Addendum 

The response to this posting made me think of adding an addendum to it. It is about few things to consider if there is an intention to approach the local university about introducing psychoanalysis to its interested students. The addendum is not a set of advises but only mentioning things to consider.

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Approaching a university department to allow few lectures on psychoanalysis is better done through the local psychoanalytic institute or society rather that by individual initiatives. It makes it an organization addressing an organization.

The involved local psychoanalytic body should discuss and design an approach to the departments of psychology, sociology and social work (psychiatry !) and prepare:1. Individual lectures- at the beginning of the academic year as 'general knowledge'. 2. if there is interest in the subject the local psychoanalytic body should design and advertise a series of 3-5 lectures in certain topics to be offered in the different social and cultural activities in the allied departments (Dreams, transference, interpretation, etc.). 3. The involved analysts should make themselves available to the faculty in the concerned departments to help in post graduate theses, both with ideas, theoretical suggestions, and readiness to help with the literature. 
This last point demands from us some humility and desire to know more about certain areas that we actually know very little ( the emergence  of the sense of being in children and how it evolves.  It is an invitation to cooperation.  

Having a framework of cooperation and performing it without making the revival of psychoanalysis our ‘hidden’ purpose of approach could lead in a natural way to making psychoanalysis a valuable addition to the academic program that is accepting it as a guest or as a trial.

I am worried-though- about three things:

A. I expect good immediate response, which could make the analysts in such project to quickly think that students are future patients, and they start upholstering their couches. This will kill the project instantly. Our lectures in such a project should be about psychoanalysis, what it has discovered about us\them, and not about the neurotic cousins.  It is important not to let our present predicament colour our approach to introducing psychoanalysis to academia. We have to be aware that it will take few years to make it natural to be part of the curricula of those departments. Most importantly, moving toward academia is a step in the direction of changing psychoanalysis as it is learned and be trained now and finding a new and better psychoanalysis.  

B. Young and recently trained analysts did not learn psychoanalysis well because both they and their training faculty were interested in the contributions of the new schools. We have to agree or disagree about this point to decide what is  fundamental in the psychoanalysis we will introduce and avoid creating confusion about us. My view is that there is nothing psychoanalytic of any form in the new schools of psychoanalysis (since Kohut). The basic and foundational is the theory of psychodynamic is: the centrality of the working of the primary processes, interpretation, analysis of transference; NOT of relations, reconstruction that links the past with the present, revealing to the patient the presence of his childhood fixations in his present conflicts.  Those points could be the source of very interesting lecture to the public, and could show that psychoanalysis is about our daily life, and there is more to learn about it and more contribution it could offer other human sciences.

C. It is VERY important that the faculty in those department know that we are not there to compete with them, find new patients, belittle their specialties, etc. we are there to contribute in an educated way to their efforts.

3. Where to Learn Psychoanalysis:

A.    Deviating and Getting Lost:

The reason I wanted to emphasize that psychoanalysis is not a profession is a wrong attitude we take from the training we get in IPA institutes. For us-trained psychoanalysts-whenever the term psychoanalysis is mentioned it meant what we learned in the institutes of psychoanalysis. The fact is that we were supposed have learned everything about psychopathology and many aspects of psychoanalysis in our professional degrees, so what we would learn in those institutes should have been the technique of practicing psychoanalysis. In other words, the institutes were for training us in the skills of psychoanalyzing. The skills are how and what to listen to (notice, observe, sense, etc.) in order to discover the unconscious elements in what we are hearing. Listening like psychoanalysts should lead to interpreting the new psychical meaning that emerges from what we discovered during our listening, and use it skillfully to make the patient recognize what else he has said (painted, did, meant, etc.) without being conscious of it. In addition to leaning this skill we learn how to reconstruct to the patient his psychical life as one comprehensive LIFE. Without noticing the difference between learning a skill and training in a new profession we created a major distortion in the concept of training; training became an objective not a means to an objective. This was the downfall of psychoanalysis as the subject matter of our professional endeavours and the worsening of the practice of that deteriorating (deteriorated) theory.

