In the Name of Psychoanalysis: Persistent Controversies and Evolution in Psychoanalysis: A Review of Impossible Training: A Relational View of Psychoanalytic Education by Emanuel Berman

In his book Impossible Training, Emanuel Berman stresses the historical roots of current standards of psychoanalytic training and demonstrates the persistence of controversies that have been present in psychoanalysis and psychoanalytic training from their inception. This perspective, of psychoanalysis and psychoanalytic education as evolving, encourages candidates and practitioners to be participants and creative voices in an evolving field rather than rote followers learning a trade. The author proposes ways that the transference of educators to the younger generation of psychoanalysts can facilitate or interfere with the training of candidates. Berman is applauded for shedding light on current controversies in psychoanalytic education by showing their roots in historical controversies. However, the author points out Berman's tendency to overvalue his side of the controversy rather than embrace controversy itself as in the best interest of the evolution and development of the field.     

BECOMING RELATED: THE EDUCATION OF A PSYCHOANALYST

The author uses a “professional memoir,” a story about his first experiences in clinical work, to illustrate what he believes to be certain fundamental aspects of an analytic attitude. Taking place in a psychiatric hospital, it is meant to highlight the central place of intuition, emotional receptivity, empathy, relatedness—and their inherent dangers—in engaging therapeutically with patients' emotional disturbances. The author postulates that these and related aspects of clinical psychoanalysis are not sufficiently emphasized in psychoanalytic training and are often eclipsed by idealizations of psychoanalytic theories and their derivative techniques, third‐party demands for evidence‐based data, preoccupations with neurobiological correlates of experience, etc. Despite the clinical fact that psychoanalysis can be extraordinarily helpful to patients, he questions whether clinical psychoanalysis is rightly regarded as a “treatment.”     

A Plea for a Measure of Cautious Optimism: Reply to Book Reviews

The author responds to four reviews of his book Impossible Training. He describes how the book came into being, discusses his attitude to the Freud—Ferenczi and Klein—Winnicott debates, and raises the dangers of rigid views as to what is truly psychoanalytic and what is truly relational. The global scene of psychoanalytic training today is discussed. It is suggested that critiques do have an impact on psychoanalytic education and that in spite of its flaws and inner contradictions, this education raised generations of sophisticated thinkers and sensitive clinicians.     

Die Destruktivität in der psychoanalytischen Ausbildung

In this study, a survey of all criticism of psychoanalytic training and of the from its beginnings formulated problems is given. Doing so, the presented literature covering the issue is discussed from four perspectives: the candidate’s perspective, the socio-political perspective, the perspective of power and the perspective of professionalization. The latter perspective involves historical aspects too and thus shows the resistance towards change, proposes solutions and therefore may be deemed to be especially relevant. In order to summarize the criticism regarding psychoanalytic training, a systemic model was developed including its systemic structure, organizational aspects and its content. Furthermore, ten hypotheses are developed as to why psychoanalytic training proves to be to a large extent resistant to change. Against the background of the existing situation in training, current job-political conditions and changes for present trainees are presented and existing exacerbations are pointed out. Ignoring these aggravated conditions and simultaneously tightening and regimenting training guidelines are understood as a destructive process for psychoanalysis and its training by the author. At the same time it is pointed out that the presented problems are not related to one single psychoanalytic society, but have been developed over decades throughout different psychoanalytic societies and countries and therefore seems to be an international problem of psychoanalytic organizations. Finally, preexisting propositions for changes are discussed, and fourteen solutions, which could help to renew future psychoanalytic training, are shown; this may also serve as a plea for a basic reform in training and organization. Regarding a reform of the training, the author deems all three issues to be relevant: the systemic-structural aspect, the content and the organizational aspect.     

Hidden gifts of love: A clinical application of object relations theory

Using an extended clinical example, the author applies aspects of Kleinian, Fairbairnian, and Bionian theory to demonstrate how individuals may come to hide away feelings of both love and aggression. In the clinical material presented, a version of a schizoid retreat was understood as a pervasive response to trauma. The author attempts to explore more specifically the nature of a ‘traumatizing outer world’ ( Guntrip, 1969 ) and how these experiences cause an individual to retreat and undermine movement toward healthy adult dependency. An understanding of these dynamics helps inform the psychoanalytic treatment process and can serve as a type of roadmap in navigating through challenging transference–countertransference enactments.     

Psychoanalysis in the university: A full‐time vision1

Psychoanalysis may be unique among scholarly disciplines and professions in having grown as an educational enterprise in a private part‐time setting, outside the university. Freud would have liked it to be otherwise, but in Central Europe, when it was created, university placement was not possible. In America, after World War II, the concept of the medical school department of psychiatry psychoanalytic institute was established in some psychoanalytic training centers but it could only partly overcome the educational and research inadequacies of traditional psychoanalytic training. The possibilities for a true university‐based full‐time training structure are explored.     

