DEPENDENCE AND BETRAYAL

An Analytic Approach to Professional Ethics *

Juan Tubert-Oklander, MD **
Psychoanalysis has had to deal, from its very beginning, with the fact that analysts do not
always honor their ethical commitment to act only in the benefit of the patient, thus
generating in the latter a feeling of betrayal. Freud, who knew better than anyone the
daimonic nature of the passions unleashed by the method he had created, was particularly
worried about the danger of sexual transgressions, ever since he knew about Jung’s
involvement with Sabina Spielrein.
This episode is, perhaps, typical of the complex interpersonal reactions generated by
such occurrences. At the beginning, Jung denied any wrongdoing, blaming the whole
business on his patient´s pathology. Although he had written to Freud about this treatment a
couple of times since 1906, it was only in his letter of March 7 1909 that he mentions the
personal conflict, in a self-serving fashion. He talks about the patient´s “violation of his
confidence and friendship”, of his “always behaving as a gentleman” vis-à-vis her erotic
demands, of “feeling unclean”, and ends up by saying “you know how it is —the devil can
use even the best of things for the fabrication of filth”.1
He also prides himself of the wisdom acquired from the self-analysis of this experience,
from which the relationship with his wife “has gained enormously in assurance and depth”
(ibid.).
Freud’s response, written two days later, accepted at face value Jung’s account of the
matter, saying that he already knew about it from a Swiss colleague who had been
approached by the woman, but that they both understood that “the only possible
explanation was a neurosis in his informant”. Freud´s conclusion was that “to be slandered

* Read in the Panel “The Unforgiven: Disruptions That Cannot be Repaired,” 47th International
Psychoanalytic Congress, Mexico City, August 2011.
** Psychoanalyst and group analyst in private practice in Mexico City. Full Member of the Mexican
Psychoanalytic Association and Training and Supervising Analyst in its Institute. Full Member of the
Argentine Psychoanalytic Association and the Group-Analytic Society.
e-mail: JTubertOklander@gmail.com
1
“A woman patient, whom years ago I pulled out of a very sticky neurosis with the greatest devotion, has
violated my confidence and my friendship in the most mortifying way imaginable. She has kicked up a vile
scandal solely because I denied myself the pleasure of giving her a child. I have always acted the gentleman
towards her, but before the bar of my rather too sensitive conscience I nevertheless don't feel clean, and that is
what hurts the most because my intentions were always honourable. But you know how it is —the devil can
use even the best of things for the fabrication of filth” [Jung, 1909a, p. 207].
 Dependence and Betrayal Page 2 of 14

and scorched by the love with which we operate —such are the perils of our trade, which
we are certainly not going to abandon on their account”.2
Soon after that, on May 30, Sabina Spielrein wrote to Freud, asking for an interview, in
order to pose “something of the greatest importance to me, which you would probably be
interested to hear about” (Spielrein, 1909a, p. 91). Freud immediately informed Jung about
this, who rapidly sent him a telegram, and then a letter in which he admitted that Spielrein
was “the person I wrote you about” (Jung, 1909b, p. 228), while still denying any
misbehavior on his part.
Freud’s reply was sympathetic, still in terms of the traditional male solidarity. He states
that “such experiences, though painful, are necessary and hard to avoid”, while they may
even be beneficiary, since “they help us to develop the thick skin we need and to dominate
‘countertransference’, which is after all a permanent problem for us”. So, they are “blessing
in disguise” (in English in the original letter). And then he adds: “The way these women
manage to charm us with every conceivable psychic perfection until they have attained
their purpose is one of nature's greatest spectacles. Once that has been done or the contrary
has become a certainty, the constellation changes amazingly” (Freud, 1909b, pp. 230-231).3
But Spielrein’s response to Freud’s initial cool and rejecting reply was to send him
some of Jung’s letters, while at the same time affirming her love for her doctor, teacher,
and lover, and writing “I would be happy if someone could demonstrate to me that he is
worthy of love, that he is no scoundrel” (Spielrein, 1909b, p. 92). Then she expanded her
account: her mother had written to Jung, and he had replied that he “did not feel
professionally obligated, for [he] never charged a fee”, this being what, from his point of
view, “clearly establishes the limits imposed upon a doctor” (Jung, quoted by Spielrein, op.
cit., p. 94). Hence, his position was that the mere fact of having accepted to take care of a

