In connection with the fact that psychoanalysis has left its pioneering years behind and can now be regarded as a normal science (Thomä 1977), there has been a growing recognition that, comparable to other sciences, mistakes can, or inevitably do, occur in practice. Mistakes can occur in psychoanalytic treatments as well as in psychoanalytic institutions, and as such they can, in principle, be investigated, provided they are discovered and acknowledged. Under this condition, open examination and discussion of any mistakes are possible, which in the favorable case can lead to constructive change in the psychoanalytic process or in institutional interactions. In contrast, a defensive attitude that denies the occurrence of mistakes prevents learning from experience (Bion 1962a).
The potential spectrum of mistakes ranges from the pole of a single, unavoidable mistake within a treatment (Thomä/Kächele 1988, p. 413) to failures in the sense of strategic treatment mistakes in the overall conception of a psychoanalysis to serious ethical boundary violations, which Schneider (2014) calls criminal misconduct (Vergehen) in a criminal law sense. Schneider also cites Chused and Raphling (1992, p. 89) in their distinction between mistakes and failures when they write, “An analyst is bound to make mistakes during his work.” In light of this inevitability of mistakes, Schneider uses a play on words with the German language by also referring to a Fehlleistung (parapraxis) as Fehler-Leistung (achievement or benefit of the mistake) which, if understood, can lead to a constructive turn in the analytic process. Casement (2002) has used a courageous account of his own cases to describe how he, and all of us as psychoanalysts, can learn from mistakes in our treatments. In a similar vein, Zwiebel (2014) argues for a psychoanalytic theory of error and for a culture of error.
From my point of view, the development of a theory of error and error culture must be connected with this constructive paradox: for as much as we need “the incorporation of the non-ideal in the conscience of the analyst” (“die Inkorporation des Nicht-Idealen im Gewissen des Analytikers”, Treurniet 1996, 28, emphasis in original, quoted from Schneider 2014), we also cannot give up our efforts to maintain an attitude in the psychoanalytic process that is as appropriate and “correct” as possible. The balancing act of working within this paradoxical situation requires accepting the tensions it produces or, rather, having a sufficient tolerance for them, which must always be found anew.
If this paradox and tension tolerance cannot be mustered by the analyst, there is a danger of soon approaching the serious malpractice pole of the error spectrum, leaving no room for the “benefit of mistakes” (Fehler-Leistung). Acts of malpractice are not one-off and short-lived, but persistent boundary violations of a sexual and non-sexual nature. When they take on the magnitude of criminal acts, Schneider's use of the term criminal misconduct seems to me very appropriate. In their seminal and highly meritorious book, which can be considered the standard work on the subject, Gabbard and Lester (1995) deal extensively with various forms of boundary violations in psychoanalysis. They describe both sexual and non-sexual boundary violations in analyses, supervisions, and institutions. A number of structural measures and practices now established in many psychoanalytic societies—such as the establishment of ethics guidelines, ethics committees, and mediation bodies, up to and including rehabilitation or expulsion of analysts from the society—can be traced back in no small measure to their suggestions. In contrast to the early, “ahistorical” (Eckstein 1960) or “prehistorical” (Balint 1954, both quoted from Gabbard and Lester, 1995, p. 167) period of psychoanalytic training, we now have—in addition to the personal analysis of each analyst—more clearly regulated forms of supervision, and the institutions just mentioned have also become more the standard. Nevertheless, in one of his more recent articles, as well as 30 years after the publication of his standard work written with Lester, and after treating, evaluating, and consulting on over 300 cases of boundary violations, Gabbard has been rather pessimistic about the effectiveness of the established
prophylaxis. However, he does not completely give up hope and sees a continuing responsibility on the part of the psychoanalytic institution and the training committee to always keep in mind the “Achilles' heel” of our profession, which is stretched between fantasy and desire.
However, it is also no secret that there can be aberrations within the institution or on the part of the institution itself. In addition to Gabbard and Lester, other authors have addressed boundary violations in psychoanalytic institutions. For example, Casement (2005) has problematized the power within a training committee in light of its abusive potential; Sandler and Goodley (2004) have described the institution's massive denials of Masud Khan's disastrous boundary violations, involving Winnicott as Khan's training analyst; and Zwettler-Otte (2007) has emphasized the importance of internationality as a triangulating counterforce in local distortions in perceptions of institutional boundary violations.
