Psychotherapist Anna Guerra explores the ethical implications of the therapist's use of her own imagination. 

Some thoughts on the microethics of our professional rules of conduct: Keeping play in imagination
by Anna Guerra, JD, MA, LPC

A client’s ability to play and imagine is essential to their healing and growth and the provision of a “playspace” where this can happen is a central component of what we do as psychotherapists. Maya Angelou writes, “The needs of a society determines its ethics” (Angelou, 1980, p. 190). “Microethics” focuses on the needs and purposes of our profession, on the ethos underlying our professional rules of conduct, going beyond “the rules,” beyond the “dos and don’ts,” the “shall and shall not” to the “one shall or shall not because we seek to do the following.” Like a microphone, microethics expands and makes audible the reasons for our rules. Providing our clients with a playspace and helping them play is part of what we do as therapists, and it is an ethos written into the various rules of our professional conduct, our ethics.

By play I mean allowing the emergence of imaginal material into conscious awareness. When my clients are “playing” they can allow thoughts, feelings, fantasies, and other material into conscious awareness, into the psychotherapeutic space which if the psychotherapy is working is a playspace. Some might say that this isn’t play at all, that this is too serious to be called play, but I think this kind of objection limits play to certain associated feelings, like joy, or associate it only with acceptable kinds of emerging imaginings. Play is broader than that; it can be serious. C.G. Jung writes:

The dynamic principle of fantasy is play, a characteristic also of the child, and as such it appears inconsistent with the principle of serious work. But without this playing with fantasy no creative work has ever yet come to birth. The debt we owe to the play of the imagination is incalculable (1921/1990, par. 93).

These ideas about play may not seem objectionable or new to many. As I write this, I even imagine some saying “you aren’t saying anything new: of course play is serious and what emerges in play is often filled with what Jungians call ‘shadow.’ We know all kinds of objectionable material arise in both the client and therapist.”

The focus on microethics, however, is a call to remember the ethos underlying our work--that the creation of a playspace and the emergence of imagination are central to the effectiveness of what we do. This is important because allowing play and space to imagine isn’t always easy. In my experience as a therapist, I have had many “psychotherapy refugees” drift into my consulting room. These are people who have been hurt in previous experiences with psychotherapists in a variety of ways, many of those involving the therapist’s difficulty with play—a core ethos of psychotherapy.

Let me give you a sense of what a therapist’s difficulties with play looks like through several typical (and highly schematized) examples. A woman comes to see me after leaving her prior therapist. She tells me that she has been engaging in extra-marital sexual intimacies with men over the internet (they never meet in vivo). She has left her former therapist because she was told by him, “you shouldn’t be doing that, you are married.” She complains that her former therapist did not help her understand what might be going on with her. They couldn’t imagine together what might be fuelling her behavior which was also very distressing to her. And then there is a female client who tells me that she has had previous therapy, “years ago,” and was unsure whether she should seek further help. “I thought my therapist was harsh sometimes and I felt ashamed and criticized for things I brought up. When I told her how I felt, she would tell me that she was ‘not like that.’ We never really talked about my perceptions of her and I didn’t make sense of my feelings.” Another client says, “I left after many years in a Jungian analysis. I stayed even after things became ‘fake’ between us. Things really changed when I asked for a reduced fee and he got angry and said he wouldn’t do this. We never really connected after that.”

In these examples, the imaginal material that might have emerged was not at “play,” because the playspace was not held or provided by the therapist. Play is defined as “an engagement in” and “moving freely or operating freely within a bounded space” (American Heritage Dictionary, 2011). The psychotherapeutic effort to at least understand what is happening in the psyche was nonexistent in these instances—there was no play, “no engagement in.” The therapist did not provide a “bounded space,” which is what allows our clients the freedom to engage safely. It is this “bounded space” that can help us expand our consciousness by alleviating some of the anxiety of the repercussions of our thoughts and imaginings—for example, it may help us try things out without the fear of making social mistakes. It creates an “as if” attitude where we can consider possible actions without the commitment to those actions and thus allows us to examine and reflect upon ourselves.

Unfortunately, despite its centrality to psychotherapy, this playspace is not always present. We shut our clients down, cut off the imaginal wellspring that can be healing. How different it would be for the woman requesting a fee reduction from her analyst to be met with curiosity. She might discover in an active playspace how money is symbolic of love and security, discover her regressive longings to be cared for and valued, as well as her fears surrounding adult agency and her unrealistic expectations of others. When the door is shut to her impulse to ask for a reduced fee, the thread to the fuller story is also lost.

II

There is a charming story in C.G. Jung’s autobiography, Memories, Dreams, Reflections (1989, pp. 36-39), that sheds light on our difficulties with imagining and playing. Jung writes that when he was 12 years of age, he came out of school and went to the Basel cathedral square. It was there that he began to have the inkling of an emerging thought. It was a thought that greatly disturbed him and which he resisted for several days, saying of this thought that he would be “committing the most frightful of sins” to allow it to enter his conscious awareness. His distress was such that his mother “noticed that something was wrong.” He resisted telling his parents out of fear of causing them “intense sorrow.” Despite his great turmoil, Jung “let the thought come:”

I saw before me the cathedral, the blue sky. God sits on His golden throne, high above the world—and from under the throne an enormous turd falls upon the sparkling new roof, shatters it, and breaks the walls asunder.

