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.