In view of these and other significant publications on the topic of boundary violations (e.g., Margolis 1997, Celenza & Gabbard 2003, Celenza 2006, Levine 2010, and others), the question arises whether anything new can be said on the topic. I am indeed of the opinion that there are already many important and differentiated contributions to the delineation of errors, mistakes, and benefits of mistakes on the one hand, versus offenses and destructive boundary violations on the other, for which we can all be grateful from a scientific and professional perspective. Nevertheless, I would like to venture an attempt to look in particular at the relationship between individual and institutional boundary violations from the perspective of disorders of thinking that arise from a common core of disturbance but then manifest themselves differently. I would also like to point out a dimension that is less described in view of the significance of sexual assault and abuse of power, but which should not be missing in the perception of the psychoanalytic community: it is boundary violation in the form of political betrayal.
It will not be surprising if I locate the origin of the disorders of thinking I am referring to in the specifically paradoxical character of the reality of the psychoanalytic situation and the psychoanalytic relationship, which,
however, precisely no longer applies to the psychoanalytic institution. These disorders of thinking occur when, first, in the treatment situation the fantasy character of the psychoanalytic situation can no longer be thought, and so cannot be recognized; and when, second, in contrast to this, the reality of the psychoanalytic institution is perceived as continuous with the psychoanalytic situation, and so under the same fantasy aspect. Indeed, it belongs to the careful handling of psychoanalytic thinking to preserve the “waking dream thought” (Bion 1962a, 1962b) and the dreaming dimension of experience, in the sense of Ogden (2005), as guiding the clinical situation while making sure this attitude is not extended to the conditions of the psychoanalytic institution. Otherwise, there will be a realization of symmetrical unconscious thinking and a loss of the necessary bi-logic between asymmetrical and symmetrical thinking in the sense of Matte-Blanco (1988), so that a clear distinction between dreaming and waking reality can no longer be made. The persistent structural confusion between the two dimensions leads to confusion and ultimately to the destruction of the respective frameworks that are so important for the maintenance of both situations.
It was already Freud (1915) who pointed out the paradox of the psychoanalytic clinic by noting how transference love is “induced by the analytic situation,” leaving no reason for the analyst's taking personal pride in his “conquest” (p. 161), but on the other hand he saw no right “to deny the character of ‘real’ love to the infatuation that emerges in the analytic treatment” (p. 168). Canestri (1993), in his discussion of Freud's comparison of transference love to a theatrical performance in which there is a sudden cry of fire, emphasized the dimensions of the imaginary and the real. He italicizes the concepts of play and reality in Freud's picture of the occurrence of transference love by quoting Freud as follows: “There is a complete change of scene; it is as though some piece of make-believe [Spiel, in German, HB] had been stopped by the sudden irruption of reality [Wirklichkeit, in German, HB]—as when, for instance, a cry of fire is raised during a theatrical performance” (1915, p. 162). Canestri concludes: “The Freudian phrase that likens the analytic situation to ‘a piece of make-believe’ proves once again that certain ambiguities and oscillations are present in the concept of transference. On the one hand, the invasion of passion in the analytic situation is compared with the invasion of reality; on the other hand, the theatrical terminology—‘change
of scene,’ ‘piece of make-believe’, ‘theatrical performance’—suggests an ‘as if’” (1993, p. 155).
In his knowledgeable and profound work, Canestri engages with various post-Freudian concepts of transference, including: extensions within the Kleinian tradition with its improved understanding of psychotic transference and the meaning of aggression, Lacan's theory of “transference as being not the shadow of preceding experience, of ancient deceits or trickeries of love, but instead an encounter between the patient's desires and those of the analyst” (p. 158), which leads—in connection with the “function of fantasy (fantasme) and, more specifically, on the function of the object of the fantasy” (p. 159)—to a model of transference and transference love (and love in general) as “a model of trickery” (p. 158). Nevertheless, he fully follows the Freudian conception of a “structural tie between ethics and technique in analytic experience” and at the same time a concept of truth “that must derive from clinical experience and not on some transcendental idea of truth, pre-existent to the analytic experience” (p. 158).
