Chapter 15 Publication Anxiety

Publishing is to the first thought as the maternity ward is to the first kiss.

This chapter is about the psychological problems specifically associated with the act of publication, whether spoken or written. I am not referring to difficulties in thinking and writing, or to the complex, difficult and important ethical issues involved in publishing clinical case material. Both these difficulties affect publication. Obviously, if someone cannot write they cannot publish; if they cannot satisfy themselves that it is ethical to publish what they have written they will not feel free to do so, and if it is not ethical they should not do so. We have a duty to protect the anonymity of our patients.

I have found, however, that protecting the patient from recognition and also securing the informed consent of the patient does not relieve me, as a psychoanalytic author, of a sense of guilt, and I have found this to be the case for other analysts. We may not feel that we are betraying a confidence, but we are left feeling that we are betraying an affiliation. Nor does getting permission fully exonerate the analyst in the eyes of the patient and those who identify with the patient. The knowledge that had seemed to be the private possession of the analytic dyad has been shared with others: what had seemed to be inter-subjective experience is offered as an object for their perusal; what had seemed like the mental content of a private relationship has become the raw material for other minds. The communications internal to one relationship have become the means of furthering the development of another relationship. In its most extreme form, it seems best represented by the myth of Iphigenia, whose father Agamemnon, when en route to the Trojan war, sacrificed his daughter to get a fair wind from the gods and to

propitiate his associates. And yet I also know that if I followed the example of some others and comp