If I am not suicidal or homicidal, is my therapist obligated in any way to inform my psychiatrist of a confidence I have shared with her?  She would like me to talk about a particular issue with him, but I'm hesitant because I don't want him to increase my meds.  My therapist has told me that if I don't tell the psychiatrist, then she will.  Can she do that even without a consent?

Dear Mary -- 
You can withdraw the consent entirely, for her to tell him anything, until this issue is resolved; although she might say she can't treat you under those circumstances.  If you make it clear you don't want him to know what she now knows, if I was her I wouldn't inform him until you and I had worked out the problem -- or I too might say I couldn't work under those restrictions.  Maybe the problem is more him than her?  I.e. you trust her to know things that you don't trust him to know without taking actions you don't agree with?  In that case I'd focus on working things out with him more than her; maybe she can help you with that part?  

Dr. Phelps