The Ethical Foundation of Analytic Action

Abstract

The eThical FoundaTion oF analyTic acTionWe shall give up the idea that there are special classes of processes that prepare or propel mental activity, that is to say, classes that are qualitatively different from the mental activity they prepare or propel; for now everything is an action.-Roy SchafeR (1976, p. 13)An ethics essentially consists in a judgment of our action, with the proviso that [the judgment] is only significant if the action implied by it also contains within it, or is supposed to contain, a judgment, even if it is only implicit. The presence of judgment on both sides is essential to the structure.-JacqueS Lacan (1959-1960, p. 311)A fter Schafer and Lacan, Renik (1993a,b) and Friedman (1993, 2007), and, more or less, the entire relational tradition (Harris 2011), it is by now a commonplace to say that psychoanalysts are interested in their own activity-that is, our activity, what we are doing with our patients, what we, as analysts, say, feel, and imagine. Analysts have grasped the ways in which their internal worlds shape, illuminate, or constrain engagement with, and perhaps the very emergence of, the patient's subjective experience. Analysands talk in the hope we will receive their message generatively, openly, all the while taking the risk that we might misrecognize, not hear, and fail to witness what they want us to recognize, hear, and witness. This risk involves, as Shulman (2016) says, "a bid for utmost intimacy" (p. 706); the emotional stakes are high. In this context, it is no wonder we care deeply about how we act and why we act as we do. This is why what we concern ourselves with is Training and Supervising Analyst, San Francisco Center for Psychoanalysis.

Consenting and Assenting to Psychoanalytic Work

“…There is merit, therefore, in the opinion of a recent commentator (Dailey 2014) that “analyst practice on the initiation of psychoanalytic treatment is in urgent need of review and revision” (p. 1123). We have a responsibility (Wilson 2016) to try to explain to ourselves (and if need be to our patients, though that may not be necessary if we understand ourselves) why the usual conditions of informed consent in other fields feel so uncomfortable for us.…”

Impossible Ethics

“…From another angle, Mitchell Wilson (2016) points out that the analyst's desire is constitutive of the analytic process from the start. When we recommend analysis, we do so with an idea of what makes analysis happen.…”

“…New meanings can erupt in hindsight, but the decision must be made in the heat of the immediate moment. Wilson (2016) (Schlesinger 1995;Faimberg 1996). In this light, what does "reasoning-inaction" look like?…”

“…It’s not easy to boil something down to honest truth without wondering what is hidden behind it. We aspire to put ourselves in a position of speaking truthfully to our patients, and to ourselves, without misleading either party, but we must also hold the awareness that more “truths” lie behind our available “truth.” As Wilson (2016) points out, “Truth is always in close proximity to lying, just as a negation is a way to acknowledge something as true while claiming it is not” (p. 1201). The ethical conduct that analysis requires invites the analyst to deceive herself; she is asked to aspire to a position in which everything she does is what is best for the patient, an assumption that denies her basic human nature.…”

“…New meanings can erupt in hindsight, but the decision must be made in the heat of the immediate moment. Wilson (2016) captures this dynamic:I say what I say and do what I do “knowing” that I can’t possibly know what I am doing, both in the doing and in what will come next. I find myself acting as much as I choose the action, and usually more so, especially in moments of emotional urgency.…”