The Patient as an Ethical Subject: Technical Implications of the Patient’s Irreducible Responsibility

Abstract As part of what has been called “the ethical turn” in psychoanalysis, analytic theorists have begun to recognize patients as ethical subjects in their own right, in possession of a full range of moral responsibilities and obligations, including to analysts themselves. While this ethical conception has made its way into our theories of mind and therapeutic action, less attention has been paid to the topic of technique. This paper attempts to tackle the question: how do we integrate an exploratory analytic method with a therapeutic stance aimed at cultivating patients’ ethical responsiveness toward Self and Other? The author reviews the literature on ethical intersubjectivity, in which therapeutic action is constituted by the mutual ethical development of both analyst and patient. Utilizing a clinical example from the treatment of a young male patient engaged in a paranoid and erotic transference, these techniques are illustrated at the level of moment-to-moment therapeutic process.