The IPA institutes were not and still are not the ideal place to learn psychoanalysis. The candidates of sixties and the mid-seventies learned most of the theory of psychoanalysis before they applied to the training programs. Most of us had training- analyst who were actively participating in expanding and sophisticating ‘psychoanalysis’. They stimulated in us the interest in learning what psychoanalysis has added to our knowledge as psychologists and psychiatrist. Therefore, we never lost our connection with our original formation and became more interested in the theory psychoanalysis. Sadly, this attitude changed when training in IPA institute became a short cut to a practice in the mental health profession. Psychoanalysis changed from being a skill that could complement our original professions to a profession in its own right. There is something basically wrong in that change: psychoanalysis was supposed to be the source of the knowledge that we seek training in the skills to use it, to understand the patient and make the patient understand himself. What happened instead is a major mistake: training analysts ignored the difference between learning and training and gave themselves the right to be both: trainers and professors. This point was not examined thoroughly enough when the problem of the training analysts was highlighted last few years in desperate efforts to solve the negative impact of that created status on training. 

Unconsciously, we sleepwalked into a trap we set for ourselves: we blurred the difference between psychoanalysis as knowledge and as practice (in ALL respectable professions the clear and sharp difference between knowledge and practice is a fundamental feature). The outcome was a gradual deterioration in both psychoanalytic knowledge and its practice. As I mentioned in the last part of this posting: psychoanalysts referred the crisis of the continuing drop of interest in psychoanalysis to misconceptions about it, due to people’s ignorance of MODERN psychoanalysis. The issue is that the crisis of psychoanalysis is due to the poor quality of modern psychoanalysis, which is a result of the poor quality of training in the IPA institutes; what else!!!!!

B.     The Restoration of the Reputation of Psychoanalysis:

Psychoanalysis was born with a very good reputation. From the beginning, which we all know, the initial refutations on moral basis and the medical professions attacks on its findings, did not sway people and the many young aspiring physicians from seeing something futuristic in it. In a nutshell, psychoanalysis had all the features that made people realize that it talked to them about what they knew to be right, because they could see it in themselves and in other people. Psychoanalysis was a theory of the subject and not a theory of “something” and needed to have the evidence to prove its believability; it was a theory of us and them and that did not need to look for confirmation of its discoveries. After a short while Freud introduced metapsychology and was tempted to use its language to create a new vocabulary for his observations, and to give them some abstract meaning. It still was relevant to people’s direct observations and understanding of the subject. Close to the end of being in charge of theorizing for psychoanalysis Freud formulated a metapsychology that was basically a reification of his findings (ego-psychology). Yet, unnoticeably, he corrected that deviation in his work “Inhibition, symptoms, and anxiety”, a work that did not catch much attention, mainly due to it heuristic discussion of the cause-effect nature of psychological phenomena. Freud’s psychoanalysis was a theory that was stemming partially from his clinical experience and mainly from true and valid observations and understanding of the subject (there is no clinical reason for Freud to have discovered the super-ego, except that the presence of the Ego was not enough to explain all the conscious faculties of the subject. The ego had to have a metapsychological addendum to explain other function its direct presence in the subject. Thus, he had to work out a place for that addendum in his metapsychology.

In my view, psychoanalysis until Freud was alive and a little after his death was distinguished and deserved its respectability. Psychoanalysis’s main concern was knowledge about a subject. Even when the conflict between the Freudians and the Kleinians emerged the subject matter remained the same and psychoanalysis preserved its distinguished status. The controversies did not reduce the value of the arguments; in a subtle way the issue was what would explain the other: does metapsychology explain psychology (Anna explains Melanie) or does psychology generate metapsychology[aF1]  (Melanie as the basis of Anna)?  Even the French controversies did not reduce psychoanalysis to mere personal disagreement: Lacan was trying to give psychoanalysis its ‘Structural’ identity and dissipate the functional point of view but went about it in provocative way.

   It is when some of Freud’s early and ardent supporters (Stekel, Jung, Rank, Ferenczi, etc.), started to argue about technique that psychoanalysis entered into a downward spiral. There are ‘possible’ causes for that feature in psychoanalysis. The first is that analysts who narrowed their views and limited them to matters of practice were usually either victims of over confidence in their knowledge of the foundational knowledge of psychoanalysis, and argued from a false position of regarding psychoanalysis a theory that has reach the point where it stopped growing, and they knew it well enough to ignore evolving it further.  The second, matters of technique relate to training and not knowledge. IPA institutes are not built to graduate psychoanalyst, they are supposed train psychoanalyst to practice psychoanalysis; their function (with time) changed to graduating clinical practitioners presuming that they also learn psychoanalysis in the process. Training in those institutes in the best case is to teach enough of psychoanalysis that makes training in the technique possible.

Where then could someone learn psychoanalysis?

