Court Opinion

ID: 9671889
Source: CourtListenerOpinion
Date Created: 2023-08-24 03:44:32.069621+00
Date Added: 2024-06-11T18:16:12.814756
License: Public Domain

DAVID T. PROSSER, J.
¶ 80 (concurring). In our society, sexual abuse of a child ranks among the most heinous crimes a person can commit. Accord Doe v. Archdiocese of Milwaukee, 211 Wis. 2d 312, 355, 565 N.W.2d 94 (1997). Charlotte Dawn (Charlotte) openly and repeatedly leveled allegations of child sexual abuse against her father, Dr. Charles Johnson, gravely damaging his personal and professional reputations. She made additional allegations against her mother and her grandfather. Charlotte now asks the court to acquiesce in her efforts to shield the psychotherapists who, Dr. Johnson alleges, implanted Charlotte's memories of abuse. As the lead opinion recognizes, that result would be contrary to public policy.
¶ 81. I join sections I, II, IV V and VI of Justice Butler's lead opinion because I agree that there is an exception to therapist-patient confidentiality and privilege where negligent therapy is alleged to have caused accusations against parents for sexually or physically abusing their children. However, I do not agree with Section III or with other statements in the lead opinion that conclude that Charlotte did not waive confidentiality and privilege in this case. I write separately to emphasize 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.
I. STANDARD OF REVIEW
¶ 82. Determinations of waiver generally present mixed questions of fact and law. See Reckner v. Reckner, 105 Wis. 2d 425, 435, 314 N.W.2d 159 (Ct. App. *4231981); accord State v. Arredondo, 2004 WI App 7, ¶ 12, 269 Wis. 2d 369, 674 N.W.2d 647 (waiver of right to testify); Meyer v. Classified Ins. Corp. of Wis., 179 Wis. 2d 386, 396, 507 N.W.2d 149 (Ct. App. 1993) (waiver of right to arbitrate). Normally, we uphold a circuit court's findings of fact unless they are clearly erroneous.
¶ 83. In this case, however, the defendants moved for summary judgment, and their motion was granted even though the court acknowledged that there were "material issues of fact." The court entered judgment against the plaintiffs on grounds that "defendants [were] unable to defend against plaintiffs allegations because of the [therapist-patient] privilege."
¶ 84. After reviewing the facts, the circuit court concluded that Charlotte had not waived her privilege against the disclosure of confidential matters or communication under Wis. Stat. § 905.11. This was a legal determination. Thus, the question whether Charlotte waived the therapist-patient privilege comes to us as a question of law, which we review de novo, applying the facts to the legal standard for waiver of privilege. Most of the facts are undisputed, but the circuit court, obeying well-established rules governing motions for summary judgment,1 construed disputed facts in favor *424of the nonmoving party — the Johnsons. After performing this analysis, the court "dismissed" the action.
II. QUESTIONS PRESENTED
¶ 85. This case presents two separate questions of "waiver." The first is whether Charlotte waived the confidentiality applicable to her medical records under § 146.822 by causing certain records to be sent to her father for billing purposes and to keep him aware of her "general progress." The second is whether the released medical records, and any other voluntary disclosures Charlotte made, constitute a "significant part" of the privileged matter, thus waiving the therapist-patient confidentiality privilege embodied in Wis. Stat. § 905.04(2).
¶ 86. These two questions are interrelated. As the court of appeals observed in State v. Allen, "[i]n many instances, the data covered by these two statutes will overlap because a patient's health care record under § 146.82 may often include a record of a confidential communication between the patient and a health care provider under § 905.04." State v. Allen, 200 Wis. 2d 301, 309, 546 N.W.2d 517 (Ct. App. 1996). Section 905.04(2) contains the therapist-patient privilege, protecting "confidential communications made or information obtained or disseminated for purposes of diagnosis *425or treatment of the patient's physical, mental or emotional condition .. . However, the privilege-holder waives that privilege if she "voluntarily discloses or consents to disclosure of any significant part of the matter or communication." Wis. Stat. § 905.11.
¶ 87. Here, Charlotte's voluntary disclosure of a significant part of the privileged matter justifies a limited release of her medical records to her parents. The plaintiffs need not have unlimited access to Charlotte's therapy records because parts of the records would not be relevant to this litigation. The lead opinion's condition of in camera review is an appropriate method to determine exactly which records must be released.
¶ 88. In contrast to this concurrence, the lead opinion identifies individual voluntary disclosures that could constitute waiver, but rejects each one in piecemeal fashion. Lead op., ¶¶ 25, 33. These individual disclosures are like pieces in a puzzle. When the puzzle is assembled, the resulting picture leaves little doubt that Charlotte voluntarily waived her privilege of confidentiality. In my view, at least two disclosures relating to litigation would have been sufficient in themselves to effect a waiver of the therapist-patient privilege. But any vestige of uncertainty is removed when the total picture of revelations is compared to commonly recognized features of treatment by recovered memory therapy.
¶ 89. To show the significance of Charlotte's voluntary disclosures, this concurrence will discuss features of recovered memory therapy,3 and then will discuss the grounds for waiver.
*426III. RECOVERED MEMORY THERAPY
