ABSTRACT
A minimum structure for psychotherapy is an agreed and preferably regular time and place within which therapist and patient can meet. A psychotherapy session, like a play, refers to, reflects on, and is an intensification of reality, but remains, through its formal structure and the neutrality of the therapist, separate from it. Psychotherapy has been described as the “purchase of friendship”. Psychotherapy has also been the subject of political critique. Psychotherapy is beyond the reach, pocket, and ken of many poorer patients who could well benefit from it. A central ethical issue for psychotherapy follows from the fact that therapists are in a position of relative power, while patients seeking therapy are often in a weak state, in desperate search for an answer to their problems. Psychoanalytic therapy attempts, through the concept of transference, to make the issue of dependency-in-the-service-of-autonomy a central vehicle for therapeutic change.
