The Pirate’s Code of psychoanalysis: Moral rules or merely guidelines?

Doris McIlwain, Macquarie University

Arnold Goldberg Moral Stealth: How ‘Correct Behavior’ Insinuates Itself into Psychotherapeutic Practice, Chicago, University of Chicago Press, 2007 (144 pp). ISBN 9-7802263-0120-4 (hard cover) RRP $47.95.

‘If you take a sonovabitch and give him psychoanalysis, you don’t get a good citizen; you get a sonovabitch—with analysis’ said Lacanian analyst Oscar Zentner in 1985, wittily disabusing his listeners of any expectation that psychoanalysis promotes fitting in with everyday conceptions of morality. Psychoanalysis has an uneasy relationship to morality as Arnold Goldberg shows in his new book Moral Stealth: How ‘Correct Behavior’ Insinuates Itself into Psychotherapeutic Practice. Psychoanalysis has been variously ‘condemned as an activity intent on undermining morality, as having nothing whatsoever to do with morality, or as itself offering a cogent ethical theory’ (Goldberg 2007, p. 11). For Goldberg ‘morality here is the very business of psychoanalysis’ (p. 12), since ‘self-scrutiny’ and sublimated gratification – the ‘taking into account the demands of society and one’s own conscience’ (p. 12) are at the heart of the endeavour.

This book challenges psychoanalysts to make use of ‘all the contradictions and uncertainties’, rather than prematurely and ‘lazily’ resolving them with an appeal to fixed moral standards. Goldberg is suggesting, in a sense, that the standards by which psychoanalysts practice, are guidelines rather than hard and fast rules. His stance calls to mind two moments in the film, Pirates of the Caribbean. In the first, the pirates are constrained by their own code to take on board a young woman who invokes ‘parley’ and is safe until the conditions are fulfilled—she has successfully spoken to the captain. The second, much later in the film, humorously revisits the first (when they had obeyed the code and behaved honorably) with an example showing their flagrant disregard of the code (again, to behave honorably). The pirates are admonished by their captain for having failed to obey the code, which, had they done so, would have required that they go on without him and leave him to die. They look lost for words to cover over this act of fellow-feeling, and mutter ‘we figured they’re not so much rules as guidelines’.

Can we consider all of the standards which Goldberg raises to be merely guidelines? He addresses a broad array of issues that do seem to fit into his notion of flexible guidelines, to be considered anew in each case; attributes that make a good therapist; nuanced ways in which a therapist might, to the benefit of the client, collude in lies she or he tells; how best to retain the scientific merit of case studies while still keeping safe the private lives (and feelings) of clients through disguised write-ups, and revisits issues of analytic neutrality compared to a more everyday self-disclosure of feelings and values on the part of the analyst. Goldberg argues that ‘to be just one must not only follow a rule of law but also reinvent it in each case’ (p. 19). Being allowed to reinvent the law seems to accord considerable power to the analyst. What keeps him or her from adopting the role of tyrant (or pirate)? Proper training, clearly specified procedures and requirements of the analyst are a start.

But for Goldberg, some of these requirements and procedures have acquired moral status. Moral positions can have a profound impact on psychoanalytic and psychotherapeutic practice without their being made explicit and often without our ever being aware of them. They have a stealthlike existence, undetected because of inattention. Psychoanalysis leaves nothing unquestioned, but Goldberg exposes an unarguable list of ‘such moral positions as confidentiality, honesty, and respect, coupled with a wish to help and heal’ (p. 31). Why, he wonders should psychoanalysis, of all activities of enquiry, ever be content with buying into foundations, rather than examining every assumption? While he is quick to say that ‘to urge that we examine a moral posture is not ever to suggest that we abandon it’ (p. 42) the pragmatic moral stance taken in his work will be for some an uneasy terrain filled with moral slippery slopes.

Being good doesn’t mean being nice: Analysts as wannabe saints

Being allowed to reinvent the law accords considerable power to the analyst.

