The PANY Bulletin

Psychoanalytic Association of New York
Volume 43, #1 Spring 2005

Ethics in Sight
The Aging Analyst

(from The Ethics Casebook)

Dr. Garcia is a senior, venerated training analyst. His patient, a candidate, has with the help of Dr. Garcia, referred his wife to you for analysis.

After an uneventful period the wife begins to report from the couch that her husband strongly suspects that Dr. Garcia is losing his cognitive capacity. He appears confused at times, is very forgetful and even once set a small fire in a wastebasket by mistakenly throwing away a lighted cigar.

You have noticed some slippage in your own contacts with Dr. Garcia but have so far disregarded the clues that indicate his growing incapacity. It is depressing to think of that brilliant mind going down the drain and you don’t want it to happen.

Your patient tells you that she has urged her husband to confront his analyst with his observations. He gingerly started to do this once and Dr. Garcia flew into a rage and threatened to report unfavorably on the progress of the analysis. He accused the candidate of being both ungrateful and unanalyzable.

Your patient wants to go to someone at the institute who can do something since her husband is afraid to do anything else for fear of further antagonizing his analyst.
What should you do with this information? What are your responsibilities for the patient’s confidentiality? What about confidentiality for the patient’s husband? What are your concerns about safeguarding the public and the profession?

What if the patient’s transference to you is influencing her account? What are the institute’s responsibilities?

Please send your responses to the Editor or to Dr. Clark directly.