Where do you think a therapist should discuss her feelings about her clients?

In defense of her offensive post in which she says disparaging things about a patient, Maderine commented on my post of earlier today that:

a) She had (or could have) changed identifying characteristics of the patient so it's perfectly OK, and
b) Gee, she was just expressing her own emotions at the experience of having this patient (oh no!) be difficult to deal with.

What you missed in my original comment, Mandarine, was that in crying out for attention about this, you are exhibiting the very behavior in which you criticize Patient X.

You certainly could have said:

"I have a patient with a difficult diagnosis that requires significant time and attention. He/she has consistently cried out for attention to the degree of feigning illness and making a false claim against me.

"This has caused me great distress, ..."

Is there any reason to identify the patient any further? This is not a scholarly article you are writing for a medical journal in which "removing identifying characteristics" is appropriate and (more importantly) agreed to by the study participants who sign a release allowing this. Do your patients sign a release allowing you to describe them in ANY way in an online blog that is personal, not professional? Doubtful. I doubt any legal privacy policy would even allow that.

If you are absolutely sure of your ethical position, let's take the post to a discussion group of therapists and ask them. Better yet, let's take it to an ethical review board in your state or let your hospital administrator review it.

Even better, you could suck it up like a moral human being and say "My feelings are hurt by this person and I'm angry and a little embarrassed by it all. I tried my best and am frustrated by the experience of treating a person who is not responding. I feel helpless. I cried out in my blog because of these feelings, and maybe I went too far. I will think about this and consider my clients' privacy more thoroughly in the future."

Maderine, the place for you to discuss your feelings about your patients is with your own therapist, a colleague or your boss. Not the Web at large. Even if you really, really want to. Just like your patient, you are desperately seeking attention. I only hope you won't sacrifice the dignity of another human being to get it.

P.S. I laughed out loud when I read on your profile that the first "interest" you list is "fiction." Maybe you ARE your patient.