The Freudian technical norm is “the refusal (Versagung) to satisfy the patient's request—that is, the imposition of privation (abstinence)—[which] favors the nonfulfillment of the wishes that keep the search in motion. … The analyst's desire for truth, together with his exercise of denial, permits the emergence of the patient's genuine desire and its analysis”(p. 158). Canestri favors the term “indifference” instead of “abstinence”, in connection with the adequate control of the analyst's countertransference, in order to be able to use the “cry of fire” as an analytic instrument for solving burning passions in difficult analytic relationships. Even if he acknowledges “that in some cases the problem continues to be extremely difficult to resolve with analytic instruments” (p. 162), he sees the responsibility lying entirely on the side of the analyst, if a psychoanalysis ends in sexual acting out with all its disastrous consequences, including its leaving patients with less prospect of profiting from a second analysis. Nevertheless, according to him, these second analyses could be a field of research into why the “cry of fire” could not be used for solving the mutual captivity in the previous destructive transference love.
Loewald (1975) has dealt with the fantasy character of the psychoanalytic
situation extensively and in a subtle way. He too draws the comparison to dramatic art by recalling Aristotle's definition of tragedy as “imitation of action in the form of action.” And he continues: “Viewed as a dramatic play, the transference neurosis is a fantasy creation woven from memories and imaginative elaborations of present actuality, the present actuality being the psychoanalytic situation, the relationship of patient and analyst. But in contrast to a play conceived and composed by its author as a deliberate creation of his mind to be enjoyed by an audience, the transference neurosis is an unwitting fantasy creation which is considered or clearly recognized as such—at any rate in earlier stages of the analysis—only by the analyst” (p. 279).
I cannot reproduce all of Loewald's rich thoughts here; indeed, a re-reading of the entire brilliant essay is worthwhile. Rather, I confine myself to emphasizing that Loewald sees in the transference neurosis a shared illusion—derived from the Latin word ludere (to play)—created jointly by the patient as the playful actor and supplier of the material and plot of the fantasy creation, and by the analyst as the assembling director who articulates and, in part, revives the plot. By means of the analyst's interpretive direction, the patient gradually becomes an author who is aware of being an author.
The role of the analyst is clearly defined: “As director of the play, the analyst must relive, re-create the action of the play. This he is able to do on the basis of his own inner life experiences and their organization, which are sufficiently similar to those of the patient. While engaging in trial identifications with the patient, i.e., with the actors and actions of the play, the analyst is the one to keep an over-all view and to direct the actors—not by telling them what to do or how to act, but by bringing out in them what they often manage to express only fleetingly, defensively, haltingly, in inhibited or distorted fashions” (p. 280).
For the double character of the psychoanalytic situation, which I have described as paradoxical, Loewald finds the image of the Janus-face: “The specific impact of a play depends on its being experienced both as actuality and as a fantasy creation. This Janus-face quality is an important ingredient of the analyst's experience in the analytic situation and becomes, if things go well, an important element in the patient's experience” (p. 280). Despite the fact that the analyst does not assume the
roles assigned to him by the patient in the transference-play, he is a participant in the interaction nevertheless. This allows not only the re-activation of the past in the present but also novel experiences for both participants: similar to a modern dramatization of an ‘original’ Greek tragedy like Oedipus Rex or Antigone according to the Zeitgeist, the infantile neurosis can be reorganized and reinterpreted in the dramatic creation of the analytic transference. But, and I want to emphasize the following conditions: the analyst, even if he is an active participant in the drama created by two artists, has to preserve his role as an interpreting director. This is all the more important as, like in any good drama, the clear distinction between fantasy and actual reality can be lost. For a while, the fantasies and fantasy play can be experienced as what we call “actual, rational life.” This is also how children experience their fantasies, and, for instance, oedipal wishes, as serious intentions and prospects. For the small child, fantasy, play, and actual life experience are still one and the same reality.
Here, the understanding analyst is in a similar position to understanding parents who “take these wishes seriously too, but for them they are serious fantasies not to be acted upon. They also may know, although often only intuitively, that these fantasy-wishes are necessary ingredients of the child's psychosexual development, expressions of the child's beginning love life. In other words, the adult may understand that they are fantasies which are not in opposition to reality” (p. 298/99), and that they are, in fact, necessary steps for the child's future.