2
“I too have had news of the woman patient through whom you became acquainted with the neurotic
gratitude of the spurned. When Muthmann came to see me, he spoke of a lady who had introduced herself to
him as your mistress, thinking he would be duly impressed by your having retained so much freedom. But we
both presumed that the situation was quite different and that the only possible explanation was a neurosis in
his informant. To be slandered and scorched by the love with which we operate—such are the perils of our
trade, which we are certainly not going to abandon on their account” (Freud, 1909a, p. 210).
3
“Such experiences, though painful, are necessary and hard to avoid. Without them we cannot really know
life and what we are dealing with. I myself have never been taken in quite so badly, but I have come very
close to it a number of times and had a narrow escape [in English in the original letter]. I believe that only
grim necessities weighing on my work, and the fact that I was ten years older than yourself when I came to
ΨA, have saved me from similar experiences. But no lasting harm is done. They help us to develop the thick
skin we need and to dominate ‘countertransference,’ which is after all a permanent problem for us; they teach
us to displace our own affects to best advantage. They are a ‘blessing in disguise’ [in English in the original
letter]. The way these women manage to charm us with every conceivable psychic perfection until they have
attained their purpose is one of nature's greatest spectacles. Once that has been done or the contrary has
become a certainty, the constellation changes amazingly” [Freud, 1909b, pp. 230–231].
 Dependence and Betrayal Page 3 of 14

helpless human being is devoid of any ethical commitment; for him, it is only the financial
agreements that constitute an obligation. This he clearly states, when he suggests to
Sabina’s mother that, if she wanted him to adhere strictly to his doctor’s role, she should
pay him a fee “as a suitable recompense for his trouble”. 4
So that Jung’s line of defense was the following: i) nothing had happened,
ii) everything was an expression of his patient’s pathology, and iii) after all, he was under
no moral obligation, because he had not charged a fee! But he also fell into a breach of
confidentiality —which he would probably had said he was not obliged to, for the very
same reason— as Spielrein recounts in the same letter to Freud.
It so happened that one of Spielrein’s acquaintances had heard Dr. Jung publicly
complain that a patient he had treated for a long time without pay was making scandalous
demands on him, and he had been forced to write to her mother, saying that she should pay
him for his services. When someone asked him whether there wasn’t a student in the colony
claiming to be his mistress, he replied it was nonsense, because she had only been his
patient. Spielrein’s informant saw nothing wrong in sharing this piece of gossip with his
friends and acquaintances, but she immediately recognized her own story.5
Finally, after a conciliatory meeting with Spielrein, which resulted from Freud’s second
letter to her, Jung was convinced that she had not been the source of the rumor and
admitted, in his letter to Freud of June 21, that he had lied about the whole matter,
particularly in his letter to her mother. He then asks Freud to write to Spielrein, telling of
his admission, and begs his pardon for “having drawn him into this imbroglio”. He
nonetheless congratulates himself for “not having been mistaken about his patient’s

