Thoughts on Confidentiality for IPA Members
Created by the IPA Confidentiality Committee
2025
GENERAL PRINCIPLES
Psychoanalytic approaches to confidentiality
For psychoanalysts, confidentiality is not merely a requirement for the safe or ethical conduct of work, it is fundamental to the psychoanalytic method in a more radical sense. Without the expectation of confidentiality, psychoanalysis would be impossible because both free association by the analysand and free listening by the analyst would be compromised. How can an analysand say everything that comes to mind if she feels that her analyst will disclose her most private thoughts? The IPA states explicitly in the Ethics Code that confidentiality is “one of the foundations of psychoanalytic practice” (IPA, 2015, Part III, paragraph 3a). The issue of confidentiality takes on specific implications, which deserve a separate discussion, when psychoanalysts use telecommunications, including for remote analysis and supervision, for communication with patients and with colleagues 1 .
Confidentiality as an ethical and technical foundation of psychoanalysis
The challenge for analysts is that the object of our study, the unconscious, is as much a part of our being as it is of our patients’ and as likely to emerge in unexpected ways. Our wish to protect our patients may be undermined by unconscious strivings in ourselves.
The analyst’s responsibility for the frame/setting
Although unconscious impulses and emotions are stirred up in both partners to the analytic encounter, there remains an important ethical asymmetry: the analyst has the responsibility to respect the autonomy and separateness of the patient. The full impact of the person of the analyst, and of the setting, on the treatment and on the patient’s reaction to it, may never be fully known to the analyst, and yet the analyst must always work with the patient’s experiences in mind.
The possibility of unresolvable conflict between competing needs or views
The need for the analysand to be able to trust the analyst to protect confidentiality is liable to come into conflict with the analyst’s ethical and scientific need to share anonymized material with colleagues in supervision, teaching, and publication. This is a conflict that rests with the analyst, and with which analysts must eternally grapple.
1 See “Thoughts on Confidentiality for Remote Treatment”
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