Morality has made inroads to psychoanalysis at the micro-level of technique, says Goldberg and good analysis has become a matter of personality. The burgeoning requirements of being a good therapist have, in a stealthlike way, come to set analysts apart—as wannabe saints. And so we have:

Slippery Slope One [SS1]: Stealthlike changes in requirements of the analyst: analytic neutrality → empathy → being a real person → being a really nice person → wannabe saint

While being a good (competent) therapist doesn’t necessarily even overlap with being a nice person, to Goldberg empathy has become synonymous with kindness rather than a good means of gathering data about personality. Introducing empathy as a psychoanalytic technique was radical enough when advocated by Kohut (1983), an American ‘self psychologist’. A radical shift from classical psychoanalytic technique, it de-emphasised the neutrality of the analyst encouraged by Freud (who in one paper on technique would have us ‘emulate the surgeon’ in cultivating a certain ‘emotional coldness’ (Freud 1912/1957, p. 115) in working with patients; but see Freud (1915/1958) for a more passionate stance).

Before empathy became synonymous with kindness, it was a therapeutic means of discerning and integrating parts of the analysand’s ‘self’ which had become split off and disconnected. Neutrality is seen by some as always having been a bit of a myth. Stephen Mitchell, a relational psychoanalyst says the personality of the therapist has always been a more powerful influence in the consulting room than classical technique suggested. He embraced the view that the analyst as real person is involved: ‘the analyst’s hopes for her patient are embedded in and deeply entangled with her own sense of herself, her worth, what she can offer, what she has found meaningful in her own life’ (1993, p. 207–208, cited in Goldberg 2007, p. 13). From being a real person, the next swift move was, according to Goldberg, to being a really nice, almost saintly person who brought to analysis the qualities of ‘curiosity, hope, kindness, courage, honesty, purposefulness, and integrity’ expected of analysts by Buechler (2004). As Goldberg notes wryly, these qualities are not ‘on a par with surgical scrubbing’ (p. 21).

To resist the ‘wannabe saint’ impulse, Goldberg suggests that we emphasise what is distinctive about analysts; ‘our personal self-reflection on what we do’, and use this to resist ‘psychological resting places’ within us, like certainty. In an optimistic voice he suggests; ‘our self-analysis should be the guide that allows us to continue not knowing if we have done the right thing. We operate in a network of self-correcting attitudes and actions, and this naturally leads to a multitude of possible results’ (p. 41). He sees this potential pluralism as ‘a healthy antidote to the unconscious need that many of us have to aspire to a version or moral perfection’ (p. 41).

Masks, Neutrality and Transparency

Self-reflection is one way analysts attempt to achieve neutrality: you need to know where your buttons are so that you can deactivate them, fast, when someone pushes them. Optimally, a therapist needs have a very thorough acquaintance with his or her own foibles and defenses, which a good personal analysis can provide. While many debate how best to achieve such neutrality, Goldberg is uncertain whether its attainment is in the patient’s best interests. So the slippery slope that underlies his work here is:

SS2: Analytic neutrality attempted → real feelings/judgments masked → anonymity → unable to treat patients for whom anonymity is a further rejection → adoption of transparent moral stance

Self-reflection is one way analysts attempt to achieve neutrality.

Self-reflection may be enhanced via personal analysis, as Goldberg suggests. It is more questionable to see this as a network of ‘self-correcting attitudes and actions’ (my emphasis), since analysts need ongoing supervisory support to detect warning signs when, buttons pushed, the distorting lens of their own needs and affective schemas (motivated knowledge structures that make you pay attention to, and accord significance to some things more than others) tint how they see the world and the person in their consulting room. This ‘countertransference’ happens to some degree in relationships all the time. The analyst is expected to be self-reflectively aware of its operation. Fireworks happen when desire blinds an analyst to alternative readings of evidence, most famously in Freud’s case ‘Dora’ where, in hindsight, he acknowledged that he was so certain that she should return the affections of her attempted seducer (Herr K) that he missed the significance of her mention of Frau K’s ‘adorable white body’ (Freud 1905/1957). Self-scrutiny is not always enough. Analysts have an unconscious too, and delay in their gaining self insight may damage the analysand. With the stakes high for errors, psychoanalysis has been careful to build in technical safeguards.

It is these technical concerns that Goldberg suggests have become conflated with moral concerns infiltrating psychoanalytic practice. They become conflated too with rules that really only sustain the sociological identity of ‘being an analyst’ as opposed to doing any other kind of therapy; rules which, if broken, mean something can no longer be called psychoanalysis. As I’ve shown, some of these technical rules, such as analyst neutrality, have already been malleable in the face of theoretical innovation, departing from the very precise requirements of Classical psychoanalysis. These days few people speak out in favour of such requirements since, in caricature, they may make analysts seem a bit robotic.