4
“The doctor knows his limits and will never cross them, for he is paid for his trouble. That imposes the
necessary restraints on him. […] Therefore I would suggest that if you wish me to adhere strictly to my role as
doctor, you should pay me a fee as suitable recompense for my trouble. In that way you may be absolutely
certain that I will respect my duty as a doctor under all circumstances” (Jung, quoted by Spielrein, 1909b, p.
94).
5
“Not long afterward I learned through acquaintances that Dr. Jung was telling people he had treated a
patient for a long time without pay, but that he had been forced to write to his mother that she should pay him
for his services because this patient was making certain demands on him. An acquaintance of his then asked
whether there wasn’t a student in the colony claiming to be involved in some sort of affair with Dr. Jung; that
was nonsense, Jung said, since she was only his patient. He said people talked about his having eight
mistresses, etc., while he was really a perfectly harmless person. […] The person to whom Dr. Jung made his
admission (someone else tells me) smiled, of course, saying that Dr. Jung wanted to paint himself as lily white
for his wife’s benefit; this person saw nothing wrong with sharing the story with his friends and
acquaintances, among whom I also number, something Dr. Jung could not have known. And of course I
recognized our story at once. Noble?” [Spielrein, 1909b, p. 103]
 Dependence and Betrayal Page 4 of 14

character”, which would have left him “with a gnawing doubt as to the soundness of his
judgment”, thus becoming “a hindrance for his work”. 6
Freud (1909c) promptly complied and wrote a letter to the young woman, on June 24,
informing her of Jung’s admission and apologizing to her for “having construed some
matters wrongly and to her disadvantage”. He then adds that, in such matters, the blame
should be put on the man and not on the woman, and congratulates her for “the dignified
way in which she had solved the conflict”.7
Of course, this apology does Freud credit, but he is still framing it in terms of the usual
gender stereotypes, while sidestepping the issue of the ethics of psychoanalytic practice. He
was also clearly relieved at the avoidance of a scandal that might have tarnished the
reputation of his designated heir and, above all, of psychoanalysis.
This episode is characteristic of our community’s response towards such
transgressions: there is regularly an attempt at denial, explaining it away as a result of the
patient’s psychopathology, blaming the victim, cynically describing it as a “work accident”
of the psychoanalyst, or even shrouding it under a cloak of silence and invisibility. Even in
those cases in which the offender ends up being excommunicated, as in the one described
by Jane Burka (2008) and Sue von Baeyer (2011), the whole business tends to be
suppressed and never talked about openly. It is like those “family secrets” that everybody
knows, but which are never mentioned. And we all know that this is the basis for the
transgenerational transmission of pathology (Kaës et al., 1993; Hernández de Tubert,
2000).

6
“In view of the fact that the patient had shortly before been my friend and enjoyed my full confidence, my
action was a piece of knavery which I very reluctantly confess to you as my father. I would now like to ask
you a great favour: would you please write a note to Frl. Spielrein, telling her that I have fully informed you
of the matter, and especially of the letter to her parents, which is what I regret most. I would like to give my
patient at least this satisfaction: that you and she know of my ‘perfect honesty.’ I ask your pardon many times,
for it was my stupidity that drew you into this imbroglio. But now I am extremely glad that I was not
mistaken, after all, about the character of my patient, otherwise I should have been left with a gnawing doubt
as to the soundness of my judgment, and this would have been a considerable hindrance to me in my work”
[Jung, 1909c, pp. 236–237].
7
The full letter is as follows:
“Dear colleague,
“I have today learned something from Dr. Jung himself about the subject of your proposed visit to me, and
now I see that I had divined some matters correctly but that I construed others wrongly and to your
disadvantage. I must ask your forgiveness on this latter count. However, the fact that I was wrong and that the
lapse has to be blamed on the man and not the woman, as my young friend himself admits, satisfies my need
to hold women in high regard. Please accept this expression of my entire sympathy for the dignified way in
which you have solved the conflict.
“Yours, faithfully,
“Freud.” (Freud, 1909c, pp. 114–115).
 Dependence and Betrayal Page 5 of 14

