Page 26 - Jan_Feb_2023_Newsletter

Privacy, disclosure and the submission of articles

and letters

Raymond Reyes, MD

Psychiatrists train with the preeminence of confidentiality as a value. It was that way
in my residency. Self-disclosure, to others but particularly to patients was discouraged,
almost prohibited. I was steeped in the practice of asking myself beforehand, "who will
this benefit?" I conducted myself according to this belief. And then in recent years,
twice I've served on panels at the Annual Meeting where speakers promoted the idea
that self-disclosure to patients, supervisors, and various others was seen as beneficial, even advantageous. I was
initially uncomfortable with the assertions of my panelist colleagues; I would say I've learned and have a broader
perspective.

This essay is not about whether we ought to disclose. At last night's Council meeting our Communications chair
Dr. Peter Forster exhorted members to contribute to our newsletter. A member-driven periodical is superior in
quality. APA awards to the Northern California Psychiatric Physician decades ago, attest to this principle.
Writing is a kind of disclosure. This recurrent Musings feature in the Newsletter invites the psychiatrist member
to reveal how we live, think, practice, and feel. And to have candor about these matters involves taking a risk.
Reactions among readers can sometimes include perhaps a negative evaluation. Thinking about this I reflected
on my past years editing the Newsletter. One feature that appears less frequently these times is the Letter (or
Letters) to the Editor. I am someone who prefers discussion toward consensus-building; the reality of
disagreement and even discord, leads I think to improved understanding, hopefully acceptance. I've often pointed
out that minority viewpoints keep us honest and enhance consensus. To concur, and to disagree in writing
certainly is a risk.

Why do we exist as a professional Society? We value collegiality. Knowing what we and others are about draws
us closer together and promotes fellowship. Members I meet and may have missed for a number of years have on
occasion mentioned something I've written. Very few greetings are as warm, genuine and definitely gratifying.

Risky or not, there is much to talk or write about as contemporary psychiatrists. There is a dwindling workforce,
with replacement by midlevel practitioners. Reimbursement, access and care availability are perennial issues.
The way we practice is in evolution, with a reduced emphasis on dynamic psychotherapy. I am a conspicuously
old-fashioned psychiatrist employed in the correctional system. At least a third of my time face to face with
patients is spent explaining who and what I am, the service(s) I represent. Reflecting on this reality is, I will
admit to the reader, sometimes a lonely endeavor. Add to that health issues, advancing age and other existential
matters. Having a personal therapist or psychiatrist is helpful. Time was when each psychiatrist had their own
psychiatrist.
Can writing be considered a form of personal psychotherapy? Others more learned that I, can debate the merits
of this notion. But at the very least, by submitting Letters to the Editor (as well as other articles) we can enjoy
OWNERSHIP of our Newsletter, in my view an important component of membership.

NORTHERN CALIFORNIA PSYCHIATRIC SOCIETY Page 26 January / February 2023