In First Principles, Alessandra Lemma examines the centrality of applied ethics to psychoanalytic practice, The book focuses on the articulation of an accessible framework for developing and exercising an identifiable method - an ethical self-discipline - to support critical reflection on therapists' psychoanalytic work with patients and to help them to approach the resolution of ethical dilemmas. Integrating key concepts from the field of applied ethics,
and bioethics specifically, Lemma re-interprets them for use within a psychoanalytic framework, articulating how we can understand psychoanalytically the concepts of beneficence, non-maleficence, autonomy,
justice, and veracity and deploy these to guide clinical work. Using clinical examples, the book outlines a working model for how therapists can reflect on their practice, as well as devoting a chapter on how to teach ethics within psychoanalytic psychotherapy trainings and outlining a detailed curriculum for teaching ethics. This book is essential reading for psychoanalytic practitioners as well as clinical psychologists, psychiatrists, psychotherapists, counsellors, and
psychoanalysts who work in the psychoanalytic tradition.
In First Principles, Alessandra Lemma examines the centrality of applied ethics to psychoanalytic practice, The book focuses on the articulation of an accessible framework for developing and exercising an identifiable method - an ethical self-discipline - to support critical reflection on therapists' psychoanalytic work with patients and to help them to approach the resolution of ethical dilemmas. Integrating key concepts from the field of applied ethics,
and bioethics specifically, Lemma re-interprets them for use within a psychoanalytic framework, articulating how we can understand psychoanalytically the concepts of beneficence, non-maleficence, autonomy,
justice, and veracity and deploy these to guide clinical work. Using clinical examples, the book outlines a working model for how therapists can reflect on their practice, as well as devoting a chapter on how to teach ethics within psychoanalytic psychotherapy trainings and outlining a detailed curriculum for teaching ethics. This book is essential reading for psychoanalytic practitioners as well as clinical psychologists, psychiatrists, psychotherapists, counsellors, and
psychoanalysts who work in the psychoanalytic tradition.
Introduction
1: The unbearable silence of responsibility
2: Bioethical principles
3: A psychoanalytic principled approach
4: The ethics of listening
5: On getting it wrong
6: Apologies matter
7: Principles in action
8: Developing the ethical chóros
Epilogue: A plea for a measure of irony
Alessandra Lemma, Fellow of the British Psychoanalytic Society and
Chartered Clinical Psychologist, is a Visiting Professor in the
Psychoanalysis Unit, University College London and Consultant, Anna
Freud National Centre for Children and Families. For 16 years she
worked at the Tavistock Clinic where she was, at different stages,
Head of Psychology and Professor of Psychological Therapies in
conjunction with Essex University. She was a recipient of
the 2022 Sigourney Award in recognition of her inventive
theoretical and clinical contributions to understanding body
modification practices, the impacts of technology on psychic
functioning and transgender identities
as well as for her efforts in developing and disseminating
worldwide a brief psychoanalytic intervention for mood disorders.
Lemma's deeply reasoned and erudite advocacy for ethical
self-discipline on the part of psychoanalysts eschews both stodgy
moralizing and formulaic guidelines. Instead, she recommends the
cultivation and sustenance of psychic space for truth, fairness,
and respect for the patient's essential Otherness. Lemma's approach
is characterized by a gentle iconoclasm that challenges us to leave
the comfort of normative narratives, societal or psychoanalytic,
while listening to our patients. Her oeuvre is wide-ranging,
writing style elegant, and arguments convincing. The result is a
book of rare literary luminosity, theoretical soundness, and
clinical significance.
*Salman Akhtar, MD, Professor of Psychiatry, Jefferson Medical
College; Training and Supervising Analyst, Psychoanalytic Center of
Philadelphia*
This remarkable book manages to be sophisticated, deeply
thoughtful, expressive, lively and practical at the same time. It
offers an approach to ethics focused especially on psychoanalysis
but applicable to all forms of psychotherapy and elsewhere too. Few
authors have absorbed the challenge of the philosophy of ethics so
completely and demonstrated so brilliantly not only that it is a
vital element in regulating psychoanalysis but also that it has the
capacity to guide and strengthen psychotherapeutic training and
practice for the benefit of therapists and patients alike.
*Professor Stephen Frosh, Department of Psychosocial Studies
Birkbeck, University of London and author of Those Who Come
After:Postmemory, Acknowledgement and Forgiveness.*
The most important skill in life is how to think ethically.
Alessandra Lemma teaches this skill to psychotherapists. To engage
in rational ethical deliberation in a mind propelled by unconscious
impulses is the human challenge. Stunning and original, wise and
empathic. A classic in practical ethics.
*Professor Julian Savulescu, Chen Su Lan Centennial Professor in
Medical Ethics; Director, Centre for Biomedical Ethics, National
University of Singapore and Uehiro Chair in Practical Ethics
Co-Director, Wellcome Centre for Ethics and Humanities, University
of Oxford*
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