I think, with Loewald's description it becomes clearer that the juxtaposition of an adult and the child inside the adult may lead to confusions in the analytic process. But Loewald chooses a helpful comparison: we must not forget the patient's life outside! We need to know: “The transition between transference neurosis and the patient's life outside of it, or the reciprocal communication between them, is similar to that between a dramatic play, a fantasy creation, and the life that people lead before seeing the play and after they come home from an evening in the theater—if the play for them is more than a pastime” (p. 282). For our topic, the significance of the theater analogy is in how it can serve as a reminder to the analyst to be awake to and observe the limits and restricted validity of his own field of action, which the emotional intensity of the analytic situation tends to blur or erase.
Against the background of these considerations, I would now like to show, by means of some examples, how a lack of understanding and working through of this specific fantasy character of analysis can so easily involve a denial of an actual cry of fire in the psychoanalytic situation and lead to various forms of boundary violations. In this context, I would like to emphasize that I do not take the term ‘disorder of thinking’ to refer to a harmless lapse, but rather as an expression of a serious, usually destructive, misconception of the psychoanalytic process with considerably damaging effects for the person concerned. This distinguishes this order of lapse from errors, in the sense of achievements of mistakes. I have myself conducted several psychoanalytic treatments with both victims and perpetrators after sexual assault in treatments that were deformed by them, and I have also become a witness to institutional assault as a training analyst, supervisor, and mandate holder in psychoanalytic institutions. In all cases, the need for confidentiality limits the scope of my presentation, but I hope to make the basic patterns sufficiently clear.
The first form of disorder of thinking on the part of the analyst, which of course is at the same time manipulative in character, consists in the abandonment and negation of the fantasy character of the analytic relationship. This is mostly expressed in the use of language as a means of destroying fantasy, even if the analyst's language initially seems to play with fantasies. The fact is, however, that, in these cases, the language used by the analyst leaves the phantasmatic space. In all five cases known to me in detail, the sexual abuse in the analysis started with a concretistic use of language by the analyst, which at first inspired the fantasies of the analysands, but then produced fright. The analyst's language no longer left any room open for the development of further possible meanings of the analysand's associations, but aimed at the realization of the analyst's own fantasies and desires in action. At the same time, the analyst asserted his own emotional authenticity. For example, one analysand, in the course of the treatment, had been preoccupied with the question of what would happen if she approached her analyst physically. In one session, she concluded her chain of ideas with the remark, “But you wouldn't respond to that anyway!” So, she definitely had the fantasy character of her ideas in mind, even if her remark had included a slightly provocative question to the analyst. However, as she told me
later, her slightly provocative, slightly imploring, remark had ultimately been intended as a protective assurance for herself of the fantasy character of the analytic encounter. Finally, it was also an expression of her ambivalent agreement with the setting. Instead of leaving the remark open-ended, or responding to the analysand's inner conflict between her libidinous desires and her simultaneous search for safe boundaries, or finding some other analytic intervention, the analyst responded with a negation of the fantasy aspect, saying, “I can't promise you that, because you are also a beautiful woman.”
In the session with me, the patient intensely recalled the fright that had run through her and how she had felt completely paralyzed. In large part on account of the ways she had established earlier in her life of relating to similar experiences with figures of authority, she did not have the power to resist becoming involved in the false game now offered by the analyst; with a mixture of fascination, disgust, and her own rescue fantasies toward the analyst, a prolonged sado-masochistic relationship developed before the contact ended, leaving her in a deeply depressed state. The patient experienced the analyst's explicit negation (“I can't promise you that”) of the fantasy character of the analytic relationship as decisive for the beginning of the analytic catastrophe. The subsequent sexual abuse was for her more a necessary consequence, rather than the actual beginning, of the destruction of her analysis and her own psychic structures.
Another analysand had a similar experience of her analyst representing a misconception of the analytic relationship in the course of the analysis. He presented himself as a representative of a supposedly modern psychoanalysis, which, beyond the treatment of the neurotic basic conflicts stemming from childhood, did not ignore the recognition of her as an adult woman in their mutual relationship. Rather, it was even crucially important for the detachment from infantile patterns to make contact with each other on an adult level as well. The “adult level” then included extra-analytical meetings, which, however, were not discussed in the sessions. There was a complete split between the so-called “analytic treatment” and the “private meetings.”
