Again I am enormously appreciative of the discussion here, especially
Sophie's contribution, which is a wonderful articulation of the complex
intersection between a frame and the human drama that takes place within
it (at its edge, and sometimes just beyond its edge).

Sophie's example of the three covering analysts is an excellent one. I
hope that if I were faced with a patient who needed to keep such a
secret that i would have the wisdom to respond empathically, like the
third analyst. One could argue that in this instance  the other
analysts' intrusive need to know reflected a personal desire that
exceeded the necessary frame. I do think that the two secrets (David's
and Sophie's) are different. One difference is that David's potential
patient was already testing him with respect to the sanctity of a future
therapeutic relationship: "if I trusted you and became attached here,
would you protect me from someone who might intrude upon my treatment?"
Sophie's secret does not seem to contain any analogous contradiction.

So having rules shouldn't mean being rule-bound. I have found (through
painful experience) that it is simply not possible to anticipate the
ethical and therapeutic conflicts that might arise from seeing patients
who are connected. I appreciate the training-analysis analogies, but
some of the stories I've heard regarding waiting-room encounters and
complicated overlaps with colleages and associates have been bitter
ones, not necessarily just more grist for the therapeutic mill. I agree
with Michael that these choices are not always simple: that tolerating
ambiguity is as important as keeping the frame. Again, for me, the frame
is that set of rules that permits me the maximum leeway for creativity,
flexibility, and a chance to focus as completely as possible on the
patient's story.

thanks to David and all for this open and edifying discussion.

paul hamburg