A Contract With A Psychoanalyst

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Since psychoanalysis is long-term and strives for profound changes in the patient, some, special, requirements are presented to the patient (and to the psychoanalysis process itself), and they are reflected in the contract. What are they needed for? They optimize the psychoanalytic process, trying to reduce the influence of destructive resistances. To keep psychoanalytic work and processes within the psychoanalytic space (permanent office, the same meeting time, and of course the same psychoanalyst).

Meetings with a psychoanalyst and the process itself are usually called sessions. Classical psychoanalysis involves three to six sessions per week. In the modern world, it is difficult to devote so much time to going through psychoanalysis: the rhythm of life is higher and there is less free time, cities have become much larger and one has to travel considerable distances to visit the analyst. Meetings with the psychoanalyst take place only in a specially designated place, usually the psychoanalyst's office. Why can't psychoanalysis happen anywhere? Because special PSYCHOANALYTIC relations arise not only between the analysand and the analyst, but also between the analysand and the analyst's office. This makes it possible to feel completely safe, attitudes towards things and objects are formed, and this attitude contributes to the transfer and development of analytic therapy. And maybe it will interfere, in any case, this is a reason for discussion.

In any analysis, and therefore in the psychoanalytic contract, there is a rule of confidentiality. The psychoanalyst, without the patient's written consent, cannot divulge confidential information about the patient in his personal life. He can use his experience in supervision and scientific work. The material must be presented in such a way that the identity of the patient cannot be identified. This point has no statute of limitations and must be observed by the analyst not only throughout his professional career, but throughout his life, this will allow a person who comes for help to a psychoanalyst to feel protected and safe. There is an exception to this rule of the contract. If the analysand poses a real danger to society, other people or to himself (a real threat of suicide), the psychoanalyst has the right to violate the rule of confidentiality. If possible, the analysand should be made aware of this.

Money. Yes, there is money in psychoanalysis. Analysts are people too, they have needs for which you need to spend money (payment for an office, food, rest, transport, other personal needs). Also, most psychoanalysts spent a lot of money on their education (personal analysis, training analysis, university studies, supervision) and it just would not be right to work with everyone for free. The psychoanalyst himself determines the amount of payment that is comfortable for himself. Of course this (like everything else in the analysis) can be discussed. I adhere to the rule that if the analysand does not warn about the impossibility of being at the session 24 hours in advance (or warns later), then he pays for his pass in full. Also with delays. Any reason for being late is not valid to reduce the amount. The same goes for the psychoanalyst. If he is late or due to his fault the session is missed (and he warned less than a day before), then either he does not receive payment in full, or he compensates for the time. Everything is also decided individually when discussing with the patient. The psychoanalyst is not entitled to receive commissions when referring or referring the analysand to other professionals.

Sooner or later, psychoanalysis will inevitably come to an end. Ideally, this should be an objectively substantiated desire of the patient, confirmed by the psychoanalyst (the analysand has really solved the problems that he wanted at the moment, the continuation of psychoanalysis will not be effective, etc.). In any other version, it is possible to assume the manifestation of latent and not worked out resistance. For completion to be therapeutic, it is a rule that the patient notifies him of his desire to complete the analysis in four appointments. This is also an individual question and is discussed with the analyst, someone needs more meetings to complete, someone needs less. These final sessions provide an opportunity to either complete the analysis or work through the resistance that pushes you to "escape" from therapy.

Some of the psychoanalysts have their own, purely individual, rules and clauses in the contract, someone adheres to the classical postulates. If you tell me about your views on this issue, it could start an interesting dialogue.

Mikhail Ozhirinsky - psychoanalyst, group analyst.