No Secrets

Secrets are hot commodities these days.  I just finished reading The Secret History of the CIA, by Joseph J. Trento, 2001.  Concurrently, I just received the latest issue of my Duke Alumni Magazine, “The Secrecy Issue.”

In my former life as a psychiatrist, confidentiality was the premise upon which the “therapeutic alliance” relied.  There was a time when confidentiality could be assured, but no more.

I make a distinction between “privacy” and “secrecy.”  Also, definitions of “secrecy” differ with respect to individuals vs. groups.

Through all the hubbub, I wonder what might lead an individual or a group to keep secrets.  One reason is that they know what they have done or are doing is wrong, so they feel ashamed.  Another possible reason is that they are afraid.  They keep activities secret for fear of judgment.

I used to tell patients that if it weren’t for gossip, therapy wouldn’t be necessary.  As soon as information of any kind leaves your lips (or typing fingers), you lose control of it.  Not only that, there is no guarantee your secret will be communicated intact.  There is always the temptation to embellish, distort, or otherwise use information to serve another agenda.

In health care, the Health Insurance Portability and Accountability Act (HIPAA), promulgated as a means to protect patient privacy, has done just the opposite.  Because of the exceptions, everyone who controls even a portion of the payment has justification for prying into patient records, for every conceivable reason.

What ultimately results is that information, misinformation, obsolete information, and gossip are mixed in a basket of data that has minimal relevance to the person whose medical, school, employment, or legal records implicate.

It is said “knowledge is power,” but ignorance is also power, the power of denial.  Secrets are burdensome to those holding them, whether owner of the secret or her confidante.  Sharing the secret unburdens the carrier.

Secrets within a group, such as in secret societies, or within an organization like the CIA, create a morass of confusion, with personal agendas creating internal conflict, information hoarding, and intrigues within the organization.  Government secrecy has become a “transparent” issue.

Certainly if the government were not allowed to operate in secret, it would become more accountable.  However, every truth and partial truth has its “spin.”  People will believe what they want to believe and will refuse to see what they don’t want to see.

Possibly the biggest secrets are the most obvious ones.  Perhaps the universe has no secrets, for those who want to see.  Maybe this is the biggest secret of all.