Do no Harm: Helping and Gratitude in this time of CoronaVirus

I have come to the end of a long CoronaVirus week. And I am reminded of a letter that Sigmund Freud wrote to his collaborator, Wilhelm Fliess, on 6th December 1896. "My dear Wilhelm, As I am dead tired, but mentally fresh, after completing the day's labour and earning the recompense that I need for my well-being, I shall try to summarize the latest speculation for you".

And I thought, dear reader, having also completed some work and earned some shillings, that I would speculate a little for you about my own experience as a putative psychoanalyst during this week. And give you some of my preliminary conclusions as to what it means for me to practice during these most challenging of times.

I said this week to those who supervise my practice as we worked through the implications of what is going on at the week: "I am not envisaging any scenario where I will suspend my practice with my existing clients. I feel I have a fundamental and ethical responsibility to, at minimum, continue this work." And this statement got me thinking about what ethical principles have guided my position.

I went back to what the psychoanalyst Jacques Lacan had to say on the subject - he set out, in his critical work "The Direction of the Treatment and the Principles of Its Power", some principles for me to orient my work at this time:

"Let us say that in the capital outlay involved in the common enterprise, the patient is not alone in finding it difficult to pay his share. The psychoanalyst too must pay:

? pay with words no doubt, if the transmutation they undergo due to the analytic

operation raises them to the level of their effect as interpretation;

? but also pay with his person, in that, whether he likes it or not, he lends it

as a prop for the singular phenomena analysis discovered in transference;

? must pay for becoming enmeshed in an action that goes right to the core of being with what is essential in his most intimate judgment: could he alone remain on the sidelines?

Wow, that's quite an ask. It got me thinking - to what extent can I honour this when I am in a physical setting with a client? And to what extent would I be able to fulfil this in an online setting where a lot of therapeutic work has gone, partly by necessity, as a result of Covid-19.

Another relevant ethical standard that was proposed to me recently was the principle of 'Do no Harm' - you can read a little more about this on the following link: https://www.alnap.org/help-library/from-principle-to-practicea-user%E2%80%99s-guide-to-do-no-harm. It requires humanitarian organisations to strive to minimize the harm they may inadvertently cause through providing help. And it brought to mind what Jacques Lacan had to say about this subject.

Drawing from another seminal work, "Aggressiveness in Psychoanalysis", Lacan made a number of provocative comments (this wasn't unusual for him) which might usefully be considered as a caution as we look to help others, perhaps in a charitable way. He says: "What appears here as the arrogant affirmation of one's suffering will show its face—and sometimes at a moment decisive enough to give rise to the kind of "negative therapeutic reaction" that attracted Freud's attention—in the form of the resistance of amour-propre, to use the term in all the depth given it by La Rochefoucauld, which is often expressed thus: "I can't bear the thought of being freed by anyone but myself." Making further reference to the unconscious aggression in the helping process, he said: "Only saints are sufficiently detached from the deepest of our shared passions to avoid the aggressive repercussions of charity."

These ethical principles have guided me during my work this week. And I am very grateful indeed to a number of people. To my clients, who have, indeed, fully 'paid their share', and perhaps, a little more than usual. To the providers of the facilities who enable my work to continue - to Mary O'Farrell at the Midleton Holistic Centre (https://www.facebook.com/pages/category/Massage-Therapist/Midleton-Holistic-Health-Centre-278250638933470/)  and Anne and Shaunna at City Therapy in Dublin (https://www.citytherapy.ie/). To my analyst, my individual and group supervisor, and to my peers - all of these people have supported me beyond the usual to keep things moving. I feel safe, as I go about my work, such that I continue to operate within an ethical context. It allows me, potentially, if I have the courage, to pay my full share in this common enterprise with my clients. And, in any scenario, CoronaVirus or not, it is a payment that I am honoured to make.

Photo by Courtney Hedger on Unsplash