Doing What’s Right: The Ethical Dimension of Psychoanalytic Work During A Pandemic

Abstract

In a time as stressful and uncertain as a pandemic, individuals struggle to weigh the risk vs. benefit ratio as they attempt to pursue at least some of their customary life satisfactions while keeping themselves and others safe. What modifications in our usual psychoanalytic approach–if any–are called for in working with patients grappling with those decisions? What kind of influence are we exerting, consciously or unconsciously, over their views and actions during these times? How do psychoanalysts’ own unrecognized needs, wishes, and anxieties affect their responsivity to their patients? This paper takes up these questions and others as part of an exploration of the ethical dimension of psychoanalytic care.

Keywords:

• micro-trauma
• ethics
• pandemic
• desire
• decision
• COVID-19

Acknowledgments

The author thanks Dodi Goldman, Ph.D., Stephen Seligman, D.M.H., Ladson Hinton, MD, and Julia Purcell for their insightful contributions to this paper.

Notes

¹ The analyst may also be influenced by a desire to disavow the simple truth that we just don’t have a good, clearcut answer for many if not most major ethical dilemmas, given their inherently enigmatic nature. We are motivated to avoid any sense of shame associated with this lack on our parts (Ladson Hinton, personal communication).

² The observations that follow relate especially to the first year or so of pandemic life, when the virus was least well understood, contagion was climbing higher and higher, protective measures were stringent, and vaccines had not yet been developed or were not widely available.

Additional information

Notes on contributors

Margaret Crastnopol

Margaret Crastnopol, PhD, is a consulting analyst and faculty of the Seattle Psychoanalytic Society and Institute and a supervisor of psychotherapy and faculty at the William Alanson White Institute in NYC. She is an associate editor of Psychoanalytic Dialogues, and on the editorial board of Contemporary Psychoanalysis. Dr. Crastnopol is also on the executive committee and board of directors of the International Association for Relational Psychoanalysis and Psychotherapy. She is the author of Micro-trauma: A Psychoanalytic Understanding of Cumulative Psychic Injury (Routledge, 2015). Dr. Crastnopol is in private practice, treating individuals and couples in Seattle, WA, and in some instances elsewhere via remote means.