What is the reason for such behavior, which one would not expect in the members of a
profession that prides itself on uncovering secrets? Is this a case of the shoemaker’s son
always going barefoot? Why did Freud act this way, in such a contrast with his belief that
truth should always have precedence over convenience or any narcissistic image? Let us
remember that he also destroyed his metapsychology paper on the countertransference, that
he always considered this subject to be very dangerous for the public image of
psychoanalysis, and that this was his reason for trying to suppress the presentation and
ultimately suppressing, the publication of Ferenczi’s (1933) last paper “Confusion of
tongues between the adults and the child” (Masson, 1984; Tubert-Oklander, 1999).
Apparently, we are dealing with a very sensitive issue.
The truth is that society in general is intolerant of any suggestion that those who are in
charge of the welfare of others may turn the power inherent in their position into an abuse
of their charges. This was the reason behind the vicious attacks Freud received when he
posed his so-called “seduction theory” of neuroses —a name which is nothing but a
euphemism, since it was really a theory of the pathogenic effects of the sexual abuse of
children. What happens with this is that the parent-child relationship is the symbolic
paradigm of every relation of authority in society. If we were to start by questioning the
benignity of the authority of parents, we might end up by doing the same with all other
similar relations, such as teacher-pupil, doctor-patient, analyst-analysand, shepherd-flock,
police-public and —Heaven forbid!— government-people (Hernández de Tubert, 1997,
2006; Hernández-Tubert, 2011).
Freud, who was politically conservative and had a major anti-political bias in analytic
matters (Pines, 1998), was surely unsettled by these implications, at least as much as he
was by the brutal reaction of his colleagues —including a close friend and teacher such as
Breuer— and by his discovery of incestuous traits in both his father and himself (Jones,
1953, p. 354). So he finally abandoned his traumatic theory of neuroses —a move that
certainly opened a brand-new path for our understanding of the human mind, while leaving
out another— and a tacit ban was placed on any further attempt at what was called
“blaming the parents.” Then, when Ferenczi revived, in the early thirties, the traumatic
theory of neuroses, he was attacked by the analytic community in the very same terms that
had been used against Freud, almost forty years before (Tubert-Oklander, 1999).
This conflict between an exclusively intrapsychic conception of mind and its
pathology, and another that gives a major place to environmental factors, has been the basis
of many institutional struggles and schisms in the psychoanalytic movement (Tubert-
Oklander, 2006). Now we are facing a new challenge, derived from the unavoidable
recognition of the fact that psychoanalysts can and often do abuse their patients. This is a
 Dependence and Betrayal Page 6 of 14

catastrophe for our profession, which depends so much on the trust that the public and the
individual patients place on its practitioners. It is also very similar to what is happening to
the Roman Catholic Church, as a result of the emergence of reports of widespread child
abuse and pedophilia by its priests.
The truth is that whenever one is placed in a position that requires taking care and
being responsible for the welfare of others —as in the case of parents, teachers, doctors,
nurses, analysts, policemen, soldiers, priests, governors, and kings— one acquires power,
privileged knowledge, and prestige, which may be used for either good or evil. Hence, there
is always a definite danger that its depository might become confused, and start to believe
that such values are actually a personal possession, forgetting that they only belong to the
chair one is circumstantially sitting on.
Those people who enjoy and lust for power are usually offended whenever someone
dares to say that power is an illusion, a non-existent entity, and nothing but a property of a
dependent relationship. I always remember the violent reaction of a senior analyst, who was
very prone to politicking, when I said that power does not really exist, that it is a delusion
born of narcissistic omnipotence.
Of course, the psychoanalytic treatment offers many a chance for the analyst to abuse
the patient. But we have been so impressed by sexual exploitation, that we have largely
overlooked other kinds of abuse, such as breach of confidentiality, aggressive, economic,
and political exploitation, and, over all, the narcissistic exploitation of the patient, which is
the more difficult to pinpoint.
These various forms of abuse, which represent an ethical transgression by the analyst,
do not occur only during the treatment, but also after its formal end, sometimes many years
afterwards. This is, of course, more frequent in the case of training analyses, in which both
parties belong to a same professional community.
The attempt to avoid thus harming the patients has led to a new meaning of the term
“abstinence” —which originally referred to a suspension of instinctual gratifications for the
patient during the analytic cure (Freud, 1919)— which is now applied to the analyst, in
what Fernández Cerdeño (2010) has called “the third rule of analysis”. This has been
clearly specified in the German Psychoanalytic Society’s prescriptions for professional
ethics, which say:
Psychoanalytic activity requires the capacity to ensure an attitude of discipline and
abstinence in all corporal and verbal expressions. Verbal aggressions (e.g., tactless
expressions that harm or devalue the patient) are as pernicious for the analytic task as
bodily actions. Consequently, analysts are obliged to avoid deviating their personal
capacity and authority towards the satisfaction of their own narcissistic, aggressive, or
 Dependence and Betrayal Page 7 of 14

