Resumen:
La presente investigación es de tipo cualitativa exploratoria e individual, aplicada a psicoanalistas y psicoterapeutas profesionalmente activos. Los factores psicoterapéuticos son elementos que facilitan el cambio dentro del encuadre psicoterapéutico pero también en el proceso se pueden propiciar situaciones de riesgo tanto para pacientes como para los psicoterapeutas debido a la naturaleza de los vínculos que se establecen.
Se busca explorar los aspectos éticos que intervienen en relación terapeuta-paciente y sobre qué ejes empírico-conceptuales desde la ética se desarrolla el ejercicio de la psicoterapia psicoanalítica. También conocer si la concepción de paciente es la misma para todos los terapeutas y cómo afrontan un dilema ético. Se pretende identificar y analizar algunos criterios éticos desde los cuales se ejerce la práctica clínica. Y particularmente cuáles son los conceptos psicológicos que se detectan en el diálogo sobre el tema de la Ética y la psicoterapia psicoanalítica
Para ello se realizaron entrevistas a psicoterapeutas con formación psicoterapéutica psicoanalítica con años de experiencia, basadas en un formato para tal fin. Se empleó un protocolo de entrevista semi-dirigida, se grabaron y transcribieron para finalmente aplicar un análisis de contenido de las entrevistas.
Los resultados nos indican que investigar sobre este tema de frente y directamente provoca algún tipo de resistencia al tocar aspectos personales pero por otro lado se observó interés para discutir sobre la mejor formación de los psicoterapeutas sobre todo cuando se trata de resolver un problema ético.
La discusión de los resultados se compone de tres aspectos básicos: conceptos alrededor de la clínica y la ética, trasgresiones a la ética en psicoterapia y su relación con la teoría y finalmente la intención y actitud hacia la ética en la psicoterapia. Una investigación sobre el ejercicio ético de la psicoterapia psicoanalítica se enfrenta a una pared hermética impuesta por aquello que pretende investigar: la confidencialidad ética, so pretexto de no exponer información privilegiada se impide abordar profundamente sobre las fallas en el proceso conscientes o inconsciente que pueden suceder en el marco psicoterapéutico si no se atienden desde un proceso secundario que incluye el análisis y síntesis de ésta temática.
Posteriores estudios han de diseñarse para abordar en específico segmentos focales de análisis, tales como la contratransferencia ética, la presentación de la ética en la formación teórica, su manejo dentro de la supervisión, la esquematización ética en el estudio de casos clínicos, la formación personal del clínico y la ética en su deseo de ser psicoterapeuta; la meta psicología del aparato psíquico, la moral y la ética: las instituciones de formación psicoterapéutica y la ética, entre otras temáticas de interés.
Palabras clave:
Relación Terapéutica,
Dilema Ético,
Confidencialidad,
Formación Profesional del Psicoterapeuta.
Abstract:
This is a qualitative, exploratory and individual research, applied to professionally active psychoanalysts and psychotherapists. It is sought to explore the ethical aspects that take part in the therapist-patient relation and under what ethical empirical-conceptual axes develops the practice of psychoanalytic psychotherapy, and to know if the conception of patient is the same for all the therapists and how they face an ethical dilemma. In this research it`s considered that psychotherapeutic factors are elements that provide change within the psychotherapeutic frame but also, in this process, risk situations may be favoured in patients and psychotherapists due to the nature of the bonds established between them.
It is known that the training of psychologists and psychotherapists, while supervising cases during long periods of time and fulfilling several hours of personal analysis, promotes that their professional conduct can be colored by the ethical standards that are required during the psychotherapeutic process of a patient and, and even when this relation is over, it should continue to be ruled by the standards of ethical codes. But once their formation ends and that their working day requires a personal style, several issues regarding ethics emerge, the same that we propose to respond through this research. What type of conception on ethics and its clinical practice prevail in psychotherapists with psychoanalytic orientation? Around which empirical-conceptual axes develops the ethical practice, in the clinical practice of psychoanalytic oriented psychotherapists? Which considerations, regarding ethics within clinical practice, psychoanalytic oriented psychotherapists place themselves? How do psychotherapists face ethical dilemmas?
The aim of this study is to identify and analyze some ethical criteria from which clinical practice is held. And particularly, which are the psychological concepts that are detected in the dialogue of ethical and psychoanalytic psychotherapy themes. A specific objective of this work is, also, to establish the type of psychological concepts that emerge when psychologists dialogue about ethics in the clinic of psychoanalytic orientation, the concept of patient, the concept of psychotherapy and the type of ethical dilemma that appear in the clinical practice, and to determine the prevalence of related ideas with theoretical-conceptual or practical-empirical aspects, in the discourse of psychotherapists with psychoanalytical orientation when boarding the theme of ethics in psychotherapy.
In order to achieve this, interviews to psychotherapists with psychoanalytic psychotherapy training with several years of experience were conducted, based in a format designed for that goal. It was used a semi directed interview protocol, the interviews were recorded and transcribed and finally analyzed through content analysis.
Results indicate that, to research about this theme face to face and directly, causes some kind of resistance when touching personal aspects, but in the other hand, we observed interest to discuss about better training of psychotherapists and their skills in solving ethical problems. Discussion of results of this research includes three basic aspects: concepts around clinic and ethics, transgressions to ethics in psychotherapy and its relation with theory and finally the intention and attitude towards ethics in psychotherapy.
It is proven that the research of ethical practices in psychoanalytic psychotherapy stands in front of an hermetic wall placed by that which we pretend to investigate: the ethical confidentiality, with the excuse of not exposing privileged information, prevents to board profoundly about conscious and unconscious failures in the process, that can take place in the psychotherapeutic frame if not attended from a secondary process that includes the analysis and synthesis of this theme.
Subsequent studies must be designed to approach specific focal segments of analysis, such as ethical countertransference, the introduction of ethics in the theoretical training, its handling within supervision, the ethical outline in the study of clinical cases, the personal training of the clinician and the ethics in his desire to become a psychotherapist; the metapsychology of the psychic apparatus, morals and ethics: institutions of psychotherapeutic training and ethics, amongst other themes of interest.
Keywords: Therapeutic relation, ethical dilemma, confidentiality, professional formation of the psychotherapist
Referencia:
Gómez Alva, A., Hernández Flores, A., García Nicolin, M. y López Ramírez, M.E. (2009). Ética y su aplicación en Psicoterapia Psicoanalítica. Clínica e Investigación Relacional, 3 (3): 695-708.