I was merely trying to put an end to that topic so we can move on to something else.
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ETA: I was rereading Accesshoop's response and had a funny thought came to my mind. I'm not going to do anything with the names on the list. But imagine if the therapist has a totally out-of-control patient who starts harassing or stalking other patients - assuming that the names on the list really are indeed patients' names. There goes her career. Seriously. Her license would be revoked. And she is someone who has written papers on ethics...... Just saying.

That's why I find it odd that she claims herself to be very strict about HIPAA. But she still used Skype, did not transition me to Skype, and even after this feature was brought to her attention on Wednesday, her patient who was scheduled the same minute that my therapy session ends, called her on Skype. I could hear the ringing and recognized that it was Skype's video call ringtone.

What I meant about using the countertransference is-

-You seem to have felt out of control about not having protection about your privacy
-She felt controlled as a response

You weren't feeling the feeling of being out of control, so you communicated the feeling to her with her reaction feeling you were trying to control. That is what sometimes known as projective identification, and a good T can use that to work with you.

But that issue doesn't apply here; I brought it up only fyi. I was trying to say I don't think it's appropriate to use the situation to analyze you. Her reaction is inappropriate overall, all the focus on you (such as Googling people-really?) deflects from her, more defensive reaction.

My T has been careless, too. In the past, others in his family have seen my emails and name, and it makes me wonder if he is careless if he is demonstrating poor judgment with privacy. I think there is a difference. I brought it up to him once before, but it's not a major issue of concern for me and I trust him a good deal.

Given the inappropriate reaction by your T, I am guessing she may be somewhat humiliated by a client bringing her professionalism to her attention. Sort of a like a dent to her pride. Not sure how to explain it, but it's only a guess.

Originally Posted by mindmechanic

Do you guys think I should send a note to the therapist NOT to bring it up to the cyber security folks at the university-hospital if she wants to keep her job? It didn't occur to me until you guys said that the cyber security folks would not be impressed. What if they are somehow obligated to report such violations to the university-hospital??

I don't know. I would not. Let her deal with it. She probably already knows the violation.