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The failure of the psychotherapeutic profession, and psychoanalysis in particular, to provide a consistent and coherent public account of the specialized nature of the psychotherapeutic relationship and setting has had harmful consequences for both the profession itself and for the public. Among the most serious of these consequences are (1) erosion and devaluation of confidentiality as a basic precondition of psychotherapy; (2) a tendency to conflate psychological and legal concepts and principles; (3) a tendency to think of psychotherapy as a form of redress or rehabilitation and a perhaps related tendency to think of the law as a form of social therapy; (4) the creation of misguided public expectations about what psychotherapists can fairly be asked to do without exceeding their mandate and what public authorities can be expected to do without overreaching the democratic limits on their powers and responsibilities.
The paper begins with a broad account of the roots in traditional society of the psychotherapeutic relationship, while emphasizing that psychoanalysis is a specifically modern institution that cannot survive for long outside a framework of law limiting the power of collective institutions over the individual. Following a schematic description of the different levels of the confidential relationship, the paper discusses the rise of the “therapeutic society” and the forces contributing to the attenuation of the working space in contemporary psychoanalytic and psychotherapeutic practice.