Legal, Ethical, And Professional (LEAP) Issues in Psychoanalysis and Psychotherapy

In the United States, it is generally taken for granted that psychoanalysis and psychotherapy are professional specialties within the overall health-care profession, medically defining its practitioners as health-care professionals....

Rethinking psychoanalysis as being outside of a medical model

This identification is, in large part, the result of a long history of medically dominated institutes and more recent economic incentives to define our work as “medical treatment” in order to gain access to insurance reimbursement.  

At the same, time, however, most practitioners are aware that the connection between psychoanalysis and medicine has been the focus of lively debate since the early days of our profession. From the beginning, many analysts have seen medical terminology (e.g., diagnosis, treatment, and cure) as providing only loose and misleading metaphors for their work.

Academy members believe these metaphors do not reflect what actually goes on in our consulting rooms and have caused far more trouble than they are worth, both limiting our thinking and bringing us under various forms of regulation that are inimical to our work.  For these reasons, we are working to re-think psychoanalysis outside the medical model.  The Academy’s library includes a wide range of papers that have been contributed as part of this scholarly project.   

But the questions raised by the project of re-thinking psychoanalysis go beyond the scholarly, the theoretical, and the clinical.  Because existing institutions and standards have been established around the view that psychoanalysis is a form of health-care, anyone attempting such a re-definition faces fundamental practical questions:   

What, if any, relationship do analytic practitioners who explicitly reject the medical model have to existing standards in law, ethics, education, and professional practice?     

And, to the extent that these standards make no sense outside of a medical context, how are we going to go about redefining what we do --legally, ethically and professionally?   

This web section is dedicated to the publication of a variety of writings that raise and attempt to answer these questions in ways that we hope individual practitioners will find useful in their own thinking.  It is very much a work in progress--and in that spirit we welcome your comments, queries, suggestions, and contributions.