erotic needs. The obligation to maintain abstinence is valid beyond the termination of the
working analytic relation [German Psychoanalytic Society, quoted by Fernández Cerdeño,
2010, my translation].
Let me now tell you a story, perhaps a fable, which is much to the point. Once upon a
time, there was a young European doctor, whom we shall call A, who decided to go to
Berlin to study psychoanalysis. There he was in analysis with a senior analyst, one of
Freud’s analysands. He graduated with a paper that showed an original thought, albeit well
within the limits of orthodox Freudian theory. He then went back to his country, where he
practiced as an analyst, until the impending war drove him to another continent. There he
became a pioneer of our profession, a well-respected organization man, who taught and
analyzed many generations of analysts. A strong, energetic man, he was a productive and
orthodox thinker and practitioner, a born leader, someone like Karl Abraham.
Then came B, a candidate from a far-away land, who had a training analysis with A. He
was a doctor who originally came from a rural area and had been orphaned as a child, when
his father died violently. Apparently he found in A a satisfactory father substitute, but was
not too happy with his analyst’s conservative stance, which was a bad match for his own
rebelliousness. Later, he had an unorthodox treatment with another rebellious analyst,
which was more to his taste.
When he returned home, he also became a pioneer of psychoanalysis in his country,
although he never occupied one of the major power positions in his organization, most
probably on account of his anarchistic trends. He compensated for this by maintaining a
perennial rebellious attitude, as an eternal adolescent, and seeking a position of power and
prestige without the analytic society. He was extremely intelligent, sensitive and creative,
an outstanding analyst, supervisor, and teacher, who had a major influence on many
generations of candidates, but he hardly ever wrote, as he was too restless for that.
As an analyst, he had an almost eerie intuition of the patient’s unconscious. His
interpretations were always sharp and precise, albeit hardly ever tactful, and sometimes
outright hurtful, but many patients forgave him for this, since he was affectionate and
tender most of the time; others left analysis with him in a hurry. He never thought much of
the formal rules of the setting; this allowed him, on many occasions, to find novel and
creative ways of dealing with difficult patients, but at other times he acted as an absolute
monarch, who seemed to believe that he was the Law. In his old age, he tended to be
surrounded and cared by some of his former analysands and students.
Now comes into the scene C, a young candidate in training analysis with B. C was also
an early orphan, who had a craving for being loved by everyone. He found in B the father
he had been looking for, was truly helped by the analysis, and learned many things from
 Dependence and Betrayal Page 8 of 14