Classically, analysts are supposed to interpret your needs not meet them, so analysts are not supposed to give you a cup of tea, shelter you under their umbrella if you leave the building together in the rain, give advice, or answer your personal question. Rather analysts are supposed to respond—why do you ask? These technical concerns arise not out of sheer cussedness, or to allow the analyst to have a quiet snooze rather than grapple with your needs and questions. They arose from theoretical concerns that had much to do with empowerment and sculpting a unique relationship. What is important is what a question means to you—what’s behind the asking of it? Merely to answer is to miss that rich opportunity for discovery. Classical technique leaves your question lingering, until an answer arises from within you, in the process leaving you free from a certain interpersonal indebtedness. This empowers you, rather than encouraging a dependency on analyst as problem solver. After all, analysts are those ‘supposed to know’ what you need (as Lacan famously observed), while you, as analysand, in fact do know, albeit unconsciously. Well, that’s the theory.

Contemporary psychoanalytic practices changed some rules; some analysts have moved from minimising and (self-reflectively) containing countertransference to using it as a signal as to what is going on in the therapeutic relationship and sometimes as a guide to what is going on within the analysand him/herself. Some analysts dispense with attempting to be a ‘blank screen’ without desires or distinguishing attributes to be more ‘authentic’ in self-disclosure, resulting in a more symmetrical relationship. Some think analytic neutrality has a lot going for it (McIlwain 2007); others have dispensed with features of it, particularly when faced with patients for whom it might reproduce neglect and abandonment.

Classically, analysts are supposed to interpret your needs not meet them.

Goldberg suggests neutrality isn’t possible, and if sought, may not be all that helpful anyway; ‘neither agreeing nor disagreeing with the patient, all the while feeling strongly about an issue, might not be in the patient’s best interest’ (p. 52). He introduces case studies intended to show that it is impossible to ‘listen without memory and desire’ as Bion (1967) requires of us. Goldberg thinks we always take sides, which makes such evenly hovering attention impossible and shows this in a case study: An analysand’s wife needed medication. There was a closet at his work full of samples of medication left by drug companies to get people hooked on expensive drugs for their treatment. A colleague saw him one day taking some, and said ‘Are you stealing from the closet?’ Goldberg says he would take the samples home in an instant himself and therefore it isn’t possible not to take sides immediately. He suggests that you can’t possibly listen to that with a neutral stance, equidistant from the id (‘yes just take what you want now’), ego (‘if you can afford to buy the drugs and that will enhance your reputation and avoid the pain of guilt, perhaps take them only on days when you can’t get them by any other means’) and superego (‘don’t even dream of taking what you want, no matter if your wife will die if you don’t’). I’ve personified the psychic agencies to give the flavour of differing motivational inputs. Yet, taking Goldberg’s suggestion as permission to become comfortable and transparent to your analysand about your own moral stance might make you a poorer analyst, closing off more than it opens up.

Leave nothing unquestioned: why buy into foundations?

Since psychoanalysis leaves no gesture or slip of the tongue unanalysed, Goldberg is intrigued as to why psychoanalysis should ever be content with buying into foundations. He suggests that we need to critically consider which standards apply in any given case. He presents us with an interesting slippery slope, to which I add a final possible, but controversial endpoint:

SS3: Psychoanalysis questions everything → psychoanalysis has no rules → confidentiality should not be a rule → psychoanalysis cannot exist

Rather than buying into foundations, for Goldberg, psychoanalysis occupies an ‘ambiguous space’ defined by two poles—between moral correctness and behaviour that is concerned with a desire to help one’s patients. It is a controversial area because there is ‘a lack of certainty about morals’ and ‘ongoing arguments about proper technique’ which does open the door to ‘a myriad of actions which some might not see as acceptable’ (p. 10). Goldberg notes ‘it highlights the fact that the application and contents of “the moral” are idiosyncratic and dependent on a multitude of factors’ (p. 10).

He doesn’t mean by this ‘anything goes’ but chooses rather to align himself with his own version of American Pragmatism which he distinguishes from such moral relativism. With pragmatism, there are no constraints on enquiry, no absolute guiding truths save those we gain from conversations with one another. Knowledge does not coincide with the correspondence of facts and sentences, but rather that the participants in communication agree upon a shared interpretive horizon. To apply their philosophy to psychoanalysis, Goldberg says if there is ‘no way the world is’, it is also true that ‘there is no way a patient is’ (p. 43). Pragmatists, he contends, see ‘what is useful as being most justified, and therefore, they insist that it is what accomplishes such an endpoint that becomes the bearer of the way the world is’ (p. 43). It is a background for any activity:

… one need not evaluate therapeutic behavior against a set of correct or prescribed rules and regulations. Rather one practices with an eye both to the chosen activity being effective and to the maintenance of a consensus of like-minded persons who constitute a community of support. Only then can we claim validity for what we do. (p. 43)

Not surprisingly, he notes that many people would part company with pragmatism at this point ‘as they begin to feel the ground is going out form under them’ (p. 43). It certainly does bring to mind the TV show House where the rule-breaking protagonist would not be such a successful diagnostician were he not so non-normative, but the show illustrates too how readily the ‘consensus of like-minded people’ can be persuaded by charismatic authority to turn a blind eye to quite risky interventions. Even moral truth by like-minded majority vote has a lot going against it historically.

The issue of confidentiality
undoes Goldberg’s pragmatic approach.

For me it is the issue of confidentiality that undoes Goldberg’s pragmatic approach. He takes issue with Bollas and Sundelsen’s (1995) uncompromising stance on the importance of confidentiality to psychoanalysis, discussing a case where he thought revealing case details to a third party (at the analysand’s request) was beneficial to therapy. From having ‘a life of compartments and concealments’ the analysand progressed remarkably after her analyst had ‘breached confidentiality’ by writing a letter to her lawyer. It is noteworthy that the breach was sought by the analysand and her analyst was the only person able to intervene on her behalf. Goldberg is challenging Bollas and Sundelsen, suggesting ‘the retreat to absolute confidentiality is but a place for the analyst to hide especially from analyzing the precise nature of the third-party involvement’ (p. 57).

Yet Goldberg himself has said earlier, that without the privilege to withhold information from courts and interested parties ‘therapists are set adrift in a sea of ethical uncertainty’ (p. 55). Many argue confidentiality from intrusion requires a certain procedural rule being in place which is beyond contestation. Confidentiality seems of a different status to those attributes that have stealthlike, come to define the behaviour of the analyst. Is confidentiality an analytic activity or is it part of ‘the frame’ without which psychoanalysis as we know it cannot function? Does it require rule-like status for psychoanalysis to exist?

I posed these questions at a recent national conference in Brisbane hosted by the Australian Psychological Society’s Psychoanalytically Oriented Psychologists Interest Group, admitting that I find myself in sympathy with Bollas. His position, in brief, is that confidentiality is vital to the unique space that is offered by psychoanalysis which should be accorded the same privilege currently enjoyed by lawyer-client relations. Responding to my paper, Professor Robert King of the University of Queensland made a crucial distinction. He suggested that ‘while most principles of technique govern the activity of analysands, confidentiality is about the activity of the analyst; something that the analyst cannot be left to decide’. Like any human, an analysts’ morality is open to subversion by desire. An analyst may justify breaches in confidentiality to break out of the loneliness and isolation of knowing a welter of powerful facts legitimately shared only in supervision, or (with the analysand’s consent) in heavily disguised case-studies, which Dr Deborah Luepnitz has charmingly called ‘true stories that I made up’ (Crumbley 2005).

The power of confidentiality

Individual decisions about confidentiality require collective backup, just as collective moral ‘oughts’ still require individual critical weighing. Individual morality, the superego, is a chunk of culture installed within us as a result of identification, and on pain of loss of love. Yet, as bearer of cultural, moral requirements, the superego is potentially open to individual and collective subversion by desire and fear—able to trim individual narcissism to promote the collective good, but also able to legitimise crusades and witch-hunts. So, imagine that collective norms mean the courts decide that therapeutic case notes should be available on demand. Then we might face a slippery slope constructed out of issues which I consider important and which might look like this:

SS4: Confidentiality broken because courts require it → trust in analytic relationship broken → free association impossible → integration of new identity in therapeutic environment much more difficult → a life of compartments and concealments must be maintained

At a collective level, critical weighing of moral oughts is required because ‘what is ethical and what is legal are not equivalent’—as Bollas (1999) underscores powerfully, speaking of the ethical demand for civil disobedience in the face of apartheid, slavery, and the persecution of Jews. The ethical-legal distinction can be forgotten when the law makes inroads to psychotherapy and psychoanalysis. Confidentiality is under threat if analysts are required to warn possible victims of their analysand’s impulses, as in the ‘Tarasoff’ decision in 1976 which ‘mandated a breach of confidentiality’ (Bollas 1999), or if therapeutic case notes can be required for legal trials.

