Commentary on the Papers of Doctors Elkind and Abarbanel

All learned professions share the problem of how to deal with incompetent, unethical, and even criminal conduct by their members. Most, if not all of these professions have created organizations composed of members that deal with such problems. Procedures have evolved over the years that attempt to address critical issues in a spirit of fairness and justice. Such is the case in the medical profession and in its speciality divisions. None of the systems that have been created work to perfection, certainly not to everybody's satisfaction, yet they are the best we have. These bodies are often organized as committees on ethics. Their membership usually is composed of colleagues who are widely respected for their integrity. They serve without compensation and they are expected to strictly avoid conflicts of interest. Should a conflict arise, they are expected to resign, and they do.

The two papers that I am about to discuss, address a specific problem that occasionally occurs in our field of psychoanalysis. Neither by their titles nor by intent do these papers address problems of ethics. However, as will become apparent in my discussion, these papers effectively do so. It is for this reason that I wrote the introductory paragraph, which is intended as a background and a frame of reference.

The first paper, written by Sue Nathanson Elkind, deals in the main with relevant theory. Taken by itself, it offers some interesting viewpoints and a listing of psychodynamics, supported by clinical vignettes. I found myself turning apprehensive, however, upon considering the role of the consultant, as outlined by the author and applied to herself. There is a subtle air of condescension versus the therapists who come across as less proficient, less astute, less sensitive than the consultant, and also emotionally more impaired. In concluding the paper the author tries to undo such an impression by claiming “imperfection” for herself as well. Such modesty may be