him. He also developed a loving and caring relationship with his analyst, which lasted until
the latter’s death.
In his personal life and professional activities, C played the role of the truly good chap,
ever young and smiling, who was well-liked by everyone. As an analyst, he was always
sensitive and caring, with careful and well-timed interpretations, and he usually tended to
play the good mother role. He was never punctilious about the analytic setting, but certainly
much more than his own analyst.
In the professional community, he tended to avoid conflict and look for compromise,
and he never accepted a position in the government of his society, perhaps because his own
analyst had never had one. Nonetheless, he was generally respected and sought as an
intermediary in situations of conflict.
There was, however, an authoritarian trait in his personality, which emerged when his
overtly benign and sympathetic approach met with an open divergence. In his old age, he
became irritable and aggressive; apparently, cracks were appearing in his well-groomed
visage.
Now comes D, another candidate who had his training analysis with C. D, unlike the
two previous links in the chain, had had a father, but had lost his mother, who had been
replaced by a series of substitutes. His father had had an unsatisfactory relation with his
own distant father, and had tried very earnestly to be ever present and act “as a father
should” towards his children, but this made him frequently behave in a dogmatic and
tyrannical way. D loved his father dearly and had a major emotional dependence on him,
who was all he had, but he also had violent conflicts with him, both in his inner world and
in their actual relationship.
In his analysis with C, D could very well work-through his relation with his mother,
with the help of his analyst’s deep, sensitive, and well-timed interpretations, but he also
found out, although he could not put it clearly into words at the time, that any attempt to
bring into the transference his conflicts with his father were rapidly bypassed and
responded to with further interpretations about his mother. This was also a main feature in
C’s theoretical position in analysis. He also kept D for a long period in a lower frequency of
sessions than what would have been desirable.
The training analysis was finally terminated, and D left quite satisfied with and grateful
about its results. However, in the following years, quite a few things occurred in his life
that made him feel a need for further analysis. So, he went back to C, with the intention of
undergoing a full analysis, but his former analyst kept him in a once-a-week mainly
supportive therapy. This helped him through a rather difficult period, but did not respond to
 Dependence and Betrayal Page 9 of 14

his deeper needs, so he left it in the end and tried to continue through self-analysis. A few
years afterwards, he sought treatment with a much older colleague that had always been
friendly towards him, who helped him to clarify the remaining obscure points.
In the meantime, he began to sense hostility in C towards him, hidden behind their
apparently friendly relationship. Unlike B, his own analyst, C had been a regular writer of
interesting papers, especially about clinical experiences —always within a tradition, like A,
his analytic grandfather, although it was a quite different tradition, initiated by B. But as the
years went by, his creativity seemed to stagnate; his papers were increasingly sparse, and he
began to repeat himself. D, on the contrary, was a prolific and creative writer, who was
always exploring new literature and novel points of view. He was also very much his own
man, and did not remain either under C’s shadow or within the small group of B’s former
analysands who kept and developed the tradition he had initiated.
As C and D belonged to the same professional community, it was unavoidable that they
met in all kinds of academic events, and it was there that D began to sense C’s hostility. B’s
and C’s approach to the study of mind was psychopathological and instinctual; D, on the
other hand, tended to think in terms of normality, mental health, and development, which
were either fostered or disturbed by relational experiences. On one occasion in which D
was putting forward his point of view, during a conference, C had an angry outburst, barely
short of being insulting, in which he utterly disqualified his former analisand’s ideas. This
made D withdraw from any regular contact with him, albeit he still respected and
appreciated him.
In the end, a manifest conflict emerged between them, on account of some institutional
dealings. C had made D a promise, which he failed to honor, but he never acknowledged
this, and even acted as if he was having a joyous triumph over him. He had also taken in
analysis someone dear to D, and tried to turn his analysand against him, but the patient
would have none of it and left the treatment. D felt both disappointed and betrayed and,
from that moment on, he cut short all relationship with C.
What had happened? This seems to be a case of transgenerational transmission. A was
a good analyst for classical neurotic patients, but failed to respond to B’s deep wounds, just
as Freud had failed to respond to Ferenczi’s therapeutic needs (Tubert-Oklander, 1999). B’s
second analyst strengthened his rebelliousness and self-esteem, but did not help him submit
to the Law. C found in B the father image he sought, but it was a father who barely
concealed his fragility, and thus the analysand turned into a caring mother for his former
analyst. In practice, however, his good intentions were marred by his narcissistic craving
for love and acceptance, which hid an omnipotent vein in his personality. D was also
looking for a father, but found instead a man who strived to be a good-enough mother. This
 Dependence and Betrayal Page 10 of 14

