Appropriate to share therapy notes?

Q. My therapist feels its not appropriate to share her notes and findings and theories on me with me, for fear it could inhibit progress. Is that right? - Rowan

A: Usually this is a real risk. Being a counselor, I know it's very hard sometimes to know how much to tell a client, and when. I also have to figure out if it's helpful to share that information, for the client, rather than just sharing clinical tidbits or jargon that makes sense to only me.

When working with someone who might have Dissociative Identity Disorder, this is a very complicated process. If the therapist tells too much, too soon, then people in the system may feel like the therapist "knows too much" (unsafe), "told my secrets" (untrustworthy), or worse "doesn't know what they are talking about!" (disconnected, not listening, not a good counselor, making up illnesses, pushing medications, etc.). The reactions from clients could be firing the therapist, refusing to seek outside help from referral sources (like medications), increased self-harm or suicidal thoughts, or severe loss of progress and trust in the counseling relationship.

Counselors should be able to tell you some basics, like what is my current diagnosis, are we making progress, are we a good fit, do we have an agreed upon set of boundaries or rules that both sides feel comfortable with, is medication an option or even recommended, are there other types of treatment or self-care things I can be doing to help my recovery?

I also don't like to share my notes because they are hard to read (handwriting), hard to understand (usually fragments or phrases that make sense to me), or are required but not therapeutically required (i.e., required by insurance companies for billing). I may also choose to leave out certain things from a chart because they are highly private and I don't think they are specific to the treatment, but I want to protect my client's confidentiality. For example, if I'm working with a client for anxiety that appears to be related mostly to a medical condition, I may opt to leave out the fact that my client discussed their homosexual lifestyle one session because it isn't directly related to our focus and therefore should remain private from anyone else who may read that chart. I want to be a counselor, not an informant.