The ethics of psychoanalysis
There are three areas of ethics that concern psychoanalysis: the ethics of psychoanalysis as a scientific discipline, the ethics of clinical psychoanalysis with the patient, and the ethics of psychoanalysis as a profession.
Ethics of psychoanalysis as a scientific discipline
Psychoanalysis is, above all, committed to seeking the truth of what takes place in the unconscious ––even if that truth may be unacceptable to reason and consciousness–– and demonstrates how that unconscious truth has a significant effect on conscious feelings, thoughts and actions.
One of Freud’s major achievements was to have the intrepidity to face, and describe, the contents of the unconscious and show us the consequences that that has on our idea of ourselves as individuals and as a species. Psychoanalysis considers that discovering the inner truth of human beings, facing with courage what is happening inside, be it what it may, is the most liberating knowledge that exists because it allows us to know what really exists and, from that knowledge of inner life, be more connected to reality and less trapped by illusions.
That said, it is important to mention that the inner truth that psychoanalysis seeks does not necessarily correspond to material historic truth and must not be confused with it. Each person’s truth is their truth and must be respected as such.
Ethics of clinical psychoanalysis
Clinical psychoanalysis is guided by an absolute respect for each individual’s singularity and it refuses any form of influence or criticism of the patient’s values, religious convictions, political ideas, personal philosophy, sexual preferences, etc. Accordingly, psychoanalysts do not emit any personal opinions on these topics.
The psychoanalyst’s listening is free of any kind of judgment or censorship of what the patient may say, firstly because it is not the psychoanalyst’s place to be the judge of anything and, second, because it would hinder the search for inner truth. What is in the interest of a psychoanalytic process is seeking truth, not judging it.
Additionally, the goal of clinical psychoanalysis is to promote the patient’s autonomy as much as possible, his/her capacity to make decisions freely and with her/his own criteria. In order to protect the patient’s autonomy, psychoanalysts are careful to avoid directing the patient in any way. Sometimes this is difficult for some patients who are looking for a guide to tell them what to do but if the psychoanalyst tells patients what they must do s/he’s treating them like small children who are incapable of having their own criteria and forming an opinion based on it. Therefore, psychoanalysts will always try to encourage patients to think for themselves and to know why they think what they think.
Clinical psychoanalysis considers that what offers individuals the greatest guarantees of reasonable well-being is knowing themselves in depth and having enough autonomy to be able to make beneficial decisions based on this knowledge.
Ethics of psychoanalysis as a profession
Psychoanalysis as a profession has a long list of ethical responsibilities. In order not to extend ourselves too much, we’ll mention four that refer specifically to patients:
Psychoanalysts must offer the most effective help possible to those people who ask for it, with maximum integrity and professional responsibility. Each patient requires an individualized adaptation of psychoanalytical theory and technique and, the greater the psychoanalyst’s mental resources, the better. This implies rigorous training, keeping up with current developments, exchanging ideas with colleagues regularly, and also having a broad knowledge of culture and society.
The confidentiality of a patient’s identity must be absolute. In order to increase professional knowledge in general and improve their practice, it is necessary for psychoanalysts to present clinical material to colleagues in order for them to be thought about and contribute to advances in the field. Therefore, when clinical material is presented to colleagues it is vital that it is done in such a way that the patient is totally unrecognizable and there exist no clue that could identify the person.
Psychoanalysis also has a social responsibility to spread the knowledge it has gained about human emotional functioning to the greater community. For instance, no matter how many areas of life are accelerating in the West thanks to technological progress, there are human timeframes that must be respected: the time to raise children, the time to learn, the time to work through and resolve emotional suffering deeply and durably. Not everything in the life of a human being can be accelerated.
Finally, psychoanalysis showed a long time ago that the only difference there is between so-called “mental disorders” and “normality” is a question of degree, and no one must be discriminated against for these reasons. Absolutely “healthy” or absolutely “ill” people do not exist (except for certain severe pathologies where the constitutional predisposition towards mental illness is very high). The potential to suffer greatly and also to recover and enjoy life is within each person.