Jung had a difficult time simply allowing the thought become conscious. To do so, he says, would be “doing” something “against my own moral judgment.” I want to stress that in his 12 year-old understanding, to think the thought is to “do” something. Is thinking the same as doing? Some might say not. After all, aren’t our minds private? But then what if we phrase the question this way, does thinking a thought through do something to us? I think some (not all) thoughts do. And then if it does change us, won’t that also have an effect on our family, or a group we might belong to?

Like Jung, our clients have difficulties thinking thoughts through. This occurs for a variety of reasons, not always because the thought is strictly taboo. Yet the issue is similar—there is something in the psyche which cannot be brought into conscious awareness for one reason or another.

When we focus on the microethics or purpose of our psychotherapeutic endeavor, we remember that a playspace is needed for the emergence of conscious awareness. This playspace has several elements, many of which are aptly described by the psychoanalysts Gabbard & Lester who describe the “analytic frame” as “an envelope within which the treatment itself takes place:”

Among other things, the analytic frame creates an atmosphere of safety. Powerful affects can be mobilized without fear of impingement or humiliating criticism from the analyst. The patient is given ‘space’ to regress and to allow unacceptable unconscious wishes and feelings to emerge (2003, pp. 39-41).

Returning to my examples above, the woman engaging in extramarital internet intimacies, if she is met with an attitude of curiosity and invited to enter the playspace, she may discover that she has difficulty with sexual intimacy when it is paired with emotional intimacy. In asking the questions, this client may discover that she has sexual needs and has difficulties filling them in her emotional attachments—splitting them because of earlier feelings of guilt over incestuous longings. The whole of her story begins to emerge as she follows the thread of her behavior. This is possible when the playspace is at work.

There are various rules in our professional standards of conduct that can be interpreted as safeguarding this essential playing function of psychotherapy. We are prohibited from dual relationships that might impact our ability to be “objective,” for example (APA, 2002). Some guidelines prohibit us from seeing family members (LPC Board, 2012). Imagine that Jung had confided in his parents. What might their response have been? The microethics of such rules points to the need for an objective or nonjudgmental stance that allows for imaginal, regressive, unacceptable parts of the psyche to emerge.

III

I want to address some working thoughts on the ethics and microethics of a therapist’s use of his own imagination. I have heard other professionals quite seriously say, “There are no ethics to the imagination.” I would agree, much as I would agree with St. Augustine, when he relinquishes responsibility for the content of his dreams. I learn a great deal from my imaginings while in session with others. My imaginings are not just peculiar to me but serve to inform me of what is occurring between me and my client. This has been much written about (Ogden, 2001). The ethical questions mostly arise in the disclosure of our imagination. Disclosures of our imaginings have an effect on our clients. The use of our imaginings might be informed by the microethical perspective that much of what we seek to do is to provide a playspace for our clients. The how, what, and when of our disclosures can either impinge or aid our client’s own process--their ability to continue playing and imagining.

Suppose for example, a female client, in session, working on issues related to her sexuality and her attractiveness, looks up at her therapist and asks, “What are you thinking?” He responds, “I was thinking about you taking off your sweater.” He sees the shocked look on her face and says bemusedly, “you asked.” The therapist in this case is not responsible for his imaginings. It is not wrong or unusual to have sexual feelings and in fact, his imaginings and feelings provide a great deal of information about what might be at work for the client. His disclosure, however, has impacted her ability to continue to play and imagine. There are many responses this client may have. She might actually take off her sweater. Or, she might feel shame and embarrassment. Or, she might experience fear that her therapist might concretize his feelings. With all of these responses, the play, her ability to “move freely or operate freely within a bounded space” might be lost. The therapist is bemused. “Playful,” he might say. He has however interrupted her play.

Carolyn Bates, a Jungian analyst, had this to say about a therapist’s disclosures: “People sometimes think analysis is about being honest with whatever comes to mind, but it is more about being mindful about what comes to mind, and how one shares it” (Personal communication, March 13, 2013). Our imaginings, our feelings and thoughts, might be shared if it supports our client’s process, if it keeps the playspace alive for them to continue to “engage in” their imaginings. When we share our thoughts, we are “doing” something to our clients. The microethical perspective would ask: is this “doing” in keeping with the purposes of psychotherapy, which in my perspective is essentially about providing a safe playspace in which our clients might discover themselves?

References

American Psychological Association (2002/2010 Amended). American Psychological Association ethical principles of psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/code/index.aspx

Angelou, M. (1980). I know why the caged bird sings. New York, NY: Bantam Books. (Original work published 1970)

Gabbard, G.O. & Lester, E.P. (2003). Boundaries and boundary violations in psychoanalysis. Washington, DC: American Psychiatric Publishing. (Original work published 1995)

Jung, C.G. & Jaffe, A. (Ed.), (1989). Memories, dreams, reflections (Richard & Clara Winston, Trans.). New York, NY: Vintage Books. (Originally published 1961)

Jung, C.G. (1990). Psychological types (H.G. Baynes, Trans.). In H. Read et. al. (Series Eds.), The collected works of C.G. Jung (Vol. 6). Princeton University Press. (Original work published 1921)

Ogden, T.H. (2001). Reverie and metaphor: Some thoughts on how I work as a psychoanalyst. In Conversations at the frontier of dreaming (pp. 17-46). Northvale, New Jersey: Jason Aronson. (Original work published 1997)

Play. (2011). In the American Heritage’s online dictionary (5th ed.). Retrieved from http://www.ahdictionary.com/word/search.html?q=Play&submit.x=37&submit.y=12

Texas State Board of Examiners of Professional Counselors, 22 Tex. Admin. Code, 22 Tex.Admin.Code §681.41l (2002).