C: Psychoanalysis as an Academic Issue:

 Answering this question is not a simple one. To evaluate answering this question properly we need to clarify the attitude of the ones who answered it: do they believe that psychoanalysis could be learned without the clinical aspect considered, or there is no psychoanalytic knowledge outside or without the clinical component. If the answering person believes that learning psychoanalysis is meant to prepare the candidate for clinical practice then the IPA institutes, or the equivalent, is the place to go. If the answer comes from an intellectual (physician, social worker, psychologist, drama teacher, etc.) it will be: go to an academic institution that has intellectuals with various interest in the human subject to study psychoanalysis well, where they know how to transmit knowledge to their students. Although some academic institutions did and still do that (though mainly for psychoanalysis as a therapeutic act) they did not take it as a branch of the humanities, or as a significant aspect of psychology in general. 

Psychoanalysis is knowledge that hast to be protected and given the opportunity to be recognized as such, expand to reach its own extent of capability and eventually change psychology as it is taught now in universities, and is involved in psychiatry and social work. By adding psychoanalysis to the existing psychology in academia makes the nature of the human subject more coherent and easily shared by all the branches of sciences that deal with the human subject. However, this kind of change and its extent is not possible without a radical change unrelated to the   psychoanalysts. We, the old and older generation, have to realize that a change in direction in the way psychoanalysis is understood, transmitted to newer generations, setup to relate to other burgeoning human sciences, branching out into different areas of interest outside the clinical aspects, and becoming ‘knowledge’ in its own right and it is not just those mystical things that are available only in the IPA institutes training system, those changes have to happen to us first with sincere intention to give up the present system and make psychoanalysis an academic issue.

However, it is a challenge to expect such thing to happen. Twenty-five years ago, IPA acknowledged the existence of the present crisis. It did nothing more than convened committees ‘puzzled’ about it till now. It resorted lately boosting our moral and suggesting that it is trying and succeeding in containing the crisis. But the most glaring failure in its efforts is not telling the membership what its findings about the causes of the crisis (curing a disease without a diagnosis).  I cannot help wondering what is the undeclared opinion of the- elected- leadership of the IPA, and if they see hope in things improving spontaneously.

I think that sincere and serious analysts about the future of psychoanalysis should just bypass the psychoanalytic organization (s) and go ahead and try with acts of good faith make contacts with the academic institutions in their locations. In other terms we should admit and announce that we the analyst will save psychoanalysis without the permission or approval or even the support of its organizations. The individual attempts will prove to the hesitant analysts that nothing tangible is coming from the IPA; it has stand or opinion about the crisis.

What is of the utmost importance is to keep in mind that taking serious measure in this regard is to save psychoanalysis and not save us and our livelihood. We can survive without psychoanalysis but psychoanalysis cannot survive without well learned and trained analysts.  

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 [aF1]

2. The fallacy of Psychoanalysis is a Profession:

The concern about the survival of psychoanalysis in North America is directly related to the numbers of patients seeking psychoanalytic psychotherapy. The numbers have dropped and are still dropping. The drop in other parts of the world, maybe, not as bad but enough to raise the alarm about the future of psychoanalysis. The concern about the future of psychoanalysis goes back to 1995 when the IPA tried-officially- to understand the reasons for that drop and could not do anything about it for the last twenty-five years. Therefore, my argument about the issue is that the shrinking status could be more serious in some parts of the world more than others, but the crisis is universal all the same. The crisis as it has been raised is clearly related to psychoanalysis as a profession and not psychoanalysis itself (as body of knowledge), because what concerned the IPA all along and the regional and the local societies is the dwindling numbers of analysts, candidates, and patients without any concern about ‘what is practiced as a profession of psychoanalysis’.

The IPA has a membership of forty-eight (48) societies (one fourth of the countries in the world). It has 12797 member and 5434 candidates in training. This means that in average each society has 267 analyst and 113 potential future members. Could those figures qualify psychoanalysis to call itself a profession; or even a profession that might have future? No. By no means we can claim that psychoanalysis is a profession, in the real sense of the word, with those numbers. Not even when the number jumps few hundreds or a couple of thousands in a society it still not qualified to be called a profession. This rigidity is because those figures were double, and in some places triple the present numbers, i.e., if psychoanalysis is a profession, it is a dying profession. Any successful profession grows stronger with time as when psychoanalysis did the first forty years of its history but started to die forty years ago. In my opinion, reviving psychoanalysis is not difficult but restoring psychoanalysis as a profession is not possible anymore, unless something be done to psychoanalysis itself.  It was wrong from the beginning to pay attention to the practice of psychoanalysis and neglect the looseness in regard to the modification introduced to the theory in the guise of developing and improving its practice.

