“The Fate of Transference Neurosis After Termination of a Satisfactory Analysis,” Haskel Norman and his colleagues (JAPA, 1976), discovered that long after the end of an analysis transference manifestations are reactivated almost immediately upon resumption of contact between analyst and analysand. The so-called resolution of the transference is a very relative and incomplete process. The transference, like libido itself, is lifelong. After the end of an analysis or therapy the analyst remains available for future therapy, and such resumptions are not at all uncommon. This leads to the truism, Once a patient always a patient. In a recent article in the American Journal of Psychiatry the author concluded that one year need elapse after the end of therapy before an ethically acceptable sexual relationship may begin between therapist and former patient. Such a judgment is a serious blunder. Transferences occur universally among people, but only the analytic transference is originated with an analytic, therapeutic purpose. Its usefulness to the patient is so unique, so powerful, and so rich in verbal intimacy (with physical abstinence) that the patient, the analyst, the profession, and society are all best served by the permanent renunciation of a total relationship, while keeping on record and in memory the partial therapeutic relationship and retaining for life the possibility of its resumption.
Again, legal and ethical considerations may not be identical here. In California it has been established that after death the privilege moves
to the representative of the deceased. The ethical question is answered by the therapist's judgment. It would seem a truism that patients deserve the same privacy after death that they were entitled to in their lifetime. Of the dead, the Latin adage goes, speak nothing but good. The basic rules of psychotherapy must be adhered to by the therapist for life. What is said in the analyst's office is said for the purpose of analysis and not for any broader social, historical, or artistic purpose. In keeping strictest confidentiality no one questions the validity of the seal of the confessional. The same spirit and the same principle should apply to an analysis, truly a secular confessional.
Upon entering the analyst's office, the creative artist or famous person becomes just another patient. If that isn't so for the analyst, then by virtue of powerful countertransference resistances the patient is offered a fatally defective treatment. Like all patients, the artist comes to therapy to resolve emotional problems and to relieve mental and emotional pain. Neither party has any obligation to history, art history, or art criticism. Any contents of analysis revealed publicly, at any time during or after a patient's life, has the same usefulness and validity as any gossip. Most people enjoy gossip. But to elevate it to an ethically acceptable status is to demean the dignity of the person's real achievements. These are public. The person is entitled to a private life where dirty laundry can be washed. It is no one else's concern.
There are two essential gratifications in the practice of analysis. One is the never-ending expansion of learning, from our experience as analysts, how the psyche works. The second gratification is more vicarious. It is the observation in one's patients of a similar experience of learning how their own psyches work, and their using that knowledge for symptom relief and ego development. That's it. If we are temperamentally suited to be analysts it will be enough. Everything else is secondary. Nothing else we might do, like publicizing in any way this most private of enterprises, should be permitted to corrupt our essential professional commitment.