Once More

Psychoanalysis and the Academy:

Six

This Post is a response to a recent discussion of the subject of psychoanalysis and the academy in the Journal of the American Psychoanalytic Association (Volume 64. #3, June 2016). It should have properly written it as a paper on the raised issues in the volume, but I did not find the energy and the endurance to engage in a well vetted paper. However, I will try my best to avoid the temptation of being slack in raising issues and expounding them. I will make sure that scrutinizing this paper will prove that it came from documented literature and not be put to shame.

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The is the last section in this long and last post.

The Irrational:

Although psychoanalysis is not a profession in its own right, because it is still a designation in very few other professions, psychoanalysts insist on considering it a profession; their profession. I argued against this claim in previous posts but still I would reemphasize that qualifying someone in psychoanalysis in the current ‘institute’ system will neither make him properly trained to practice psychotherapy and claim professionalism, nor will it give him the proper academic certification all professionals should have to join the professional world.  My qualification as a psychologist allows me to practice the profession of psychotherapy; my training in psychoanalysis makes me capable of doing it in a specialized way. No responsible government agency would qualify a tailor or an architect to practice psychotherapy just because they passed training in a recognized psychoanalytic institute. I advocate moving training in psychoanalysis to the academic system, but not in the simplistic way K&M are suggesting: keeping but moving the current inadequate system of training to academia, as if this change of address would change the quality of training.

There is a basic incorrect and biased conviction in the analytic community that goes back to the beginning of the discovery of psychoanalysis. Because the initial Freudian discovery, and for quite some time after, looked as if it is happening in the field of clinical practice, the term ‘psychoanalysis’ became synonymous to clinical work. Point in fact: psychoanalysis was first discovered in the field of psychopathology but Freud’s main aspiration was to take those discoveries to all other human phenomena. The result is a big difficulty to talk about psychoanalysis as the main discovery of the human subject in the twentieth century  without encountering discomfort and active resistance from the clinical psychoanalysts. They think of the other fields of the discovery as merely applications of psychoanalysis. When I advocated moving psychoanalysis to academia I meant it in its real meaning and not the biased and restricted meaning the clinicians use to claim their ownership of it. This difficulty, when discussed, shows that psychoanalysts are protective of the term in its limited meaning for personal gain, and not for anything that pertains to the discovery itself. However, it is not only the clinical analysts who are insistent on limiting its meaning, but some none clinicians tend to keep it that way for the hope that getting trained in a recognised institute will give them the prestigious status that the title has always carried. Steven Levy (ibid 511-515), in describing a truly fascinating experience, which is the closest to an academic program in psychoanalysis says: “ A significant challenge to our institute’s experimental program is sustaining an appreciation among our faculty that committing to a career as a clinical analyst by members of our very diverse student body is not the only valuable or even sought-after outcome” (414). In a nutshell, it is obvious that keeping analysis in this limited status is not rational, if not outright wrong, and is making the organizations that protect that limited meaning instruments of its destruction.

The Rational:

      

Delivering the theory of psychoanalysis as information that could be better done in seminars- the first of the tripartite system- was logical at the beginning when there was only one evolving theory. The source of the theory was even still generating its evolution. This obvious fact should have raised some questions: If Freud, who is the source of the theory, keeps modifying and adding to it, shouldn’t we expect the new generations of analysts to also come with new additions to the theory? Would we consider Freud’s and the pioneers’ works the yardstick to which psychoanalysis is measured? Could the evolution of the theory reveal the need for something more than what the limited field of the psychopathology of the individual requires? Is not also possible that we will realize or be forced to change the system of training, as it happened in all other professions after linking with various other branches of knowledge? Many more questions could be envisaged if we allow ourselves to consider what we know now of psychoanalysis. Nevertheless, what transpired up till now is insistence on rejecting any major changes to our curricula. Yet, if we get over our reluctance to give up what we irrationally hold on to we will admit that a good part of the seminars in contemporary training  is ‘useless’. Only a limited part of Freud’s text has value and only if studied scholarly to expose the way this brilliant mind started from nothing to create the great theory of the human subject, step by logical step. We cannot present his clinical work (Dora, Hans, etc.) as teaching material for the current candidates. The British schools of after the war and their equivalents in France and the US are no longer great revelations after being accepted and developed by equally good thinkers that took them further ahead. No contemporary analyst would talk of projective identification without running into the issues of narcissistic configurations. No analyst would talk about the Oedipus position without dealing with the formation of the intrapsychical.   The rational thing to consider is that we are dealing with a mature psychoanalysis that is different from the psychoanalysis that engendered the institute system of training.

