MEETING OUR PATIENTS HALFWAY: TOWARD AN ETHIC OF CARE IN PSYCHOANALYSIS

Abstract

The question of if, when, and how we “care for” our patients has been the subject of much debate within our field. While some hold the ethic of care in high regard and as central to our work with patients, others disparage it as, among other concerns, gratifying our patients, inhibiting their autonomy and agency, and demanding too much of us as clinicians. This paper traces, albeit briefly, the long history of “care,” while questioning whether the disparagement of care might be linked to holdovers from our psychoanalytic past, including the repudiation of all things feminine, soft, dependent, and vulnerable in favor of a more robust, masculinized theory. The paper searches for some deeper understanding of “care,” suggesting that it is care that provides the therapist (or, for that matter, anyone) the capacity to empathize – to mediate experience between self and other. Care, if practiced with care (and it should not be called care if it does not), propels the analyst to employ empathy both as a method of psychoanalytic investigation and data collection and as a force for healing itself.

Keywords:

• Ethics of care
• history of care
• care as the capacity to empathize
• care as mutative
• defamation of care
• analytic love
• intersubjectivity vulnerability

Notes

¹ The word “nostalgia” in the novel’s title comes from a Homeric word nostos (homecoming) and algos (pain or ache). In the 17th century, the word was coined to describe the severe anxieties of Swiss mercenaries who longed to return home. Later (1770), nostalgia was used by physicians sailing with Captain Cook as a medical diagnosis, which in the most severe cases led to death. Nostalgia is the forerunner of the World War I diagnosis, shell shock, and today’s PTSD.

² Perhaps some of the debate over whether the goal of our work as clinicians is “cure” or “care” (i.e., healing) derives from “care’s” Latinate origin – cura.

³ Heidegger’s philosophy in general, and his ethic of care in particular, has come under considerable scrutiny and criticism in light of his membership in the National Socialist Party from 1933–1945 and the release in 2014 of his Black Notebooks, which reveal much more of his anti-Semitism and how it influenced his philosophical project.

⁴ Freud’s rejection of Ferenczi (his student, mentee, collaborator, and friend) just before Ferenczi was to present his famous “Confusion of Tongues” paper (1933) at the 12^th Psychoanalytic Congress in Weisbaden – an article that spoke to the power of love in psychoanalysis – was a bitter blow to Ferenczi. Tragically, Ferenzi died only months later from pernicious anemia – perhaps, too, from a broken heart.

Additional information

Notes on contributors

Hilary Maddux

Hilary Maddux is a licensed clinical social worker and has had a private practice for more than 25 years on Manhattan’s Upper West Side. She received her analytic certificate from the Institute for the Psychoanalytic Study of Subjectivity (IPSS) in New York City. Hilary works with individuals and couples, including the elderly and members of the LGBTQ community, and has a special interest in trauma, abuse, illness, and death and dying, as well as the interface of psychoanalysis with philosophy, the arts, ethics, and social justice.