Origins of the ethical attitude

This paper seeks to explore the genesis of the capacity for an ethical attitude, personally and professionally. As analysts working in intimate clinical settings, ethics is at the foundation of our professional lives, as it is at the foundation of our humanity and what it is we struggle towards in our own personal development. The ethical attitude presupposes special responsibilities that we choose to adopt in relation to another. Thus, a parallel situation pertains between caregiver and child and between analyst and patient: they are not equal partners, but nevertheless are in a situation of mutuality, shared subjectivity, and reciprocal influence. The basic premise of this paper is that the analytic attitude is an ethical attitude, and that the ethical attitude is a developmental achievement, and as such it may reach beyond the depressive position.     

Ethics and the sexual countertransference

In this paper I shall suggest that, in addition to 'conscience', the archetype of Eros plays an important part in 'benign relatedness' and that this is what constitutes an ethical attitude. I also propose that the idea of 'benign relatedness' can provide us with a workable concept for those serving on Ethics Committees especially when our Code of Ethics is unclear or limited. I attempt to show that the analytic attitude is essentially ethical and define what I see as the analytic attitude as a way of demonstrating this. By discussing the neurotic sexual countertransference and unconscious identity I hope to clarify the main reasons for unethical enactments. I use examples of ethical problems, including a personal experience, to illustrate the kinds that occur and lastly I discuss how mourning plays an important part in the resolution and avoidance of these problems.     

Ethical breaches and deviations of method in psychoanalysis: A heuristic model for the differentiation of boundary transgressions in psychoanalytic work

The boundary concept has been central to discussions on ethics and psychoanalysis over the past few decades. The main distinction has been between less malignant boundary crossings and more harmful violations. More recently, the concept has been criticized as not discriminating between technique and ethics. The author argues that these problems are connected to the way the boundary concept is defined. He suggests that it is specified to indicate a delimitation of an analytic area of conduct. In an analogous manner, an area of ethical conduct is framed by a boundary between ethical and unethical actions in the treatment situation. The analytic area has a narrower limitation than ethics and a stricter articulation of its concept of attitude; not all unanalytic actions are unethical. This simple model of interpersonally specified boundaries allows us to discriminate between different kinds of transgression in analytic work. In addition to violations and crossings, a third instance is described denoting a transgression of the analytic but not the ethical boundary. These can be called boundary stretchings, and are either intended or unintended deviations of method. The slippery slope mechanism of ethical misconduct is an imminent risk if boundary stretchings are ignored and not subject to scrutiny and analysis.     

Confidentiality and paradox: the location of ethical space

Implicit in Jung's alchemical metaphor of the vas bene clausum is the idea of an analytic frame with a space inside it for something vital, a relationship between two selves, to develop. For this to happen, analysts must respect their patients' rights to confidentiality. The paper explores the analyst's state of mind and the intrapsychic processes that are constellated when struggling with ethical dilemmas about issues of confidentiality in analytic work. The author suggests that at times when analysts consider breaking confidentiality, there is often a disturbing inner conflict between their moral principles (codes of ethics) and their internal personal ethical attitude. At these difficult moments, the mutuality of the work and the vas bene clausum can be significantly disrupted. The analyst tries to find a third position, a mental and emotional ethical space where the subjective and the objective, the ethical and the unethical can become more companionable bedfellows.     

Helping patients by analyzing self-criticism

This paper is addressed to patients' need for help with punitive self-critical attitudes. Such help has not always been sufficiently provided by psychoanalysts, owing to an unrecognized failure of neutrality. Historically, a gradual overemphasis on the concept of an unconscious sense of guilt has acted as a barrier to the appreciation of shame. An alternative concept, punitive unconscious self-criticism, which stands in contrast to constructive self-criticism and is common to the painful affects of guilt, shame, humiliation, and depression, can facilitate helpful analytic treatment. Heinz Kohut's contributions are examined. His analytic stance is differentiated from his theories of development. In the former, characterized by an affirmative attitude, he takes a position of functional neutrality toward shame and pays consistent though unstated attention to the effects of punitive unconscious self-criticism. The affirmative attitude can be employed without adoption of Kohut's self psychology, i.e., without abandoning the basic psychoanalytic approach to mental conflict and development. The concept of punitive unconscious self-criticism and the concept of divergent conflict, provide sufficient explanatory power. Clinical examples are used to illustrate these ideas.     

