Ethical Issues in Psychoanalysis

Ethics in Psychoanalysis
Blair A. Casdin, LCSW-R

This course will provide its participants with a thorough understanding of ethical principles of psychoanalytic practice. Topics discussed will include the Hippocratic mandate to “do no harm” and the NASW code of ethics, consideration of the psychoanalytic frame, boundaries and boundary violations, confidentiality, morals, values and judgements, and ethical issues in psychoanalytic writing and education. In each class, candidates will engage in discussions of relevant articles and present case presentations/clinical vignettes around ethical dilemmas in psychoanalytic practice.

Upon completion of this course the candidate

1. will understand and apply ethical principles of psychoanalytic practice;
2. will have learned how to protect patient confidentiality in documentation, consultation as well as psychoanalytic writing;
3. will recognize and avoid serious boundary violations.

Classes will be held at the office of Blair Casdin, 26 W. 9th Street, Suite 2D, on the following dates:
7:30-10:00pm on 7/13, 8/3, 8/10
3:00-8:00pm on 10/7
9:00am-2:00pm on 10/21
9:00am-2:00pm on 11/11

Class 1: “First, do no harm.” The Hippocratic Oath and the overview of the contemporary ethical principles of clinical practice.

Gabbard, G.O. (1995). “The Early History of Boundary Violations in Psychoanalysis.” J. Amer. Psychoanal. Assn., 43: 1115-1136.

Edelstein, L. (1943) The Hippocratic Oath: Text, Translation and Interpretation. Baltimore: The Johns Hopkins Press.

NASW (2008). Code of Ethics. Washington, DC: NASW

Additional Reading:

Corcoran, K. (1998), “Clients without a cause: Is there a legal right to effective treatment?” Research on Social Work Practice, 8(5): 589-596.

Gabbard, G.O. (1999). “Boundary Violations and the Psychoanalytic Training System.” J. Appl. Psychoanal. Stud., 1:207-221.

Class 2: Confidentiality. The protected space of psychoanalytic practice and the limits of confidentiality, including mandated reporting and the duty to warn.

Bollas, C (2003). “Confidentiality and Professionalism in Psychoanalysis.” Brit. J. Psychother., 20: 157-176.

Lear, J. (2003), “Confidentiality as a virtue.” In C. Levin, A. Furlong, M.K. O’Neil (eds), Confidentiality: Ethical perspectives and clinical dilemmas. Hillsdale, NJ: The Analytic Press, pp. 4-17.

Case reference: Tarasoff v. Regents of University of California, 551 P. 2d 334 (1976).

Class 3: The psychoanalytic frame: Consideration of space, time and fees, and the common challenges to maintaining the frame.

Aron, L. & Hirsch, I. (1992). “Money matters in psychoanalysis.” In N. Skolnick 7 S. Warshaw (Eds.), Relational Perspectives in Psychoanalysis (pp. 239-256). Hillsdale, NJ: The Analytic Press.

Bass, A. (2007), “When the frame doesn’t fit the picture.” Psychoanalytic Dialogues, 17:1-28.

Hirsch, I. (2008). Coasting in the Countertransference: Conflicts of Interest Between Analyst and Patient. New York & London: Taylor and Frances. Chaps. 7.

Hirsch, I. (2008). Coasting in the Countertransference: Conflicts of Interest Between Analyst and Patient. New York & London: Taylor and Frances. Chaps.  8.

Additional Reading:

Whitson, G. (1989?). “Money Matters in Psychoanalysis: The Analyst’s Co-participation in the Matter of Money” (working copy) LET ME KNOW IF YOU’D LIKE A COPY

Class 4:
Part I: Enactments, boundary crossings and violations. Countertransference acting out and enactments.

Hirsch, I. (2008). Coasting in the Countertransference: Conflicts of Interest Between Analyst and Patient. New York & London: Taylor and Frances. Chap. 1.

Sandler, AM. (2004). “Institutional responses to boundary violations: The case of Masud Khan.” International Journal of Psychoanalysis, 85, 27-44.

Part II: Enactments, boundary crossings and violations

Celenza, A. (2006). “Sexual Boundary Violations in the Office: When is a Couch Just a Couch?” Psychoanal. Dial., 16: 113-128

Maroda, K.J. (2005), “Legitimate gratification of the analyst’s needs.” Contemporary Psychoanalysis, 41: 371-388.

Additional Reading:

Gabbard, G. & Lester, E. P. (1995). Boundaries and Boundary Violations in Psychoanalysis. New York: Basic Books.

Class 5:
Part I: Values, judgment and diagnosis.

American Psychiatric Association (2013). “Highlights of Changes from DSM-IV-TR to DSM-5.”

Boodman, S. (1989). “A Horrible Place A Wonderful Place.” The Washington Post.

Caplan, P. and Cosgrove, L. (Eds.) (2004). Bias in Psychiatric Diagnosis. Northvale, NJ: Jason Aronson. (Readings to be determined…)

Optional Podcast:

Part 2: Ethical Considerations in Psychoanalytic Writing and Education

Aron, L. (2016). “Ethical considerations in the writing of psychoanalytic revisited.” Psychoanalytic Perspectives, 13 (2): 267-290.

Cresci, M. B. (2002). “Ethics and values in psychoanalytic education: Challenges for today.” International Forum of Psychoanalysis, 11: 49-60.

Gabbard, G.O. (2000). “Disguise or Consent: Problems and Recommendations Concerning the Publication and Presentation of Clinical Material.” International J. of Psychoanal. 81(6):1071-1086.

Class 6:

Part 1: Self-Disclosure. Is it avoidable? Is it appropriate?

Levenson, E. A. (1996), “Aspects of self-revelation and self-disclosure.” Contemporary Psychoanalysis, 32: 237-248.

Renik, O. (1995), “The ideal of the anonymous analyst and the problem of self-disclosure.” Psychoanalytic Quarterly, LXIV, pp. 466-495.
Part 2: Practice Practicalities: Class will cover practical issues in setting up a private practice including marketing, record keeping, working with insurance companies, and any other questions.

American Psychoanalytic Association (1997). “Charting Psychoanalysis.” J. Amer. Psychoanal. Assn., 45:656-672.

Bernstein, S.B. (2000). “Developing a Psychoanalytic Practice.” Psychoanal. Inq., 20(4):574-593.