ABSTRACT
Lacan's seminar The Ethics of Psychoanalysis (1959-1960) pursues, from a Freudian perspective, a fundamental philosophical question classically addressed by Aristotle's Nichomachean Ethics: How is human life best lived and fulfilled? Is there is an ethic of this type intrinsic to psychoanalysis? Lacan placed the problem of desire at the center of his Ethics. His notorious self-authorized freedom from convention and probable crossing of limits (see Roudinesco 1993) may have led mainstream analysts to ignore his admonition: "At every moment we need to know what our effective relationship is to the desire to do good, to the desire to cure" (Lacan 1959-1960, p. 219). This means that the analyst's desire, as well as the patient's, is always in play in his attempt to sustain an ethical position. An examination of Lacan's seminar highlights this link, but also points to a number of unresolved issues. The patient's desire is a complex matter, readily entangled in neurotic compromise, defense, and transference, and the analyst's commitment to it is also problematic because of the inevitable co-presence of his own desire. Lacan suggested that more emphasis be placed in training on the desire of the analyst, but beyond that a proposal is advanced for the institutionalization of a "third" as reviewer and interlocutor in routine analytic practice. Analysis may not be a discipline that can be limited to a dyadic treatment relationship.
Subject(s)
Ethics, Medical , Motivation , Physician-Patient Relations/ethics , Psychoanalytic Theory , Psychoanalytic Therapy/ethics , Career Choice , Countertransference , Creativity , Curriculum , Defense Mechanisms , Delusions/psychology , Delusions/therapy , Freudian Theory , Humans , Mentors , Morals , Neurotic Disorders/psychology , Neurotic Disorders/therapy , Object Attachment , Power, Psychological , Psychoanalytic Therapy/education , Psychotherapy, Multiple/education , Psychotherapy, Multiple/ethics , Transference, Psychology , Unconscious, PsychologyABSTRACT
Core ethical principles for the conduct of psychotherapy with children and adolescents transcend times, trends, and jurisdictions. Advances in technology, variations in state law, and the evolution of federal law should stimulate consideration of how these ethical principles apply to new situations; however, the guiding compass remains the psychotherapist's obligation to create and protect the integrity of the psychotherapeutic space to provide the child or adolescent the freedom to identify, examine, explore, and hopefully resolve the issues that bring one to treatment. Boundaries, privacy, confidentiality, and the patient's autonomy are components of this space. Together, they reflect a basic respect for the patient central to professional conduct and essential to any effective treatment process.