¶ 90. This concurrence is not intended to pass judgment on the legitimacy of recovered memory therapy. However, an understanding of commonly practiced methods of recovered memory therapy is essential to any evaluation of whether Charlotte waived her privilege by voluntarily disclosing "any significant part" of the privileged matter. Without understanding the salient features of the privileged matter, it would be nearly impossible to determine whether Charlotte disclosed any significant part of the matter or the communications relating to the matter.
¶ 91. Studies reveal that therapists practicing recovered memory therapy use a wide variety of techniques,4 including hypnosis, age regression, free narrative recall, flashbacks, body memories, and survivors' groups. See Daniel Brown, et al., Memory, Trauma Treatment, and the Law 482-83 (W.W. Norton & Co. 1998)5 (hereinafter Brown, Memory, Trauma Treatment, and the Law); Ellen Bass & Laura Davis, The Courage To Heal 73-75 (Harper & Row, 1st ed. 1988) (hereinafter Bass, The Courage to Heal); Hollida Wake-field & Ralph Underwager, Return of the Furies: An Investigation Into Recovered Memory Therapy 128 (Open Court Publishing 1994) (hereinafter Wakefield, *427Return of the Furies); Joanne M. Hall & Lori Kondora, Beyond "True" and "False" Memories: Remembering and Recovery in the Survival of Childhood Sexual Abuse, 19:4 Advances in Nursing Science (June 1997) (hereinafter Hall, Beyond "True" and "False" Memories). Clinicians disagree about which techniques are preferable, or even acceptable. Brown, Memory, Trauma Treatment, and the Law at 482-83. However, some observers believe there are certain common patterns running through treatment methods. Wakefield, Return of the Furies at 149. This concurrence relates some of these commonalities in an effort to understand Charlotte's disclosures.
¶ 92. For many patients the first step on the road to recovered memories is entering treatment for problems other than abuse, such as depression, eating disorders, or marital distress. Cathy Spatz Widom & Suzanne Morris, Accuracy of Adult Recollections of Childhood Victimization: Part 2 Childhood Sexual Abuse, 9 Psych. Assessment 34, 42 (Mar. 1997) (hereinafter Widom, Accuracy of Adult Recollections of Childhood Victimization)-, Bass, The Courage to Heal at 50, 217-19; Wakefield, Return of the Furies at 149; see generally Harrison G. Pope Jr. & James I. Hudson, "Recovered Memory" Therapy for Eating Disorders: Implications of the Ramona Verdict, 19:2 Int. J. of Eating Disorders (Mar. 1996) (hereinafter Pope, "Recovered Memory" Therapy for Eating Disorders). Some therapists question women exhibiting these symptoms about the possibility that they were abused as children. Id.
¶ 93. A common thread running through most recovered memory treatment methods is the use of hypnosis. Donald A. Eisner, The Death of Psychotherapy 72 (Praeger Publishers 2000); Wakefield, Return of the Furies at 128-130. In one recent survey about recovery *428of repressed memories of sexual abuse, 97 percent of therapists agreed that "[h]ypnosis is a worthwhile psychotherapy tool." Wakefield, Return of the Furies at 133. Almost 90 percent of the respondents had either a master's degree or a Ph.D. "[T]he issue is not whether hypnosis is used, but how it is used." Brown, Memory, Trauma Treatment, and the Law at 519. A critical feature of the hypnotic procedure is a "flashback," or "the reliving of a traumatic experience, or an aspect of trauma, as if it were happening now." Wakefield, Return of the Furies at 137-42.
¶ 94. Recovered memory practitioners concede that hypnotized patients are "especially vulnerable to suggestive influence from their doctors," and therefore therapists should not " 'push' their clients to recall [child abuse.]" John G. Watkins, Dealing With the Problem of "False Memory" in Clinic and Court, Fall 1993 J. Psych. & Law 297, 301 (hereinafter Watkins, Dealing With the Problem of "False Memory"). However, memories of abuse "usually emerge only after much resistance...." Id. at 303. A patient recalling abuse may exhibit physical manifestations of terror, including "sweating through" and physically reliving the abuse. Id. at 308.
¶ 95. During these physical manifestations, patients may experience "body memories" to "gain information about hypothesized abuse that is not remembered." Wakefield, Return of the Furies at 145; see also Hall, Beyond "True" and "False" Memories. In essence, the patient's physical symptoms correspond to the childhood abuse even without conscious memories. Id.
¶ 96. Some therapists believe that once patients recover memories of abuse, they "can get well only if they 'confront the abuser.1" Watkins, Dealing With the Problem of "False Memory" at 301. However, there is *429dispute over whether this technique is effective. Id,.; see also Brown, Memory, Trauma Treatment, and the Law at 36, 167.
¶ 97. As therapy continues, patients are often asked to make journal entries, keep a diary, or create artwork in an effort to recover more memories. Brown, Memory, Trauma Treatment, and the Law at 414-16; Christine Courtois, Recollections of Sexual Abuse: Treatment Principles and Guidelines 36-37 (W.W. Norton & Co. 1999); Wakefield, Return of the Furies at 145-46; Bass, The Courage to Heal at 83. In a related tactic, patients are asked to read books relating to remembered childhood abuse such as The Courage to Heal.6
¶ 98. Another common technique is to advise the patient to cut off all ties with her family and join a "survivors' group" which becomes the patient's "new family." Wakefield, Return of the Furies at 143-44. As The Courage to Heal puts it, "It is painful to make a break with your family, but it is even more painful to *430keep waiting for a miracle." Bass, The Courage to Heal at 305. The book also notes that some women "have changed their names, casting off any identification with the abuser." Id. at 306.
