1. Psychotherapy and Ethics

Freud had little patience with the idea that psychoanalysis could teach us anything about ethics, and his belief that he was developing a new science in accordance with the philosophy of science of his day underlay his view that his creation was value free. But psychoanalytic psychotherapy is not value free, and it could hardly be expected to be given that ethical issues are the very stuff of psychotherapeutic practice. Those who hope that they might learn something from it about ethics nevertheless face two major obstacles. The first is that it based on an ethic: the value of the individual and the alleviation of suffering. It does not, however, follow that it's pointless to explore this ethical underpinning. It’s actually important for us to do so in order to see, for example, if the values expressed are internally consistent or whether they unwttingly collude with the forces in the culture that actually contribute to individual suffering.

The second problem is that of free will. As Foucault remarked towards the end of his life ‘free will is the ontological condition of ethics’; but Freud was a determinist, and the experience of practitioners tends to undermine any easy assumptions about our personal agency. Two hundred years before Freud, Spinoza struggled with the same dilemma. Like Freud, he was a determinist, but he argued that we have to hold people responsible for their actions and that a sense of personal autonomy is important for us. Perhaps what we need to do, therefore, is to study the conditions in which we feel we are free. As one of his biographers points out, this turns the whole question into an empirical one: a matter of observation and psychology. Spinoza’s answer to the question, which derives from his metaphysics, is that we feel free when we are obeying our own necessity, by which he means when we act according to our nature as part of nature. The stories of four patients illustrate the argument, and the chapter concludes with the suggestion that Spinoza’s thinking is relevant to the psychology of the ‘scourge’ in another way in his contention, again derived from his metaphysics, that the idea of a god external to his creation as opposed to an immanent god, is one of the mainstays of theocratic tyranny.