helped him, but he missed the confrontation with a truly strong and loving father. He had
expected his analyst to be truthful, sympathetic, and firm, and he did not like what he saw
in him in the years after the end of the analysis.
One result of these experiences was that in his professional work he seemed, for a time,
in danger of falling into an lawless everything-goes attitude, and this made him sometimes
act in a tactlessly tough manner towards some of his patients, mainly men. It took him
years of analysis and reflection to discover that he was neurotically compensating for the
lack of a law-imposing father, just as his own father had, and find a more balanced stance.
But what helped him to stand fast in front of these conflicts? In the first place, he had
had a good female analyst during his youth, and this analysis had left in him an imprint of
what a true analysis should be, but hardly ever is. Then, in the course of this history of
decades, he managed to build a good marriage and family, which supported him all the
way. Finally, there was his last analysis with his elder colleague, who was not an elaborate
interpreter, but gave him what he had been looking for all along: a clear, ethical, truthful,
and non-corrupt father image, which did not compete with him, but enjoyed instead his
development and creativity.
Von Baeyer (2011) has put forward in this Panel the hypothesis that boundary
transgressions in analysis are an expression of an unresolved narcissistic pathology in the
analyst, which is expressed as hatred of analysis. I would add that it is not only hatred of
Analysis, but also of Law, Truth, Authority, Good, and Love —i.e., of anything that sets a
limit to omnipotence. But why does the analyst need such omnipotence? Because he or she
has been deeply hurt during her or his early development and family history, and the
training analysis has not been able to heal these wounds. The result is envy towards the
patient: “Why should this bastard or this bitch receive from me what I was never able to get
from my parents or my analyst?”
Not all patients generate such envy; the narcissistic analyst is quite able to help those
analysands he or she feels somehow inferior, or who accept the role of being forever her or
his children, but he or she cannot tolerate those who pretend to become independent adults.
This is quite similar to those parents who are never willing to accept that their child has
grown up, thus leaving their daughter or son with the only options of submitting and
cancelling any further growth, or somehow severing the relation with their parents.
Laius and Oedipus have to meet sometime in a crossroad, and there everything depends
on their being able to let love, respect, and charity overcome rivalry, envy, and hubris
(Kohut, 1982). The acceptance of the flow of generations, the difference between them, the
current of time, which harbors both growth and loss, flowering life and old age, life and
 Dependence and Betrayal Page 11 of 14

death, sets an unbeatable limit to the omnipotence that ensues when the original structuring
experiences have been painfully unhappy. This is the Law of Life, to which we all should
all submit. The result is that we renounce the absolute, the cost is acknowledging our
unavoidable incompleteness and limitations, and our prize is feeling alive, for as long as we
are allowed to, transmitting that very life to others and striving to enjoy happiness
whenever we find a chance for it.
As analysts, we can only be as good as we actually are, and we know that, even if it is
never everything it should be, we can make an effort to be good-enough and, above all,
truthful to our patients, not to attempt to show them an image of ourselves we know to be
untrue, and be willing to learn from them about our own shortcomings (Ferenczi, 1933).
Neither parents, nor teachers, doctors, analysts, priests, or governors are ever up to the
ideals they should look up to, but they can try to be worthy of incarnating them, for the
time being, without ever deluding themselves into believing they actually are these ideals.
If this be so, those who are under their care might learn something about life they have
never learnt in the past, and the world shall be a little bit better for that.
Boundary violations and betrayals by psychoanalysts create a rupture in the analytic
container and provoke trauma and breakdown in the analytic dyad, the analytic institute,
and society-at-large. The repair of such a devastating disruption is slow to come and
difficult to achieve, but necessary to strive for, if we are to preserve psychoanalysis as an
ethical profession in an often immoral world.
 Dependence and Betrayal Page 12 of 14

References
Burka, J. B. (2008): “Psychic fallout from breach of confidentiality: A patient/analyst’s
perspective.” Contemporary Psychoanalysis, 44 (2): 177–198. Also in the page of the
William Alanson White Institute (visited March 13, 2011):
<http://www.wawhite.org/uploads/Journals/Burka_Pages_from_CP44_2_Final_Files.p
df>
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