¶ 99. As one of the final steps in the cleansing process, recovered memory therapists and survivors' groups often recommend filing civil lawsuits against the accused abuser.7 One recent study reported that 1 of every 16 accused parents has a lawsuit filed against him or her, and "[mjany others have been threatened." Wakefield, Return of the Furies at 146. Practitioners believe that civil litigation fulfills a double purpose by ensuring that the abuser is held liable for the abuse and providing therapeutic closure for the victim. Id. at 147.
¶ 100. Having outlined some of the broad characteristics of the admittedly diverse therapy at issue, I turn to the discussion of waiver.
IV WAIVER
A. Records Release
¶ 101. As the lead opinion correctly notes, patient health care records prepared by "health care providers" are confidential. Wis. Stat. § 146.82(1). The lead opinion appears to assume, without expressly deciding, that Charlotte waived the confidentiality of some of her records because it analyzes whether the information contained in those records constituted a waiver under Chapter 905.
*431¶ 102. Two categories of records are at issue. The first category encompasses Charlotte's billing records from various medical providers. Section 146.82(2)(a)3. specifically authorizes release of records "[t]o the extent that the records are needed for billing, collection or payment of claims." Charlotte repeatedly wrote her father to ask for money and she appears to have sent him some of her bills directly. She wrote her father on February 12, 1992, "you should receive a bill [from Kay Phillips]," and on April 22,1992, "I will transfer the bills for prior hospitalizations to you ... I will mail the bills later this week."
¶ 103. While Charlotte may have sent some billing records directly, she undoubtedly caused other billing records to be sent to her father for payment. In his sworn affidavit, Dr. Johnson described the billing records he received from Rogers Memorial Hospital, South Street Clinic, Kay Phillips and her employer, Heartland Counseling Services, Grand Teton Mental Health Consultants (for Dr. Israelstam), St. Marys Hospital, and Waukesha Memorial Hospital. It is unlikely that six different providers would have sent medical bills to Dr. Johnson in St. Louis without Charlotte's explicit authorization. By this authorization, Charlotte waived any applicable privilege under § 146.82 with respect to these records.
¶ 104. A second set of records relates to an intake report filled out upon Charlotte's admittance to St. Marys Hospital. At intake, Charlotte voluntarily filled out a form empowering St. Marys to disclose some of her medical records. The form allows the patient to determine the purpose of the disclosure and to decide exactly what information will be disclosed by checking boxes on the form.
*432¶ 105. Charlotte indicated that the purpose of disclosure was to show her "progress." She signed a form stating "I hereby request and authorize St. Marys Hospital Medical Center to provide access to my hospital records" to "Dr. Charles Johnson (father)" to show her "progress." This authorization was signed several months after she had accused Dr. Johnson to his face of sexually abusing her.
¶ 106. Charlotte also checked the box marked "The specific information listed here," to indicate what information should be disclosed. By hand, she then made the following notations: "medical (physical) test results; medications prescribed; general progress."
¶ 107. Under the umbrella of "general progress," St. Marys released Charlotte's admission report, some consultation notes, and a discharge report to Dr. Johnson.
¶ 108. In her deposition, Charlotte conceded the possibility that her father required her to provide some medical records if she wanted him to continue paying for her treatment. This can be seen in the following exchange between counsel for Rogers Memorial Hospital and Charlotte:
Q: ... Do you know if it's possible that your dad required some sort of update on your treatment in exchange for making any types of payments for your medical bills?
A: It's possible. I'm not aware of it, but it is possible.
¶ 109. This concession mirrors Dr. Johnson's sworn statement that "I asked Charlotte to provide me with information regarding her care."
¶ 110. Charlotte waived the confidentiality of the admission report, consultation notes, and discharge *433report by signing the release form as she did and by her statements at the deposition.
¶ 111. In any event, Charlotte's voluntary admissions at her deposition duplicate much of the information in these reports.
B. Chapter 905 Waiver
¶ 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.
*434Lead 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 Overeat-ers 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 *435disorders 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 *436her 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 *437by 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 *438Bass, 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 *439physical, 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 "[although 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 *440another 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 *441examine 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 *442than 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 *443Sampson 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
*444¶ 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 ignorance17 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 *445disclosed 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. *446The 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 E WILCOX joins this opinion's discussion of waiver and Justice N. PATRICK CROOKS joins this opinion in its entirety.

