Review by Francoise Jaffe (USA)

The National Institute for the Psychotherapies attracted a record number of attendees for its annual conference, entitled Privacy Matters: Secrecy and Disclosure in the Analytic Relationship, held on May 9, 2015, in New York City. The three presenters, Sue Grand, PhD, Lewis Aron, PhD, and Steven Cooper, PhD, focused on different aspects of this timely topic, offering thought provoking and often controversial insights that nevertheless carried a common message: analyst, question thyself.

Sue Grand took the idea of privacy into the realm of sexuality in the analytic relationship, highlighting how exploration of the patient’s sexual desires, which was the foundation of analytic thought, can and has led to analytic “secrets” and transgressions, damaging the very patients it seeks to help. She pointed out that by its very nature, analytic treatment seeks to open desires, and then gets caught in its own game. She advocated for a greater awareness on the part of the analyst for all that is “unsaid” in the treatment, including the analyst’s own desires and their implications for the patient. She also advocated for creating a climate in which these “secrets” can be explored and confronted.

What are the moral, legal, and ethical issues involved in writing about patients? Lew Aron reviewed many aspects of these questions and concluded that there is no consensus or standard for handling them, either among analysts or among lawyers. The trend among the younger generation of relational psychoanalysts has been to include patients in the writing process. However, Aron pointed out the many potential pitfalls of doing so, including having patients who consciously acquiesce to being written about but unconsciously rebel, as well as the lack of training and conversation surrounding the topic. He recommended that therapists question their motivation when choosing to write about a particular patient, and seek a consultation to help them evaluate the appropriateness of their selection.

Steven Cooper questioned the idea of fixed boundaries and proposed instead a notion of boundaries as fluid and continuously redefined by circumstances and interactions. He pointed out that the desire to be known is universal and developmentally crucial, but since most of our mental life is not even conscious to us, how do we decide what can be known? Cooper proposed that the analyst’s task is to get to know the patient in his own mind so that the patient can start to discover his mind through his therapist’s, but there has to be awareness that what can be shared and what needs to remain private is always shifting, a distinction that has to be honored. Cooper demonstrated that, in effect, psychoanalysis is an exercise in safely breaking down boundaries, an art that requires that the analyst be aware of his own movement as well as his movement in relation to his patient’s.

These inspiring and multifaceted talks gave rise to many questions, which were debated in a roundtable format to conclude what had been a very stimulating day.

Francoise Jaffe, LCSW, PhD is a 2014 graduate of the National Institute of the Psychotherapies (NIP) where she trained in the four year adult program after spending two years in NIP’s Child and Adolescent program.  She also completed a certificate in Parent Infant Psychotherapy from Columbia University. Her short story, Mind Strings, appeared recently in Psychoanalytic Perspectives.  She holds a PhD in Marketing and, in a former life, was a faculty member at the University of Michigan.  In her present life, she is in private practice in Manhattan and Westport, CT.

Francoise Jaffe, LCSW, PhD
Psychotherapy and Psychoanalysis
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