Seeking an Analytic Identity

Abstract

Rothstein has stimulated all analysts to rethink how we can better commit ourselves to our analytic work. In this paper I focus on factors in analysts' personalities and experiences in their training and practice that contribute to or distract from establishing an analytic identity.

First, I explore analysts' background and motivation. In admissions to psychoanalytic institutes we look for candidates who can see psychoanalysis as an intellectual puzzle to be solved and an emotional involvement to be experienced. We look for earlv conflicts that the candidate can sublimate in the service of analytic functioning. We assume that the capacity to sublimate is only partial and that analysts in their development continue to recognize conflicts in transference—countertransference reactions.

Second, I give some examples of experiences from analysts' training that stimulate the formation of their analytic identities. These include transient identifications and counter-identifications with the training analyst, supervisor, seminar leader, and favorite analytic authors.

Third, I discuss more external factors that influence the development of analytic identity. These include the climate in training and continuing education at the institute. How much does the institute support its members in immersion in psychoanalysis? Economic factors continue to he an important factor in determining individual choice in this immersion.

Finally, I review studies on the effectiveness of psychoanalysis. Dedicated analysts with considerable experience believe that analysis works despite some limitations. Part of high motivation to continue analytic work includes understanding how analytic results differ from the simpler solutions achieved by nonanalytic therapies.     

WORKING WITH RELIGION: OFTEN NEGLECTED ASPECTS OF TRANSFERENCE AND COUNTERTRANSFERENCE

The author contends that psychoanalytic theory has generally presented religious beliefs as developmentally immature or pathological. This viewpoint has resulted in a neglect of religion on the part of psychoanalysts and an avoidance of their religious life by patients. Even though there has been an evolution from the traditional Freudian foundational approach to religion as an “illusion” to the inclusion of psychoanalytical training within some Christian institutes and attributions that psychoanalysis, itself, is a religion, religious beliefs should be included in psychotherapy because they can become involved in transference and countertransference issues in ways that are ignored if religious issues are not discussed in therapy. The author presents clinical material to illustrate this problem.

     

Psychoanalytic Training: The “Faculty System”

The primary and ideal version of the task faced by training institutes is simple: to help aspiring candidates become competent. Candidates receive assistance in developing their knowledge and skills as practitioners. But to look at training more closely is to see a far more complex set of demands and expectations. Indeed, training as it is actually conducted in most institutes can easily seem inconsistent, contradictory, and, at times, self-defeating. Moreover, in the golden age of psychoanalysis, training was considerably more haphazard and casual than it has become, but our efforts to become more systematic and thoughtful about training coincide with a general decline in our level of originality. Why has training, the development of competence, seemingly so clear and simple a task, become so complex and confusing?     

Killing Me Softly

Abstract

“Forced termination” of psychoanalysis occurs when the analyst electively terminates the treatment for reasons of his own, independent of the clinical indications for termination. The author describes his own experience with the forced termination of his training analysis. The literature is reviewed, with an emphasis on the attitude of each author regarding the straggle around the decision. The author explores sources of general ethical knowledge, the ethical foundations of the analyst-analysand relation ship, and the application of these ideas to psychoanalysis. From these princi ples, the ethical problems of forced termination are derived and examined. The author proposes reforms to address these problems.     

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.     

Couple Psychoanalysis in the United Kingdom: Past,Present, and Future

ABSTRACT

The evolution of couple psychoanalysis in the United Kingdom is historically rooted in, and currently supported by, what might be called the Tavistock tradition, which principally derives from the work of Tavistock Relationships, a London-based organization combining clinical practice, training, and research. Practitioners working within this tradition draw on a range of psychoanalytic theories and differ in the ways they are applied in clinical practice and with different client groups, but they are united by their focus on relationship dynamics and how these can be affected by unconscious processes. This article charts how the main ideas and practices associated with the Tavistock tradition of couple psychoanalysis came into being, describes the conceptual building blocks that provide the platform for current training and practice, and identifies nodal points that might indicate directions of growth in the future.     

