A training analysis for psychoanalytic psychotherapists

For historical reasons, psychoanalytic psychotherapy has been regarded as a second-class treatment in comparison with psychoanalysis, and standards for training in it have lagged behind those for psychoanalysis. However, psychoanalytic psychotherapy is the treatment of choice for many healthier (or higher-level) patients who cannot receive analysis for any reason, and also for a large population of more-disturbed patients who are not appropriate for psychoanalysis. Mastering techniques of psychoanalytic psychotherapy may be as difficult as mastering those of psychoanalysis, and should require comparable theoretical training, supervision, and personal treatment. This "development lag" in the training of psychoanalytic psychotherapists has taken place for several reasons: (1) Psychoanalytic ideas first emerged in America in the context of a new movement toward an electric, but dynamic psychiatry from which psychoanalysis had to establish its separate identity. (2) Psychotherapy was associated with techniques of suggestion and manipulation from which psychoanalysis wished to separate. (3) Because psychotherapy was seen as an inferior form of therapy which required little training, institutes were slow in being established, and reluctant to require a "training analysis." It is suggested that with the full training of psychoanalytic psychotherapists, this discipline may be regarded as a profession comparable to psychoanalysis. It is further suggested that the optimal treatment for the full training of the psychoanalytic psychotherapist is psychoanalysis, and that a "training psychotherapy" is not an adequate substitute, but may provide a transitional step to resolve initial resistances and to prepare the therapist for a training analysis.     

The impact of graduation from psychoanalytic training

To examine candidates' experience of graduation from psychoanalytic training, 1997-2001 graduates of the Columbia University Center for Psychoanalytic Training and Research were sent a confidential questionnaire about their first year after analytic training. Of this group, 72 percent (23/32) returned the survey. Questions focused on the impact of graduation on time availability, net income, professional advancement, and sense of personal and professional autonomy. Graduates from analytic training were found to have more income in their first postgraduate year, a mean increase of 30,000 dollars, and more available time, a mean increase of sixteen hours. Increased earnings came primarily from seeing more patients during the time made available with the end of classes. In addition, graduates did not terminate their control cases or stop supervision. Graduates most valued their sense of professional accomplishment and ability to spend more time with their families. Although graduates also experienced relief from evaluation pressure, they did not rank this high in importance. For candidates, graduation profoundly impacts the structure of professional and personal life, but does not mean an end to learning.     

IUSAM-APdeBA: A higher education institute for psychoanalytic training

The history of the last century shows the almost constant presence of psychoanalysis in the academic setting and, simultaneously, the incredible absence of analytic training at the universities. This paper outlines the project of the Buenos Aires Psychoanalytic Association (APdeBA) to create a higher education institution of its own (IUSAM) specifically aimed at lodging psychoanalytic training within a university setting. The project was approved by the Argentine educational authorities in 2005 and received the economic support of the International Psychoanalytical Association (IPA). The academic structure of the university is described, whose goal is broadened to the interdisciplinary field of mental health with psychoanalysis as an integrating axis. Some of the characteristics of the traditional 'university model' as well as its relationship with psychoanalysis are pointed out. With the IUSAM, psychoanalytic training is not included as a part of an already established university, it rather creates a new one, with the support of a well-known psychoanalytical association (APdeBA) which endorses its activities and guarantees its identity. IPA's requirements for analytic training (didactic analysis, supervisions and seminars) have been fully preserved in this new context. Finally, some of the advantages and disadvantages of including analytic training into an academic environment are listed .     

The value of infant observation in the psychoanalytic training

The following case report is an attempt to describe how infant-mother observation is an exercise in a psychoanalytic mode of thinking and reacting, developing knowledge of object-relation theory. The aim of infant observation is not therapeutic; however, this paper suggests that it also might have a therapeutic side effect, creating mental space for the mother and thereby, helping her from becoming too engulfed by the intensive needs of the baby.     

The French model of psychoanalytic training: Ethical conflicts1

Research on psychoanalytical education within the IPA may be clarified by reflecting on the ethic behind each of the three main models (Eitingonian, French and Uruguayan). In fact, the ethic underpinning psychoanalytical education, whatever the model, is confronted by irreducible conflicts between transmitting psychoanalysis by means of analytical experience or by means of academic teaching. Transmission by experience is essentially based on the ethic of psychoanalytic practice, which is difficult to regulate through institutional standards, whereas the academic aspect can be evaluated by objective and public criteria. The importance of both aspects and their relative weight in the training process depend on the conception of psychoanalysis underlying each model. This paper will look primarily at the French training model, the essentially analytical aspects of which favour the transmission of the very ethical foundations of psychoanalytic practice itself: the application of the method both as a working tool and as a tool of evaluation. It presupposes expanding the observation and analysis of transference beyond the framework of treatment to that of supervision. From this analysis, the paper will attempt to demonstrate how the French model proposes dealing with the inevitable conflicts between transmission by means of analysis and training by means of apprenticeship.     

Between paranoia and creativity: candidates' experience of psychoanalytic training

There is widespread concern regarding various aspects of psychoanalytic education. A recent paper by Patrick Casement, drawn widely from his long experience as a supervisor both in the U.K. and abroad, implied that the British Psychoanalytical Society is not exempt from these concerns. To investigate this, a semistructured, anonymous questionnaire was devised and sent to all candidates and all recently qualified analysts at the society. Overall there was a 58% response rate, with 77% of candidates and 39% of recently qualified analysts responding. Concerns were expressed about aspects of the training, but on the whole these were balanced by appreciation. Although strong criticism was expressed by a minority, it seems that when something goes wrong for a candidate, this experience is felt keenly by the peer group as well. The results are discussed in the context of the current training and ethos of the British Society, as well as in relation to a more widespread move toward "competency-based" education. The maturational tasks facing both candidates and trainers are also addressed.     

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.     

The Emperor's clothes: Some serious problems in psychoanalytic training

The author discusses some of the key problems in psychoanalytic training, in particular those problems that stem from the power differential between training analysts and students in training. One effect of this differential can be that some students feel a pressure to comply with their teachers and supervisors, even their training analyst, in ways that can be seriously detrimental to their development. Further, when something goes wrong in a student's training, how is this to be viewed by those in charge of the training? Also, how are complaints dealt with? Is suffi cient weight given to external reality? Too often training analysts, and training committees, get into pathologising a student in a process that should be recognised as ‘wild analysis in committee’, rather than considering more carefully the external realities that may be affecting a student's progress in the training. This ‘analysis’ in committee should never be allowed. There is an urgency for immediate changes to be made in psychoanalytic training so that the problems discussed, with more care being taken, should be prevented from happening. Too often, however, an institutional resistance to change dominates discussions in committee, and in society meetings, with the result that little or no change takes place even after years of debate.