Academia and Proper Training:

S. Levy says: “The psychoanalytic educational programs of the future must be more diverse in their student body, less exclusively focused on creating the clinical analyst at the expense of more broadly teaching psychoanalytic ideas, less hierarchal, and more adventurous. Somehow we have confused protecting the freedom of our ideas with controlling broader access to them” (ibid, 515). Levy is implicitly stating that the institute system of training is not adequate to deal with the whole spectrum of demands that future psychoanalysis sets up for the aspiring future psychoanalysts. Psychoanalysis is a whole field of knowledge that covers more than psychotherapy and comprises several other areas of human endeavours. The success of psychoanalysis changed it from a theory of psychopathology to a theory of the human phenomena, in spite of our passion to limit it to clinical work. The new knowledge when gathered, integrated, and be ready to deliver will make us realize that the institutes would be very inefficient in that regard. The first leg of the tripartite system-the seminars- demand a new and open minded revisions because future psychoanalyst (especially the university trained) will have to learn some serious aspects of the other branches of the theory. It is understandable that the old generation of psychoanalysts-like my generation- find it difficult to give the baton of clinical training to a new generation of none clinical analysts, but idealizing our forefathers should not stop us from growing up.

The second leg of the tripartite system of training is supervision. This was the original Freudian didactic method. It is still considered part of training and vaguely considered a didactic part of analysis since personal analysis is no longer considered a didactic requirement but a therapeutic demand. Supervision kept something from its original purpose of discussing and learning how to deal with situations, difficulties, transference issues, i.e., how analysis is done by an experienced analyst. This is the point where the supervisor could recommend personal analysis as the only and the way to experience the analytic process. Wallerstein (2009, p. 611)) called the insistence on personal emersion in psychoanalysis [personal analysis] a psychoanalytic dogma. Thus, personal analysis should be a recommendation and not an obligation and an dealt with as an important part of training without which the candidate would not benefit enough from supervision. Small-groups supervision is also advantageous.

Although supervision and group supervision could be done within the training system of the institutes it would take a different meaning and have a different impact if done in the academic context: it will channel competitiveness amongst the candidates toward the program instead of keeping it subject to transference conflicts with the supervisors. New ways and areas of supervision could be best introduces and managed in academia and its different stages of training .

An Academic Department of Psychoanalysis:

Psychoanalysis is now part of the social fabric of all the edumacated societies. Therefore it has be a distinct department in the university because it will answer to the wide range of human interests. It would be ridiculously ambitious to tackle the subject of how to establish departments of psychoanalysis in a post or even a series of papers. But, I would like to express two ideas in that regard.  Department of psychoanalysis should not be extensions of other departments like psychology for instance: psychoanalysis is a different psychology, a different psychiatry or social work. It is also a novel way of understanding phenomena that was never look at before from a psychoanalytic point of view like business administration, political dynamics, etc. In departments of psychoanalysis all the branches that will be subjected to it should be presented as possible future professional fields. Clinical psychoanalysis is just one of those fields (a humbling idea to analysts who are not proud of their original professions).

This takes us to the issue of certification and the role of the national societies and IPA. The present system of training- the institutes system- does not lead to certification for an obvious and very direct reason: the training institution has to be citified first as a viable training centre by a civil authority that is responsible for the professional and educational standers and in charge of public health. Secondly, training in those certified institute has to be certifiable. Certifying the graduates of a certified training institution has to happen by an independent authorized body of professionals. As a psychologist, I have to graduate from a certified department of psychology of a recognized university. The Ontario College of Psychologists is mandated to issue me the licence to deal with patients (citizens) based on verifying my education, training and competence. This is the rule with all professions. In psychoanalysis, specifically, the institutes are not certifiable, because they are not part of recognized educational system, let alone the absence of uniformity in the standards of competence within national and international institutes. Point in fact: whatever the diligence and seriousness of trying to make and keep the standers of training on a high degree of competence, those efforts are not conducive to proper certification: we can certify ourselves but depend on our basic profession to get us the right to deal with patients.

The IPA and its component institutions are relics of Freud’s secret society but without any secrecy or effectiveness anymore. It could be saved, if it is so dear to us, by saving psychoanalysis. Take care of the content and it will take of the container.

Part Six: Epilogue

For a long time, it baffled me as a training analyst, that we were- in Canada- unsatisfied with our training system, but we only tinkered with some of its details, which did not satisfy us either. This was also the situation in most of the training institutions in the different parts of the world, as our colleagues acknowledged in personal communication and in the biannual pre-congress meetings of the IPA. My bafflement dissipated gradually when I discovered -in myself too- that we are attached to a system of training that we inherited, because it fitted well the closed community of psychoanalysts, which we cherished blindly. Opening up our closed community would have required changing our system of qualifying psychoanalysts and giving up the desire to keep it closed. Changing the system of training would have resulted in opening up our analytic community to others (none clinical psychoanalysts). Dr. Kernberg, who was and still is critical of our training system says: “I believe that the educational stagnation…of psychoanalytic education derives largely from the present-day training analysis system as a major source of inhibition of the educational process (Division Review, Autumn 2016,13). He mentions as one of the factors in the resistance to change isolating the institutes from the scientific and academic fields, thus all the elements that contribute to training remain within the closed circle of psychoanalysts who assume all these responsibilities. He is more open to some changes in the present situation but does not see more than ameliorating what has been the cornerstone of the Institute System. However, Kernberg offers a view of an model institute of the future; an institute that does not exist yet.