Teaching the Candidate in Case Seminar

There has been insufficient focus on the impact and usefulness of the case seminar for teaching in psychoanalytic institutes. In order to better understand case seminar, questionnaires were submitted to candidates, graduates, and faculty in two psychoanalytic teaching institutes. The responses indicate that the case seminar format should be standardized; level of experience of candidates should be similar; professors should examine suitability of the case beforehand; and candidates need to be prepared for the group process. Findings are useful in improving the teaching of psychoanalysis and encouraging the creative use of the candidate's self in psychoanalytic training.     

Like a phoenix from the ashes – or “sack cloth and ashes”?:1 The reconstitution of psychoanalytic institutions in Germany since 1945 and its consequences

Abstract

Here, I attempt to formulate some thoughts about the past, present, and future of psychoanalysis and its institutions in Germany. To do this, I have employed my varied experience as a supervisor and consultant to many such psychoanalytic institutes over the past several years. Themes discussed include the history of psychoanalysis in postwar Germany, the organizational structure of German psychoanalytic institutes, and their cultures in regard to group and organizational dynamics, and political and economic aspects. Finally, I add brief thoughts about the future, taking into account recent developments relating to planned changes in laws governing psychotherapy in Germany. Further, I attempt to analyze and comment on: coming to terms with the past; how to begin after the “Zero Hour”; the form of organization of psychoanalytic institutes in Germany; missing patients and missing candidates; constructive debate and hurting people’s feelings; the lack of “detoxification” and “recycling” of the poisonous remains of psychoanalytic processes; and the future of psychoanalytic institutions in Germany. I end with an example of a typical primary task used in conducting large groups in the institutes in which I worked, and include an anonymized table listing individual interventions, their duration, and frequency. These should provide an idea of my way of working, and an overview of the dimensions of the task.     

The future of psychoanalysis and its institutes.

If the function of psychoanalytic training institutes is to train practitioners of psychoanalytic technique, it is unreasonable to expect institutes to offer effective training in research or other scholarly applications of psychoanalysis. But if one insists that the training of psychoanalysts should, at least in some instances, encompass more than the teaching of psychoanalytic therapy, the training institutes have been failing in their function to educate candidates for scholarly activities. Whether the structure of the independent training institutes can permit such broadened training is questioned. One solution is to move the educational function into the university setting.     

Themen der Ausbildungsforschung in der Psychotherapie

This review is based upon an appraisal of training research in psychotherapy showing that many questions are still unanswered. By means of a schema for the organization of research results that differentiates input, process and output variables, unselected results are summarized relating to issues such as the choice of the psychotherapeutic profession, pre-experiences of candidates, the selection of an orientation, personality factors, characteristics of training institutes, quality standards, as well as the organisation and structure of training programs. Process oriented studies mainly focus on the operationalisation and development of skills, the significance, the effects of and the satisfaction with training components. Finally, the output category comprises results related to graduation, to professional development during and following training and to the development of competence and its prediction.     

Psychoanalysis, the Anxiety of Influence, and the Sadomasochism of Everyday Life

After reviewing recent upheavals within psychoanalytic institutions and our diminished status in the worlds of academia, psychiatry, and the media, this essay turns to the historical trends that led to the current state of siege in which psychoanalysis finds itself—trends most clearly manifested on the East Coast institutes of the United States. I hypothesize that a legacy of arrogant entitlement on the part of the founding fathers made for an abiding institutional authoritarianism. This hierarchicalism fostered a loss of self-determination and individuation, negative Oedipal submission, identifications with the aggressor within psychoanalytic organizations, and a pseudospeciation with regard to potential critics in the outside world. Promising in many respects, nonetheless many of the current changes in psychoanalytic education and theory inevitably represent a positive Oedipal rebellion against the generation that had oppressed the one now in ascendancy and, more insidiously, a means of containing the candidates now in our charge. Finally, I argue that our future depends on our ability to embrace unwanted and disavowed truths about the history of our field and thereby to reclaim both our idealism and our credibility.     

