The Ethics Of Being Used

The themes of use, being used, misuse, and abuse are immersed in our psychoanalytic work, yet not readily discussed. What do we offer a person seeking our help and how are we to be used? The word “use” has several meanings, including availing oneself, employing for one's own purpose, and consuming (Webster's, 1996). From a British object relations viewpoint, a thing (object) is not simply a material object or a person, but anything which is the object of the mind, including a representation or image. The analytic relationship is an object of both the patient's and analyst's minds, which change over the course of treatment. Unfortunately, the word “use” has been confused with “manipulate,” as when a person feels used for another person's ends. Yet to benefit from treatment a person needs to use it. Ethics defines principles by which people use each other. How is the analytic relationship as an object of the mind to be used and for what and whose ends?

There have been a number of analysts and philosophers who have attempted to define the human relationship that is conducive to growth, that is, appropriate use. Fromm's (1956) concept of love with its four aspects (care, concern, respect, responsibility), and Buber's (1937) concepts of I-Thou and I-It are relevant. Clinically, Freud's (1959) concept of free association and Bion's (1995) concept of “without memory or desire” may be a part of the therapeutic self that permits the use of the analytic object, but is not the same as the use of the object. Melanie Klein's (1973) concept of the “good breast” is a symbolic expression of the capacity of give and receive (see also Segal, 1964). It is a forerunner