 Before the circuit court, all the defendants filed motions to dismiss and Rogers Memorial Hospital filed an alternative motion for summary judgment. The circuit court, while continuing to refer to the defendants' "motion to dismiss," effectively converted the motions to dismiss into summary judgment motions by considering facts outside the pleadings. See Wis. Stat. § 802.06(2)(b) ("If on a motion asserting... failure of the pleading to state a claim upon which relief can be granted ... matters outside of the pleadings are presented to and not excluded by the court, the motion shall be treated as one for *424summary judgment. ...") (emphasis added). The lead opinion follows this approach, lead op., ¶¶ 10, 31-51, and so does this concurrence.

 "All patient health care records shall remain confidential. Patient health care records may be released only to the persons designated in this section or to other persons with the informed consent of the patient or of a person authorized by the patient." Wis. Stat. § 146.82 (2001-02).

 The terms "recovered memory therapy" and "repressed memory therapy" are often used interchangeably in the professional literature. See Alan W Scheflin & David Spiegel, From Courtroom to Couch: Working With Repressed Memory and *426Avoiding Lawsuits, 21:4 Psych. Clinics of N. Am. at 847, 857 (Dec. 1998). This concurrence refers to "recovered memory therapy." No significance should be ascribed to this word choice.

 Because there is no single method of practicing recovered memory therapy, this concurrence summarizes only some of the more commonly practiced features of the technique.

 This extensive volume comprehensively reports and summarizes the professional literature in this area. Dr. Israelstam referred to this book in preparation for his deposition in this case.

 The Courage to Heal, by Ellen Bass and Laura Davis, is one of the seminal texts on recovered memory therapy and is seen as the "Bible" of its practices. Hollida Wakefield & Ralph Underwager, Return of the Furies: An Investigation Into Recovered Memory Therapy 133 (1994). It has sold more than 750,000 copies and is used by many practitioners. Id. at 133-34. The authors published a companion workbook in 1990 and a revised edition of the main volume in 1996.
The meteoric rise of the recovered memory therapy movement began in 1988 with publication of The Courage to Heal. Donald A. Eisner, The Death of Psychotherapy 68 (2000). Later, some professionals questioned the legitimacy of The Courage to Heal because at the time of its first publication, neither of its authors had any degrees or formal training. Id. at 134. But in the late 1980s and early 1990s, the book was at the height of its popularity.