Psychoanalysis and Social Work

Abstract

This paper traces the close relationship between psychoanalysis and social work after Freudian theory's dramatic impact on social work practice in the 1920s. It shows how revisions and expansion of psychoanalytic theory beyond its traditional base influenced clinical work during later decades until the 1960s, when society turned its attention to macrosystems intervention and other theoretical frameworks and practice models. The paper considers the impact of this change in emphasis on clinicians, direct practice, and schools of social work. Although it describes the resurgence of direct practice that occurred in the 1970s and 1980s, it discusses the reasons for the greatly diminished role of psychoanalytic theories in social work curricula. It concludes that there is little reason for optimism about psychoanalysis regaining a prominent position within the profession at the present time and comments on some implications of this state of affairs for those committed to advanced clinical training.     

Self‐supervision,surveillance and transgression

Transgression is not only an inevitable part of systemic supervision but is also necessary if we are to work towards innovative and inclusive supervisory and therapeutic practice. Defying culturally generated ‘rules’ of systemic practice can allow for more relevant and productive ways of talking. Systemic practitioners are increasingly finding themselves trying to practice systemic therapy in employing authorities and training courses which are dominated by inflexible professional narratives and manualised procedures. Our profession is committed to ethical inner and outer dialogue, to self‐ and relational reflexivity as distinct from the rule‐bound surveillance culture in which we live and work. Systemic supervisors and therapists may find themselves at odds with monological institutional discourse and attempts from within our own profession to manualise practice. I introduce examples from supervisory conversations to illustrate how supervisors can develop more culturally sensitive practices through supporting practitioners to hear and have heard their own marginalised and oppressed voices and those of their clients.     

Evaluating progress in training: character or competence?

Jung was mercurial in his attitudes to method and technique, leaving us a problematic legacy when it comes to evaluating the progress of trainees. Some would say that those of us involved with the assessment of candidates during their training continue to rely too heavily on intuition and subjective assessments. However good our admissions' procedures and the structures in place to review progress, the emotional and financial demands for trainees of embarking on an analytic training, the tendency for analytic institutes to remain opaque and slow to link up with the external world and the cliques within our profession make more objective assessments of progress and readiness to qualify at best haphazard and at worst inadequate. Some trainees have an immediate talent for analytic work; others develop their gifts more slowly; some never find this capacity. Working from a definition of analytic talent, the paper begins to map out a Jungian framework for assessing progress, emphasizing the significance of both character and competence and the developing relationship between them.     

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.     

Psychoanalysis and politics

Abstract

Following the trauma of Nazi persecution, mainstream psychoanalysis abandoned its concern for the unconscious elements in social and political processes. The self-restriction was given a theoretical justification by H. Hartmann in his psychology of the self. The present author here sketches the periphery movement of an alternative “political psychoanalysis” with reference to M. Langer, A. Mitscherlich, P. Parin and his own work. His thesis is that if psychoanalysts do not consider their own entanglement in the social structures and conflicts that characterize their own time, they are in danger of themselves becoming, within their institutes, unconscious victims of irrational social influences, and in addition miss the opportunity to enlighten society by critical involvement.     

Sollen Psychoanalytiker Psychotherapeuten ausbilden?

With respect to the radical changes in psychotherapeutic education as a consequence of the Law for Psychotherapy that has been put into force, the author elaborates on political, medical and strategic aspects. It is of special interest whether psychoanalysts having had the “monopoly” of training in depth psychological therapy should further take responsibility for the training in and the development of this method. Meanwhile, other therapeutic schools are claiming depth psychological psychotherapy for themselves and they deny the essential role of psychoanalysis as a foundation of it. In addition, the psychoanalytic institutes themselves do not agree on this issue. A further aspect of the question is that of marketing strategies: in order to survive, it is for psychoanalytic institutes at a time of lessening interest in standard psychoanalytic training important to offer training in depth psychological therapy with its comparatively less expensive and less extensive curriculum. But the essential question remains: should psychoanalysts train psychotherapists and take responsibility for an independent depth psychological therapy, or not? The author calls for a separate profound education in depth psychology taught by psychoanalysts in order to maintain a positive atmosphere for psychoanalysis e.g. in clinical institutions. He agrees with the IPV that this would help to solve “the crisis of the psycho analysis”. Finally, some of the most important, unsolved questions referring to a separate and profound education in depth psychology are presented and possible solutions are offered. It is of crucial importance to take up again the discussion within the psychoanalytical associations and to adjust their medical as well as political attitude to the new ways depth psychology is taught at psychoanalytical institutes.     

