In a message dated 97-10-30 12:06:27 EST, Paul Hamburg wrote:

<< David Mittelman presents the dilemma of a patient who is reluctant to
reveal the source of her referral (another patient) as she comes in to
seek treatment.

I feel perfectly comfortable with the way you handled this dilemma. What
I would have done differently is only to explain to the patient that my
policy would not allow me to knowingly treat two friends. Since there
was no possibility of continuing a treatment, the visit would be a
consultation, it would be unnecessary to question her reluctance to
reveal the name of the referring patient—it is not terribly relevant for
the purposes of arranging referral to a colleague—and there might have
been less sense of question regarding the success of the intervention.

I find clear rules in such moments to be liberating for me and for the
patient even as their effect is to limit the possibilities of action.>>


Thanks Paul!  Your approach would have certainly simplified things.

I recall that about three years into my analysis, I was entering my analyst's
waiting room only to greet a colleague and who was coming out of my analyst's
office.
"She must be in supervision with him,"  I thought.  What a fantasy indeed!
 It turned out that she had been seeing him for several years prior to my
ever having met him!
It stirred up much useful material in the therapy, and it did not seem to be
an impediment to the work (although she and I briefly discussed our
respective treatments on a few occasions, and to that extent it created
another arena for acting out).  However, I'm certain that it might have been
quite different had she been a close friend of mine.

David Mittelman