He recommends four main things to ameliorate training as conducted now- a-days:

1.    Establishing objective assessment methods of competency regarding the candidates’ theoretical knowledge, acquisition of technical expertise and developing a psychoanalytic attitude (creating a speciality Board for that purpose). He stipulates theoretical knowledge as an amalgam of some of the familiar concepts- though fundamental- in the literature, like motivation, structure, development, the spectrum of defense mechanisms, etc.  (ibid,14). This amalgamation of concepts does not indicate a strong theoretical base. I had candidates who knew all those concepts, in addition to the improvised concepts of the new schools without understanding them or differentiating between knowing concepts and developing a theoretical stance.  He considered technical expertise the intuitive understanding of the material, formulating notions about understanding such analytic material and giving them appropriate interpretations. I also had candidates who were gifted in that regard but inappropriate in the timing or the verbal expression of their understanding (supervision has little input in teaching those subtleties). The aspect of the psychoanalytic attitude is not clarified in Kernberg’s paper, but in my opinion the most determining factor in that respect is the analyst’s character. In training, we discover the future psychoanalysts but we do make of the candidate the psychoanalyst of the future.

2.    The supervisory functions in the new system would be separate from certifying the candidates. The supervisory function would be responsible for evaluating the training faculty based on measures of productivity and creativity and other features of skill and distinction. With tongue-in-cheek, Kernberg sees some advantage in connecting with the university departments of psychology, psychiatry and the university centres of psychoanalysis, in that regard. He realises that the institutes-unsupported by the academics of psychoanalysis and the human sciences- would not survive long.

3.    The key point in his proposal is RESEARCH. He considers research as a vital part of any future training modality; even proposes creating a department of research in every training institute. Kernberg is not careful in using this term. Researcher is an act of deciding what is right, proven, categorically different from other things, quantitively measurable, and most importantly misunderstood because of being undifferentiated from other aspects of the phenomena that are implicitly mixed with the subject of the research. It also depends on the experimental model to examine the hypotheses. What Kernberg calls research is just attempts at using quantifying measuring scales to allow methodical description of purely subjective conceptions. The two examples he gives (suggested by Tuckett and Korner) show the distinction I mentioned here. Research is not the solution to problems but the topic to be researched is the problem; it has to be solved by defining it within a research hypothesis first, before it is researched. 

4.    Adding to the curricula the literature of other psychoanalysts beside Freud and the legendary characters in our traditions (which is actually done but maybe less that what Kernberg would like). He also suggests teaching issues like the recent the neuropsychological findings, principle of experimental psychology, developmental psychology, etc.  As a psychologist who studied those subjects academically, and practiced some and wrote about most of them in addition be being a training faculty in an active institute (in my time) I have to think seriously: how could we include all those things in the curricula of an institute that requires three hours a week for seminars, four hours a week (at least) of personal analysis, three more hours of supervision in addition to at least fifteen hours of psychoanalytic work with supervised patients,  and earn a living at the same time. Dr. Kernberg’s proposal is about an ideal system of training that cannot be sustained in the present institute system of training. This if we want psychoanalysis to become a profession in its own right.

Fifty years ago, all what was known about the human subject was easy to condense in the institutes’ curricula. What is presently done in our training institutes is less than what is required in an undergraduate degree in the subject of psychoanalysis (B.A. in psychoanalysis). A regular clinical psychotherapist, who wants to do psychoanalytical psychotherapy needs two or three more years of core psychoanalysis at the level of a curriculum of a M.A. (in psychoanalysis). To qualify for psychoanalysis the candidate needs either a higher Diploma in clinical psychoanalysis or a Ph.D. in psychoanalysis. This is the way to approach education in psychoanalysis; examining the field, the minimum requirement for each level of practice, matching the requirement to the demand of competence. Somethings similar have to be done for none clinical psychoanalysis [which is imperative if we want clinical psychoanalysis to survive and flourish]. But that should be mainly done by the academicians of the related human sciences.

My basic idea about training is to phase out the training institutes sponsored by the local, national and international psychoanalytic societies and move training to the academic domain. I would not have written a better post or paper to support my views than Dr. Kernberg’s paper. It is uncanny that he is proposing innovations in the education of psychoanalysis, which would be easy and natural to execute in universities without reservations, and meet more than what stipulated as measures for success.

The obstacle in accepting this point of view is the chronic pride of the clinical psychoanalysts (it is also called narcissism). They want to be the authority of certifying themselves, forgetting that they are initially certified by their original profession to practice; being it psychoanalysis or something else. Psychoanalytic certification of the title “psychoanalyst” is only important to the certified psychoanalysts, but not to anyone else. However, a university degree in psychoanalysis is something else.

I will be posting a new long post on missing a central point in the nature of psychoanalysis, which created the chronic (false!) pride of the clinical psychoanalyst, and was always the undeclared reason for the chronic conflicts in the psychoanalytic organizations.