Von den Schwierigkeiten, Analytiker zu werden

The results of a study concerning the social situation of students in psychoanalytic training in DPG institutes are presented. The study based on a questionnaire worked out at the meetings of the spokesmen of DPG candidates as a reaction to the changing external conditions. The Psychotherapist Act, the introduction of a new medical specialization and the planning of demand have put a considerable strain on the training conditions and have led to reduced numbers of applicants also because more and more competing, low cost training courses for psychotherapy have come onto the market. Data are presented concerning age, gender, marital status of students, beginning and termination of training, original profession of students, means of funding, frequency and costs of training analysis and supervision, as well as monthly income and expenses. The findings show for example that students nowadays are considerably older than they used to be (see Pohl 1974 and Pollmann 1985), the number of men in training decreased as well as the number of physicians while the number of women and psychologists increased. The frequency and the expenses for training analysis strongly increased while the income decreased. Many students therefore can no longer fund their training by their current income. In addition the assumption is confirmed that psychoanalytic training takes considerably longer than required by the law. As a consequence it seems necessary to reduce costs and duration of training in order to keep psychoanalytic training competitive and practicable for applicants. Therefore it is proposed by the authors to give credit for theory acquired elsewhere, to start treating patients at earlier stages of training, to allow group supervision on a larger scale and to bring the costs for training analysis and supervision in line with the rates paid by the health insurance companies in order to keep costs manageable. Other means of support, such as scholarships or reasonable loans are discussed. It is proposed to promote and further use the innovative and creative potential of candidates at an early stage to prompt research and development of psychoanalysis. It is imperative to promote psychoanalysis in the public so that it can defend its place in society and make its contribution to public health.     

What's Possible? What Matters? Reply to Commentaries

The three discussants agree that a definition of psychoanalysis tied to session frequency is problematic and needs to change. Yet none supports my recommendation to redefine the practice of psychoanalysis in terms of the practitioner's training. This prompted me to look more closely at my proposal and push my thinking further. I argue that psychoanalysis, like many other professions, needs to define its practice as the application of its complex and evolving knowledge and skill base, grounded in its unique field of inquiry. Although there are individual exceptions, the inculcation of this knowledge and skill base is generally best accomplished through psychoanalytic training. This assertion, however, rests on the premise that our training curricula keep pace with our rapidly evolving field of inquiry and knowledge. To further clarify my vision I examine the nature of psychoanalytic expertise. I suggest that such expertise amounts to the inculcation and integration of a large number of psychoanalytic frames of reference. I contend further that the nature of contemporary psychoanalytic theories is such that important psychoanalytic frames of reference are proliferating more rapidly than in the past, that the relationships among them are becoming more complex, and that consequently the application of psychoanalytic theory to practice is also becoming more complex. Psychoanalytic training programs need to recognize this expanding complexity and revise curricula and pedagogic methods on an ongoing basis to reflect this evolution within our field.     

From Fallibilism to Clinical Humility: Brothers and Corpt on the Feminine and the Maternal

ABSTRACT

Reflecting on the contributions of Brothers and Corpt leads this contrite fallibilist from the cognitive attitude of holding theories lightly to the necessity of embracing vulnerability, the requirements of the so-called feminine, and the maternal. The ethical turn in psychoanalysis, well-represented by these two thinkers, includes, indeed requires, rethinking our normative gendered unconsciousness. Such rethinking further involves clinical humility, including a readiness to be affected by our patients’ challenges to our presumptions.