By Gittel Goldstein, PMH, NP

Marriage is all about becoming one. It is about the balance of achieving the self and the new whole that has been created. Growing the new wholeness, or marriage, or home, while maintaining your individuality is a lifetime process as it never stays the same over time.

There is a Gemara in Shabbos (53b) about a woman who was missing her hand. Her husband never knew about it until after her death. Some point out that she must have been modest to keep something like this from her husband. Others say obviously she would have wanted to keep this from him; the true modesty was with the husband. His modesty was in respecting her privacy and space, or in his love and caring for her and her feelings he could incorporate her need for privacy in this matter.

A surface discussion with a young gentleman about dating revealed his take on the above Gemara as an understanding that keeping secrets in a marriage is important, maybe even optimal.

A truly caring marriage and relationship is where each person cares deeply about the other person, enough to afford them privacy. As trust builds, they may share. Allowing privacy and space is the sign of a healthy relationship. When space is given, many times, in due course, the person will open of his or her own accord and start to share.

This can also be applied to the relationship a doctor, nurse practitioner, or therapist has with a patient or client.

It can start off with the patient sharing only surface matters, maybe even for a very long time. Weeks, months, maybe longer. As trust builds with small revelations and close monitoring of reaction or acceptance, the patient will then start revealing his or her true essence and real issues. This can only happen after trust has been established. That trust is built on allowing for the privacy and space for the patient to open up of their own accord.

Another kind of secret is the revealing of information by the doctor or therapist, uncovering the secrets of the patient to the patient only as the patient is able to tolerate. Oftentimes, a person may not realize the full implications of their actions or their motivations. Telling all at once can cause denial or the breaking of hope and trust in the process or ability to heal.

Accomplished providers know that with too much information the person can break. They are positive, practical, and only give the client what the client can handle at that time.

I had a child who was born ill. While the baby was in the ICU, a doctor came to speak with us about the baby’s situation. He gave us small pieces of information every couple of hours, focusing on the small chance that the baby would be OK. “Twenty percent of these babies walk away with no problems,” he said. He was realistic, though, and practical, and we were hopeful.

The next day, this doctor’s superior called us in for a “serious meeting.” As we sat in the office, the doctor outlined every single thing that could go wrong. He wanted to prepare us for the worst, as anything could happen. The doctor was unable to hold implications and the responsibility, as he felt unsure of the outcome and could not hold the information, putting the onus on the parents.

A half-hour later, my husband and I got up to leave the office, disheartened, fearful. As we got to the door, my husband turned and stopped. Looking back at the doctor, he said, “Doctor, will my baby live?”

How we speak and what information we give can make all the difference in motivating a person to try again despite all the forces working against them.

Gittel Goldstein PMH, NP, graduated from NYU with a master’s of science and nursing. She has experience in emergency, inpatient, and community outpatient care. She has an online tele-psychiatry practice and can be reached by phone at 914-775-5586 or by email:


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