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Freudian psychoanalysis reveals changes in confidentiality and personhood in patients using digital platforms, suggesting a need for ethical adaptations.
Freudian psychoanalysis holds a conception of personhood in which patients are divided by a conflict between their outward presentation and their hidden, inner turmoil. The Freudian analyst too is split, occupying a position within the patient's internal dialogue while also listening in from outside of it. Addressing the analyst as both self and other, the patient's confidentiality is necessarily preserved but also inherently violated. As digital technologies reshape psychic structure, this paradox in confidentiality, constitutive of the analytic situation, may no longer arise. Personhood in the digital age is arguably less grounded in the patient's internality and instead diffused into a distributed, online self. How should our analytic task-including the preservation of confidentiality-be altered for patients who construct their selves in external digital networks? Whether the patients' growing disregard for privacy and evacuation of innerness is a defensive resistance or a tectonic shift in the structure of the psyche, the analyst must remain committed to an ethics in practice, as abstinence, neutrality, and anonymity (confidence) are not only gestures of professional respect for the analysand but in situ features of a successful treatment, features whose intransigence safeguards the fundamental rule and so makes it possible to vary other aspects of technique to discover what complementary subject position best frees the patient's desire, regardless of the shape of her psyche (Report on Confidentiality, 2018, p. 6).
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Evens et al. (2025) studied this question.
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