What if there is an ethical dimension in psychoanalysis?

The implications of an ethical dimension in psychoanalysis are explored, together with the questions whether and in what sense analysis has anything to contribute to ethical reflection, and whether and in what sense ethical considerations can play a role in analytic theory and process. As regards theory, analytic construction of an ethical agent would require a refocusing of structural and dynamic considerations in order to provide an integrative source of decision-making capacity to serve as the responsible agent in ethical deliberation, choice, and action. Suggestions are made for formulating the nature of the ethical agent in terms of a theory of motivation rather than of drive, and in terms of an integrative theory of the self. To the extent that analysis involves ethical considerations, the way lies open for dialogue and mutually enriching contributions of analysis to ethics and vice versa. Various aspects of the analytic perspective are explored that in themselves carry ethical implications or can be enriched by ethical reflection. Beyond theoretical considerations, the interaction between ethical factors and genetic, structural, and dynamic issues in clinical psychoanalysis loom as matters for future exploration.     

Are waves of relational assumptions eroding traditional analysis?

The author designates as ‘traditional’ those elements of psychoanalytic presumption and practice that have, in the wake of Fordham's legacy, helped to inform analytical psychology and expand our capacity to integrate the shadow. It is argued that this element of the broad spectrum of Jungian practice is in danger of erosion by the underlying assumptions of the relational approach, which is fast becoming the new establishment. If the maps of the traditional landscape of symbolic reference (primal scene, Oedipus et al.) are disregarded, analysts are left with only their own self‐appointed authority with which to orientate themselves. This self‐centric epistemological basis of the relationalists leads to a revision of ‘analytic attitude’ that may be therapeutic but is not essentially analytic. This theme is linked to the perennial challenge of balancing differentiation and merger and traced back, through Chasseguet‐Smirgel, to its roots in Genesis. An endeavour is made to illustrate this within the Journal convention of clinically based discussion through a commentary on Colman's (2013) avowedly relational treatment of the case material presented in his recent Journal paper ‘Reflections on knowledge and experience’ and through an assessment of Jessica Benjamin's (2004) relational critique of Ron Britton's (1989) transference embodied approach.     

An Authority Behavior Inventory

This article describes the development and validation of an Authority Behavior Inventory (ABI) to assess acceptance of authority. Each of the 24 items on the self-report ABI correlated significantly with corresponding peer ratings. In two studies (n = 200 and n = 150), the ABI was shown to have high internal consistency and high degrees of concurrent validity. Validity was assessed by means of correlations with the General Attitude Towards Institutional Authority Scale (Rigby, 1982, 1984a) using a student and a nonstudent sample; and, among nonstudents, with ratings of attitude to authority provided independently by both the subjects and their raters. In addition, the ABI discriminated significantly between matched subjects judged by peers as differing in attitude to authority, and between supporters of two Australian political parties differing in conservatism.     

Authority as paradox: The transformations of Don Quijote

The author's contention is that the analysand's temporary attribution of authority to the analyst is inherent in the analytic situation; this is seen as a transitional and paradoxical form of authority pertaining neither to internal nor external reality, but dwelling in the analytic third. The author proposes a conceptualization of psychoanalytic authority as a form of aesthetic authority according to Gadamer's defi nitions. While the scientifi c and hermeneutic codes for the understanding of authority in psychoanalysis assume that the main issue at stake is the delimitation of the objectivity or the subjectivity of the analyst's knowledge, this aesthetic perspective centres on the analysand's attribution of a claim of truth to analytic interpretations, and on the experience of recognition. The experience of recognition of a possible truth is particular and context-bound, as well as self-transformational. A reading of three episodes from Cervantes's The history of Don Quixote de la Mancha illuminates the transitional and paradoxical character of aesthetic authority within a transformational dialogue. These episodes are read as dramatizations of different positions vis-à-vis the paradoxical authority that characterizes transformational dialogues.     

