ABSTRACT
Psychoanalysis has long been caricatured as the site where a patient presents profoundly personal material to an analyst who, in turn, says almost nothing. This nearly silent analyst serves as a receptacle for the patient, who is expected to vocalize any and all memories, thoughts and desires, “whatever comes to mind.” Though a caricature, Freud and classical psychoanalysis are rightly credited for this kind of weird, modern relationship that has no parallel: the consulting room as uniquely intimate space and the therapeutic bond as one that cannot be trespassed, entirely confidential, unconditional and without “legs” to the outside world. In that space, the patient offers all that he or she cares to or is able. All of this is fostered by an analyst who establishes a fee and sessions on an ongoing and regularized basis and by helping to create a conversation unique to each therapeutic couple. Efforts are made by the analyst to create a safe and secure environment, characterized by features that make both the analyst and the setting predictable, stable, reliable, accessible and inviting. At the same time and despite the intimacy fostered, professional distance is maintained so that genuine “real” intimacy between the two participants never develops. Modern therapy, of nearly every stripe, struggles to achieve some form of this impossible aspiration. Not surprisingly, the challenge to maintain appropriate legal, moral and ethical boundaries and prevent professional breaches—the problems of self-disclosure, mutual analysis, various forms of boundary crossings, personal, out-of-office and sexual contact—have also been ongoing professional preoccupations. Breaches occur more often than the profession cares to admit.
