When, why, and how clinicians decide to write about clients are ethical concerns. There are risks and potential clinical ramifications as well as responsibilities for how these decisions are made. On the basis of 141 interviews with psychoanalysts who have published in 3 major national and international psychoanalytic journals, the author explores decisions about whether to only disguise the client's material or whether, in addition, to ask consent outlines and some of the clinical consequences. The author concludes that clinicians need to individualize their decision making based on the particular client and the nature of the therapeutic relationship and offers ways to go about making these judgments.