An Authority Behavior Inventory

This article describes the development and validation of an Authority Behavior Inventory (ABI) to assess acceptance of authority. Each of the 24 items on the self-report ABI correlated significantly with corresponding peer ratings. In two studies (n = 200 and n = 150), the ABI was shown to have high internal consistency and high degrees of concurrent validity. Validity was assessed by means of correlations with the General Attitude Towards Institutional Authority Scale (Rigby, 1982, 1984a) using a student and a nonstudent sample; and, among nonstudents, with ratings of attitude to authority provided independently by both the subjects and their raters. In addition, the ABI discriminated significantly between matched subjects judged by peers as differing in attitude to authority, and between supporters of two Australian political parties differing in conservatism.     

Response to ‘Transgender medicalization and the attempt to evade psychological distress’ (Withers 2020) and to Herdzik’s (2021) response to Withers

Psyche is non-binary and multiple and clinical work in the analytic container must be held in the fluidity of multiplicity. Analysts are called to bring Queer energy to analytical attitude. Queer energy is intrinsically non-conforming and desires to confront a priori concepts in service to the unfolding of the Self. A Queer analytic attitude seeks to blur narrative, deconstruct language and listen deeply for what is emergent in the field. Queer energy is also deeply activating and often results in polarizations of attitude and a failure to hold what is emergent. This response to Withers (2020) and to (Herdzik 2021) is an invitation for all of us to engage our activated complexes around work with transgender issues and the fluidity of the Queer experience. The multiplicity of the Self seeks to be known through analytic process. Consciously held authentic experience of what is emergent and thus unknown is at the core of this process. An analysis capable of holding Queer energy offers a theatre for the exploration of gender identity and its expression.     

Retrospective treatment of incest victims: suggested analytic attitudes.

This paper includes a brief consideration of literature relevant to childhood sexual abuse detection and prevalence. That literature indicates that such detection may be difficult and that the occurrence of childhood sexual abuse is widespread. These findings, as well as a consideration of literature relevant to trauma, stress, and the identification of survivors of sexual abuse, suggest an analytic attitude of receptivity to the hypothesis of the event of sexual abuse as well as the fantasy of sexual abuse. A second analytic attitude suggested concerns diagnosis. Childhood trauma is implicated in the development of BPD, as the majority of borderline patients have experienced the trauma of child abuse. Further, trauma can lead to dissociation as a defense against stress, and multiple personality disorder is an extreme example of dissociation. The analytic attitude suggested here is that the diagnosis of BPD or MPD may be a necessary but not a sufficient explanation when the symptomatology is a defensive reaction to the traumatic event of childhood sexual abuse. Lastly, it is suggested that the abuse may need to be central to the treatment in analytic work with sexually abused victims. This is suggested in light of the importance of recovery and integration of traumatic memories with their associated affects.     

Neutrality,tenderness and the analyst's subjectivity

Addressing the rôle of the analyst in the psychoanalytic relationship, the author takes issue with the emphasis on acknowledging the analyst's subjectivity and the critique of concepts like neutrality and abstinence as these issues are presented in the relational tradition. He advocates a better articulation and emphasis of these concepts in the service of understanding the impact of the analyst's subjectivity, and demonstrates how the mere loosening up of analytic neutrality and abstinence and an acceptance of the analyst's self-disclosure make transference analysis more difficult to handle. Such an attitude also increases the risk for ethically dubious conduct, since there is a close link between clinical methods and ethical standards in psychoanalysis. In conclusion, the author points to the importance of the analyst's continuous self-reflection and countertransference analysis.     