We have to solve an additional problematic in the crisis. We-the clinal psychoanalysts- are the ones who turned the fundamental discovery of the twentieth century and the pillar of the Western civilization into something very unidentifiable as a body acknowledge. Better, we analysts kept working on therapeutic of psychoanalysis claiming to improve it, turning it into a profession. We became contented with having an international organization that gave memberships to the practicing psychoanalysts without any examination or investigation of the quality of the theory they practice. Assuming the right to training analysts, the IPA was happy to increase the number of training institutes without any serious examination of the nature, content and quality of the training offered and the training faculties. No wonder we realized the serious problem with the status of the training- analyst and were unable to deal with it.

  Psychoanalysis in its mightiest time as a profession in the sixties and seventies of last center was-in fact and better judgment- less important or significant compared with the discoveries it generated during that period of time. It continued rejuvenating the Western culture. In that period of time psychoanalysis penetrated all the cultural and social aspect of the culture. It positioned itself in the midst of the revived intellectual life after WWII. To clarify what I mean I would that discovering that dreams are wish fulfillment is far more important than interpreting a dream in a psychotherapy. Realizing that symptoms have meaning gave the society a new sense of the structural nature of our psychological nature, instead of the previous preoccupation with causes and effects. Psychoanalysis and some psychoanalysts positioned structuralism in the humanities and created the advancements we are enjoying right now.

It is a moral obligation to revive psychoanalysis before it totally dies because it belongs to our civilization and not to us as clinicians. Morality and moral obligation are offshoots of responsibility. Our moral responsibility to save psychoanalysis from its impending death comes from the fact that we, and nobody or anything else have caused it to go dying: who or what else? Psychoanalysis, as was conceived by none clinicians and we did not consider ‘real’ psychoanalysis kept changing, getting better and more comprehensive. The changes in education, in child rearing, accepting the idea of latent meaning in ordinary speech, etc., kept developing, expanding and improving its basic premises, without input from the organization of psychoanalysis (the IPA). The theory of psychoanalysis was shaping the society while we stagnated or went afar from the essential discovery. There is an undeniable fact related to that: when we stopped building the theory of the subject there was nothing left for us to do but to turn our attention to its practice as psychotherapy. We lost our bearings. Clinical psychoanalysis as practice has a profession and practitioners, but psychoanalysis as a body of knowledge and a theory of the subject has thinkers, philosophers, scientists, practitioner in a wide range of other specialties. Just to give a glaring example: it has movies and theater to practice.

Psychoanalysis is not the profession of psychotherapy.

All analyst without exception have professions that preceded bestowing on themselves the title psychoanalysts. We all have obtained university degrees that qualified us to apply to training in IPA institutes of psychoanalysis. This is not facetious remark or just an argumentative ploy. We have to have professional rights in the mental health field to have access to training in psychoanalysis. Therefore, we mislead, mostly ourselves, when we do not acknowledge this fact. If we miss this fact, we should then allow anyone with a recognized profession (psychology, law, history of arts, commerce, etc.) apply and get training in psychoanalysis and bestow on himself the title psychoanalyst; and practice it. The criteria for accepting people in training was loose but got tightened up gradually to be limited to mental health professionals: psychology, psychiatry and social work (the details are not relevant to what I am to underline). However, some institutes, when they felt the pinch, and under some pressures from the training committees and the influence of some senior analysts accepted some none health providers in training (I know few cases in the Canadian Society). Those members, if they are truly good, are wealth to any society and this trend should be encouraged. But they should not be permitted to see patients based on their training in the IPA institutes only.  