A Warrior's Stance: Commentary on Paper by Terry Marks-Tarlow

This commentary highlights specific aspects of a psychoanalytic complexity perspective in considering and discussing Terry Marks-Tarlow's article, “Merging and Emerging: A Nonlinear Portrait of Intersubjectivity During Psychotherapy.” The advantages of a complexity theory sensibility reside in the areas of (a) providing a robust theoretical framework for understanding the sources and phenomenology of complex emotional life and (b) understanding the clinical implications of thinking through a complexity theory lens. The latter involves examining the attitudes that emanate from such a revolutionary perspective and their impact on the therapeutic relationship and on therapeutic action and change. Special emphasis is placed on the distinction between two vital dimensions of psychoanalytic discourse: the phenomenological and the explanatory. This distinction is used as a lens through which the author considers the essential themes of understanding the complexity of the multiple sources of personal lived experience and their concomitant meanings, personal situtatedness (or “thrownness”), emotional responsibility, and personal freedom.     

CLINICAL WINNICOTT: TRAVELING A REVOLUTIONARY ROAD

The author contends that, contrary to the usual perception that Winnicott followed a linear progression “through pediatrics to psychoanalysis,” Winnicott's vision was always a psychoanalytic one, even during his early pediatric work. His place in the development of psychoanalytic theory is highlighted, and the author discusses such key Winnicottian concepts as transitional space, the false self, and the use of the object. Winnicott's unique approach to the form and value of analytic interpretation is particularly emphasized, and his thoughts on the treatment of depression are also addressed, as well as his distinction between regression and withdrawal. Included is a summary of convergences and divergences between Winnicott's thinking and that of Bion.     

Psychoanalysis and University in Brazil: Possibilities and Limits of This Articulation

The goal of this article is to clarify some of the aspects concerning the academic teaching and research that is carried out in the field of psychoanalysis in the Brazilian Universities, versus the transmission and training in psychoanalytic institutions. The author describes how psychoanalysis is present in the Brazilian university context, from undergraduate to graduate studies, and also points out perspectives regarding the future of psychoanalysis in Brazil.     

INSIGHT AGONISTES: A READING OF SOPHOCLES'S OEDIPUS THE KING

In this reading of Sophocles's Oedipus the King, the author suggests that insight can be thought of as the main protagonist of the tragedy. He personifies this depiction of insight, calling it Insight Agonistes, as if it were the sole conflicted character on the stage, albeit masquerading at times as several other characters, including gods, sphinxes, and oracles. This psychoanalytic reading of the text lends itself to an analogy between psychoanalytic process and Sophocles's tragic hero. The author views insight as always transgressing against, always at war with a conservative, societal, or intrapsychic chorus of structured elements. A clinical vignette is presented to illustrate this view of insight.     

Rapprochement in Sight? Postmodern Family Therapy and Psychoanalysis

This paper explores aspects of the theory and practice of psychotherapy with the aim of identifying similarities in the approaches of both family therapists and psychoanalytic psychotherapists. The author calls for a dialogue between the disciplines, and makes specific reference to the potential value of this in relation to training and research.     

BEFORE BABEL: REFLECTIONS ON READING AND TRANSLATING FREUD

The author offers some thoughts on reading and teaching Freud, on translating Freud, on translation in general, and on a possible kinship between translation and the psychoanalytic process. His reading of Freud's works, and the years he spent translating them into Hebrew and editing Hebrew editions of his writings, have made a deep and salient impression on his personal psychoanalytic palimpsest. The author began this labor prior to his psychoanalytic training and has no doubt that, to this day, the experience greatly shapes not only his attitude toward Freud himself, but also the nature of how he listens to patients and the way he thinks and writes about psychoanalysis.     

The coming changes in psychoanalytic education: Part I

The author presents a critical overview of the literature on psychoanalytic education, focusing on criticism regarding structural aspects of our educational institutions. He then presents arguments for the need of radical changes in the organizational structure of institutes, and focuses on the problems of the training analysis system. He proposes concrete solutions for these problems, in the form of changes both in the assignment of responsibilities for the personal analysis of candidates and in the selection and function of supervisors.     

The coming changes in psychoanalytic education: Part II

This paper is the second part of a general analysis of problems in contemporary psychoanalytic education. Having proposed changes in the training analysis and supervisory systems in Part I, here the author focuses on concrete proposals regarding changes in the curriculum, seminars and classroom teaching; the governance of psychoanalytic institutes, relationship of institutes with their respective psychoanalytic society and the role of the university in the development of science and research; the admission, progression, and graduating processes; certifi cation and accreditation.     

PSYCHOANALYSIS IN CHINA: AN ESSAY ON THE RECENT LITERATURE IN ENGLISH

Using extensive quotation, the author reviews the introduction and current state of psychoanalysis and psychoanalytic psychotherapy in China from the vantage point of recent publications in English. Psychoanalysis was briefly introduced to China before the Communist era, then forbidden, and has experienced an accelerated reintroduction since the late 1980s. The author briefly summarizes the cultural and historical background of China relevant to the introduction of psychoanalysis, the traumatic history of China, and the deep structure of thought and philosophical differences from Western culture that challenge a simple imposition of psychoanalytic ideas and practice, and some psychological effects of rapid cultural change throughout China. Training programs in China, the general enthusiasm for analysis among the Chinese, and a number of notable contributions by Western and Chinese authors are discussed. Also surveyed are the use of distance technology for training and treatment, the personal experience of Chinese senior and junior colleagues, and ongoing challenges to the continuing growth of psychoanalysis and analytic psychotherapy in China.     

