ABSTRACT
Case reports detailing quandaries about confidentiality are surprisingly rare in the literature. In the following contribution, Guy Da Silva summarizes two analytic cases, one involving the analysand's conscious desire for disclosure of the analytic work, the other an unconscious desire for “exposure.” Each case, in different ways, illustrates how the desire for disclosure can intertwine with the patient's psychopathology. Like Penelope Garvey in the chapter that follows, Da Silva found that his psychoanalytic community had accumulated very little reliable experience or capacity for professional support at the time of his quandary. Drawing on the clinical ideas of Bion, he details how the analyst's ethical dilemma and his personal struggle to maintain confidentiality further the clinical “work of transformation” in which the analysand's internal difficulties can evolve through the analytic relationship.
