Opinion ID: 1714111
Heading Depth: 2
Heading Rank: 2

Heading: Chapter 905 Waiver

Text: ¶ 112. It is undisputed that patients can prevent disclosure of communications made for purposes of diagnosis or treatment of the patient's physical, mental or emotion condition . . . . Wis. Stat. § 905.04(2). However, the patient waives this privilege if she voluntarily discloses any significant part of the matter or communication. Wis. Stat. § 905.11. In this case, the matter at issue is whether Charlotte underwent recovered memory therapy. Charlotte and the defendants deny that such therapy occurred. However, Charlotte's voluntary disclosures lead to a different conclusion. Charlotte waived her § 905.04(2) privilege by voluntarily disclosing a significant part of the matter  namely, persuasive information that she underwent recovered memory therapy. ¶ 113. The lead opinion summarizes the grounds for waiver: [T]he Johnsons claimed that confidentiality did not apply to Phillips' records, and Charlotte otherwise waived her privilege and confidentiality rights by: (1) signing the limited release for her records; (2) providing medical bills to her parents that related to her treatment; (3) confronting her parents about the abuse during her therapy sessions; (4) telling her high school friend, [Nidhi] Jain, that she was in therapy and being hypnotized; (5) filing a restraining order against her parents; (6) communicating with an attorney about commencing a suit against her parents for the abuse she believed she suffered. Lead op., ¶ 25. ¶ 114. After evaluating each of these grounds in isolation, the lead opinion concludes that Charlotte did not waive her confidentiality privilege. Lead op., ¶ 78. But the grounds cannot be fairly evaluated by considering one, rejecting it, and then considering another afresh, as if no other ground existed. Rather, the grounds should be considered together, as a totality of information. [8] ¶ 115. In furtherance of this purpose, the following is an application of the facts construed in favor of the nonmoving party (the Johnsons), to the legal standard of voluntary disclosure. It reflects two changes from the lead opinion's waiver analysis: First, it considers some additional grounds culled from Charlotte's voluntary admissions at her deposition. Second, it revises the order of presentation. As noted above, some of these grounds individually justify a finding of waiver, and when the grounds are viewed collectively the finding is inescapable. ¶ 116. Charlotte testified at her deposition that she originally entered therapy, in the form of 12-step programs in Alcoholics Anonymous (AA) and Overeaters Anonymous (OA), due to alcohol abuse and an eating disorder, bulimia. ¶ 117. In 1991 she entered the care of Kay Phillips, but she has refused to disclose who referred her to Phillips. Most patients entering treatment for eating disorders or alcohol abuse do not undergo recovered memory therapy to treat their problems. We know, however, that many recovered memory therapy patients enter treatment for a disorder other than their memories of abuse. Widom, Accuracy of Adult Recollections of Childhood Victimization at 42; Bass, The Courage to Heal at 50, 217-19; Wakefield, Return of the Furies at 149; see generally Pope, Recovered Memory Therapy for Eating Disorders. ¶ 118. Charlotte's billing records show that after her referral to Kay Phillips, Charlotte received extensive psychotherapy treatment during 1991, 1992, and 1993. While this fact is not determinative of the type of treatment Charlotte received, it provides another data point to consider. The AA 12-step recovery program makes no mention of psychotherapy. [9] The OA 12-step program was adapted directly from the AA program and similarly does not reference psychotherapy. [10] This suggests that Charlotte's therapy progressed beyond limited treatment for an eating disorder or alcohol abuse. [11] At her deposition, Charlotte testified that she believed her eating disorder and alcohol abuse were symptoms of the fact that she was abused as a child. ¶ 119. Next, as Charlotte testified at several points during her deposition, she began to experience  and experiences to this day  flashbacks to her childhood, and specifically, to memories of childhood abuse. Charlotte also experiences body memories of abuse. As discussed above, body memories are commonly reported among abuse survivors undergoing recovered memory therapy. Charlotte has somehow preserved these memories despite the fact that she can remember almost nothing else from her life before age 14, and little of her life thereafter. At her deposition, Charlotte had trouble remembering the names of lifelong friends, and testified that she could not remember the names of old roommates, boyfriends, or other acquaintances. It is of course possible to maintain the belief that a patient might experience such flashbacks and body memories absent the use of recovered memory therapy. ¶ 120. At her deposition, Charlotte admitted that she owned The Courage To Heal, but claimed that she never read it. She stated that she bought it because it was common knowledge among participants in the types of programs she took part in that she should purchase it. She also admitted that maybe she had told her mother to read the book. As already noted, The Courage