Psychoanalytic Ethics

Question 1

Thesis:

Answer 1

“fundamental pivot” for analytic experience is patient’s self-disclosure (honesty) effected through free association
-Without honesty, we would have a fundamentally different enterprise “phenomenologically.” Analysts seek to examine the nature of the world as experienced, not what is happening “in” the patient, but goes to the patient by examining their relationship with the person

Question 2

Fundamental rule is different from __________

Answer 2

free association

Question 3

Free association is

Answer 3

a method. As such, it is a tool that is used by the analyst to access an analysand’s unconscious. Other tools include dream interpretation and analysis of parapraxes (“Freudian Slips”)
- analyst places everything the patient says in quesiton, listening skeptically

Question 4

The fundamental rule is

Answer 4

something the client agrees to at the beginning of analysis, and it is an underlying oath that is intended to continue throughout analysis: the client must promise to be honest in every respect

Question 5

Freud acknowledged that the pledge to the fundamental rule

Answer 5

was almost impossible for any client to do, but that it was necessary nonetheless. He even confronted the fact that at some point during the analysis, the analysand will undoubtingly fail to keep this promise. He encouraged analysts to reflected on their own self-analysis and appreciate how truly difficult this is for one to do.

Question 6

Freud’s instructions on free association:

Answer 6

• “Tell me what you know about yourself.”
• “Ordinarily, you try to keep a connecting thread…excluding any intrusive ideas.”
• “You must never give in to these criticisms, but must say it in spite of them—indeed you must say it precisely because you feel an aversion to doing so…so say whatever foes though your mind.”

Question 7

Qualities of free association

Answer 7

• Gives permission to think thoughts freely and spontaneously
• Provides permission to ponder thoughts expressed and their significance
• Provides opportunity to voice experience, i.e., confide in another, without consequence
• Discerning productive associations in the interest of insight

Question 8

Neutrality

Answer 8

• Therapists must treat everything disclosed to them in complementary manner, i.e., in strictest confidence
• Therapists must listen with evenly hovering attention and pledge to listen without censure or judgment
• Cf. Principle of Fidelity, Respect for Dignity

Question 9

Therapeutic ambition

Answer 9

• Violations of neutrality
  - Therapist directs the Rx (“you need to do something”)
• Response to the transference
  - Patient’s response to the gratifying positive relationship with the therapist
  
  • Undermines undirected listening and hovering attention

Question 10

Abstinence

Answer 10

-Patient’s desires cannot be satisfied, therapist is a proxy or surrogate
-Violations of abstinence
Therapist lapse of professional role
Loss of control of emotions and boundary violations
-Countertransference and dropping one’s “professional role”
-Cf. Principle of Justice and Beneficence, nonmaleficence

Question 11

Therapeutic process

Answer 11

• Interpretation is mutative in eliciting a difference way of thinking/listening, i.e., new, more relevant material
• Implications for increasing “observing ego” and learning from experience in the here and now

Question 12

What else does the therapist do?

Answer 12

• Therapist listens with third ear
• Therapist assumes an anonymous, neutral, objective stance
• Therapist attempts to foster a transferential relationship, allowing the patient to make projections onto the therapist
• Therapist develops a working alliance with the patient which allows patient to tolerated periods of negative transference
• Client participates fully