Again, the analysand did not succeed in freeing herself from both forms of contact for a long time. An important motive for the continuation of the heavily strained relationship was based on the patient's hope that
the analyst himself might notice his “mistake” and thus clear the way for an analysis. Tragically, the hope for the analyst's self-reflection was dashed. Instead, a sexual relationship developed, which the analyst did not problematize in the context of what he saw as an adult relationship with the patient. Rather, he gave in more and more to his need to tell the patient about his own personal conflicts outside the official sessions of analysis and in connection with the sexual intimacy, in order to retreat again largely to a pseudo-role as a neutral analyst within the “analysis.” Again, it was the patient who in the end felt that she herself had to help the man from whom she had originally sought help. It is clear that a severe narcissistic pathology must have underlaid the behavior of this analyst. My sense is that he partly fulfilled characteristics of the persons Gabbard and Lester (1995) have assessed as “lovesick.” Of course, the question also suggests itself whether he had not wormed his way into the patient's confidence by a purposeful trick and by using a perfidious seduction. That would then have been a deliberately criminal act. And indeed: his behavior was a criminal act either way! However, I fear that he himself had a certain belief in the validity of the split he represented, within the framework of a probably narcissistically motivated, almost psychotic-like disorder of thinking.
Also, apparently no one from his professional environment had noticed the destruction he had caused to the basic pillars of analytic thinking, which in truth is limited to working through real effective fantasies in an artificial situation. All the more tragic, I would like to emphasize once again the self-damaging insistence of the patient on keeping open a chance for her analyst at that time to find his way (back?) to an adequate analytic thinking. It was she who, of course, also in her own interest, had repeatedly problematized the simultaneity of the analytic and extra-analytic meetings. The analyst's false reassurances that there was no cause to worry, i.e., his rejection of the actual cry of fire, camouflaged the oil he himself was pouring from inside and outside into the already burning theater. They had confused the analysand and kept her from taking the alarm seriously until she reacted—by becoming severely depressed—in the sense of an emergency braking.
I would like to note that despite the predominant pattern of male analyst/female patient in deformed analytic processes, a mix-up of fantasy and life reality can also occur in female analysts. Although they are less
frequent, they also occur in different forms. As far as I know, sexual relationships between female analyst and male patient tend to lead to longer-term partnerships, but this does not make them any less problematic. The question of how an originally fantasized relationship can become real in an everyday life also remains in these cases. As a historically known example, I would like to refer to the marriage between Frieda Fromm-Reichmann and Erich Fromm, which was formed out of an analytic relationship and failed in everyday life. In addition, there are also non-sexual forms of disturbed thinking among female analysts: for example, an aging analyst had asked a younger analysand for a photograph of her as a child, which she put up in her apartment as a substitute for a fantasized but non-existent daughter. As far as I can assess, from a distance, this search for consolation for her aching childlessness was not an expression of a general psychosis of the analyst, but it was nevertheless an expression of a serious disorder of thinking, in the sense of its being an extension of the analytic fantasy of being a wet nurse to the analyst's own life. Here, too, a reversal of neediness occurred over time, with the analysand developing the guilt-laden feeling of having to continue to stay in treatment with her analyst in order to keep her alive, both narcissistically in her self-worth and economically in her social existence, by means of her fee payments. The analysand's associated and simultaneous fantasies of her omnipotence and death wishes against her analyst could only become clearer in the second analysis.
I would like now to bring in a case that can serve as an example of not understanding and so not internalizing the paradoxical character of the psychoanalytic-psychotherapeutic process, the paradoxical coincidence and nonidentity of the external reality of the therapeutic relationship and the fantasized reality associated with it. A therapist who has not internalized an understanding of the fantasy character of the therapeutic situation and thus cannot feel it, will not be able to protect the framework of the therapeutic situation, even if he does not himself initiate a boundary violation.
