Response to Stone’s “Thinking About Our Work: Case Presentations Robert Pepper1 issn 0362-4021 © 2014 Eastern Group Psychotherapy Society group, Vol. 38, No. 2, Summer 2014 171 1 Director of Training, Long Island Institute of Mental Health. Correspondence should be addressed to Robert S. Pepper, LCSW, PhD, CGP, 110-50 71st Road, #1e, Forest Hills, NY 11375. E-mail: DrRobertSPepper@aol.com. As an author of numerous articles on boundaries, I have often fretted (along with other writers on psychotherapy) over the challenge of using clinical material while protecting the confidentiality of the patients. Some of us, me included, have met this task with mixed results. For example, in the preface to his book Nearer to the Heart’s Desire, a collection of case vignettes, George Weinberg (1993) wrote that “all names, physical descriptions, places, times of occurrence and identifiable events have been changed. Obviously my patients have the right to absolute confidentiality” (p. vii). However, in the chapter titled “Tennis, Anyone?,” the story of a deeply troubled female professional tennis player, Weinberg (1993) disguised her identity only to provide the reader with the real full names of other women with and against whom she played, obviously revealing his patient’s identity to anyone knowledgeable about tennis or inclined to look up the matches. After reading this chapter, I couldn’t help but wonder why no one picked up this glaring faux pas before publication. Could it be that there is confusion as to what constitutes boundaries and confidentiality in writing about patients? As complicated as it is writing about individual psychotherapy patients, it is even more complicated when writing about group therapy. Obviously, the ethical writer disguises identities, but sometimes members recognize themselves anyway, as Stone also points out. And even if the injury does not rise to the level of an ethical violation (or even worse, libel), damage can be done. In one case, for example, from my own writing of clinical experiences, a middleaged female group member was able to identify herself in an article that I had published about boundaries in group. She confronted me in the group and told me in 172 pepper front of the other members that she felt angry, hurt, and betrayed by me. The group rallied around her, supported and protected her. Some worried that perhaps they were not safe with me and that one day I could do the same thing to them. It was a mess. I bit my tongue when I felt the urge to get defensive. Instead, I gathered my strength and sat silently as it all played out. And even though I thought I had been scrupulous in hiding critical identifying facts, she read my unconscious and figured out about whom I was writing. I felt guilty about what I had done to her, even if it was inadvertent. I identified with her sense of having her confidence violated by someone she trusted. And just when I thought it all might turn into an ugly group revolt, she said something that shifted the whole mood in the room. She told the group that what had offended her most was that I had referred to her in the article as “middle-aged.” The group erupted in hilarious laughter. The group moved on, and she and I moved on. She had had a strong attachment to me, and over the time we worked together, there was much more good than bad. She was able to forgive me and let it go. In retrospect, one factor that seemed to have played a significant role in defusing the potential for greater harm here was that the group took place in a secure frame environment. Members were known to each other only on a first-name basis; there was no contact outside the group. I believe that anonymity and safety were preserved here because “looping” could not occur. Whatever happened in group stayed in group. No part of it could come back to haunt her in her real life. It has occurred to me that both examples have at least one thing in common, aside from their manifest intention of furthering professional knowledge. They both reflect, to some extent, the...