Individual decisions about confidentiality require collective backup.

In her book Relational Remembering philosopher Sue Campbell discusses ‘frequent defense counsel demands for access to women’s confidential records in sexual assault cases so that they can scrutinize client-therapist interactions’ (2003, p. 153) noting that ‘social practices such as violations of confidentiality significantly constitute women’s real lack of relational boundaries’ (p. 154). Research reveals that asking for case notes (whose relevance to the case was frequently left under-justified) has been associated with attempts to undermine a woman’s pursuit of justice, with searches for ‘evidence that the primary witness is not credible, or for inconsistencies in her account or for material that embarrasses her or humiliates her enough to convince her not to proceed’ (lawyer Katherine Kelly reporting on interviews with defense counsel, cited in Campbell, 2003, p. 161). Most relevant to concerns about confidentiality in psychoanalysis is Campbell’s comment that making a woman’s therapeutic case-notes available ‘may involve betraying her trust in the very relationship to which she has turned in an attempt to re-establish herself as a person with boundaries—a person who has some control over when and to whom she’s accessible’ (2003, p. 168).

Christopher Bollas is clear on the damage done in such cases; ‘when the psychoanalyst agrees—even following legal appeal—to hand over his clinical notes to a court, the structure of confidentiality is destroyed’ (1999, p. 2). He suggests that ‘when the individual loses his right in a particular situation, it is lost on behalf of all people’. Psychoanalysts are not unique in requiring confidentiality for their profession to be possible. As Bollas notes ‘journalists assert privilege even though they may be found in contempt of court and subject to sentence’ and that ‘in giving suspended or very light sentences the courts acknowledge the strong ethical basis of journalism’s claim for privilege’ (1999, p. 4). Also, the lawyer-client relation is privileged; ‘lawyers are legally exempt from reporting on their clients, if they nonetheless choose to do so, they will have violated their oath, which in turn will have been a violation of their profession, and they will lose their license to practise’ (Bollas 1999, p. 5).

The point here is not just that breaches of confidentiality do harm; confidentiality has constructive, transformative powers. Analysis involves a transformation in which the analysand moves from ‘a condition in which he keeps secrets from himself to a condition in which he has a private life’ (Lear 2003, cited in Goldberg 2007, p. 55). Confidentiality is crucial then in modifying the results of repression (where one unknowingly keeps secrets from oneself) and to Lear ‘confidentiality is not just one value to be weighed against competing values; it is constitutive of the process itself’ (2003, p. 5, cited in Goldberg 2007, p. 55).

WHAT WORKS TO MAKE GOOD ANALYSIS: WHAT MAKES ANALYSTS

One theme running tacitly through Goldberg’s work is that there is a blurring of technical considerations addressing efficiency of intervention with those technical considerations linked to issues of professional identity. So his slippery slope might look like this:

SS5: Emphasis on technique promoting effective analysis → emphasis on what techniques may be properly called analysis → strict definitions of analysis precluding innovation → smugness and/or idealism

Confidentiality is not part of the Pirates’ Code; it is more rule than guideline.

An allied slippery slope, for me, has as its endpoint unchallengeable authority rather than smugness or idealism. While it is not part of Goldberg’s explicit project, if, as he suggests, analysts need to be free to reinvent the law afresh on each occasion, there is considerable power being vested in an individual. I see a paradox, then, at the heart of psychoanalysis. As a theory, it offers a radical critique of all too common forms of authority ‘I’m just doing my job’; it uncovers the pervert beneath the authoritarian imposing arbitrary rule. Yet, as a practice, it creates experts who can assess a person; people with a platform from which to moralise. Something has to keep those experts honest and accountable. Grasping the nettle, Adam Phillips (1995) suggests ‘psychoanalysis can be useful as a critique of the whole project of wanting authorities’ (p xiii). He applies that dictum with characteristic reflexivity to the authority of the analyst him or herself; ‘In so far as the psychoanalyst becomes an expert on how people should live—becomes, that is to say any kind of guru, any kind of official expert—he has complied’ (p. xv). For Phillips an analyst is ‘a professional who sustains his competence by resisting his own authority’ (p. xvi). If analysts just become the high priests of culture, tightly defining what constitutes the good life, they forfeit the radical promise of analysis.