A therapist working psychodynamically, though not explicitly analytically, was surprised by a female patient who, in their second session, approached him, blurting out: “I want you.” His raw and helpless response was, “But you can't, that's forbidden!” His being in the midst of a personal life crisis made the incident especially disturbing for him. He
was newly living alone and suffering from having only recently separated from his wife. The patient then said, referring to the expression of her desire, “Why, there's nothing to it,” apparently in an effort to reassure both him and herself. Unfortunately, after her reassuring words, followed by his apparent acceptance of them, they ended up engaging in sexual contact during the session. They had sexual relations again in each of the next two sessions. Then, in the following session, when the patient tried to touch the therapist, out of fear and guilt, he told her to get back in her seat and stay there. He said he wanted to continue “just therapy” with her now. This came, unsurprisingly, as a shock to the patient who was, as one might expect, extremely angry and hurt. And after no effort was made to address what had just happened between them, the patient finally ended the session, announcing that she would “finish him off.” Shortly thereafter she made a criminal report against the therapist.
Even if I take into account the typical excuses, evasions, and attempts at guilt reversal on the part of therapeutic offenders, which are also likely to play a role in the present case, it is still clear that the therapist had not really understood the meaning of the therapeutic setting. He knew the rule of abstinence only as an external norm, but not as an internalized law. He could only observe therapeutic abstinence or indifference like a car driver who follows the speed limit as long as he thinks there is a police presence: when there is no police presence, he speeds. Certainly, passions are at play here as well: like the motorist who basically needs to speed, for this man his desires for narcissistic and sexual validation were so pressing, they were paired with his denying danger, aggression, and potential destruction. However, given his unsatisfied passionate needs, this therapist was not able to think or feel in depth the specific dual character of the therapeutic drama. In other words, and following the Freudian (1913) concept of the ethical progress of the company of brothers after the murder of the primal father, it could also be said: the therapist reinstated the prohibition of incest only because of castration anxiety, but not because of an inner recognition of the paternal law (cf. also Erdheim 2010). It fits in with this that he did not really want to talk about the boundary violation that had occurred with the patient or to acknowledge his transgression. Rather, he placed his hope in being able to literally sit out the serious violation of the patient and the setting. His refusal to think was likely another source of disappointment and hurt for the patient.
I now come to an inverse form of disorder of thinking, which consists in dealing with each other within the psychoanalytic institution as if the specific fantasy character of the analytic treatment situation continues to apply there unchanged. To remain in the image: in this case, it is thought as if the dramatic play would not end at all, but as if it would only be continued outside the treatment room with new actors. This is always the case when, in discussions or controversies, interpretations of the possible emotional motives of the opponent or of an analyst in training take the place of factual arguments. The latter case relates to problems of psychoanalytic supervision, to which I will return later. However, an overextension of the fantasy space occurs within the institution whenever conceptual differences among analysts are unilaterally shifted to an emotional level, for example, by means of the insinuation of allegedly competitive thinking or envious attacks. This is not to say that there is no competition or envy in the analytic community. Similarly, I do not deny that competitive or envious feelings can be clothed in the garb of psychoanalytic theory. However, I think that a discussion of theoretical concepts and of treatment concepts deserve a proper examination and cannot be engaged in by switching levels and thus switching to an interpretation of possible fantasies. This includes, for example, such familiar invalidating clichés as “You want to castrate me now,” or “This is now an attempt to seduce me,” or “This is not psychoanalysis,” when, in fact, the core issue is about conceptual differences.
Nevertheless, it remains contradictory and complicated, for there are indeed seductions and destructive attacks on democratic structures and the constitution of a work-group (Bion 1961) within a psychoanalytic institution. This becomes all the more possible when a psychoanalytic group has ceded its differentiated self-determination to a leader figure whom it follows either out of idealization or fear. Usually both are in play and interrelated, and one follows from the other: when the group loses its ability to think, idealization is usually followed by fear of the leader figure. From a variety of institutional contexts, I have noticed the pattern of a small group of analysts who are either unsettled or divided and who are then united, and to that extent “saved,” by a charismatically appearing analyst who usually comes from outside. This leader connects
with the messianic expectations, familiar in the regression to the basic assumption mentality of Pairing, but mostly a fixation on the basic assumption mentality of Dependence follows. The individual analysts give up their own thinking, or no longer dare to express their independent thinking in the group. Instead, in identification with their new idol, they create an illusory sense of security, before the group finally disintegrates through its abuse of power and the fear induced by the despotism. Such a psychoanalytic group, e.g., in the form of an individual institute, needs, in cases like this, help from a third authority, either from the national society to which it belongs or from the International Psychoanalytic Association. In principle, a moderation outside the established international structures would also be conceivable, but the ethical questions that are almost invariably pending make, in my view, an intervention on the part of higher-level national or international psychoanalytic bodies indispensable.