to Heal has been called the `Bible' of the recovered memory movement. Wakefield, Return of the Furies at 133. It has also been termed the greatest impetus to the search for memories of forgotten childhood sexual abuse. Eisner, The Death of Psychotherapy at 68. ¶ 121. In her affidavit, Nidhi Jain, now a physician, testified that she spoke to Charlotte in 1992 and that Charlotte revealed that she was being hypnotized by her therapist. Charlotte denied admitting as much to Jain, but acknowledged that Jain was her best friend during high school. Charlotte's admission that she underwent hypnosis is a disputed fact. Nevertheless, the circuit court correctly considered this fact to be true on defendants' motion to dismiss. ¶ 122. The lead opinion concludes that even if this court could find the fact that Charlotte was hypnotized, that would prove nothing. Hypnosis has many uses apart from recovered memory therapy. Nonetheless, evidence of Charlotte's hypnosis is very significant. ¶ 123. The undisputed portion of the puzzle assembled to this point reveals a patient suffering from depression and eating disorders, taking part in psychotherapy, experiencing flashbacks and body memories, and in possession of The Courage to Heal. The disputed piece is the admission of hypnosis. ¶ 124. In November 1991, Charlotte asked her father to come to Rogers Memorial Hospital for a meeting. At that meeting, Charlotte openly accused Dr. Johnson and her grandfather of sexual abuse. In October 1993, Charlotte similarly confronted her mother, accusing her of physical abuse. These confrontations conform to another belief held by some practitioners of recovered memory therapy  that the patients can get well only if they `confront the abuser.' Watkins, Dealing With the Problem of False Memory at 301. ¶ 125. As her therapy continued, Charlotte testified that she kept a journal to express her feelings [o]ff and on since I started recovery probably. Once again, keeping a journal does not link a person to recovered memory therapy, but keeping a journal is often recommended to recovering patients by their therapists. See Bass, The Courage to Heal at 145-46; Wakefield, Return of the Furies at 145-46. This admission is another piece of circumstantial evidence. ¶ 126. On June 18, 1992, Charlotte filed a petition for a temporary restraining order against her parents and cut off all contact with them. In her accompanying statement of the facts, Charlotte accused her parents of physical, emotional and sexual abuse and discussed the confrontation with her father after recalling the sexual abuse. (Emphasis added.) A year later, she wrote to the court requesting renewal of the restraining order alleging that her parents are perpetrators of incest and physical abuse which has created a condition diagnosed by my physicians as post-traumatic stress disorder.  (Emphasis added.) ¶ 127. It is unclear from the record whether the Johnsons contested the restraining order. However, had they done so, they could have made a strong argument to obtain Charlotte's medical records under Wis. Stat. § 905.04(4)(c): (c) Condition an element of claim or defense. There is no privilege under this section as to communications relevant to or within the scope of discovery examination of an issue of the physical, mental or emotional condition of a patient in any proceedings in which the patient relies upon the condition as an element of the patient's claim or defense . . . . ¶ 128. With her own words, Charlotte claimed that she had a condition, namely, post-traumatic stress disorder, caused by physical, emotional and sexual abuse from her parents, and she made this claim in litigation. In Steinberg v. Jensen, 194 Wis. 2d 439, 534 N.W.2d 361 (1995), Justice Janine Geske wrote: Clearly, once a patient-litigant puts his or her physical, mental, or emotional condition into issue in a lawsuit, any confidential physician-patient communications relating to that issue, including those relevant to discovery under ch. 804, Stats., are not privileged. Steinberg, 194 Wis. 2d at 481 (Geske, J., concurring). [12] ¶ 129. The lead opinion concludes, somewhat cryptically, that [a]lthough Charlotte previously relied on her emotional condition to obtain an injunction, she did not waive her privilege, since she did not have one. As such, there is nothing improper with Charlotte raising her privilege now. Lead op., ¶ 48. This appears to mean that Charlotte waived her privilege for the sole purpose of obtaining the restraining order, and now reasserts it in the present context. ¶ 130. Yet [o]nce a privilege has been waived, it cannot be invoked at a later time unless the particular privilege so permits. [13] 7 Blinka Wisconsin Practice: Wisconsin Evidence § 511.1 at 318 (2d ed. 2001). As another court succinctly wrote long ago, when a secret is out, it is out for all time, and cannot be caught again like a bird, and put back in its cage. People v. Al-Kanani, 307 N.E.2d 43, 44 (N.Y. 1973) (quoting People v. Bloom, 85 N.E. 824, 826 (N.Y. 1908)). For that reason, in State v. Johnson, this court did not allow a litigant who had waived the physician-patient privilege in a prior proceeding to reassert the privilege in a subsequent proceeding. 