Your therapist wrote about you. How does that make you feel?

Say you're browsing through your therapist's just-published memoirs. God how you've always loved their mind, and now that their brilliance is out in the world, you feel proud and grateful that you get to trust this funny, wise, compassionate soul with your story. All of your story, which nobody else has ever heard. "That's my therapist!" you want to shout.

Then, you find something that makes the hair behind your neck stand up. It's a case study. Your therapist is describing a patient who suffers paranoid episodes while traveling. He believes someone has hidden contraband in his luggage. He tears open his bags at the airport check-in counter, the queue behind him watching with annoyance and amusement. He is shaking with fear and shame at how completely he believes, but also does not believe, his delusions. He wants to disappear to escape the torment.

Your therapist then explains the therapeutic technique they used to help this guy.

You know that guy. You are that guy.

Therapists writing about their patients is an evergreen genre. It also presents some of the field's thorniest legal and ethical questions.

Since Freud, the very foundations of psychoanalytical knowledge have been built on therapists documenting insights from their work with individual patients. Because each patient goes through a unique journey in analysis, this kind of knowledge does not lend itself to conventional empirical research with large samples. Writing also helps therapists get objective distance from, reflect on, and improve their work.

Academic utility aside, therapists' accounts could serve to humanise the therapy room and demystify the figure of the therapist. They could also be high on 'entertainment value', even if you are not a mental health nerd. A great example of all these qualities at work is Lori Gottlieb's blockbuster Maybe You Should Talk to Someone. First published in 2019, the book has sold over a million copies.

But what do therapist memoirs mean for the patient's sacred (and legally guaranteed) right to privacy and confidentiality?

Like Gottlieb says she did, therapists can secure their patients' consent before writing about them. They can also avoid writing about anyone they are currently seeing. They can disguise the patient thoroughly such that no reader can identify them. This is the approach Freud himself took with his famous case study on Dora.

Notwithstanding such guardrails, I have to admit that I find the idea of therapists turning their patients' stories into case material deeply uncomfortable.

As a (guilty) consumer of such stories, I do see their point.

But I cannot shake off the feeling that if my therapist were really to write about my fear of luggage sabotage (who did you think I was talking about?), even with my consent, seeing it being broadcast to the whole world would make me want to throw up, dig a hole in the ground, and bury myself in it.

The thing about consent is, you assume that the spirit of it will hold forever. But what if I were to change my mind? What if at the time of granting consent, I wasn't in full possession of my rational faculty? What if I don't want my story to be monetised, turned into a Lancet paper, or more terrifying, into a 'major motion picture'? What if I couldn't say no to my therapist because I couldn't risk straining our relationship or, shudder, disappointing them?

I'm excited that at Sanity's 2024 annual meet-up, we will unravel this tantalising pull between a therapist's professional need – even responsibility – to create knowledge based on their work on the one hand, and professional ethics and patients' rights on the other.

Please put your hands together for Mukti Shah, one of the most powerful and sagacious voices from the therapist community here on Sanity, who will be speaking on this topic at the meet-up. Mukti has also kindly agreed to take our questions, of which I have a few spicy ones.

I know a lot of you do, too. You can't miss this. Register below. (PS: It's a free event with limited places available for people who are not Sanity community members, so do share the link with your friends.) See you there!