I have already mentioned above the institutional catastrophe surrounding Masud Khan's boundary violations. In a dismaying way, group regressions have also emerged in other countries and regions of the IPA, where a basic assumption mentality prevailed for a long time and a single leader figure was given permission to operate omnipotent, preoedipal fantasies. As one, but unfortunately not the only, example of the collapse of analytic thinking in the institution, I cite the tragic development of a former European psychoanalytic institute from the end of the 1970s until the closure of the newly founded institute more than 30 years later. Here a psychoanalyst, idealized at first as a balancing savior in a group torn apart by conflict, had taken over the leadership of the institute and later of the training committee and, as became publicly known only after his death, had coerced several female candidates and probably also patients into engaging in sexual relations. Still, while he was alive a resistance did develop among some of the members of the institute against his behavior, which was increasingly perceived as irritating, sometimes charming, then again despotic and angry. Group formations and splits occurred, which also involved the candidates, who ultimately had to join a camp formed pro or contra him.
It is noteworthy that during the period of his criminal sexual acts, this man published articles problematizing the psychoanalytic framework and representing himself as a kind of fighter for freedom, and that even
after his death and the disclosure of his misconduct, he still found supporters and defenders. Equally remarkable, but also typical, was his reaction after the withdrawal of his function as a training analyst and supervisor by the central training committee of the society, in that he angrily cast himself as a victim. Unfortunately, but also not untypically, there was also considerable tension between the institute and the society to which it belonged, because the analysts of the institute sometimes felt abandoned by the society and not sufficiently consulted or listened to when difficult situations arose. Unfortunately, the society was also not consistent enough in the beginning to exclude this man completely from the society, beyond the withdrawal of his function as a training analyst—he finally took this step himself maintaining his subjective victim mentality. I cannot, here, further describe the tragic catastrophe characterized by projections and splits, but I would like to pick out an important element that even in other, less tragic and destructive courses, nevertheless represents a counterproductive factor or boundary violation within psychoanalytic training: I mean the involvement of candidates in disputes among teaching analysts or in a too strong emotional-spiritual dependence. It is quite clear that role models and intellectual guiding figures are indispensable components in the formation of one's own psychoanalytic identity. But if they are used in service of partisan interests, here too the fantasy of a personal power has taken the upper hand over a differentiated psychoanalytic thinking that promotes personal independence.
I can also only briefly mention a terrible destruction of boundaries on a completely different level: what if one's own analyst becomes a traitor in a despotic regime? According to the personal communication of my colleague and friend Jorge Canestri, who sadly passed away recently, he had visited an institute in crisis in a dictatorially ruled country as the then head of the Ethics Committee of the IPA at the time of the Latin American military dictatorships. He had been unwelcome upon arrival and encountered a wall of silence at his first meeting with institute staff. Because of the stubborn silence, he broke off the first meeting after some time, citing the group's refusal to work. However, at the same time he made it clear that he would not stop looking for what motive or fact was hidden behind the silence. Only through persistent confrontation with the obvious resistance character of the silence did it come out that the group was characterized by fear of the president of the institute, who, as
it turned out later, had even betrayed politically active candidates to the police apparatus of the military junta.
What can be said psychoanalytically about such a man? One can only speculate about the personal motives, but it is clear that this man was not acting as a psychoanalyst, but was in fact a criminal and was rightly expelled from the IPA after his unmasking. However, it was all the more important to spread this information internationally as well, so that he could not be accepted into another psychoanalytic society of the IPA. There are other examples where members expelled from their society because of boundary violations have moved to other countries and found admission because the psychoanalytic society there did not know about their history. This makes it all the more important to provide information on analysts within the IPA who have had an ethically justified sanction imposed on them. This information cannot be seen as a violation of confidentiality, and is an indispensable measure against renewed abuse in the false name of psychoanalysis.