Training analysis in the dutch society for psychoanalytic psychotherapy: A survey of attitudes and feasibility

SUMMARY

As is the case in many training courses in psychoanalytic psychotherapy, one of the training requirements of the Dutch Society for Psychoanalytical Psychotherapy (NVPP) is a training analysis, currently a minimum duration of 700 hours. During the last few years, this requirement has become somewhat controversial. Because the NVPP does not have information about the current interest in NVPP membership, the Board of the NVPP decided to do a survey. Of 995 psychiatrists, clinical psychologists and psychotherapists, who had recently completed their training, or were still in training, 623 filled in a questionnaire. Of those who are interested in the NVPP training, 39 per cent judged the training analysis as not feasible in terms of time, and 61 per cent in terms of money. Forms of personal treatment thought desirable for anyone who wishes to become a psychoanalytic psychotherapist at a specialist level are, in descending order, psychoanalytic psychotherapy (63%), psychoanalysis (39%), psychoanalytic group psychotherapy (25%), and psychoanalytic marital or family therapy (6%). Respondents who judge personal analysis as not feasible, also tend to judge psychoanalysis to be equivalent to other forms of psychoanalytic psychotherapy, whereas those who judge personal analysis as feasible, tend to think that personal analysis is essential for a psychoanalytic psychotherapist at the specialist level.     

Countertransference, supervised analysis, and psychoanalytic training requirements.

Because psychoanalysts have an ever expanding appreciation for the many factors that contribute to the psychoanalytic treatment process, they no longer view themselves simply as the receiver of the patient's transferences. When patient and analyst meet in the consulting room, they bring along with them a blend of intrapsychic and external ingredients--including countertransference--that make up the analytic soup. Candidates in psychoanalytic training must contend with even more sources of indirect countertransference reactions (Racker 1968) than experienced graduate analysts, due to aspects of the training experience itself. The author contends that minimum graduation requirements for supervised analyses are one such source of indirect countertransference. Four clinical examples of control analyses demonstrate this form of indirect countertransference during the assessment, opening, middle, and termination phases. These examples are followed by implications and recommendations for didactic psychoanalytic training curricula, countertransference awareness, supervision of control cases, institute governance policies and procedures, publication of clinical material, and future research.     

A Mixed Bag: The Realities of Psychoanalytic Practice

For a variety of reasons, psychoanalytic training is done in somewhat of a vacuum. It teaches a theory and a way of practicing that does not always translate well to day-to-day private practice work. The clinical realities of psychoanalytic practice prove the psychoanalytic method to be one that provides help to a wider audience than classical psychoanalytic training programs might suggest. The psychoanalytic approach offers the analyst many special opportunities to work with and help a wide variety of patients. Analysts who accept both the limitations as well as the wide application and broad benefits of the psychoanalytic approach may have a more fulfilling experience than their training experiences might foster. At the same time, the analyst's level of therapeutic skill, the patient's diagnosis, and many multiple external factors create different limitations in the practice and outcome of psychoanalytic work. Extensive case material is used to show the broad range of patients who are helped by the psychoanalytic method. The clinical material also shows the less than perfect, but often good enough outcomes of these difficult cases with often severely disturbed patients.     

THE DIDACTICS OF PSYCHOANALYTIC EDUCATION2

The author first discusses general didactic considerations regarding psychoanalytic education and the teacher‐pupil relationship. He then demonstrates that psychoanalytic education is greatly influenced by the ideal of a liberal education, of which in Germany there is a strong tradition under the name ‘Bildung’. The main characteristics of ‘Bildung’ ‐ as opposed to professional training ‐ are that the objectives remain undefined and there is no attempt to achieve defined and operationalisable professional qualifications. The relationship between teacher and pupil is characterised by authority and trust. A psychoanalytic education by means of a ‘liberal education’ is based upon the assumption that the student should be motivated and supported in achieving competence through a passionate study of the world of psychic reality. Today, however, psychoanalytic education must be seen within a contemporary context that forces us to abandon the ideals of a liberal education, to operationalise the subjects studied and to control the education itself with regard to efficiency and results. These modern demands are the result of a professionalisation which has reached all social professions and from which psychoanalysis also cannot escape. Because of this, it is especially important to reflect on our educational methods and objectives. The author makes several suggestions on this subject. It is to be hoped that psychoanalysis will find its own way, without, on the one hand, losing sight of the special nature of psychoanalytic competence through an over‐hasty adaptation to the process of professionalisation and, on the other hand, without reverting to unquestioned and outdated ideas on education.