133 Wis. 2d 207, 225-26, 395 N.W.2d 176 (1986). ¶ 131. The lead opinion also asks the question, just what was waived [by Charlotte's allegations in her petition for restraining order]? Lead op., ¶ 49. The lead opinion concludes, in essence, that nothing was waived because Charlotte made no mention of her medical records or her communications to her therapists. Id. The lead opinion's interpretation stretches the coverage of the privilege unnecessarily and passes over the well-accepted maxim that the law has a right to every person's evidence and that therefore, privileges are narrowly construed. See Burnett v. Alt, 224 Wis. 2d 72, 88, 589 N.W.2d 21 (1999). It is unreasonable to expect a privilege-holder to detail her medical records when disclosing facts about her medical condition. When a patient makes allegations in litigation of abuse based on her medical condition, there is a due process requirement that the accused have some access to the accuser's records. Failure to allow reasonable access would deny the accused the right to present a complete defense. [14] The Johnsons would have had the right to examine Charlotte's medical records as a result of Charlotte's petition, and once waived, this privilege may not be reclaimed. This ground alone would justify a finding of waiver. ¶ 132. Continuing our collective analysis, many recovered memory therapists recommend that the patient cut off all contact with her biological family and instead establish a new family within the patient's treatment groups. See Bass, The Courage to Heal at 305-06; Wakefield, Return of the Furies at 143-44. Charlotte's action is consistent with that recommendation. She even changed her name from Charlotte Johnson to Charlotte Dawn. ¶ 133. Finally, the record contains a series of letters sent during 1994 by Charlotte's attorney, Lee Atterbury, to Bruce Gillman, the attorney then representing the Johnsons. In Attorney Atterbury's first letter, dated January 6, 1994, he threatened a lawsuit against the Johnsons as a civil remedy against her parents for childhood sexual abuse, and offered the possibility of negotiating a settlement of this matter prior to the commencement of a lawsuit. On February 25, Attorney Atterbury sent Attorney Gillman a detailed settlement proposal consisting of an annuity with lump sum and monthly payments totaling more than one million dollars. [15] This proposal apparently was rejected, because on April 6, Attorney Atterbury made very revealing statements in a third letter: I have handled cases such as this for many years. I have conversed with and/or corresponded with some of the finest, unbiased minds in both the legal and medical/psychological communities. I have no doubts as to the validity of repressed memories. . . . . [T]he majority of the reputable therapists in this country subscribe to the reality of repressed memories. In my experience, those who have testified to the contrary are either experts for hire or members of a bizarre fringe that all but advocate pedophilia as a valid lifestyle. (Emphasis added.) ¶ 134. Even a cursory reading of these letters reveals Attorney's Atterbury's unveiled references to the validity and reality of repressed memories. The lead opinion admits that the passage suggests Charlotte discussed the type of therapy she underwent. Lead op., ¶ 52. However, the opinion refuses to conclude that Charlotte waived the privilege on those grounds because any communication between Charlotte and her attorney is privileged. Id. ¶ 135. The same cannot be said of the communications between Charlotte's attorney and the Johnsons' attorney. The lead opinion glosses over this distinction, and attempts to excuse the disclosure based on Harold Sampson Children's Trust v. The Linda Gale Sampson 1979 Trust, 2004 WI 57, ¶ 46, 271 Wis. 2d 610, 679 N.W.2d 794. ¶ 136. Sampson simply does not control this case. In Sampson, an attorney inadvertently, but voluntarily, produced privileged documents during discovery because the attorney did not realize that the documents were privileged. Id., ¶ 4. The court held that under those circumstances, no waiver had occurred because only the client can waive the attorney-client privilege. Id. ¶ 137. This case is much different, because it is inconceivable that Attorney Atterbury's disclosure was inadvertent. It also is impossible to conclude that Charlotte did not have full knowledge of her attorney's activities, as the letters make clear: I will forward your letter to my client. That is my duty. I will also advise my client that threats of retribution, promises of tough defense, etc., are not new to me. . . . . I have previously advised my client that litigation of this type can be as nasty and vindictive as the perpetrators' budget allows. ¶ 138. In fact, it is hard to escape the conclusion that Charlotte not only knew of these letters, but also caused the letters to be sent. If that is not the case, Charlotte may have a claim of malpractice against her attorney. [16] ¶ 139. Therefore, the Sampson rule does not protect this disclosure because (1) this disclosure was not inadvertent; and (2) the privilege holder (Charlotte) acquiesced in the disclosure. ¶ 140. This ground, too, is enough to justify waiver. It is worth noting once again that the filing of such a lawsuit is recommended in the recovered memory literature as one of the final steps in the recovery process, as it may help lead