Consenting and Assenting to Psychoanalytic Work.

Area of Science:

• Psychoanalysis
• Psychology
• Medical Ethics

Background:

• Historically, patient consent in psychoanalytic literature has been underexplored.
• Post-Freudian theories suggest potential for misunderstandings regarding consent in psychoanalysis.
• The concept of transference introduces complexities to patient consent.

Purpose of the Study:

• To re-examine the understanding of patient consent to treatment within psychoanalysis.
• To differentiate between cognitive 'consent' and conflicted 'assent'.

Main Methods:

• Conceptual analysis based on psychoanalytic theory and literature.
• Distinction between etymological and intersubjective grounds for consent and assent.
• Exploration of unconscious responses within the analytic setting.

Main Results:

• Psychoanalytic consent is not a static, one-time event but a dynamic, evolving process.
• Patients' 'assent' is characterized by conflict and partial disagreement with analytic work.
• Informed consent emerges through working through unconscious reactions to the analytic process.

Conclusions:

• Informed consent in psychoanalysis is a multilayered, repetitive, and ambivalent process.
• It is better understood as 'good-enough assenting' over time rather than a simple agreement.
• This process acknowledges the inherent complexities of the psychoanalytic relationship.