The Psychoanalytic Frame and the Consent Situation: The Child Patient’s Position in the Publication Dilemma

The author explores the current dilemma regarding consent standards for the publication of child patient clinical material, and the psychic impact on the child when seeking permission to publish. It is proposed that a psychoanalytic view creates an additional dimension to the more universal ethic of ‘do no harm’, requiring clinicians to consider the unconscious experience of the patient as the core of the matter. The term consent situation is introduced to describe the way in which providing a draft of the clinician’s writing about the patient’s experience in treatment, and then asking the patient and family for permission to publish it, subjects them to external realities of an oedipal nature, compromising the frame around the treatment, and the vital cycle of the containing function in the treatment. The frame could potentially be compromised from the beginning in the form of a leaky container, during the treatment as a betrayal of the frame, or after the treatment has ended as an intrusion into the containing object. The author shows how this is a burden to all young patients that could be collectively carried by the professional community, by using creative modifications to systems of professional development and publishing.