On Getting it Wrong

Abstract

Abstract This chapter discusses the importance of recognizing the ubiquity of therapist error and treatment failures. It considers different forms of ‘when things go wrong’ in an analytic dyad. This can cover, for example, misjudgements, lapses in attention or moments of misattunement. The term ‘violation’ is reserved to describe actual physical and/or sexual transgressions and sustained emotional abuse of the patient to meet the therapist’s own needs. Within the broad category of ‘getting it wrong’, two types of ethical breaches are distinguished: one that leads to fracture, that is it breaks the analytic relationship irreparably; the other creates a relational gap, which if mentalized, can potentially be transformed into an opening that adds perspective to the work of therapy. The chapter discusses occupational risks around boundary issues (fees, confidentiality, and endings) and the specific ethical risks of online therapy.