Discussing this point is of crucial importance, because it puts psychoanalysis in its proper place. If the mental health provider, who is trained in psychoanalysis feels competent to do psychotherapy he should do that on his own initiative that is rooted in his own professional background. However, there is more to psychotherapy than what the IPA institutes provide. Practicing psychoanalysis (psychotherapy) should not be authorized by the IPA and its institutes. What I mean is that we should not link practicing psychoanalysis to training in IPA institutes but to really learning psychoanalysis both theory and technique and having the right to deal with patients. This issue should addressed this point: is 2000-2500 hours of training in IPA institutes (excluding personal analysis) enough to make ‘anyone’ learn psychoanalysis (as a body of knowledge and technique)? I training in IPA institutes adequate for all of us-irrespective of our backgrounds- be learn what it takes to practice psychoanalysis?  The answer is no, not enough whatever the numbers are. This is not a matter of how long training has to last to reach its objective. The issue is that when we go for training, we should integrate psychoanalysis with what we already learned in our specialty, not adapt our specialty and basic profession to psychoanalysis. I learned psychoanalysis when I was already a clinical psychologist. My profession as diagnostician by way of psychometric testing did not change or was modified by psychoanalytic training; maybe I became more particular in interpreting the patient’s psychometric profiles, and maybe I improved my understanding of some of the cognitive functions that I deal with in interpreting the patient’s associations. But, training in psychoanalysis was to learn the body of knowledge called psychoanalysis, which could allow me do psychotherapy in a special way. Psychoanalysis was never my profession.

1.The Moral Obligation of the Contemporary Psychoanalysts

In my opinion psychoanalysis in North America is living under a false name or already dead. In Europe and South America, it is living on low heart beat. If I do not have the statistics or the proofs to support my opinion the challenger of my judgement does not have the evidence to prove me wrong either.   

Being an old psychoanalyst, I strongly believe that my generation of psychoanalysts have a moral obligation to persuade, guide, and actively help getting psychoanalysis out from its current rot, to where it should flourish. It is difficult, yet there is no substitute for trying. The difficulty is that- we the old guys- have to recognize that we resisted the inevitable development and evolution of psychoanalysis and some of us (particularly in north America) preferred to come up with their personal views and claimed them appropriate to replacing the old with the new. They still call them psychoanalysis. In other parts of the world different things happened, but each area had its own style in modifying psychoanalysis and improvising its method to keep it breathing. They do not disclose easily its status and the IPA too keeps that as secrets. The psychoanalytic institutions hide the facts about psychoanalysis from the psychoanalysts !!!!.  Those attempts to replace a dying psychoanalysis have failed to actually fill its vacant place or revive it as substitutes. The most they did was postponing the inevitable.

I will address that point in another posting. But for now, I would say that we-psychoanalysts- helped preventing the death of psychoanalysis but did not do what should have been done to revive it. We always claimed that we are the custodians of psychoanalysis and limited any input from none analysts (none clinically inclined intellectual). Their contributions might have been useful but we did not take full advantage of them.

Secondly, there are two possible venues to revive psychoanalysis: to tinker with the present way analysis is transmitted from generation to another (training), make some tweaks in the its practice and use publicity to declare its improvement. The other venue is changing completely the way analysis is transmitted (education), declaring it a science and not a profession, then looking into what is left off it that could still be of significance. To do that we must move its base from the IPA accredited training institutes to academia, and making it either a program in the departments of humanities or even make it one of the departments of the humanities in the university.In a very recent posting it was found out that the programs of psychodynamic and psychoanalytic subjects in some universities were in big demand in the departments of human studies that was offering them. In some large and reputable universities there was waiting lists to register in those programs. I had an old experience (1964-1969) that convinced me- in that early time- that psychoanalysis would have a very welcomed and prosperous place in the departments of psychology at universities.

Experienced and old analysts like me oppose making the shift from training (acquiring a skill or a trade) to learning and obtaining an academic degree in a branch of knowledge (enough to qualify for a licenced profession). We -old analysts-cannot forget that when we went to learn psychoanalysis, we were already highly reputed professionals in our fields. Teaching psychoanalysis in universities will let teenagers do what we considered for a long time a privilege that we should cherish. We do not notice that those youngsters have to learn much more than what was available to learn in our time, and they will be the analysts who will do the real research in psychoanalysis. We also resist to acknowledge that psychoanalysis in academia (with the graduate and post graduate levels of studies) will open it to more than just the field of psychotherapy. In Europe some universities were dedicated to open doors for psychoanalysis but mainly in psychotherapy. The IPA institutes in those countries maintained their traditional functions, which blurred the difference between learning and training. A leap from training in parochial and archaic institutes to learning in open well-connected departments of the humanities will be faced by our resistance, but eventually the resistance will collapse. When that happens, it will be our duty to participate in introducing good psychoanalysis to the universities. It will be our duty to participate and contribute to putting psychoanalysis where it should have been three decades ago.

An additional thing to do is to give the IPA a specific period of time to wind down its role in psychoanalytic education and  to improve its function as a membership institution.