 "In my experience, nearly every client who has undertaken this kind of suit has experienced growth, therapeutic strengthening, and an increased sense of personal power and self-esteem as a result of the litigation." Bass, The Courage to Heal at 310.

 The court briefly mentioned a similar "totality of the circumstances" approach in Harold Sampson Children's Trust v. The Linda Gale Sampson 1979 Trust, 2004 WI 57, ¶ 30 n.16, 271 Wis. 2d 610, 679 N.W.2d 794. The court did not seriously consider the test, commenting that it would be "difficult to apply." Id. On the facts of this case, the totality analysis is not difficult to apply and presents a workable analytic framework.

 Alcoholics Anonymous Recovery Program, available at http://www.alcoholics-anonymous.org/default/en_about_aa_sub. cfm? subpageid=17&pageid=24 (last visited July 1, 2005).

 Overeaters Anonymous (OA) Recovery Program, available at http://www.oa.org/twelve_steps.html (last visited July 1, 2005).

 This is not to say that a person could not enter psychotherapy as part of treatment for an eating disorder or alcohol abuse. In fact, OA recommends that its patients independently seek psychotherapy. See http://www.oa.org/ courier02/ courier02.htm (last visited July 1, 2005). However, neither OA nor AA provides psychotherapy services as part of a recovery program, meaning that Charlotte's therapy had progressed beyond the "12-step program" level.

 Other courts, construing similar privileges, have reached similar conclusions. " 'The whole purpose of the (physician-patient) privilege is to preclude the humiliation of the patient that might follow disclosure of his ailments. When the patient himself discloses those ailments by bringing an action in which they are in issue, there is no longer any reason for the privilege.'" In re Lifschutz, 467 P.2d 557, 569 (Cal. 1970) (quoting City and County of San Francisco v. Superior Court, 231 P.2d 26, 28 (Cal. 1951)). "The physician-patient privilege . .. [is] to be used for preserving legitimate confidential communications, not for suppressing the truth after the privileged one lets the bars down." State v. Carter, 641 S.W.2d 54, 59 (Mo. 1982).

 Frofessor Blinka cites the Fifth Amendment right against self-incrimination, which a person may waive at one hearing and assert at a later one. 7 Blinka Wisconsin Practice: Wisconsin Evidence § 511.1 at 318 n.1 (2d ed. 2001). The therapist-patient privilege does not fall within that category.

 In criminal cases, the defendant has the right to examine the alleged victim's medical records if (1) the defendant makes a prima facie showing that "the records contain relevant information necessary to a determination of guilt or innocence .. . not merely cumulative to other evidence available to the defen*441dant;" and (2) after an in camera inspection of the records, the court concludes that "the records will likely contain evidence that is independently probative to the defense." State v. Green, 2002 WI 68, ¶ 34, 253 Wis. 2d 356, 646 N.W.2d 298.
In civil cases, a party's medical records must be produced if the party places his or her medical condition "in issue." Ranft v. Lyons, 163 Wis. 2d 282, 291-92, 471 N.W.2d 254 (Ct. App. 1991). If the records are "in issue," the circuit court may conduct an in camera inspection and redact information not "in issue."

 Attorney Gillman demanded monthly payments of $1200 for ten years to cover Charlotte's therapy expenses, monthly payments of $2500 for ten years to cover Charlotte's living expenses, a lump sum payment of $100,000 after five years, and a lump sum payment of $500,000 after ten years.

 SCR 20:1.2(a) ("Scope of representation") provides that "A lawyer shall abide by a client's decisions concerning the objectives of representation... and shall consult with the client as to the means by which they are to be pursued." Similarly, SCR 20:1.6(a) *444("Confidentiality of information") provides that "A lawyer shall not reveal information relating to representation of a client unless the client consents after consultation ...."

 The following exchange occurred at Charlotte's deposition as the plaintiffs attorney questioned her about books she might have read:
Q: Repressed Memories?
A: I don't know what you're talking about.

 1t is evident that the court is splintered in this case. See lead op. ¶ 3 n. 1; ¶ 4 n. 3 & 4. As such, the lead opinion has no precedential value. Its holding is binding only on the parties here.