The Effect of an Ethical Decision-Making Training on Young Athletes’ Attitudes Toward Doping

This article examines whether a training program in ethical decision making can change young athletes’ doping attitudes. Fifty-two young elite athletes were randomly assigned to either an ethical decision-making training group or a standard-knowledge-based educational program group. Another 17 young elite athletes were recruited for no-treatment control purposes. The ethical decision-making training comprised six 30-min online sessions in which the participants had to work through 18 ethical dilemmas related to doping. The standard-knowledge-based educational program was also conducted in six online sessions of comparable length to that of the ethical training. A short version of the Performance Enhancement Attitude Scale was administered to measure the effects of the trainings on doping attitude. Prior to as well as after the intervention, the mean doping attitude scores of the young athletes were low to very low, indicating vehement rejections of doping. The results of our experiment showed that the ethical training led to an attenuation of these rejections. No intervention effect was found in the standard education group. The observed slight increase in the doping attitude score could be an indication that the ethical decision-making training was successful in breaking up the athletes’ stereotypical style of reasoning about doping.     

Apparitions in the Fog Commentary on Paper by Adrienne Harris and Barbara H. Gold

Although an intersubjective analytic approach reflects postmodern concerns about the problems associated with authority and influence, it does not altogether escape them. Interpreting subjective states invokes a veiled analytic authority, and labeling them as dissociative creates a pathway for the influence of questionable assumptions about the origins of dissociation as a defense against trauma. Harris and Gold's paper can be used to illustrate these ideas.     

Oppression, freedom, and recognition in an analytic therapy group: group and therapist interactions from relational and group analytic perspectives

Group analytic and relational writings point to the development of mutual recognition between individuals as a main treatment goal. To achieve this, it is necessary to face up to issues of control and oppression in the therapeutic relationship, particularly as enacted by the therapist. The relationship between the therapist and group members is a co-construction, shaped by their respective subjectivities. The therapist's willingness to enter into an open examination of his or her enactments can stimulate change in relationships with patients, resulting in freer and more spontaneous communication in the group. To illustrate, several sessions of an analytic therapy group are presented in which there were struggles between (1) the desire for equality and mutuality and (2) firm exercise of authority.     

密尔自由观的伦理辨析

约翰·密尔从个人与社会关系的独特伦理视角对自由主义进行了新的阐释,他认为自由就是由社会合法地对个体行施的那种权力的本性和限制.密尔坚持个人自由,主张张扬人的个性,提出自由要以社会的进步和人类整体的幸福为其价值目标.尤其是密尔对自由的伦理道德诉求、对个性自由的伦理价值分析、给自由以限度、给自由以功利主义解释等伦理主张和理论建构,不仅极大地丰富和完善了自由主义理论,推动了自由主义理论与实践的发展,而且还具有重要的现代价值.     

Four Roles of Ethical Theory in Clinical Ethics Consultation

When clinical ethics committee members discuss a complex ethical dilemma, what use do they have for normative ethical theories? Members without training in ethical theory may still contribute to a pointed and nuanced analysis. Nonetheless, the knowledge and use of ethical theories can play four important roles: aiding in the initial awareness and identification of the moral challenges, assisting in the analysis and argumentation, contributing to a sound process and dialogue, and inspiring an attitude of reflexivity. These four roles of ethical theory in clinical ethics consultation are described and their significance highlighted, while an example case is used as an illustration throughout.     

科技伦理责任功效探微

高科技发展所带来的伦理问题引发了社会对于科技伦理责任的关注。本文主要对科技伦理责任功效问题进行探讨,指出科技伦理责任能够提供科技进步的精神动力,引导科技行为的道德选择,影响科技主体的价值信念。同时,分析了科技伦理责任功效的实现基础,即观念、态度、动力和控制四大系统。     

The concept of the therapeutic alliance.

Certain conceptual aspects of the therapeutic alliance are considered. Although therapeutic alliance, transference, and the real relation are intermingled and intertwined in the actuality of the analytic relationship, they remain distinguishable and open to differentiating analysis. The distinctions between the therapeutic alliance and transference, and between alliance and the real relation, are explored and their differences clarified, including the difference between therapeutic misalliances and transferences. Some of the component dimensions of the therapeutic alliance are explored, including empathy, the therapeutic framework, responsibility, authority, freedom, trust, autonomy, initiative, and ethical considerations including values and confidentiality. Further exploration of these and other dimensions of the therapeutic alliance is called for, especially the extension of these dimensions to their practical clinical application.