to closure for the victim. See Bass, The Courage to Heal at 310. ¶ 141. Despite Charlotte's professed ignorance [17] of the procedures and practices of recovered memory therapy, she had a violent reaction to one question from the plaintiffs' attorney: Q: Are you presently aware of the controversy about whether or not false memories can be produced by suggestive influences? A: I believe that's a load of shit, if that's what you're asking me. ¶ 142. It is hard to believe that Charlotte would feel so passionately about a subject she claimed to know very little about. ¶ 143. Given all this information, the grounds for waiver may be summarized as follows: (1) Charlotte disclosed that she entered therapy due to an eating disorder and alcohol abuse before ever having a flashback; (2) she underwent psychotherapy; (3) she was the subject of hypnosis as part of her therapy; (4) she experienced flashbacks and body memories of childhood abuse; (5) she purchased The Courage to Heal, the Bible of repressed memory therapy; (6) she confronted her parents during therapy sessions; (7) she kept a journal and did artwork detailing her experiences; (8) she filed a restraining order against her parents and cut off all contact with them; (9) she changed her name; and (10) she threatened to file a civil lawsuit against her parents, and as part of that threat, her attorney referenced repressed memories. Reference to the literature discussed above reveals that all these events are hallmarks of recovered memory therapy. ¶ 144. When the grounds for waiver are considered singly, it is perhaps possible to conclude that Charlotte did not disclose any significant part of the privileged matter. Considered together, however, it is difficult, if not impossible, to escape the conclusion that she voluntarily admitted undergoing recovered memory therapy. Accordingly, I would hold that Charlotte waived her privilege under Chapter 905 and allow the Johnsons to access her medical records pertaining to recovered memory therapy. ¶ 145. Having reached that conclusion, it becomes necessary to determine the records Charlotte must disclose. Like the lead opinion, I am wary of fishing expeditions. Accordingly, I join the lead opinion's suggested procedure encompassing in camera review to determine which records should be produced to the plaintiffs. In my view, the court should require production of any of Charlotte's records specifically dealing with recovered or repressed memory therapy. The court could redact any information not waived, pursuant to Ranft v. Lyons, 163 Wis. 2d 282, 292, 471 N.W.2d 254 (Ct. App. 1991). ¶ 146. With these comments and observations, I respectfully concur. ¶ 147. I am authorized to state that Justice JON P. WILCOX joins this opinion's discussion of waiver and Justice N. PATRICK CROOKS joins this opinion in its entirety. ¶ 148. JON P. WILCOX, J. ( concurring in part, dissenting in part ). I agree with Justice Bradley's well-written dissent that [t]he rationale proffered by the lead opinion in carving out an exception to the patient-therapist privilege and right of confidentiality, and in engrafting criminal procedure to implement the exception, is supported neither by public policy nor precedent. Justice Bradley's dissent, ¶ 152. Therefore, I do not agree with the lead opinion's decision to set up an in camera review procedure of Charlotte's records. See lead op., ¶ 71. ¶ 149. However, I wholeheartedly join Justice Prosser's concurrence insomuch as it recognizes that in this case, numerous undisputed facts show that Charlotte waived her privilege of confidentiality by voluntarily disclosing a significant part of the privileged matter. Justice Prosser's concurrence, ¶ 81. As such, I would allow the Johnsons access to Charlotte's medical records. ¶ 150. ANN WALSH BRADLEY, J. ( dissenting. ) This case rests upon the holding in Sawyer v. Midelfort, 227 Wis. 2d 124, 595 N.W.2d 423 (1999). There, this court determined that plaintiffs could maintain a third-party negligence claim against a therapist whose treatment allegedly resulted in implanting and reinforcing false memories of child sexual abuse. Id. at 129. However, the holding of Sawyer was limited. ¶ 151. The concurring opinion in Sawyer wrote separately to reiterate the narrow scope of the majority's decision based on the unique facts of [the] case. Id. at 162 (Wilcox, J. concurring). It sounded a caution that the majority opinion, if expanded, would place an unreasonable burden on therapists' treatment choices and undermine the confidentiality that is essential to the patient-therapist relationship. Id. The concurrence forewarned of a future day when [other suits] will soon follow and of the risks attendant to any future expansion of the majority's limited holding. Id. Regrettably, with this case, that day has now arrived. ¶ 152. While I am in concert with the lead opinion in many respects, I cannot agree with its attempted significant expansion of the Sawyer court's limited holding. Rather, I embrace the sentiments expressed in the Sawyer concurring opinion. The rationale proffered by the lead opinion in carving out an exception to the patient-therapist privilege and right of confidentiality, and in engrafting criminal procedure to implement the exception, is supported neither by public policy nor precedent.