I would like to talk briefly about the field of supervision. To take up the relationship between fantasy and reality once again: to me, it seems important to note that though working with fantasies does play a significant role in supervision, the supervisory situation does not have the same fantasy character as the analytical situation. There may well be a parallel process between the presented analysis and the supervision process itself but, by definition, supervision is primarily about professional development and not centered on self-awareness. I am well aware that the boundaries are fluid and that the interpretation of enactments in supervision is also part of learning. The sometimes difficult borderline between the two areas is known as the “teach or treat” question (Frawley-O'Dea 1998, Cabaniss 2001) and certainly distinguishes psychoanalytic supervision from other forms of learning. Nevertheless, it seems to me crucially important, here as well, to not stretch the fantasy level too far and to keep reminding ourselves that transference may occur in supervision, but that interpretation of transference is not the primary goal of supervision. Gabbard and Lester are therefore very much to be agreed with when they consider genetic interpretations towards supervisees in supervision to be inadmissible (Cabaniss 2001 p. 171). And Cremerius' (1987)
comment that the parent-child model is ineffective in training, although it has been (and is?) often practiced, is in my view another formulation for the fact that in the prevalence of a dramatic fantasy the real supervision relationship is misconceived.
In supervision there is both the danger of the supervisor taking over the function of the supervisee's personal analyst, and of not offering any analytic interpretations of the supervisee's words or behaviors. The latter would be a purely didactic cognitive form of supervision. The art of thinking in supervision consists rather in using actual enactments for a deeper understanding of the supervised analysis and the supervisee's handling of the transference without crossing the line into general personal statements.
Here is a brief example: in an examination before a panel of training analysts, an applicant for the training analyst position presented an analysis with a man in which the emphasis of the patient's creative abilities against the background of his life history was important to him. The examiner panel took a different approach, which would not necessarily be problematic. However, the examiner group did not question the basic theoretical concept of the applicant, but was strongly guided by the idea of having to interpret the averted aggression. Instead of entering into a more nuanced discussion of the use of aggression-centered and non-aggression-centered interpretations, the following smug comment was eventually made to the applicant, “I guess you can't think aggression at all, can you?” Such a comment constitutes a boundary violation because it impermissibly concerned the overall person of the applicant and did not remain related to a circumscribed situation. Not boundary violating, in my view, would have been less encompassing feedback, such as the following questions: “How do you see the importance of aggression in this patient?” Or: “Why have you so underweighted the role of aggressive drives compared to confirming abilities in this patient?” These or similar questions, including remarking that there were too few aggression-centered interpretations in this case, would not have denied the applicant's ability to feel, think, and conceptualize aggression at all.
Psychoanalytic supervision, unlike psychoanalytic treatment, is not about the child in the analyst-in-training. Rather, it is about reviewing and communicating where the strengths and weaknesses of a candidate
or an applicant for the training analyst position lie. Likewise, part of a respectful attitude on the part of the supervisor is to offer their own analytic concept as a learning model, but not to expect blind allegiance. An effort to empathize with the ideas and conceptions of candidates and to enter into a dialogue about them, if necessary, promotes analytic thinking and represents an important element in the prophylaxis against the disorders of thinking described here. A corresponding methodological approach was followed, for example, at working sessions of the former Working Party “End-of-Training-Evaluation-Project” (ETEP) of the EPF and is also included in the new forum “Exploring Training Process and Practice” (ETTP) of the EPF (cf. Tuckett 2005, Junkers, Tuckett, Zachrisson 2008, Blass 2014).
The dialectic of psychoanalytic thinking, which requires a continuous movement of discerning and positioning among levels of fantasy and levels of non-phantasmatic reality, both in the treatment situation and in the institution and supervision, can, in spite of its effectiveness, give rise to errors or boundary transgressions of varying degrees. The more we can establish a culture of error in psychoanalytic training and, persistently, at our meetings, conferences, and congresses, and at the same time grasp the various forms of destructive disorders of thinking, the more alert we might all become to those factors that pose a threat and danger to our humane psychoanalytic method, so valued and successful in the vast majority of cases.