Goldberg notes that, on pain of rejection from an analytic community, ‘the effectiveness of treatment may take a backseat to the issue of credentials, that is, remaining within a tradition … we argue over … who can wear the banner of certitude’ (p. 44). Pragmatism would ask psychoanalysis to recognise that ‘we are engaged in conversations aimed at increasing our capacities to better make our way in the world’ (p. 44). He thinks many of schools of analysis make people better, but that within psychoanalytic circles, attention is paid to deviance rather than consensus. This is often expressed as hyper-attunement to deviance in a way that exaggerates differences to make one’s own theoretical grouping, or clique, seem more distinctive, leading to a lack of curiosity towards new ideas if they arise from a group defined as different. Goldberg suggests that this can lead to a neglect of innovation. He suggests too that we are intrigued by moral deviance. His book is written in a spirit of freedom which urges us to ‘live through the painful state of uncertainty’ that comes from acknowledging that we look through ‘a lens of unconsciously embedded guidelines … live by words and ideas that are never spoken’ (p. 20). He would have us critically appraise our moral commitments rather than permit them, stealthlike, to determine our theoretical interests and our conduct. As Joel Whitebook observes in his work, Perversion and Utopia, psychoanalysis promotes a critical approach to the law (in many senses of that word); that optimally one submits to it, not because it is law, but because one deems it worthy. I take that to be the message of Goldberg’s book to psychoanalysts.

I think however, that confidentiality is not part of the Pirates’ Code; it is more rule than guideline. With its loss, therapeutic safety is lost and those marginalised, or vulnerable (as we all are at moments of transition) may find that in therapy their speech can no longer be allowed to run away with them so fresh answers might arise. The contextualised nature of their account of themselves may at any moment be unsympathetically recontextualised in a court of law. Psychoanalysis is a unique space and a unique relationship which optimally allows a person to examine afresh where their life and dreams are going. It warrants the protection, the privilege for all of confidentiality.

REFERENCES

Bion, W. 1967, Second Thoughts, Karnac Books, London.

Bollas, C. 1999, ‘On the loss of confidence in psychoanalysis’, International Psychoanalytical Association Newsletter, vol. 8, no. 2 [Online], Available: http://www.academyprojects.org/leboll1.htm [2007, Dec 20].

Bollas, C., Sundelson, D. 1995, The New Informants: The Betrayal of Confidentiality in Psychoanalysis and Psychotherapy, Aronson, Inc. Northbrook, NJ.

Campbell, S. 2003, Relational Remembering: Rethinking the Memory Wars, Rowman & Littlefield Publishers, Inc, London.

Crumbley, A. 2005, ‘A conversation with Deborah Luepnitz’, Dialogues, Observing Ego [Online], Available: http://www.theobservingego.com/archives/dialogues/000027.php [2007, Dec 20].

Freud, S. 1905/1957, ‘Fragments of an analysis of a case of hysteria’, in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 7, pp. 1–122, Hogarth Press and the Institute of Psycho-Analysis, London.

Freud, S. 1912/1957, ‘Recommendations to physicians practicing psycho-analysis’, in The Standard Edition of the Complete Psychological Works of Sigmund Freud, trans. J. Strachey, A. Freud, A. Strachey & A. Tyson, vol. 12, pp. 109–120, Hogarth Press and the Institute of Psycho-Analysis, London.

Freud, S. 1915/1958, ‘Observations on transference love’, The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 12, pp.159–171, Hogarth Press, London.

Kohut, H. 1982, ‘Introspection, empathy, and the semi-circle of mental health’, International Journal of Psychoanalysis, vol. 63, no. 4, pp. 395–407.

Lear, J. 2003, Therapeutic Action: An Earnest Plea for Irony, Other Press, Newark.

McIlwain, D. 2007, ‘Ethically neutral’, paper presented to the Australian Psychological Society’s Psychoanalytically Oriented Psychologists Interest Group National Conference, Being in your right mind – challenging the virtues of ‘untroublesomeness’: Psychoanalytic practice, morality and complacency.

Phillips, A. 1995, Terrors and Experts, Faber and Faber, London.

Whitebook, J. 1995, Perversion and Utopia: Studies in Psychoanalysis and Critical Theory, MIT Press, Cambridge.

Doris McIlwain is senior lecturer in Psychology at Macquarie University. Her research interests are personality and philosophy of psychoanalysis, charisma, and affective personality profiles (narcissists, Machiavellians and psychopaths). Her work has been published in Meanjin, Philosophical Psychology, the Journal of Neuropsychoanalysis and Theory and Psychology. She is a foundation member of Working Through Psychoanalysis and has a small private practice.

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